Inframammary approach to nipple-areola-sparing mastectomy

Inframammary approach to nipple-areola-sparing mastectomy. Plastic and reconstructive surgery, Nov 2013, Vol. 132(5), p.700e-708e.

Salibian, A.H, et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/11000/Inframammary_Approach_to_Nipple_Areola_Sparing.2.aspx

Different approaches have been advocated for performing nipple-areola–sparing mastectomy. The inframammary approach has been viewed as having limited applications, particularly in large breasts. The authors review their experience with nipple-areola–sparing mastectomy using the inframammary approach for different breast sizes.

Breast reconstruction following nipple-sparing mastectomy

Breast reconstruction following nipple-sparing mastectomy: A systematic review of the literature with pooled analysis. Plastic and reconstructive surgery, Nov 2013, Vol. 132(5), p.1043-54.

Endara, M., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/11000/Breast_Reconstruction_following_Nipple_Sparing.1.aspx

Nipple-sparing mastectomy is a controversial option for breast cancer treatment due to locoregional recurrence and distant metastasis. In addition to these oncologic factors, technical factors such as ideal incision type or reconstructive options are also debatable. This systematic review examines current trends with nipple-sparing mastectomy, including selection criteria, locoregional and distant metastasis rates, incision choice, and reconstructive options.

A review of the management of ductal carcinoma in situ following breast conserving surgery

A review of the management of ductal carcinoma in situ following breast conserving surgery.The breast, Dec 2013, Vol. 22(6), p.1019-25.

Boxer, M.M., et al.

http://www.thebreastonline.com/article/S0960-9776(13)00246-4/abstract?rss=yes

Ductal carcinoma in situ (DCIS) is a heterogeneous, pre-malignant disease accounting for 10–20% of all new breast tumours. Evidence shows a statistically significant local control benefit for adjuvant radiotherapy (RT) following breast conserving surgery (BCS) for all patients. The baseline recurrence risk of individual patients varies according to clinical-pathological criteria and in selected patients, omission of RT may be considered, following a discussion with the patient. 

Biological therapies in breast cancer

Biological therapies in breast cancer: Common toxicities and management strategies. The breast, Vol. 22(6), p.1009-18.

Barrouso-Sousa, R., et al.

http://www.thebreastonline.com/article/S0960-9776(13)00262-2/abstract?rss=yes

In recent years, a number of new molecules – commonly known as biological therapies – have been approved or are in late stages of regulatory evaluation for the treatment of advanced breast cancer. These innovative compounds have improved treatment efficacy and have probably contributed to the increase in survival length observed in some breast cancer subtypes. 

Another review on triple negative breast cancer

Another review on triple negative breast cancer: Are we on the right way towards the exit from the labyrinth?
The breast, Dec 2013, Vol. 22(6), p.1026-33.

Chiorean, R., et al.

http://www.thebreastonline.com/article/S0960-9776(13)00241-5/abstract?rss=yes

Triple negative breast cancer is a heterogeneous group of tumors, lacking the expression of estrogen, progesterone and HER-2 receptors. As frequency, it accounts about 15–20% of all breast cancers. Although in the last years there was a “boom” in publishing over this issue, multiple molecular classifications being elaborated, “the triple negative breast cancer odyssey ” is still far away from ending, as the complicated molecular pathways of pathogenesis and drug resistance mechanisms remain yet insufficiently explored.

Comparing five alternative methods of breast reconstruction

Comparing five different methods of breast reconstruction surgery: A cost-effectiveness analysis. Plastic and reconstructive surgery, Nov 2013, Vol. 132(5), p.709e-723e.

Grover, R., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/11000/Comparing_Five_Alternative_Methods_of_Breast.3.aspx

The purpose of this study was to assess the cost-effectiveness of five standardized procedures for breast reconstruction to delineate the best reconstructive approach in postmastectomy patients in the settings of nonirradiated and irradiated chest walls.

Buried flap reconstruction after nipple-sparing mastectomy

Buried flap reconstruction after nipple-sparing mastectomy: Advancing toward single-stage breast reconstruction. Plastic and reconstructive surgery, Oct 2013, Vol. 132(4), p.4893-497e.

Levine, S.M., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/10000/Buried_Flap_Reconstruction_after_Nipple_Sparing.3.aspx

Recent evolutions of oncologic breast surgery and reconstruction now allow surgeons to offer the appropriate patients a single-stage, autologous tissue reconstruction with the least donor-site morbidity. The authors present their series of buried free flaps in nipple-sparing mastectomies as proof of concept, and to explore indications, techniques, and early outcomes from their series.

Trends in incidence of breast cancer among women under 40 in seven European countries

Trends in incidence of breast cancer among women under 40 in seven European countries: A GRELL co-operative study. Cancer epidemiology, Oct 2013, Vol. 37(5), p.544-49.

Leclere, B., et al.

http://www.cancerepidemiology.net/article/S1877-7821(13)00077-5/abstract

Young women are not usually screened for breast cancer (BC). The trends in incidence in this population may better reflect changes in risk factors. However, studies on this subject are scarce and heterogeneous. The aim of this study was to describe the trends in incidence of BC in women under 40 from 1990 to 2008, using pooled European data. 

The benefits and harms of breast cancer screening

The benefits and harms of breast cancer screening: An independent review. British journal of cancer, 2013, 108 p.2205-40.

Marmot, M.G., et al.

http://www.nature.com/bjc/journal/v108/n11/full/bjc2013177a.html

The breast cancer screening programmes in the United Kingdom currently invite women aged 50–70 years for screening mammography every 3 years. Since the time the screening programmes were established, there has been debate, at times sharply polarised, over the magnitude of their benefit and harm, and the balance between them. The expected major benefit is reduction in mortality from breast cancer. The major harm is overdiagnosis and its consequences; overdiagnosis refers to the detection of cancers on screening, which would not have become clinically apparent in the woman’s lifetime in the absence of screening. Professor Sir Mike Richards, National Cancer Director, England, and Dr Harpal Kumar, Chief Executive Officer of Cancer Research UK, asked Professor Sir Michael Marmot to convene and chair an independent panel to review the evidence on benefits and harms of breast screening in the context of the UK breast screening programmes. The panel, authors of this report, reviewed the extensive literature and heard testimony from experts in the field who were the main contributors to the debate. 

The sex hormone system in carriers of BRCA1/2 mutations

The sex hormone system in carriers of BRCA 1/2 mutations: a case-control study. The lancet oncology, Nov 2013, Vol. 13(12), 1226-32.

Widschwendter, M., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70448-0/fulltext

Penetrance for breast cancer, ovarian cancer, or both in carriers of BRCA1/BRCA2 mutations is disproportionately high. Sex hormone dysregulation and altered end-organ hormone sensitivity might explain this organ-specific penetrance. We sought to identify differences in hormone regulation between carriers of BRCA1/2 and women who are negative for BRCA1/2 mutations.

2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer

2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer: An open-label, randomised controlled trial. The lancet, Sept 2013, Vol. 382(9897), p.1021-28.

Goldhirsch, A., et al.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61094-6/abstract?rss=yes

Trastuzumab has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. The standard of care is 1 year of adjuvant trastuzumab, but the optimum duration of treatment is unknown. We compared 2 years of treatment with trastuzumab with 1 year of treatment, and updated the comparison of 1 year of trastuzumab versus observation at a median follow-up of 8 years, for patients enrolled in the HERceptin Adjuvant (HERA) trial.

Adjuvant docetaxel and cyclophosphamide plus trastuzumab in patients with HER2-amplified early stage breast cancer

Adjuvant docetaxel and cyclophosphamide plus trastuzumab in patients with HER2-amplified early stage breast cancer: A single-group, open-label, phase 2 study. The lancet oncology, Oct 2013, Vol. 14(11), p.1121-28.

Jones, F.E., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70384-X/abstract?rss=yes

Previous results suggest that docetaxel plus cyclophosphamide improves disease-free survival (DFS) and overall survival compared with doxorubicin plus cyclophosphamide in early stage breast cancer. We assessed the addition of 1 year of trastuzumab to a non-anthracycline regimen, docetaxel plus cyclophosphamide, in patients with HER2-amplified early stage breast cancer and examined whether this regimen was equally effective in patients with TOP2A-amplified and TOP2A-non-amplified disease.

Breast cancer in women at high risk

Breast cancer in women at high risk: The role of rapid genetic testing for BRCA1 and -2 mutations and the consequences for treatment strategies. The breast, Oct 2013, Vol. 22(5), p.561-68

Francken, A.B., et al.

http://www.thebreastonline.com/article/S0960-9776(13)00210-5/abstract?rss=yes

Specific clinical questions rise when patients, who are diagnosed with breast cancer, are at risk of carrying a mutation in BRCA1 and -2 gene due to a strong family history or young age at diagnosis. These questions concern topics such as 1. Timing of genetic counseling and testing, 2. Choices to be made for BRCA1 or -2 mutation carriers in local treatment, contralateral treatment, (neo)adjuvant systemic therapy, and 3. The psychological effects of rapid testing. The knowledge of the genetic status might have several advantages for the patient in treatment planning, such as the choice whether or not to undergo mastectomy and/or prophylactic contralateral mastectomy.

The effects of postmastectomy adjuvant radiotherapy on immediate two-stage prosthetic breast reconstruction

The effects of postmastectomy adjuvant radiotherapy on immediate two-stage prosthetic breast reconstruction: A systematic review. Plastic and reconstructive surgery, Sept 2013, Vol. 132(3), p.511-18.

Lam, T.C., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/09000/The_Effects_of_Postmastectomy_Adjuvant.1.aspx

The authors performed a systematic review of the literature on the outcome of therapy for patients with breast cancer who underwent adjuvant radiotherapy after an immediate two-stage prosthetic breast reconstruction, either following tissue expansion (stage 1) or after removal of the tissue expander and insertion of a final breast implant (stage 2). Their outcomes were compared to those of patients who had reconstruction without postmastectomy irradiation.

Impact of surgical techniques, biomaterials and patient variables on rate of nipple necrosis after nipple-sparing mastectomy

Impact of surgical techniques, biomaterials and patient variables on rate of nipple necrosis after nipple-sparing mastectomy. Plastic and reconstructive surgery, Sept 2013, Vol. 132(3), p.330e-338e.

Gould, D.J., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/09000/Impact_of_Surgical_Techniques,_Biomaterials,_and.4.aspx

Nipple-sparing mastectomy is appropriate for selected patients with early-stage breast cancer or high breast cancer risk. However, the postoperative rate of nipple necrosis is relatively high (10 to 30 percent). This study analyzed the impact of clinicopathologic and surgical variables on partial and total nipple necrosis rates after nipple-sparing mastectomy and compared overall complication rates between nipple-sparing and skin-sparing mastectomy.

NICE approves new test for spread of breast cancer

NICE approves new test for spread of breast cancer.

NHS Choices, Aug 2013

http://www.nhs.uk/news/2013/08August/Pages/NICE-approves-new-test-for-spread-of-breast-cancer.aspx

Duration of trastuzumab for HER2-positive breast cancer

Duration of trastuzumab for HER2-positive breast cancer. The lancet oncology, July 2013, Vol.14(8), p.678-79.

Montemurro, F. and Aglietta, M.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70273-0/fulltext?rss=yes

Several large randomised trials completed in the mid-2000s produced overwhelming evidence that the anti-HER2 monoclonal antibody trastuzumab, administered either concomitantly or sequentially with adjuvant chemotherapy for 12 months, increases the cure rate for women with HER2-positive operable breast cancer. One surprising aspect of this success story is that the choice of 12-month treatment duration was mostly as a result of a best guess, rather than on the basis of pre-existing evidence. 

Predictors of recurrence for ductal carcinoma in situ after breast-conserving surgery

Predictors of recurrence for ductal carinoma in situ after breast-conserving surgery. The lancet oncology, Aug 2013, Vol.14(9), p. e348-e357.

Benson, J.R. and Wishart, G.C.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70135-9/abstract?rss=yes

Ductal carcinoma in situ (DCIS) constitutes a major public health problem, with up to half of screen-detected cancers representing pure forms of DCIS without evidence of invasion. A proportion of cases detected with routine screening would not have progressed to a life-threatening form of breast cancer during the patient's lifetime, and overdiagnosis of breast cancer is a cause for concern.

Combination endocrine treatments unproven in breast cancer

Combination endocrine treatments unproven in breast cancer. The lancet oncology, Sept 2013, Vol. 14(10), p.917-18.

Buzdar, A.U.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70364-4/fulltext?_eventId=login&rss=yes

Ovarian ablation, which was introduced more than 100 years ago, was the first endocrine treatment for advanced breast cancer, followed by adrenalectomy and hypophysectomy. These ablative therapies have since been replaced by antioestrogen treatments, luteinising-hormone-releasing hormone agonists, and aromatase inhibitors.Other endocrine treatments with different mechanisms of action have also become available for breast cancer: oestrogens, progestins, androgens, antiandrogens, and selective oestrogen-receptor downregulators.

Subglandular breast augmentation with textured, anatomic, cohesive silicone implants

Subglandular breast augmentation with textured, anatomic, cohesive silicone implants: A review of 440 consecutive patients. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.295-303.

Lista, F., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/08000/Subglandular_Breast_Augmentation_with_Textured,.11.aspx

The Allergan Style 410 implant is a textured, anatomic, highly cohesive silicone gel–filled breast implant. Despite its widespread use in both Europe and Canada, limited data exist regarding long-term outcomes. The purpose of this study was to investigate outcomes using the Style 410 implant for primary subglandular breast augmentation.

Breast reconstruction with the Bostwick Autoderm technique

Breast reconstruction with the Bostwick Autoderm technique. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.261-70.

Ladizinsky, D.A., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Breast_Reconstruction_with_the_Bostwick_Autoderm.6.aspx

In 1990, Bostwick presented a technique wherein excess skin in the ptotic breast provides a deepithelialized inferiorly based dermal flap at the time of mastectomy. This adjoins the inferior border of the pectoralis major muscle, creating a complete autologous vascularized pocket, which is then covered by Wise pattern skin flaps.

Microvascular autologous breast reconstruction in the context of radiation therapy

Microvascular autologous breast reconstruction in the context of radiation therapy: Comparing two reconstructive algorithms. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), 251-57.

Patel, K., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Microvascular_Autologous_Breast_Reconstruction_in.1.aspx

When postmastectomy radiation therapy is anticipated, delaying autologous reconstruction prevents radiation delivery issues and radiation-induced contour irregularities. Delayed-immediate autologous breast reconstruction may allow for maintenance of the breast skin envelope as compared with delayed reconstruction with the temporary insertion of a tissue expander. The authors compared perioperative complications and revision surgery rates of comparative cohorts to determine which method is preferable.

The timing of preoperative prophylactic low-molecular-weight heparin administration in breast reconstruction

The timing of preoperative prophylactic low-molecular-weight heparin administration in breast reconstruction. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.279-84.

Keith, J.N., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/The_Timing_of_Preoperative_Prophylactic.8.aspx

Venous thromboembolism continues to be problematic despite increased recognition and advancements in venous thromboembolism prophylaxis. Although migration toward preoperative chemoprophylaxis increases, plastic surgeons seem reticent to adopt this practice. This study evaluates preoperative enoxaparin administration in breast reconstruction patients.

Quality-of-life outcomes between mastectomy alone and breast reconstruction

Quality-of-life outcomes between mastectomy alone and breast reconstruction: Comparison of patient- reported BREAST-Q and other health-related quality-of-life measures. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.201e-209e.

Eltahir, Y., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Quality_of_Life_Outcomes_between_Mastectomy_Alone.3.aspx

Published data on quality of life in women after breast reconstruction are inconsistent. This cross-sectional study evaluated the quality of life of women after successful breast reconstruction in comparison with those who underwent mastectomy alone.

Patterns of metastatic spread in early breast cancer

Patterns of metastatic spread in early breast cancer. The breast, August 2013, Vol. 22(4), p.449-54.

Klevesath, M.B., et al.

http://www.sciencedirect.com/science/article/pii/S0960977613000982

The aim of this study was to prospectively investigate metastatic pathways of spread to lymph node versus bone marrow and identify biological characteristics that determine these patterns in early invasive breast cancer.

A prognostic tool to predict fatigue in women with early-stage breast cancer undergoing radiotherapy

A prognostic tool to predict fatigue in women with early-stage breast cancer undergoing radiotherapy. The breast, August 2013, Vol. 22(4), p.504-09.

Courtier, N., et al.

http://www.sciencedirect.com/science/article/pii/S0960977612002032

Fatigue during and after radiotherapy impacts negatively on normal functioning and quality of life. A pre-treatment estimate of the risk of fatigue would facilitate the targeting of timely interventions to limit consequential behavioural symptoms arising. We have developed a prognostic tool to predict the risk of fatigue in women with early-stage breast cancer undergoing radiotherapy.

Should all postmenopausal patients with hormone receptor-positive breast cancer receive initial therapy with aromatase inhibitors?

Should all postmenopausal patients with hormone receptor-positive breast cancer receive initial therapy with aromatase inhibitors?  The breast, August 2013, Vol. 22(4), p.488-94.

Aapro, M., et al.

http://www.sciencedirect.com/science/article/pii/S096097761300009X

In the past few years aromatase inhibitors (AIs) have shown superior efficacy to the previous standard adjuvant endocrine therapy, tamoxifen, and are now recommended as part of current adjuvant endocrine therapy. A range of treatment strategies have been explored.

Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer

Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer: A review of the literature. The breast, August 2013, Vol. 22(4), p.395-404.

Walker, M.J., et al.

http://www.sciencedirect.com/science/article/pii/S0960977612002494

A small positive association has been consistently demonstrated between perceived breast cancer risk and mammography use. Evidence specific to women with familial breast cancer risk has not been previously reviewed.

The effect of mammography pain on repeat participation in breast cancer screening

The effect of mammography pain on repeat participation in breast cancer screening: A systematic review. The breast, August 2013, Vol. 22(4), p.389-94.

Whelehan, P., et al.

http://www.sciencedirect.com/science/article/pii/S096097761300057X

Uptake is crucial to reducing breast cancer mortality through screening. This review synthesised all available evidence on mammography pain as a deterrent to subsequent breast screening. Ten databases were searched. Studies containing empirical data relating mammography pain to breast screening re-attendance were included (n = 20). In the most robust studies asking women why they had not re-attended, 25%–46% cited pain, equivalent to approximately 47,000–87,000 women per year in England. The most robust evidence for an association between pain experienced at a previous mammogram and subsequent rates of re-attendance suggests that women who previously experienced pain are more likely than those who did not to fail to re-attend: RR 1.34 (95% CI: 0.94–1.91). The complexity of the pain phenomenon and of screening behaviours must be recognised. However, there is sufficient evidence to conclude that painful mammography contributes to non-re-attendance. Given the importance of cumulative participation, effective pain-reducing interventions in mammography are needed.

Sorting through the arguments on breast screening

Sorting through the arguments on breast screening.  JAMA, 2013, 309(24), p.2553-4.

Marmot, M.G.

http://jama.jamanetwork.com/article.aspx?articleid=1691913

Views on the benefits and harms of breast cancer screening are sharply polarized and increasingly vocal. Allegations of harming women are flung in both directions. The antiscreeners claim that benefit is minimal and overdiagnosis is so frequent that women are being subject to unnecessary interventions and treatment. The proscreeners claim that if the critics win the day, women will be deprived of the benefits that screening brings of early diagnosis and reductions in mortality from breast cancer.

Cancer Research UK podcast: June 2013 (Angelina Jolie)

Cancer Research UK podcast: June 2013.

Angelina Jolie’s decision to go public about her genetic risk of breast cancer and double mastectomy. Plus, we take a look at the importance of clinical trials for improving survival for cancer patients. And we’ve got this month’s heroes and zeros. Read a full trasncript here: http://www.cancerresearchuk.org/cancer-info/news/podcast/transcripts/june-2013-podcast-transcript

[podcast]:
Original audio source (94345351-cancerresearchuk-073-cancer-research-uk-podcast.mp3)

Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy

Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy: A prospective, multicentre cohort study. The lancet oncology, June 2013, Vol. 14(7), p.609-18

Kuehn, T., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70166-9/abstract?rss=yes

The optimum timing of sentinel-lymph-node biopsy for breast cancer patients treated with neoadjuvant chemotherapy is uncertain. The SENTINA (SENTinel NeoAdjuvant) study was designed to evaluate a specific algorithm for timing of a standardised sentinel-lymph-node biopsy procedure in patients who undergo neoadjuvant chemotherapy.

Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastoplexy

Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastopexy: How safe is it? Plastic and reconstructive surgery, May 2013, Vol. 131(5), p.962-97

Alperovich, M., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/05000/Nipple_Sparing_Mastectomy_in_Patients_with_a.9.aspx

Nipple-sparing mastectomy has gained popularity, but the question remains of whether it can be offered safely to women with a history of reduction mammaplasty or mastopexy. The authors present their experience with nipple-sparing mastectomy in this patient population.

The role of nipple-sparing mastectomy in breast cancer

The role of nipple-sparing mastectomy in breast cancer: A comprehensive review of the literature. Plastic and reconstructive surgery, May 2013, Vol. 131(5), p.969-984

Mallon, P., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/05000/The_Role_of_Nipple_Sparing_Mastectomy_in_Breast.11.aspx

The role of nipple-sparing mastectomy for breast cancer is controversial, as there is concern regarding its oncologic safety and complication rate. The authors reviewed the literature to quantify the incidence of occult nipple malignancy in breast cancer, identify the factors influencing occult nipple malignancy, quantify loco-regional recurrence rates, and quantify nipple-sparing mastectomy complication rates.

Screening has not reduced deaths from breast cancer

Screening has not reduced deaths from breast cancer. BMJ 2013; 346: f3780

Wise, J.

http://www.bmj.com/content/346/bmj.f3780.full?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+bmj%252Frecent+%2528Latest+from+BMJ%2529

Mammographic screening has not had any effect, so far, on breast cancer mortality at the population level in England, a new analysis concludes.

Arm lymphoedema after breast cancer

Arm lymphoedema after breast cancer. The lancet oncology, May 2013, Vol. 14(6), p.442-43

Mortimer, P.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70097-4/fulltext?_eventId=login&rss=yes

[Register to download full text article - free of charge]

Breast-cancer-related lymphoedema is a substantial problem in women after they have undergone breast cancer treatment. Despite the introduction of breast-conserving surgery and minimal lymphatic intervention (eg, sentinel-lymph-node biopsy [SLNB]), incidence rates remain disappointingly high. In The Lancet Oncology, Tracey DiSipio and colleagues report the findings of their systematic review and meta-analysis in which they shown that roughly one in five women with breast cancer will develop arm lymphoedema. The incidence was four times higher in women undergoing axillary lymph-node dissection compared with those who received sentinel-lymph-node biopsy.

Predictors of axillary lymph node metastases in early breast cancer

Predictors of axillary lymph node metastases in early breast cancer and their applicability in clinical practice. The breast, June 2013, Vol. 22(3), p.357-61.

Yoshihara, E., et al.

http://www.thebreastonline.com/article/PIIS0960977612001890/abstract?rss=yes

Lymph node involvement is the most important prognostic factor in breast cancer. It is a multifactorial event determined by patient and tumour characteristics. The purpose of this study was to determine clinical and pathological factors predictive for axillary lymph node metastasis (ALNM) in patients with early breast cancer and to build a model to portend lymph node involvement.

Detection of local recurrence following breast-conserving treatment in young women with early breast cancer

Detection of local recurrence following breast-conserving treatment in young women with early breast cancer: Optimization of long-term follow-up strategies. The breast, June 2013, Vol. 22(3), p.351-56

van der Sangen, M.J.C., et al.

http://www.thebreastonline.com/article/PIIS0960977612001865/abstract?rss=yes

The detection of a local recurrence (LR) in young women with breast cancer after breast-conserving treatment (BCT) was investigated to compare the impact of different long-term follow-up strategies.

Association between common risk factors and molecular subtypes in breast cancer patients

Association between common risk factors and molecular subtypes in breast cancer patients. The breast, June 2013, Vol. 22(3), p.344-50.

Turkoz, F.P., et al.

http://www.thebreastonline.com/article/PIIS0960977612001737/abstract?rss=yes

Breast cancer is the most commonly diagnosed cancer in women worldwide and characterized its by molecular and clinical heterogeneity. Gene expression profiling studies have classified breast cancers into five subtypes: luminal A, luminal B, HER-2 overexpressing, basal-like, and normal breast-like. Although clinical differences between subtypes have been well described in the literature, etiologic heterogeneity have not been fully studied. The aim of this study was to assess the associations between several hormonal and nonhormonal risk factors and molecular subtypes of breast cancer.

Acupuncture relieves menopausal discomfort in breast cancer patients

Acupuncture relieves menopausal discomfort in breast cancer patients: A prospective, double blinded, randomized study. The breast, June 2013, Vol. 22(3), p.320-23

Bokmand, S. and Flyger, H.

http://www.thebreastonline.com/article/PIIS096097761200166X/abstract?rss=yes

his study evaluates the effect of acupuncture on hot flashes and disturbed night sleep in patients treated for breast cancer. The effect of acupuncture was tested against a sham-acupuncture group and a no-treatment control group. Plasma estradiol was measured to rule out this as cause of effect. Side effects of the treatment were registered.

Pathological response and survival after neoadjuvant therapy for breast cancer

Pathological response and survival after neoadjuvant therapy for breast cancer: A 30-year study. The breast, June 2013, Vol. 22(3), p.301-08

Guiu, S., et al.

http://www.thebreastonline.com/article/PIIS0960977612001634/abstract?rss=yes

HER2-positive and triple-negative breast cancer (TNBC) still have a poor prognosis. Pathological complete response (pCR) is usually considered a surrogate marker for outcome. The aim of this study was to reconsider these parameters on a large population after a long follow-up. 

Factors influencing postoperative length of hospital stay after breast cancer surgery

Factors influencing postoperative length of hospital stay after breast cancer surgery. The breast, June 2013, Vol. 22(3), p.289-294

Marla, S., et al.

http://www.thebreastonline.com/article/PIIS0960977612001609/abstract?rss=yes

As part of a feasibility study to restructure the breast cancer services in Glasgow, factors influencing ‘postoperative length of stay’ and bed utilisation in patients undergoing surgery for breast cancer were examined.

Differences in sleep disturbance, fatigue and energy levels between women with and without breast pain prior to breast cancer surgery

Differences in sleep disturbance, fatigue and energy levels between women with and without breast pain prior to breast cancer surgery. The breast, June 2013, Vol. 22(3), p.273-76

Van Onselen, C., et al.

http://www.thebreastonline.com/article/PIIS0960977612001531/abstract?rss=yes

The purpose of this study was to evaluate for differences in occurrence and severity ratings of sleep disturbance, fatigue, and decreased energy in women who reported breast pain prior to surgery for breast cancer. Of the 390 women who completed self-report measures for each symptom, 28.2% reported pain in their breast prior to surgery. 

International guidelines for management of metastatic breast cancer

International guidelines for management of metastatic breast cancer from the European School of Oncology - MBC Task Force: Surveillance, staging and evaluation of patients with early-stage and metastatic breast cancer. The breast, June 2013, Vol. 22(3), p.203-10

Lin, N.U, et al.

http://www.thebreastonline.com/article/S0960-9776(13)00062-3/abstract

In clinical practice, the surveillance and follow-up of patients with breast cancer (BC) is quite variable. At the 7th European Breast Cancer Conference, the ESO-MBC Task Force convened a series of lectures, followed by open debate, on the use of physical examination, imaging, and laboratory tests in patients with early-stage BC, and for restaging evaluations and follow-up among patients with MBC.

Leser-Trelat sign and breast cancer

Leser-Trelat sign and breast cancer. The lancet, May 2013, Vol. 381(9878), p.1653

Al Ghazal, P., et al.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61257-4/fulltext?rss=yes

A 71-year-old, obese woman presented to our clinic with multiple seborrheic keratoses over her entire body. She reported the rapid appearance of the tumours several weeks before an initial diagnosis of breast cancer. 

Persistent pain and sensory disturbances after treatment for breast cancer

Persistent pain and sensory disturbances after treatment for breast cancer: six-year nationwide follow-up study. BMJ 2013; 346.

Mejdahl, M.K., et al.

http://www.bmj.com/highwire/filestream/640586/field_highwire_article_pdf/0/bmj.f1865.full.pdf

Objective: Toexamine thedevelopment of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain.Design: Repeated cross sectional study in a previously examined

nationwide cohort.All eligible women who underwent surgery for primary breast cancer in Denmark in 2005 and 2006 and were examined in 2008 were surveyed again with the same questionnaire.

Breast reconstruction modality outcome study

Breast reconstruction modality outcome study: A comparison of expander/implants and free flaps in select patients. Plastic and reconstructive surgery, May 2013, Vol. 131(5), p.928-34.

Fischer, J.P., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/05000/Breast_Reconstruction_Modality_Outcome_Study___A.2.aspx

Choosing a breast reconstructive modality after mastectomy is a critical step involving complex decisions. The authors provide outcomes data comparing two common reconstructive modalities to assist patients and surgeons in preoperative counselling and discussions.

Repairing the high-riding nipple with reciprocal transposition flaps

Repairing the high-riding nipple with reciprocal transposition flaps. Plastic and reconstructive surgery, April 2013, Vol. 131(4), p.687-89.

Spear, S.L., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/04000/Repairing_the_High_Riding_Nipple_with_Reciprocal.5.aspx

The high-riding nipple-areola complex is a clinical problem that can be encountered following cosmetic and reconstructive breast surgery. Because of the desire to avoid scars on the superior aspect of the breast and the limited availability of superior breast skin, it can be technically challenging to place the nipple-areola complex in a lower position. 

Double venous system drainage in deep inferior epigastric perforator flap breast reconstruction

Double venous system drainage in deep inferior epigastric perforator flap breast reconstruction: a single-surgeon experience. Plastic and reconstructive surgery, April 2013, Vol. 131(4), p.671-76

Boutros, S.G.

http://journals.lww.com/plasreconsurg/Abstract/2013/04000/Double_Venous_System_Drainage_in_Deep_Inferior.1.aspx

Breast reconstruction with the deep inferior epigastric perforator (DIEP) flap has many advantages. The main drawback is the technical difficulty and risk of failure. Many flap failures are the result of venous insufficiency. The author explored the routine use of double venous system anastomosis in DIEP flap breast reconstruction.

Incidence of unilateral arm lymphoedema after breast cancer

Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis.  The lancet oncology, May 2013, Vol. 14(6), p.500-15.

DiSippio, T., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70076-7/abstract?rss=yes

The body of evidence related to breast-cancer-related lymphoedema incidence and risk factors has substantially grown and improved in quality over the past decade. We assessed the incidence of unilateral arm lymphoedema after breast cancer and explored the evidence available for lymphoedema risk factors.

Quality of life and symptoms in male breast cancer survivors

Quality of life and symptoms in male breast cancer survivors. The breast, Vol. 22(2), April 2013, p.197-9.

Ruddy, K.J., et al.

http://www.thebreastonline.com/article/PIIS0960977612002585/abstract?rss=yes

Little is known about quality of life and symptoms of male breast cancer survivors.

A new level 1 oncoplastic technique for breast conserving surgery

A new level 1 oncoplastic technique for breast conserving surgery: Rotation gladular flap. The breast, Vol. 22(2), April 2013, p.186-9.

Massey, E.J.D., et al.

http://www.thebreastonline.com/article/PIIS0960977613000143/abstract?rss=yes

When performing conservative surgery for breast cancer, breast reshaping can be a challenging procedure. Level 1 oncoplastic surgery (OPS) techniques, i.e. advancement or rotation of glandular flaps, should be performed when less than 20 per cent breast volume is excised.

Trends in tertiary breast reconstruction

Trends in tertiary breast reconstruction: Literature review and single centre experience. The breast, Vol. 22(2), April 2013, p.173-8.

Mohan, A.T., et al.

http://www.thebreastonline.com/article/PIIS0960977612001166/abstract?rss=yes

Autologous flap reconstruction can improve aesthetic results after failed implant reconstruction and be considered following previous failed autologous flap reconstruction. This study presents a review of the indications, motivation and outcomes of tertiary breast reconstruction.

An evaluation of patient reported outcomes following breast reconstruction utilizing Breast Q.

An evaluation of patient reported outcomes following breast reconstruction utilizing Breast Q.  The breast, Vol. 22(2), April, 2013, p.158-161.

Sugrue, R., et al.

http://www.thebreastonline.com/article/PIIS0960977612002457/abstract?rss=yes

Breast Q questionnaire measures patient's perceptions following breast reconstruction using quality of life and satisfaction. This study assessed patient reported outcomes following mastectomy and reconstruction utilizing Breast Q.

Aromatase inhibitors in the treatment of elderly women with metastatic breast cancer

Aromatase inhibitors in the treatment of elderly women with metastatic breast cancer. The breast, Vol. 22(2), April 2013, p.142-9.

Gluck, S., et al.

http://www.thebreastonline.com/article/PIIS0960977612002597/abstract?rss=yes

The proportion of elderly women in the population is rising, and in tandem, the incidence of breast cancer rises with age. Because of health and tolerability concerns, as well as life expectancy, physicians may be reluctant to advise a standard treatment regimen for elderly patients with metastatic breast cancer. 

Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are not suitable for a "standard chemotherapy regimen"

Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are not suitable for a "standard chemotherapy regimen": The CASA randomized trial.  The breast, Vol. 22(2), April 2013, p.130-7.

Crivellari, D., et al.

http://www.thebreastonline.com/article/PIIS0960977613000179/abstract?rss=yes

There is no optimal treatment for breast cancers lacking estrogen (ER) and progesterone (PgR) receptors in elderly women with co-morbidities that prevent use of “standard chemotherapy regimens” such as AC or CMF. The CASA trial studied pegylated liposomal doxorubicin and low dose, metronomic cyclophosphamide + methotrexate (CM) for older (>65), vulnerable women with operable, ER and PgR-negative breast cancer.

Meta-analysis of breast cancer outcome and toxicity in adjuvant trials of aromatase inhibitors in postmenopausal women

Meta-analysis of breast cancer outcome and toxicity in adjuvant trials of aromatase inhibitors in postmenopausal women. The breast, Vol. 22(2), April 2013, p.121-29.

Aydiner, A.

http://www.thebreastonline.com/article/PIIS0960977613000167/abstract?rss=yes

The present meta-analysis examines randomized trials of third-generation aromatase inhibitors (AIs) as alternatives to tamoxifen in three treatment settings: monotherapy, sequenced therapy and extended therapy. Eleven randomized controlled trials (RCTs) were chosen based on their similarity in terms of study design and included 34,070 post-menopausal women who had undergone surgery for estrogen-sensitive early breast cancer.

Gene expression profiling in breast cancer

Gene expression profiling in breast cancer: A clinical perspective. The breast, Vol. 22(2), April 2013, p.109-120.

Arpino, G., et al.

http://www.thebreastonline.com/article/PIIS0960977613000180/abstract?rss=yes

Gene expression profiling tests are used in an attempt to determine the right treatment for the right person with early-stage breast cancer that may have spread to nearby lymph nodes but not to distant parts of the body. These new diagnostic approaches are designed to spare people who do not need additional treatment (adjuvant therapy) the side effects of unnecessary treatment, and allow people who may benefit from adjuvant therapy to receive it.

Overview of the evidence on digital breast tomosynthesis in breast cancer detection

Overview of the evidence on digital breast tomosynthesis in breast cancer detection. The breast, Vol. 22(2), April 2013, p.101-08.

Houssami, N. and Skaane, P.

http://www.thebreastonline.com/article/S0960-9776(13)00019-2/abstract

Digital breast tomosynthesis (DBT, or 3D-mammography), a three-dimensional derivative of digital mammography, reduces the effect of tissue superimposition and may improve mammographic interpretation. In this review, we examined the evidence on the accuracy of DBT in clinical studies. Published studies of DBT were relatively small studies, mostly test-set observer (reader) studies or clinical series that included symptomatic and screen-recalled cases, and were generally enriched with cancers.

Breast screening controversy continues

Breast screening controversy continues. BMJ 2013; 346:f477.

Godlee, F. [editorial]

http://www.bmj.com/content/346/bmj.f477.pdf%2Bhtml


When the Marmot report on breast cancer screening was published in November last year, many will have hoped for an endtothisparticular controversy.Prompted by callsi n the BMJ for more honest information on the harms of screening (BMJ 2010;340:c3106, BMJ 2011;343:d6894), Marmot and his committee were charged with asking whether the screening programme should continue, and if so, what women should be
told about the risks of overdiagnosis.

Survival is better after lumpectomy than mastectomy in early breast cancer

Survival is better after lumpectomy than mastectomy in early breast cancer, US study shows. BMJ, 2013, 346:f557

Mayor, S.

http://www.bmj.com/content/346/bmj.f577.pdf%2Bhtml


Women with early stage breast cancer who are treated with lumpectomy and radiotherapy have significantly better survival than women who have a mastectomy, a retrospective study of US data has found.

Breast conserving surgery using the round block technique combined with partial reconstruction using the latissimus dorsi flap

Breast conserving surgery using the round block technique combined with partial reconstruction using the latissimus dorsi flap. The breast, Feb 2013, Vol. 22(1), p.98-99.

Zaha, H. and Onomura, M.

http://www.thebreastonline.com/article/PIIS0960977612002263/abstract?rss=yes

The round block technique (RBT) is one of the frequently used volume displacement procedures in oncoplastic breast surgery. We report a useful technique which combines RBT with immediate partial breast reconstruction using the latissimus dorsi flap (LD flap) for breast-conserving surgery (BCS). 

Pre-operative factors indicating risk of multiple operations versus a single operation in women undergoing surgery for screen detected breast cancer

Pre-operative factors indicating risk of multiple operations versus a single operation in women undergoing surgery for screen detected breast cancer. The breast, Feb. 2013, Vol. 22(1), p.78-82.

O'Flynn, E.A.M., et al.

http://www.thebreastonline.com/article/PIIS0960977612001294/abstract?rss=yes

We aim to identify preoperative factors at diagnosis which could predict whether women undergoing wide local excision (WLE) would require further operations. 1593 screen-detected invasive and non-invasive breast cancers were reviewed. Age, presence of ductal carcinoma in situ (DCIS), invasive cancer size on mammography, mammographic sign, tumour type, grade and confidence of the radiologist in malignancy were compared.

Implication of breast cancer phenotype for patients with leptomeningeal carcinomatosis

Implication of breast cancer phenotype for patients with leptomeningeal carinomatosis. The breast, Feb. 2013, Vol. 22(1), p.19-23.

Torrejon, D., et al.

http://www.thebreastonline.com/article/PIIS096097761200210X/abstract?rss=yes

We aimed to study the implications of breast cancer (BC) subtypes for the development and prognosis of leptomeningeal carcinomatosis (LC).

Do primary mammary osteosarcoma and chondrosarcoma exist?

Do primary mammary osteosarcoma and chondrosarcoma exist? A review of a large multi-institutional series of malignant matrix-producing breast tumours. The breast, Feb. 2013, Vol. 22(1), p.13-18.

Rakha, E.A., et al.

http://www.thebreastonline.com/article/PIIS0960977612001968/abstract?rss=yes

The existing literature describing the clinicopathological features and behaviour of matrix-producing (MP) malignant breast tumours presents conflicting results. As a consequence it remains uncertain whether these tumours should be treated as sarcoma and managed by a specialist sarcoma team or treated using the same principles as conventional ductal carcinoma, a dilemma that prompted this study. Improved understanding of the clinicopathological characteristics of primary mammary MP-sarcomas, namely osteosarcoma and chondrosarcoma, is required.

Efficacy of HER2-targeted therapy in metastatic breast cancer

Efficacy of HER2-targeted therapy in metastatic breast cancer. Monoclonal antibodies and tyrosine kinase inhibitors. The breast, Feb 2013, Vol. 22(1), p.1-12.

Nielsen, D.L., et al.

http://www.thebreastonline.com/article/PIIS0960977612001944/abstract?rss=yes

Therapies targeting the human epidermal growth factor receptor (HER) 2 are effective in metastatic breast cancer (MBC). We review the efficacy of HER2-directed therapies, focussing on monoclonal antibodies and tyrosine kinase inhibitors targeting HER2 that have been tested in phase II–III studies in MBC.

The use of dermal autograft as an adjunct to breast reconstruction with tissue expanders

The use of dermal autograft an an adjunct to breast reconstruction with tissue expanders. Plastic and reconstructive surgery, Dec. 2012, Vol. 130(6), p.1179-85.

Rinker, B.

http://journals.lww.com/plasreconsurg/Abstract/2012/12000/The_Use_of_Dermal_Autograft_as_an_Adjunct_to.2.aspx

A cellular dermal matrices are commonly used in breast reconstruction but add cost to the procedure and have been associated with complications. Dermal autograft may represent a useful alternative to matrices.

A systematic review of antibiotic use and infection in breast reconstruction

A systematic review of antibiotic use and infection in breast reconstruction: What is the evidence? Plastic and  reconstructive surgery, Jan 2013, Vol. 131(1), p.1-13.

Phillips, B.T., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/01000/A_Systematic_Review_of_Antibiotic_Use_and.1.aspx

The literature reports overall complication rates in breast reconstruction to be as high as 60 percent. Infection rates can exceed 20 percent, much higher than anticipated in clean elective surgery. There is no consensus among surgeons regarding the necessary duration of antibiotic prophylaxis, although the Centers for Disease Control and Prevention guidelines suggest only 24 hours. This systematic review examines antibiotic regimens and associated infection rates in breast reconstruction.

Evaluating sterile human acellular dermal matrix in immediate expander-based breast reconstruction

Evaluating sterile human acellular dermal matrix in immediate expander-based breast reconstruction: A multicenter, prospective, cohort study. Plastic and reconstructive surgery, Jan. 2013, Vol. 131(1), p.9e-18e.

Venturi, M.L., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/01000/Evaluating_Sterile_Human_Acellular_Dermal_Matrix.5.aspx

Human acellular dermal matrices have gained increasing use in immediate expander-based breast reconstruction. However, some studies suggest that these grafts may be associated with a higher incidence of infection and seroma. To evaluate complication rates after matrix-based breast reconstruction, the authors conducted a prospective, multicenter, cohort study to evaluate a sterile human acellular dermal matrix in immediate expander-based breast reconstruction, specifically, to determine whether it offered a more favorable risk profile with respect to infection and seroma. A secondary purpose was to determine whether the sterilization process affects graft incorporation.

Comprehensive outcome and cost analysis of free tissue transfer for breast reconstruction

Comprehensive outcome and cost analysis of free tissue transfer for breast reconstruction: An experience with 1303 flaps.  Plastic and reconstructive surgery, Feb. 2013, Vol. 131(2), p.195-203.

Fischer, J., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/02000/Comprehensive_Outcome_and_Cost_Analysis_of_Free.4.aspx

Free tissue transfer is standard for postoncologic reconstruction, yet it entails a lengthy operation and significant recovery. The authors present their longitudinal experience of free tissue breast reconstructions with an emphasis on predictors of major surgical and medical complications.

Microsurgical breast reconstruction for nipple-sparing mastectomy

Microsurgical breast reconstruction for nipple-sparing mastectomy. Plastic and reconstructive surgery, Feb 2013, Vol. 131(2), p.139(e)-147(e).

Tanna, N., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/02000/Microsurgical_Breast_Reconstruction_for.3.aspx

Nipple-sparing mastectomy warrants thorough preoperative evaluation to effectively achieve risk reduction, high patient satisfaction, and improved aesthetic outcome. To the authors' knowledge, this review represents the largest series of microsurgical breast reconstructions following nipple-sparing mastectomies.

Breast imaging of the pregnant and lactating patient

Breast imaging of the pregnant and lactating patient: Physiologic changes and common benign entities. AJR, Feb. 2013, Vol. 200(2), p.329-336.

Vashi, R., et al.

http://www.ajronline.org/content/200/2/329.abstract

The purpose of this article is to review key clinical, histologic, and imaging features of expected physiologic changes within the breast and common benign breast disease in the pregnant and lactating patient.

Survival is better after lumpectomy than mastectomy in early breast cancer

Survival is better in lumpectomy than mastectomy in early breast cancer. BMJ, 2013, 346:1577.

Mayor, S.

http://www.bmj.com/highwire/filestream/627882/field_highwire_article_pdf/0/bmj.f577


Women with early stage breast cancer who are treated with lumpectomy and radiotherapy have significantly better survival than women who have a mastectomy, a retrospective study of US data has found. Researchers analyzed data in the California cancer registry from all 112 154 women in the state who had been given a diagnosis of early stage, invasive breast cancer between 1990 and 2004 and who were treated with either lumpectomy and radiotherapy or mastectomy and were followed to December 2009.