Thursday 3 October 2013

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.