Another review on triple negative breast cancer

Another review on triple negative breast cancer: Are we on the right way towards the exit from the labyrinth?
The breast, Dec 2013, Vol. 22(6), p.1026-33.

Chiorean, R., et al.

http://www.thebreastonline.com/article/S0960-9776(13)00241-5/abstract?rss=yes

Triple negative breast cancer is a heterogeneous group of tumors, lacking the expression of estrogen, progesterone and HER-2 receptors. As frequency, it accounts about 15–20% of all breast cancers. Although in the last years there was a “boom” in publishing over this issue, multiple molecular classifications being elaborated, “the triple negative breast cancer odyssey ” is still far away from ending, as the complicated molecular pathways of pathogenesis and drug resistance mechanisms remain yet insufficiently explored.

Comparing five alternative methods of breast reconstruction

Comparing five different methods of breast reconstruction surgery: A cost-effectiveness analysis. Plastic and reconstructive surgery, Nov 2013, Vol. 132(5), p.709e-723e.

Grover, R., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/11000/Comparing_Five_Alternative_Methods_of_Breast.3.aspx

The purpose of this study was to assess the cost-effectiveness of five standardized procedures for breast reconstruction to delineate the best reconstructive approach in postmastectomy patients in the settings of nonirradiated and irradiated chest walls.

Buried flap reconstruction after nipple-sparing mastectomy

Buried flap reconstruction after nipple-sparing mastectomy: Advancing toward single-stage breast reconstruction. Plastic and reconstructive surgery, Oct 2013, Vol. 132(4), p.4893-497e.

Levine, S.M., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/10000/Buried_Flap_Reconstruction_after_Nipple_Sparing.3.aspx

Recent evolutions of oncologic breast surgery and reconstruction now allow surgeons to offer the appropriate patients a single-stage, autologous tissue reconstruction with the least donor-site morbidity. The authors present their series of buried free flaps in nipple-sparing mastectomies as proof of concept, and to explore indications, techniques, and early outcomes from their series.

Trends in incidence of breast cancer among women under 40 in seven European countries

Trends in incidence of breast cancer among women under 40 in seven European countries: A GRELL co-operative study. Cancer epidemiology, Oct 2013, Vol. 37(5), p.544-49.

Leclere, B., et al.

http://www.cancerepidemiology.net/article/S1877-7821(13)00077-5/abstract

Young women are not usually screened for breast cancer (BC). The trends in incidence in this population may better reflect changes in risk factors. However, studies on this subject are scarce and heterogeneous. The aim of this study was to describe the trends in incidence of BC in women under 40 from 1990 to 2008, using pooled European data. 

The benefits and harms of breast cancer screening

The benefits and harms of breast cancer screening: An independent review. British journal of cancer, 2013, 108 p.2205-40.

Marmot, M.G., et al.

http://www.nature.com/bjc/journal/v108/n11/full/bjc2013177a.html

The breast cancer screening programmes in the United Kingdom currently invite women aged 50–70 years for screening mammography every 3 years. Since the time the screening programmes were established, there has been debate, at times sharply polarised, over the magnitude of their benefit and harm, and the balance between them. The expected major benefit is reduction in mortality from breast cancer. The major harm is overdiagnosis and its consequences; overdiagnosis refers to the detection of cancers on screening, which would not have become clinically apparent in the woman’s lifetime in the absence of screening. Professor Sir Mike Richards, National Cancer Director, England, and Dr Harpal Kumar, Chief Executive Officer of Cancer Research UK, asked Professor Sir Michael Marmot to convene and chair an independent panel to review the evidence on benefits and harms of breast screening in the context of the UK breast screening programmes. The panel, authors of this report, reviewed the extensive literature and heard testimony from experts in the field who were the main contributors to the debate. 

The sex hormone system in carriers of BRCA1/2 mutations

The sex hormone system in carriers of BRCA 1/2 mutations: a case-control study. The lancet oncology, Nov 2013, Vol. 13(12), 1226-32.

Widschwendter, M., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70448-0/fulltext

Penetrance for breast cancer, ovarian cancer, or both in carriers of BRCA1/BRCA2 mutations is disproportionately high. Sex hormone dysregulation and altered end-organ hormone sensitivity might explain this organ-specific penetrance. We sought to identify differences in hormone regulation between carriers of BRCA1/2 and women who are negative for BRCA1/2 mutations.

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.

NICE approves new test for spread of breast cancer

NICE approves new test for spread of breast cancer.

NHS Choices, Aug 2013

http://www.nhs.uk/news/2013/08August/Pages/NICE-approves-new-test-for-spread-of-breast-cancer.aspx

Duration of trastuzumab for HER2-positive breast cancer

Duration of trastuzumab for HER2-positive breast cancer. The lancet oncology, July 2013, Vol.14(8), p.678-79.

Montemurro, F. and Aglietta, M.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70273-0/fulltext?rss=yes

Several large randomised trials completed in the mid-2000s produced overwhelming evidence that the anti-HER2 monoclonal antibody trastuzumab, administered either concomitantly or sequentially with adjuvant chemotherapy for 12 months, increases the cure rate for women with HER2-positive operable breast cancer. One surprising aspect of this success story is that the choice of 12-month treatment duration was mostly as a result of a best guess, rather than on the basis of pre-existing evidence. 

Predictors of recurrence for ductal carcinoma in situ after breast-conserving surgery

Predictors of recurrence for ductal carinoma in situ after breast-conserving surgery. The lancet oncology, Aug 2013, Vol.14(9), p. e348-e357.

Benson, J.R. and Wishart, G.C.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70135-9/abstract?rss=yes

Ductal carcinoma in situ (DCIS) constitutes a major public health problem, with up to half of screen-detected cancers representing pure forms of DCIS without evidence of invasion. A proportion of cases detected with routine screening would not have progressed to a life-threatening form of breast cancer during the patient's lifetime, and overdiagnosis of breast cancer is a cause for concern.

Combination endocrine treatments unproven in breast cancer

Combination endocrine treatments unproven in breast cancer. The lancet oncology, Sept 2013, Vol. 14(10), p.917-18.

Buzdar, A.U.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70364-4/fulltext?_eventId=login&rss=yes

Ovarian ablation, which was introduced more than 100 years ago, was the first endocrine treatment for advanced breast cancer, followed by adrenalectomy and hypophysectomy. These ablative therapies have since been replaced by antioestrogen treatments, luteinising-hormone-releasing hormone agonists, and aromatase inhibitors.Other endocrine treatments with different mechanisms of action have also become available for breast cancer: oestrogens, progestins, androgens, antiandrogens, and selective oestrogen-receptor downregulators.

Subglandular breast augmentation with textured, anatomic, cohesive silicone implants

Subglandular breast augmentation with textured, anatomic, cohesive silicone implants: A review of 440 consecutive patients. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.295-303.

Lista, F., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2013/08000/Subglandular_Breast_Augmentation_with_Textured,.11.aspx

The Allergan Style 410 implant is a textured, anatomic, highly cohesive silicone gel–filled breast implant. Despite its widespread use in both Europe and Canada, limited data exist regarding long-term outcomes. The purpose of this study was to investigate outcomes using the Style 410 implant for primary subglandular breast augmentation.

Breast reconstruction with the Bostwick Autoderm technique

Breast reconstruction with the Bostwick Autoderm technique. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.261-70.

Ladizinsky, D.A., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Breast_Reconstruction_with_the_Bostwick_Autoderm.6.aspx

In 1990, Bostwick presented a technique wherein excess skin in the ptotic breast provides a deepithelialized inferiorly based dermal flap at the time of mastectomy. This adjoins the inferior border of the pectoralis major muscle, creating a complete autologous vascularized pocket, which is then covered by Wise pattern skin flaps.

Microvascular autologous breast reconstruction in the context of radiation therapy

Microvascular autologous breast reconstruction in the context of radiation therapy: Comparing two reconstructive algorithms. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), 251-57.

Patel, K., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Microvascular_Autologous_Breast_Reconstruction_in.1.aspx

When postmastectomy radiation therapy is anticipated, delaying autologous reconstruction prevents radiation delivery issues and radiation-induced contour irregularities. Delayed-immediate autologous breast reconstruction may allow for maintenance of the breast skin envelope as compared with delayed reconstruction with the temporary insertion of a tissue expander. The authors compared perioperative complications and revision surgery rates of comparative cohorts to determine which method is preferable.

The timing of preoperative prophylactic low-molecular-weight heparin administration in breast reconstruction

The timing of preoperative prophylactic low-molecular-weight heparin administration in breast reconstruction. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.279-84.

Keith, J.N., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/The_Timing_of_Preoperative_Prophylactic.8.aspx

Venous thromboembolism continues to be problematic despite increased recognition and advancements in venous thromboembolism prophylaxis. Although migration toward preoperative chemoprophylaxis increases, plastic surgeons seem reticent to adopt this practice. This study evaluates preoperative enoxaparin administration in breast reconstruction patients.

Quality-of-life outcomes between mastectomy alone and breast reconstruction

Quality-of-life outcomes between mastectomy alone and breast reconstruction: Comparison of patient- reported BREAST-Q and other health-related quality-of-life measures. Plastic and reconstructive surgery, Aug 2013, Vol. 132(2), p.201e-209e.

Eltahir, Y., et al.

http://journals.lww.com/plasreconsurg/Abstract/2013/08000/Quality_of_Life_Outcomes_between_Mastectomy_Alone.3.aspx

Published data on quality of life in women after breast reconstruction are inconsistent. This cross-sectional study evaluated the quality of life of women after successful breast reconstruction in comparison with those who underwent mastectomy alone.