Do all patients with HER2 positive breast cancer require one year of adjuvant trastuzumab? A systematic review and meta-analysis

 

Do all patients with HER2 positive breast cancer require one year of adjuvant trastuzumab? A systematic review and meta-analysis

by Paul Stewart, Phillip Blanchette, Prakesh S. Shah, Xiang Y. Ye, R. Gabriel Boldt, Ricardo Fernandes, Ted Vandenberg, Jacques Raphael

The Breast: Open Access: Published: October 21, 2020

One year of adjuvant trastuzumab is considered the standard treatment for patients with HER2 positive breast cancer. However, a shorter duration of trastuzumab may be associated with reduced costs and side effects. Results from randomized trials with diverse non-inferiority margins comparing one year to a shorter duration of adjuvant trastuzumab are not consistent and have not been systematically reviewed using a non-inferiority meta-analysis approach.We conducted a systematic review and meta-analysis of randomized trials to assess whether a shorter duration of adjuvant trastuzumab was non-inferior to one year of treatment or not.

Correlation of size and focality with prognosis in small breast carcinoma: a single institution case series

 

Correlation of size and focality with prognosis in small breast carcinoma: a single institution case series

 

by Mauro G. Mastropasqua, Francesca Addante, Sara Pirola, Giuseppe Ingravallo, Giuseppe Viale 

 

The Breast: Open Access: Published: October 16, 2020

 

The clinical behavior and prognosis of small multifocal and microinvasive breast cancers are still debated together with the best method of assessing tumor size in multiple invasive carcinomas. This study evaluates the clinico-pathological features of single and multiple breast cancers up to 0.5 cm in order to evaluate the rate of recurrences.

Eligibility of real-world patients with metastatic breast cancer for clinical trials

 

Eligibility of real-world patients with metastatic breast cancer for clinical trials

 

by Atul Batra, Shiying Kong, Winson Y. Cheung 

 

The Breast: Open Access: Published: October 17, 2020

 

The results of clinical trials in metastatic breast cancer (MBC) are generalized to real-world patients. This study determines the proportion of real-world patients who would be eligible for clinical trials and compares outcomes in eligible versus ineligible patients.

Highlights

•One third of patients with metastatic breast cancer are clinical trial ineligible.

•Renal dysfunction and prior immunosuppression are common reasons.

•Ineligible patients are less likely to receive chemotherapy, but not hormonal therapy.

•Systemic treatment, but not eligibility, is associated with overall survival.

•Eligibility criteria should be broadened to represent more real-world patients.

HER2 positivity is not associated with adverse prognosis in high-risk estrogen receptor-positive early breast cancer patients treated with chemotherapy and trastuzumab

 

HER2 positivity is not associated with adverse prognosis in high-risk estrogen receptor-positive early breast cancer patients treated with chemotherapy and trastuzumab

 

by Shuai Li, Jiayi Wu, Ou Huang, Jianrong He, Li Zhu, Weiguo Chen, Yafen Li, Xiaosong Chen, Kunwei Shen 

 

The Breast: Open Access: Published: October 14, 2020

 

Co-expression of human epidermal growth factor receptor-2 (HER2) and hormone receptor (HR) predicted worse prognosis in early breast cancer before trastuzumab was developed. We aimed to investigate whether HER2 positivity was still associated with worse outcome in high-risk estrogen receptor (ER) positive patients treated with trastuzumab and chemotherapy. In the present study, 227 ER+/HER2+ patients treated with trastuzumab and chemotherapy (HER2-pos-T group) and 1097 ER+/HER2-patients treated with chemotherapy alone (HER2-neg group) during 2009 and 2015 were retrospectively enrolled for the comparison of disease-free survival (DFS) and overall survival (OS).

Breast-Conserving Surgery with or without Irradiation in Women with Invasive Ductal Carcinoma of the Breast Receiving Preoperative Systemic Therapy: A National Cohort Study

 

Breast-Conserving Surgery with or without Irradiation in Women with Invasive Ductal Carcinoma of the Breast Receiving Preoperative Systemic Therapy: A National Cohort Study

by Jiaqiang Zhang, Chang-Yun Lu, Lei Qin, Ho-Min Chen, Szu-Yuan Wu 

The Breast: VOLUME 54, P139-147, DECEMBER 01, 2020

To investigate the outcomes of adjuvant whole breast radiation therapy (WBRT) in patients with invasive ductal carcinoma of the breast (breast IDC) receiving preoperative systemic therapy (PST) and breast-conserving surgery (BCS), and their prognostic factors, considering overall survival (OS), locoregional recurrence (LRR), distant metastasis (DM), and disease-free survival.

Differences in breast cancer risk after benign breast disease by type of screening diagnosis

 Differences in breast cancer risk after benign breast disease by type of screening diagnosis

 

by Javier Louro, Marta Román, Margarita Posso, Laura Comerma, Carmen Vidal, Francina Saladié, Rodrigo Alcantara, Mar Sanchez, M. Jesús Quintana, Javier del Riego, Joana Ferrer, Lupe Peñalva, Xavier Bargalló, Miguel Prieto, María Sala, Xavier Castells

 

The Breast: Open Access: Published: October 03, 2020

 

We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens.

 

Highlights

•Breast cancer risk after a benign breast disease varied with the screening type.

•Incident benign breast disease had a higher breast cancer risk than prevalent.

•The risk remained increased regardless of benign breast disease subtype.

Symptoms in Long-term Breast Cancer Survivors: A Cross-sectional Study in Primary Care

 

Symptoms in Long-term Breast Cancer Survivors: A Cross-sectional Study in Primary Care

 

by S.W.M.C. Maass, L.M. Boerman, D. Brandenbarg, P.F.M. Verhaak, J.H. Maduro, G.H. de Bock, A.J. Berendsen

 

The Breast: VOLUME 54, P133-138, DECEMBER 01, 2020

 

Various long-term symptoms can manifest after breast cancer treatment, but we wanted to clarify whether these are more frequent among long-term breast cancer survivors than matched controls and if they are associated with certain diagnoses.

First-line bevacizumab and eribulin combination therapy for HER2-negative metastatic breast cancer: Efficacy and safety in the GINECO phase II ESMERALDA study

 First-line bevacizumab and eribulin combination therapy for HER2-negative metastatic breast cancer: Efficacy and safety in the GINECO phase II ESMERALDA study

 

by Anne-Claire Hardy-Bessard, Fabien Brocard, Florian Clatot, Alain Lortholary, Benoît You, Julien Grenier, Jérôme Martin-Babau, Brigitte Lucas, Jérôme Meunier, Jean-Marc Ferrero, Aude-Marie Savoye, Adina Marti, Raymond Despax, Isabelle Moullet, George Emile

 

The Breast: Open Access: Published: September 30, 2020

 

Combining bevacizumab with paclitaxel significantly improves progression-free survival (PFS) versus paclitaxel alone in HER2-negative metastatic breast cancer (MBC). Eribulin is active and tolerable in pretreated MBC. To assess whether eribulin may offer a more tolerable yet effective combination partner for bevacizumab, we evaluated a bevacizumab/eribulin combination regimen as first-line therapy for MBC.

Immediate Breast Reconstruction after Mastectomy with Polyurethane Implants versus Textured Implants: A Retrospective Study with Focus on Capsular Contracture

 

Immediate Breast Reconstruction after Mastectomy with Polyurethane Implants versus Textured Implants: A Retrospective Study with Focus on Capsular Contracture

 

by Andrea Loreti, Giacomo Siri, Matteo De Carli, Benedetta Fanelli, Floriana Arelli, Diana Spallone, Ornella Abate, Massimo La Pinta, Elena Manna, Emanuele Zarba Meli, Leopoldo Costarelli, Damiana Andrulli, Laura Broglia, Paola Scavina, Lucio Fortunato

 

The Breast: VOLUME 54, P127-132, DECEMBER 01, 2020

 

Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants.

Circulating tumour DNA analysis to direct therapy in advanced breast cancer (plasmaMATCH): a multicentre, multicohort, phase 2a, platform trial

 Circulating tumour DNA analysis to direct therapy in advanced breast cancer (plasmaMATCH): a multicentre, multicohort, phase 2a, platform trial

by Nicholas C Turner, Belinda Kingston, Lucy S Kilburn, Sarah Kernaghan, Andrew M Wardley, Iain R Macpherson, Richard D Baird, Rebecca Roylance, Peter Stephens, Olga Oikonomidou, Jeremy P Braybrooke, Mark Tuthill, Jacinta Abraham, Matthew C Winter, Hannah Bye, Michael Hubank, Heidrun Gevensleben, Ros Cutts, Claire Snowdon, Daniel Rea, David Cameron, Abeer Shaaban, Katrina Randle, Sue Martin, Katie Wilkinson, Laura Moretti, Judith M Bliss, Alistair Ring

 

The Lancet Oncology:  VOLUME 21, ISSUE 10, P1296-1308, OCTOBER 01, 2020

ctDNA testing offers accurate, rapid genotyping that enables the selection of mutation-directed therapies for patients with breast cancer, with sufficient clinical validity for adoption into routine clinical practice. Our results demonstrate clinically relevant activity of targeted therapies against rare HER2 and AKT1 mutations, confirming these mutations could be targetable for breast cancer treatment...

Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): a randomised, double-blind, placebo-controlled, phase 3 trial

 Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): a randomised, double-blind, placebo-controlled, phase 3 trial

by Véronique Diéras, Hyo S Han, Bella Kaufman, Hans Wildiers, Michael Friedlander, Jean-Pierre Ayoub, Shannon L Puhalla, Igor Bondarenko, Mario Campone, Erik H Jakobsen, Mathilde Jalving, Cristina Oprean, Marketa Palácová, Yeon Hee Park, Yaroslav Shparyk, Eduardo Yañez, Nikhil Khandelwal, Madan G Kundu, Matthew Dudley, Christine K Ratajczak, David Maag, Banu K Arun

 

The Lancet Oncology: ARTICLES| VOLUME 21, ISSUE 10, P1269-1282, OCTOBER 01, 2020

 

The addition of veliparib to a highly active platinum doublet, with continuation as monotherapy if the doublet were discontinued, resulted in significant and durable improvement in progression-free survival in patients with germline BRCA mutation-associated advanced breast cancer. These data indicate the utility of combining platinum and PARP inhibitors in this patient population.

Efficiency in DIEP Flap Breast Reconstruction: The Real Benefit of Computed Tomographic Angiography Imaging

 Efficiency in DIEP Flap Breast Reconstruction: The Real Benefit of Computed Tomographic Angiography Imaging

 by Haddock, Nicholas T.; Dumestre, Danielle O.; Teotia, Sumeet S. 

Plastic and Reconstructive Surgery: October 2020 - Volume 146 - Issue 4 - p 719-723

Background: In deep inferior epigastric perforator (DIEP) flap breast reconstruction, many surgeons use preoperative imaging for perforator mapping as a method to plan the operation, reduce operative times, and potentially limit morbidity. This study compared operative times for specific portions of DIEP flap harvest with and without preoperative computed tomographic angiography imaging.

Methods: Two patient groups undergoing DIEP flap breast reconstruction were studied prospectively. In the experimental group, the harvesting surgeon was blinded to the preoperative computed tomographic angiography scan; in the control group, the harvesting surgeon assessed the scan preoperatively. Times for initial perforator identification, perforator selection, flap harvest time, and total procedure times were compared. Perforator choice was evaluated. Correlation of perforator choice preoperatively and intraoperatively was also performed.

Results: Times were recorded in 60 DIEP flaps (27 blinded and 33 unblinded). The nonblinded group was more efficient in all categories: time to first perforator identification (28.6 minutes versus 17.8 minutes; p < 0.0001), time to perforator decision-making (23.1 minutes versus 5.6 minutes; p < 0.0001), time to flap harvest (128 minutes versus 80 minutes; p < 0.0001), and total operative time (417 minutes versus 353 minutes; p < 0.001). Perforator location was not different between groups. Blinded intraoperative decisions correlated with preoperative imaging in 74 percent of flaps. More perforators were included in the blinded flaps compared to the nonblinded flaps (2.3 versus 1.4; p < 0.001).

Conclusions: Use of preoperative computed tomographic angiography leads to decreased operative times, specifically with regard to perforator identification and perforator selection. Without preoperative computed tomographic angiography, surgeons included more perforators in the flaps. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.