Wednesday 26 March 2014

Anastrozole for prevention of breast cancer in high-risk postmenopausal women

Anastrozole for prevention of breast cancer in high-risk postmenopausal women: An international, double-blind, randomised placebo-controlled trial. The Lancet, March 2014, Vol. 383(9922), p.1041-48.

Cuzick, J., et al.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62292-8/abstract?rss=yes

Aromatase inhibitors effectively prevent breast cancer recurrence and development of new contralateral tumours in postmenopausal women. We assessed the efficacy and safety of the aromatase inhibitor anastrozole for prevention of breast cancer in postmenopausal women who are at high risk of the disease.

Breast cancer chemoprevention

Breast cancer chemoprevention: little progress in practice? The Lancet, March 2014 Vol. 383(9922), p.1018-20.

Cameron, D.A.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62555-6/fulltext?rss=yes

In The Lancet, Jack Cuzick and colleagues report the first results from IBIS-II (International Breast cancer Intervention Study II), in which 3864 postmenopausal women at high risk of breast cancer were randomly assigned to receive the potent, non-steroidal aromatase inhibitor anastrozole or placebo every day for 5 years. After a median follow-up of 5 years, 40 (2%) of 1920 women in the anastrozole group and 85 (4%) of 1944 in the placebo group had developed breast cancer (hazard ratio 0·47, 95% CI 0·32—0·68). This finding is in keeping with those of other similar studies.So far, unsurprisingly, the investigators have not recorded evidence for a difference in breast cancer or all-cause mortality: 18 deaths had been reported in the anastrozole group and 17 in the placebo group.

Venous thromboembolism risk in mastectomy and immediate breast reconstruction

Venous thromboembolism risk in mastectomy and immediate breast reconstruction: Analysis of the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program Data Sets. Plastic and Reconstructive Surgery, March 2014, Vol. 133(3), p.263e-273e.

Fischer, J.P., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/03000/Venous_Thromboembolism_Risk_in_Mastectomy_and.9.aspx

Venous thromboembolism, including deep venous thrombosis and pulmonary embolism, is a morbid and costly complication following surgical procedures. The authors aim to assess the added risk of venous thromboembolism in patients undergoing immediate breast reconstruction.

The effect of prior abdominal surgery on abdominally based free flaps in breast reconstruction

The effect of prior abdominal surgery on abdominally based free flaps in breast reconstruction. Plastic and reconstructive surgery, March 2014, Vol. 133(3), p.247e-255e.

Roostaeian, J., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/03000/The_Effect_of_Prior_Abdominal_Surgery_on.4.aspx

The abdomen has long remained the preferred donor site in breast reconstruction. Over time, the flap has evolved to limit morbidity with reduced muscular harvest. Previous abdominal operations, however, may limit the ability to perform a muscle- or fascia-sparing flap. The purpose of this study was to evaluate outcomes in women who had prior abdominal operations and underwent abdominally based autologous breast reconstruction.

Mastectomy rates for ductal carcinoma in situ vary widely in UK

Mastectomy rates for ductal carcinoma in situa vary widely in UK, audit shows [news item]. BMJ 2014; 348:g2332

Mayor, S.

http://www.bmj.com/content/348/bmj.g2332?rss=1&hwoasp=authn%3A1395931440%3A4044144%3A3266341127%3A0%3A0%3AKU2BGBsYX8ly%2BjhKOx1Tkg%3D%3D

Data from the UK NHS Breast Cancer Screening Programme show significant variation between hospitals in the number of women with ductal carcinoma in situ undergoing mastectomy when lumpectomy would normally be indicated, shows an audit reported last week at the European Breast Cancer Conference.

Breast cancer screening offers few benefits to women over 70

Breast cancer screening offers few benefits to women over 70, finds study [research news].  BMJ 2014; 348:g2333.

Wise, J.

http://www.bmj.com/highwire/filestream/691661/field_highwire_article_pdf/0/bmj.g2333

Extending the Netherlands’ breast cancer screening programme to include women over the age of 70 did not lead to a fall in the number of advanced stage breast cancers detected, even though the number of early stage tumours detected rose, an evaluation has found. The study’s leader, Gerrit-Jan Liefers, a surgical oncologist and head of the geriatric oncology research group at Leiden University Medical Centre, said that if the programme were effective he would expect the incidence of advanced stage cancer to decrease, because any cancer would have been detected at an earlier stage. The study’s finding “implies that the effect of
screening in elderly women is limited and leads to a large proportion of overdiagnosis,” he said.