Extended therapy with letrozole as adjuvant treatment of postmenopausal patients with early-stage breast cancer: a multicentre, open-label, randomised, phase 3 trial

 

The Lancet Oncology: VOLUME 22, ISSUE 10, P1458-1467, OCTOBER 01, 2021

 

Background

The benefit of extending aromatase inhibitor therapy beyond 5 years in the context of previous aromatase inhibitors remains controversial. We aimed to compare extended therapy with letrozole for 5 years versus the standard duration of 2–3 years of letrozole in postmenopausal patients with breast cancer who have already received 2–3 years of tamoxifen.

Methods

This multicentre, open-label, randomised, phase 3 trial was done at 69 hospitals in Italy. Women were eligible if they were postmenopausal at the time of study entry, had stage I–III histologically proven and operable invasive hormone receptor-positive breast cancer, had received adjuvant tamoxifen therapy for at least 2 years but no longer than 3 years and 3 months, had no signs of disease recurrence, and had an Eastern Cooperative Oncology Group performance status of 2 or lower. Patients were randomly assigned (1:1) to receive 2–3 years (control group) or 5 years (extended group) of letrozole (2·5 mg orally once a day). Randomisation, with stratification by centre, with permuted blocks of size 12, was done with a centralised, interactive, internet-based system that randomly generated the treatment allocation. Participants and investigators were not masked to treatment assignment. The primary endpoint was invasive disease-free survival in the intention-to-treat population. Safety analysis was done for patients who received at least 1 month of study treatment. This trial was registered with EudraCT, 2005-001212-44, and ClinicalTrials.gov, NCT01064635.

Findings

Between Aug 1, 2005, and Oct 24, 2010, 2056 patients were enrolled and randomly assigned to receive letrozole for 2–3 years (n=1030; control group) or for 5 years (n=1026; extended group). After a median follow-up of 11·7 years (IQR 9·5–13·1), disease-free survival events occurred in 262 (25·4%) of 1030 patients in the control group and 212 (20·7%) of 1026 in the extended group. 12-year disease-free survival was 62% (95% CI 57–66) in the control group and 67% (62–71) in the extended group (hazard ratio 0·78, 95% CI 0·65–0·93; p=0·0064). The most common grade 3 and 4 adverse events were arthralgia (22 [2·2%] of 983 patients in the control group vs 29 [3·0%] of 977 in the extended group) and myalgia (seven [0·7%] vs nine [0·9%]). There were three (0·3%) serious treatment-related adverse events in the control group and eight (0·8%) in the extended group. No deaths related to toxic effects were observed.

Interpretation

In postmenopausal patients with breast cancer who received 2–3 years of tamoxifen, extended treatment with 5 years of letrozole resulted in a significant improvement in disease-free survival compared with the standard 2–3 years of letrozole. Sequential endocrine therapy with tamoxifen for 2–3 years followed by letrozole for 5 years should be considered as one of the optimal standard endocrine treatments for postmenopausal patients with hormone receptor-positive breast cancer.

 

Chemotherapy de-escalation using an 18F-FDG-PET-based pathological response-adapted strategy in patients with HER2-positive early breast cancer (PHERGain): a multicentre, randomised, open-label, non-comparative, phase 2 trial

 

Chemotherapy de-escalation using an 18F-FDG-PET-based pathological response-adapted strategy in patients with HER2-positive early breast cancer (PHERGain): a multicentre, randomised, open-label, non-comparative, phase 2 trial

 

by José Manuel Pérez-García, Geraldine Gebhart, Manuel Ruiz Borrego, Agostina Stradella, Begoña Bermejo, Peter Schmid, Frederik Marmé, Santiago Escrivá-de-Romani, Lourdes Calvo, Nuria Ribelles, Noelia Martinez, Cinta Albacar, Aleix Prat, Florence Dalenc, Khaldoun Kerrou, Marco Colleoni, Noemia Afonso, Serena Di Cosimo, Miguel Sampayo-Cordero, Andrea Malfettone, Javier Cortés, Antonio Llombart-Cussac, PHERGain steering committee and trial investigators 

 

The Lancet Oncology: VOLUME 22, ISSUE 6, P858-871, JUNE 01, 2021

 

18F-FDG-PET identified patients with HER2-positive, early-stage breast cancer who were likely to benefit from chemotherapy-free dual HER2 blockade with trastuzumab and pertuzumab, and a reduced impact on global health status. Depending on the forthcoming results for the 3-year invasive disease-free survival endpoint, this strategy might be a valid approach to select patients not requiring chemotherapy.

CDK 4/6 inhibitors mired in uncertainty in HR positive and HER2 negative early breast cancer

 

CDK 4/6 inhibitors mired in uncertainty in HR positive and HER2 negative early breast cancer

The Breast:  VOLUME  55, P75-78, FEBRUARY 01, 2021

by Serena Di Cosimo, Luca Porcu, Fatima Cardoso 

Highlights

•HR+/HER2-early BC patients have continuous risk of relapse and need new therapies

•Current short follow-up precludes any final conclusion re. adjuvant CDK4/6 inhibitors

•The proportional hazard assumption was hampered by the low number of events

•Wide point estimate 95%CI translated into imprecise number needed to treat (NNT)

•Besides efficacy, toxicity, compliance and cost are issues to consider in decision-making

•Research efforts need to continue to establish CDK4/6 inhibitor predictive biomarkers

Abstract

Cell-cycle abnormalities are common in estrogen receptor- and/or progesterone receptor-positive, and HER2-non-overexpressing (HR+/HER2-) breast cancer, and have long been considered potential therapeutic targets. Cyclin-dependent kinase (CDK) 4/6 inhibitors have dramatically changed the therapeutic management of HR+/HER2-advanced breast cancer by prolonging progression-free and overall survival when given in combination with endocrine therapy. In this article, available data from PALLAS and monarchE trials regarding the efficacy and toxicity of adjuvant combined therapy with CDK 4/6 inhibitors and endocine therapy in HR+/HER2-early breast cancer are reviewed, and relevant issues including study hypothesis, patient selection, and duration of follow-up are discussed.

Long-term outcome and prognostic value of Ki67 after perioperative endocrine therapy in postmenopausal women with hormone-sensitive early breast cancer (POETIC): an open-label, multicentre, parallel-group, randomised, phase 3 trial

 

 Long-term outcome and prognostic value of Ki67 after perioperative endocrine therapy in postmenopausal women with hormone-sensitive early breast cancer (POETIC): an open-label, multicentre, parallel-group, randomised, phase 3 trial

by Ian Smith, John Robertson, Lucy Kilburn, Maggie Wilcox, Abigail Evans, Chris Holcombe, Kieran Horgan, Cliona Kirwan, Elizabeth Mallon, Mark Sibbering, Anthony Skene, Raghavan Vidya, Maggie Cheang, Jane Banerji, James Morden, Kally Sidhu, Andrew Dodson, Judith M Bliss, Mitch Dowsett

The Lancet Oncology: ARTICLES| VOLUME 21, ISSUE 11, P1443-1454, NOVEMBER 01, 2020

Background

Preoperative and perioperative aromatase inhibitor (POAI) therapy has the potential to improve outcomes in women with operable oestrogen receptor-positive primary breast cancer. It has also been suggested that tumour Ki67 values after 2 weeks (Ki672W) of POAI predicts individual patient outcome better than baseline Ki67 (Ki67B). The POETIC trial aimed to test these two hypotheses.

Methods

POETIC was an open-label, multicentre, parallel-group, randomised, phase 3 trial (done in 130 UK hospitals) in which postmenopausal women aged at least 50 years with WHO performance status 0–1 and hormone receptor-positive, operable breast cancer were randomly assigned (2:1) to POAI (letrozole 2·5 mg per day orally or anastrozole 1 mg per day orally) for 14 days before and following surgery or no POAI (control). Adjuvant treatment was given as per UK standard local practice. Randomisation was done centrally by computer-generated permuted block method (variable block size of six or nine) and was stratified by hospital. Treatment allocation was not masked. The primary endpoint was time to recurrence. A key second objective explored association between Ki67 (dichotomised at 10%) and disease outcomes. The primary analysis for clinical endpoints was by modified intention to treat (excluding patients who withdrew consent). For Ki67 biomarker association and endpoint analysis, the evaluable population included all randomly assigned patients who had paired Ki67 values available. This study is registered with ClinicalTrials.gov, NCT02338310; the European Clinical Trials database, EudraCT2007-003877-21; and the ISRCTN registry, ISRCTN63882543. Recruitment is complete and long-term follow-up is ongoing.

Findings

Between Oct 13, 2008, and April 16, 2014, 4480 women were recruited and randomly assigned to POAI (n=2976) or control (n=1504). On Feb 6, 2018, median follow-up was 62·9 months (IQR 58·1–74·1). 434 (10%) of 4480 women had a breast cancer recurrence (280 [9%] POAI; 154 [10%] control), hazard ratio 0·92 (95% CI 0·75–1·12); p=0·40 with the proportion free from breast cancer recurrence at 5 years of 91·0% (95% CI 89·9–92·0) for patients in the POAI group and 90·4% (88·7–91·9) in the control group. Within the POAI-treated HER2-negative subpopulation, 5-year recurrence risk in women with low Ki67B and Ki672W (low–low) was 4·3% (95% CI 2·9–6·3), 8·4% (6·8–10·5) with high Ki67B and low Ki672W (high–low) and 21·5% (17·1–27·0) with high Ki67B and Ki672W (high–high). Within the POAI-treated HER2-positive subpopulation, 5-year recurrence risk in the low–low group was 10·1% (95% CI 3·2–31·3), 7·7% (3·4–17·5) in the high–low group, and 15·7% (10·1–24·4) in the high–high group. The most commonly reported grade 3 adverse events were hot flushes (20 [1%] of 2801 patients in the POAI group vs six [<1%] of 1400 in the control group) and musculoskeletal pain (29 [1%] vs 13 [1%]). No treatment-related deaths were reported.

Interpretation

POAI has not been shown to improve treatment outcome, but can be used without detriment to help select appropriate adjuvant therapy based on tumour Ki67. Most patients with low Ki67B or low POAI-induced Ki672W do well with adjuvant standard endocrine therapy (giving consideration to clinical–pathological factors), whereas those whose POAI-induced Ki672W remains high might benefit from further adjuvant treatment or trials of new therapies.

Funding

Cancer Research UK.

Changes in weight, physical and psychosocial patient-reported outcomes among obese women receiving treatment for early-stage breast cancer: A nationwide clinical study

Changes in weight, physical and psychosocial patient-reported outcomes among obese women receiving treatment for early-stage breast cancer: A nationwide clinical study

by Antonio Di Meglio, Stefan Michiels, Lee W. Jones, Mayssam El-Mouhebb, Arlindo R. Ferreira, Elise Martin, Margarida Matias, Ana Elisa Lohmann, Florence Joly, Laurence Vanlemmens, Sibille Everhard, Anne-Laure Martin, Jerome Lemonnier, Patrick Arveux, Paul H. Cottu, Charles Coutant, Lucia Del Mastro, Ann H. Partridge, Fabrice André, Jennifer A. Ligibel, Ines Vaz-Luis

The Breast: VOLUME 52, P23-32, AUGUST 01, 2020

Background

Evidence on how weight loss correlates to health-related quality-of-life (HRQOL) among obese breast cancer (BC) patients is limited. We aimed to evaluate associations between weight changes and HRQOL.

Methods

We included 993 obese women with stage I-II-III BC from CANTO, a multicenter, prospective cohort collecting longitudinal, objectively-assessed anthropometric measures and HRQOL data (NCT01993498). Associations between weight changes (±5% between diagnosis and post-treatment [shortly after completion of surgery, adjuvant chemo- or radiation-therapy]) and patient-reported HRQOL (EORTC QLQ-C30/B23) were comprehensively evaluated. Changes in HRQOL and odds of severely impaired HRQOL were assessed using multivariable generalized estimating equations and logistic regression, respectively.

Results

14.1% women gained weight, 67.3% remained stable and 18.6% lost weight. Significant decreases in functional status and exacerbation of symptoms were observed overall post-treatment. Compared to gaining weight or remaining stable, obese women who lost weight experienced less of a decline in HRQOL, reporting better physical function (mean change [95%CI] for gain, stability and loss: −12.9 [-16.5,-9.3], −6.9 [-8.2,-5.5] and −6.2 [-8.7,-3.7]; pinteraction[weight-change-by-time] = 0.006), less dyspnea (+18.9 [+12.3,+25.6], +9.2 [+6.5,+11.9] and +3.2 [-1.0,+7.3]; pinteraction = 0.0003), and fewer breast symptoms (+22.1 [+16.8,+27.3], +18.0 [+15.7,+20.3] and +13.4 [+9.0,+17.2]; pinteraction = 0.044). Weight loss was also significantly associated with reduced odds of severe pain compared with weight gain (OR [95%CI] = 0.51 [0.31–0.86], p = 0.011) or stability (OR [95%CI] = 0.62 [0.41–0.95], p = 0.029). No associations between weight loss and worsening of other physical or psychosocial parameters were found.

Conclusions

This large contemporary study suggests that weight loss among obese BC patients during early survivorship was associated with better patient-reported outcomes, without evidence of worsened functionality or symptomatology in any domain of HRQOL.

Adjuvant denosumab in early breast cancer (D-CARE): an international, multicentre, randomised, controlled, phase 3 trial

Adjuvant denosumab in early breast cancer (D-CARE): an international, multicentre, randomised, controlled, phase 3 trial

by Robert Coleman, Dianne M Finkelstein, Carlos Barrios, Miguel Martin, Hiroji Iwata, Roberto Hegg, John Glaspy, Alvaro Montaño Periañez, Katia Tonkin, Ines Deleu, Joohyuk Sohn, John Crown, Suzette Delaloge, Tian Dai, Ying Zhou, Danielle Jandial, Arlene Chan

The Lancet Oncology ARTICLES| VOLUME 21, ISSUE 1, P60-72, JANUARY 01, 2020

Background

Denosumab is a fully human monoclonal antibody that binds to, and inhibits, the receptor activator of RANKL (TNFSF11) and might affect breast cancer biology, as shown by preclinical evidence. We aimed to assess whether denosumab combined with standard-of-care adjuvant or neoadjuvant systemic therapy and locoregional treatments would increase bone metastasis-free survival in women with breast cancer.

Method

In this international, double-blind, randomised, placebo-controlled, phase 3 study (D-CARE), patients were recruited from 389 centres in 39 countries. We enrolled women (aged ≥ 18 years) with histologically confirmed stage II or III breast cancer and an Eastern Cooperative Oncology Group performance status of 0 or 1. On eligibility confirmation, investigators at each site telephoned an interactive voice response system to centrally randomly assign patients (1:1) based on a fixed stratified permuted block randomisation list (block size 4) to receive either denosumab (120 mg) or matching placebo subcutaneously every 3–4 weeks, starting with neoadjuvant or adjuvant chemotherapy, for about 6 months and then every 12 weeks for a total duration of 5 years. Stratification factors were breast cancer therapy, lymph node status, hormone receptor and HER2 status, age, and geographical region. The primary endpoint was the composite endpoint of bone metastasis-free survival. This trial is registered with ClinicalTrials.gov, NCT01077154.

Findings

Between June 2, 2010, and Aug 24, 2012, 4509 women were randomly assigned to receive denosumab (n=2256) or placebo (n=2253) and included in the intention-to-treat analysis. The primary analysis of the study was done when all patients had the opportunity to complete 5 years of follow-up with an analysis data cutoff date of Aug 31, 2017. The primary endpoint of bone metastasis-free survival was not significantly different between the groups (median not reached in either group; hazard ratio 0·97, 95% CI 0·82–1·14; p=0·70). The most common grade 3 or worse treatment-emergent adverse events, reported in patients who had at least one dose of the investigational product (2241 patients with denosumab vs 2218 patients with placebo), were neutropenia (340 [15%] vs 328 [15%]), febrile neutropenia (112 [5%] vs 142 [6%]), and leucopenia (62 [3%] vs 61 [3%]). Positively adjudicated osteonecrosis of the jaw occurred in 122 (5%) of 2241 patients treated with denosumab versus four (<1 152="" 2218="" 82="" acute="" and="" consciousness.="" deaths="" depressed="" due="" group="" hypocalcaemia="" in="" leukaemia="" level="" myeloid="" o:p="" occurred="" of="" patients="" placebo="" the="" to="" treated="" treatment-emergent="" treatment-related="" two="" versus="" with="">

Interpretation

Despite preclinical evidence suggesting RANKL inhibition might delay bone metastasis or disease recurrence in patients with early-stage breast cancer, in this study, denosumab did not improve disease-related outcomes for women with high-risk early breast cancer.

Funding

Amgen.

[News] Promising radiotherapy classifier for early breast cancer

[News] Promising radiotherapy classifier for early breast cancer

by Manjulika Das 

The Lancet Oncology: NEWS| VOLUME 20, ISSUE 12, PE665, DECEMBER 01, 2019

A gene expression-based Adjuvant Radiotherapy Intensification Classifier (ARTIC) could differentiate between patients with early breast cancer who would benefit from whole-breast radiotherapy following breast-conserving surgery and those with a higher risk of locoregional recurrence who need more intensive treatment, according to a recent study.

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

The Breast: August 2019 Volume 46, Pages 4–11

by K.M. de Ligt, M. Heins, J. Verloop, C.H. Smorenburg, J.C. Korevaar, S. Siesling 

A clear picture of treatment-related health problems following breast cancer treatment is useful in anticipating the informational and other needs of patients during follow-up. This study aimed to identify treatment-related health problems in breast cancer patients up to five years after diagnosis. Secondly, the use of care associated with these health problems was identified.

Trends in axillary lymph node dissection for early-stage breast cancer in Europe: Impact of evidence on practice

Trends in axillary lymph node dissection for early-stage breast cancer in Europe: Impact of evidence on practice

by Carlos A. Garcia-Etienne, Robert E. Mansel, Mariano Tomatis, Joerg Heil, Laura Biganzoli, Alberta Ferrari, Lorenza Marotti, Adele Sgarella, Antonio Ponti, EUSOMA Working Group  

The Breast: June 2019, Volume 45, Pages 89-96

Data from recently published trials have provided practice-changing recommendations for the surgical approach to the axilla in breast cancer. Patients with T1-2 lesions, treated with breast conservation, who have not received neoadjuvant chemotherapy and have 1–2 positive sentinel nodes (Z0011-criteria) may avoid axillary lymph node dissection (ALND). We aim to describe the dissemination of this practice in Europe over an extended period of time.

Use of letrozole after aromatase inhibitor-based therapy in postmenopausal breast cancer (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled, phase 3 trial

[Articles] Use of letrozole after aromatase inhibitor-based therapy in postmenopausal breast cancer (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled, phase 3 trial

by Eleftherios P Mamounas, Hanna Bandos, Barry C Lembersky, Jong-Hyeon Jeong, Charles E Geyer, Priya Rastogi, Louis Fehrenbacher, Mark L Graham, Stephen K Chia, Adam M Brufsky, Janice M Walshe, Gamini S Soori, Shaker R Dakhil, Thomas E Seay, James L Wade, Edward C McCarron, Soonmyung Paik, Sandra M Swain, D Lawrence Wickerham, Norman Wolmark

The Lancet Oncology: Volume 20, issue 1, P88-99, January 01, 2019

After 5 years of aromatase inhibitor-based therapy, 5 years of letrozole therapy did not significantly prolong disease-free survival compared with placebo. Careful assessment of potential risks and benefits is required before recommending extended letrozole therapy to patients with early-stage breast cancer.

Efficacy of scalp cooling in reducing alopecia in early breast cancer patients receiving contemporary chemotherapy regimens

Efficacy of scalp cooling in reducing alopecia in early breast cancer patients receiving contemporary chemotherapy regimens

by Arlene Chan, Astrid Bauwens, Sally Pontre, Sally Jackson, Frances McGlone, Tracie Ernenwein, Jun Chih, Christopher Reid  

The Breast: October 2018 Volume 41, Pages 127–132

Hair loss as a result of chemotherapy for early breast cancer (EBC) is a frequent and distressing side effect. Minimising hair loss may improve mood and body image. Our aim was to determine scalp cooling (SC) efficacy in EBC patients receiving contemporary chemotherapy regimen, to inform future patients choice to use SC or not.

Prolactin Induced Protein (PIP) is a potential biomarker for early stage and malignant breast cancer

Prolactin Induced Protein (PIP) is a potential biomarker for early stage and malignant breast cancer

 by Anju Gangadharan, Themba Nyirenda, Kishan Patel, Nydia Jaimes-Delgadillo, Dominique Coletta, Takemi Tanaka, Ayal C. Walland, Zena Jameel, Srinivasa Vedantam, Sittinon Tang, Ciaran Mannion, Grace Y. Lee, Andre Goy, Andrew Pecora, K. Stephen Suh  

The Breast June 2018 Volume 39, Pages 101–109

Breast cancer (BC) is the second leading cause of cancer-related mortality in women. Bioinformatic analysis and expression screening showed that Prolactin Induced Protein (PIP) was differentially expressed in BC. The objective of this investigation was to characterize the expression pattern of PIP, an aspartyl proteinase, in malignant and non-malignant breast tissues.

The Cost of Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer

The Cost of Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer

by Billig, Jessica I.; Duncan, Anthony; Zhong, Lin; Aliu, Oluseyi; Sears, Erika D.; Chung, Kevin C.; Momoh, Adeyiza O.  

Plastic and Reconstructive Surgery: May 2018 - Volume 141 - Issue 5 - p 1094–1102

Background: Contralateral prophylactic mastectomy may be unnecessary from an oncologic perspective; therefore, the debate persists about the value of contralateral prophylactic mastectomy in women with early-stage unilateral breast cancer. Given finite health care resources, this study aims to evaluate the cost of contralateral prophylactic mastectomy and breast reconstruction. Methods: Women with unilateral breast cancer undergoing either unilateral mastectomy or unilateral mastectomy with contralateral prophylactic mastectomy and immediate breast reconstruction were selected from the Truven MarketScan databases between 2009 and 2013. Demographic and treatment data were recorded, and over an 18-month follow-up period, the treatment cost was tallied. A log-transformed linear model was used to compare cost between the groups. Results: A total of 2343 women were identified who met our inclusion criteria, with 1295 undergoing unilateral mastectomy and 1048 undergoing contralateral prophylactic mastectomy. Complication rates within 18 months were similar for women undergoing unilateral mastectomy and contralateral prophylactic mastectomy (39 percent versus 42 percent; p = 0.17). Management with unilateral mastectomy with reconstruction required an adjusted cumulative mean cost of $33,557. Contralateral prophylactic mastectomy with reconstruction was an additional $11,872 in expenditure (p < 0.001). The cost of initial procedures (mean difference, $6467) and secondary procedures (mean difference, $2455) were the greatest contributors to cost. Conclusions: In women with unilateral breast cancer, contralateral prophylactic mastectomy with reconstruction is more costly. The increased monetary cost of contralateral prophylactic mastectomy may be offset by improved quality of life. However, this financial reality is an important consideration when ongoing efforts toward reimbursement reform may not pay for contralateral prophylactic mastectomy if outcomes data are not presented to justify this procedure.

Neoadjuvant chemotherapy for early breast cancer

Title: Neoadjuvant chemotherapy for early breast cancer

Author: Petros Charalampoudis and Andreas Karakatsanis

Publication: The Lancet (Oncology)  

Volume 19, No. 3, e128, March 2018

Abstract: 

The pivotal meta-analysis1 by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) provides high-quality data on the concept of risk-adapted breast-conserving therapy. The investigators showed equivalent survival in patients treated with the same chemotherapy before or after surgery, with a significantly higher frequency of local recurrence in patients receiving neoadjuvant chemotherapy (NACT) compared with the adjuvant group. This difference in local recurrence was not accompanied by a decrease in survival.

(See also the associated correspondence on the right hand menu)

Regional Nodal Irradiation in Early-Stage Breast Cancer

N Engl J Med 2015; 373:317-327 July 23, 2015

BACKGROUND

Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes.

Radiofrequency ablation of early breast cancer followed by delayed surgical resection

Radiofrequency ablation of early breast cancer followed by delayed surgical resection: A promising alternative to breast-conserving surgery. The Breast, Oct 2011, Vol. 20(5), p.431-436

Ohtani, S., et al.

To examine the radiofrequency ablation (RFA) reliability in early breast cancer, we performed RFA followed by delayed surgical resection on 41 patients with invasive or non-invasive breast carcinoma less than 2 cm. MRI scans were obtained before ablation and resection. Excised specimens were examined pathologically by haematoxylin-eosin and nicotinamide adenine dinucleotide-diaphorase staining. 40 patients completed 1 RFA session, which was sufficient to achieve complete tumour cell death. Overall complete ablation rate was 87.8% (36/41). There were no treatment-related complications other than that of a superficial burn in 1 case. After RFA, the tumour was no longer enhanced on MRI in 25/26 (96.2%) cases. Residual cancer, which was suspected on MRI in 1 case, was confirmed pathologically. MRI could be an applicable modality to evaluate therapeutic effect. RFA could be an alternate local treatment option to breast-conserving surgery for early breast cancer.

Breast Journal Vol 17 Iss 1 Jan - Feb 2011

Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision.
Gill J et al.
p3-8
Abstract only

Improvement in dcis detection rates by mri over time in a high-risk breast screening study.
Warner E et al.
p9-17
Abstract only

Breast reconstruction in women under 30: a 10-year experience.
Ellsworth WA et al.
p18-23
Abstract only

Outcome of small invasive breast cancer with no axillary lymph node involvement.
Sánchez-Muñoz A et al.
p32-8
Abstract only

The prognosis of tumors with only microscopic skin involvement without clinical t4b signs is significantly better than t4b tumors in breast carcinoma.
Duraker N et al.
p47-55
Abstract only

Sentinel lymph node biopsy after neo-adjuvant chemotherapy in breast cancer.
Stell VH et al
p71-4
Abstract only

Age <40> is an independent prognostic factor predicting inferior overall survival in patients treated with breast conservative therapy
Kim K et al.
p75-8
Abstract only


N.B. Articles for which there is no abstract are not included here.