Thursday, 18 July 2013

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.

Monday, 15 July 2013

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.