Putative relationship between hormonal status and serum pyrrolidone carboxypeptidase activity in pre- and post- menopausal women with breast cancer

Putative relationship between hormonal status and serum pyrrolidone carboxypeptidase activity in pre- and post- menopausal women with breast cancer. The breast, Dec. 2012, Vol. 21(6), p.751-54.

del Pillar Carrera-Gonzalez, M., et al.

http://www.thebreastonline.com/article/PIIS0960977612000288/abstract?rss=yes

In breast cancer, hormonal changes are rather constant in post-menopausal women since they tend to vary only over long time spans. However, in pre-menopausal women, the development of breast cancer is associated with hormonal physiological variations.

Health care utilization one year following the diagnosis benign breast disease or breast cancer

Health care utilization one year following the diagnosis benign breast disease or breast cancer. The breast, Dec. 2012, Vol. 21(6), p.746-50.

Keyzer-Dekker, C.M.G., et al.

http://www.thebreastonline.com/article/PIIS0960977612000240/abstract?rss=yes

We analyzed health care utilization (HCU) and its predictors in the first year after the diagnostic process for breast cancer (BC) or benign breast disease (BBD) using questionnaires. The impact of trait anxiety on HCU was examined.

Axillary lymphadenectomy for breast cancer

Axillary lymphadenectomy for breast cancer: A randomized controlled trial comparing a bipolar vessel  sealing system to the conventional technique. The breast, Dec. 2012, Vol. 21(6), 739-45.

Nespoli, L., et al.

http://www.thebreastonline.com/article/PIIS0960977612001713/abstract?rss=yes

To compare safety and efficacy of a bipolar vessel sealing system (BVSS) to the conventional technique in axillary node dissection.

CT staging for breast cancer patients with poor prognostic tumours

CT staging for breast cancer patients with poor prognostic tumours. The breast, Dec. 2012, Vol. 21(6), p.735-38.

James, J.J., et al.

http://www.thebreastonline.com/article/PIIS0960977612001695/abstract?rss=yes

The aim of this study was to assess the value of computed tomography (CT) staging of the chest, abdomen and pelvis in patients with poor prognostic tumours and no symptoms of metastatic disease in those who have undergone primary surgical management for the treatment of breast cancer.

Characteristics of HER2-positive breast cancer diagnosed following the introduction of universal HER2 testing

Characteristics of HER2-positive breast cancer diagnosed following the introduction of universal HER2 testing. The breast, Dec. 2012, Vol. 21(6), p.724-29.

Pathmanathan, N., et al.

http://www.thebreastonline.com/article/S0960-9776(12)00187-7/abstract

The aim of this study was to determine the impact of universal HER2 testing on the clinico-pathologic profile of HER2+ breast cancer. Data were extracted from breast cancer pathology reports spanning two periods: before (2003/4, n = 379), and after (2008/9, n = 560) the introduction of universal testing.

An exploratory study of sunitinib in combination with docetaxal and trastuzumab as first-line therapy for HER-2 positive metastatic breast cancer

An exploratory study of sunitinib in combination with docetaxal and trastuzumab as first-line therapy  for HER-2 positive metastatic breast cancer. The breast, Dec. 2012, Vol. 21(6), p.716-23.

Cardoso, F., et al.

http://www.thebreastonline.com/article/PIIS0960977612001889/abstract?rss=yes

This exploratory study assessed the safety, pharmacokinetics, and antitumor activity of sunitinib combined with docetaxel and trastuzumab.

Accelerated partial breast irradiation

Accelerated partial breast irradiation: The need for well-defined patient selection criteria, improved volume definitions, close follow-up and discussion of salvage treatment.  The breast, Dec. 2012, Vol. 21(6), p.707-715.

Moser, E.C. & Vrieling, C.

http://www.thebreastonline.com/article/PIIS0960977612002007/abstract?rss=yes

Breast-conserving therapy, including whole breast irradiation, has become a well-established alternative to mastectomy in early-stage breast cancer patients, with similar survival rates and better cosmetic outcome. However, many women are still treated with mastectomy, due to logistical issues related to the long course of radiotherapy (RT). To reduce mastectomy rates and/or omission of RT after breast-conserving surgery, shorter, hypofractionated RT treatments have been introduced. 

Disease burden and treatment outcomes in second-line therapy of patients with estrogen receptor-positive advanced breast cancer

Disease burden and treatment outcomes in second-line therapy of patients with estrogen receptor-positive advanced breast cancer: A review of the literature. The breast, Dec. 2012, Vol. 21(6), p.701-06.

Boswell, K.A., et al.

http://www.thebreastonline.com/article/PIIS0960977612001919/abstract?rss=yes

To determine the variable burden of disease of patients with advanced estrogen receptor-positive (ER+) breast cancer and assess the current treatment landscape after failure of first-line endocrine therapy.

Costs of different follow-up strategies in early breast cancer

Costs of different follow-up strategies in early breast cancer: A review of the literature. The breast, Dec. 2012, Vol. 21(6), p.693-700.

Van Hezewijk, M., et al.

http://www.thebreastonline.com/article/PIIS0960977612001956/abstract?rss=yes

We reviewed the literature between January 1985 and June 2011 on the costs of different follow-up strategies for patients treated for early breast cancer. A total of 186 abstracts were retrieved of which eleven publications were considered relevant; 6 randomised clinical trials, 4 retrospective cohort studies and 1 ‘minisymposium’.  The follow-up strategies, outcome measures and methods of analysis used in these studies vary widely, so no general conclusions can be drawn. However, from the results we infer that patient-led follow-up by a nurse practitioner, follow-up by a general practitioner, or telephone follow-up is feasible and cost-effective, without routine additional tests, except annual mammograms.

The advantages of free abdominal-based flaps over implants for breast reconstruction in obese patients

The advantages of free abdominal-based flaps over implants for breast reconstruction in obese patients. Plastic & reconstructive surgery, Nov. 2012, Vol. 130(5), p.991-1000.

Garvey, P.B., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2012/11000/The_Advantages_of_Free_Abdominal_Based_Flaps_over.4.aspx

The authors hypothesized that, for obese patients, delayed abdominal-based free flap (rather than implant-based and immediate) breast reconstruction would result in fewer overall complications and reconstruction losses.

Long-term outcomes following fat grafting in prosthetic breast reconstruction

Long-term outcomes following fat grafting in prosthetic breast reconstruction: A comparative analysis.  Plastic & reconstructive surgery, Nov 2012, Vol. 130(5), p.984-90.

Seth, A.K., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/11000/Long_Term_Outcomes_following_Fat_Grafting_in.3.aspx

Autologous fat grafting has become a common technique for optimizing aesthetic outcomes following breast reconstruction. Its long-term oncologic implications, however, remain unclear. The authors evaluated long-term outcomes following tissue expander breast reconstruction with and without fat grafting.

The impact of mammographic screening on breast cancer mortality in Europe

The impact of mammographic screening on breast cancer mortality in Europe: a review of observational studies. Journal of medical screening, Sept. 2012, Vol. 19 Supp.1, p.14-25.

Broeders, M., et al.

http://jms.rsmjournals.com/content/19/suppl_1/14.full.pdf+html


Valid observational designs are those where sufficient longitudinal individual data are
available, directly linking a woman’s screening history to her cause of death. From such studies, the
best ‘European’ estimate of breast cancer mortality reduction is 25–31% for women invited for
screening, and 38–48% for women actually screened. Much of the current controversy on breast
cancer screening is due to the use of inappropriate methodological approaches that are unable to capture the true effect of mammographic screening.

Breast cancer: incidence, mortality and survival

Breast cancer: incidence, mortality and survival. Office for national statistics, England, September 2012.

http://www.ons.gov.uk/ons/rel/cancer-unit/breast-cancer-in-england/2010/sum-1.html

Breast cancer is the most common cancer in women in England. In 2010, 41,259 new cases were diagnosed, an increase of 1.8 per cent (731 cases) compared to 2009. There were 126 new cases per 100,000 women in 2010, compared with 125 new cases per 100,000 women in 2009. These incidence rates have increased by 90 per cent between 1971 and 2010.

Trastuzumab emtansine for HER2-positive advanced breast cancer

Trastuzumab emtansine for HER2-positive advanced breast cancer. New england journal of medicine, October 2012.

Verma, S., et al.

http://www.nejm.org/doi/full/10.1056/NEJMoa1209124#t=articleTop

We randomly assigned patients with HER2-positive advanced breast cancer, who had previously been treated with trastuzumab and a taxane, to T-DM1 or lapatinib plus capecitabine. The primary end points were progression-free survival (as assessed by independent review), overall survival, and safety. Secondary end points included progression-free survival (investigator-assessed), the objective response rate, and the time to symptom progression. Two interim analyses of overall survival were conducted.

Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer

Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer (TA263). NICE guidance, August 2012.

http://guidance.nice.org.uk/TA263

NICE does not recommend bevacizumab in combination with capecitabine as first-line treatment for metastatic breast cancer when other chemotherapy (including drugs known as taxanes or anthracyclines) is not appropriate, or taxanes or anthracyclines have been given in the past 12 months.

lnfiltration of epinephrine in reduction mammoplasty

Infiltration of epinephrine in reduction mammoplasty: a systematic review of the literature. Plastic & reconstructive surgery, October 2012, Vol. 130(4), p.773-778.

Hardwicke, J.T., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Infiltration_of_Epinephrine_in_Reduction.7.aspx

Evidence of the benefit of dilute epinephrine infiltration before reduction mammaplasty is provided by several controlled trials. Despite variation in operative technique and data collection, a reduction in intraoperative blood loss has been shown. The aim of this review of the literature is to weigh the available evidence with respect to reducing blood loss during surgery and other outcome measures such as postoperative drainage.

Breast augmentation

Breast augmentation.  Journal of plastic & reconstructive surgery, October 2012, Vol. 130(4), p.5983-612e.

Adams, W.P. & Mallucci, P.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Breast_Augmentation.40.aspx

The process of breast augmentation includes patient education, tissue-based preoperative planning, refined surgical technique, and defined postoperative management. This CME article reviews and discusses the current relevant topics and issues surrounding breast implants.

Current status of implant-based breast reconstruction

Current status of implant-based breast reconstruction in patients receiving post-mastectomy radiation therapy. Plastic & reconstructive surgery, October 2012, Vol. 130(4), p.513e-524e.

Kronowitz, S.J.

http://journals.lww.com/plasreconsurg/Fulltext/2012/10000/Current_Status_of_Implant_Based_Breast.9.aspx

Increasing numbers of patients with breast cancer are being treated with postmastectomy radiation therapy. The author reviewed the literature to determine the clinical impact of this increasing use of postmastectomy radiation therapy in patients with breast cancer who desire implant-based breast reconstruction.

Differentiating fat necrosis from recurrent malignancy in fat-grafted breasts

Differentiating fat necrosis from recurrent malignancy in fat-grafted breasts: an imaging classification system to guide management.  Plastic & reconstructive surgery, October 2012, Vol.130(4), p.761-72.

Parikh, R.P., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Differentiating_Fat_Necrosis_from_Recurrent.6.aspx

In breast reconstruction with autologous fat grafting, concerns persist about the ability to differentiate palpable masses representing fat necrosis from recurrent cancer. The authors' objective was to develop standardized imaging classifications to distinguish benign from malignant lesions after fat grafting. 

Bad medicine: clinical breast examination

Bad medicine: clinical breast examination, October 2012, BMJ 2012; 345: e6789.

Spence, D.


http://www.bmj.com/content/345/bmj.e6789?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%25253A+bmj%25252Frecent+%252528Latest+from+BMJ%252529

To question clinical examination is to open a rich vein of debate. Clinical examinations are unquestioned, given disproportionate weight, and considered “must do.” Not doing a full examination implies you are a bad doctor. But much of examination is mere ritualistic dogma passed down through the ages.