Breast cancer research and treatment
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Breast Cancer Res. Treat. · Nov 2014
Use of risk-reducing surgeries in a prospective cohort of 1,499 BRCA1 and BRCA2 mutation carriers.
Inherited mutations in BRCA1 or BRCA2 (BRCA1/2) confer very high risk of breast and ovarian cancers. Genetic testing and counseling can reduce risk and death from these cancers if appropriate preventive strategies are applied, including risk-reducing salpingo-oophorectomy (RRSO) or risk-reducing mastectomy (RRM). However, some women who might benefit from these interventions do not take full advantage of them. ⋯ Childbearing influenced the use of RRSO and RRM in both BRCA1 and BRCA2. Uptake of RRSO is high, but some women are still diagnosed with ovarian cancer before undergoing RRSO. This suggests that research is needed to understand the optimal timing of RRSO to maximize risk reduction and limit potential adverse consequences of RRSO.
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Breast Cancer Res. Treat. · Aug 2014
Impact of hospital volume on breast cancer outcome: a population-based study in the Netherlands.
For low-volume tumours, high surgical hospital volume is associated with better survival. For high-volume tumours like breast cancer, this association is unclear. The aim of this study is to determine to what extent the yearly surgical hospital breast cancer volume is associated with overall survival. ⋯ Being a male, having a higher age at diagnosis, a higher tumour grade, a larger tumour size, a higher number of positive lymph nodes, an earlier year of diagnosis and a lower SES resulted in a reduced survival and influenced death, all to a larger extent than surgical volume did. In the Netherlands, surgical hospital volume influences 10-year overall survival only marginally and far less than patient and tumour characteristics. No difference in survival was revealed for invasive non-metastatic breast cancer patients in hospitals with 75-99 operations per year compared with hospitals with over 200 operations per year.
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Breast Cancer Res. Treat. · Jul 2014
Comment LetterSentinel lymph node identification rates and axillary concordance can only be accurately determined by comparing 'like with like' injected materials.
Despite the accepted status of sentinel lymph node biopsy (SLNB) as the standard for axillary staging in breast cancer patients with clinically and radiologically negative axillae pre-operatively, there is surprisingly still a lack of consensus on the most appropriate site of injection of radioactive tracer with or without blue dye. ⋯ The only way to determine the optimal injection site of radioactive tracer and blue dye for SLN identification intra-operatively and accurate concordance rates is by direct comparisons of 'like with like' when it comes to injected materials at different injection sites.
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Breast Cancer Res. Treat. · Jul 2014
Multicenter StudyPhase 2 study of eribulin mesylate as first-line therapy for locally recurrent or metastatic human epidermal growth factor receptor 2-negative breast cancer.
Eribulin mesylate, a novel non-taxane microtubule dynamics inhibitor, is approved for treatment of metastatic breast cancer (MBC) in patients who have previously received at least 2 chemotherapeutic regimens for MBC that should have included an anthracycline and a taxane in the adjuvant or metastatic setting. This phase 2 study evaluated efficacy and safety of eribulin as first-line therapy for human epidermal growth factor receptor 2-negative (HER2-negative) MBC. Patients with measurable HER2-negative locally recurrent breast cancer or MBC with ≥12 months since prior neoadjuvant or adjuvant (neo/adjuvant) chemotherapy received eribulin mesylate 1.4 mg/m(2) IV on days 1 and 8 of each 3-week cycle. ⋯ Median PFS was 6.8 months. Thirty-six patients (64 %) had grade 3/4 treatment-related adverse events; most common were neutropenia (50 %), leukopenia (21 %), and peripheral neuropathy (21 %). These results demonstrate that eribulin has substantial antitumor activity as first-line treatment for HER2-negative MBC with acceptable safety.
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Breast Cancer Res. Treat. · Jul 2014
Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers.
Women with a mutation in BRCA1 or BRCA2 face a lifetime risk of breast cancer of approximately 80 %. Tamoxifen treatment of the first cancer has been associated with a reduction in the risk of a subsequent contralateral cancer. We studied 1,504 women with a known BRCA1 or BRCA2 mutation, 411 women with bilateral breast cancer (cases) and 1,093 women with unilateral breast cancer (controls) in a matched case-control study. ⋯ Among women with 1-4 years of tamoxifen use the odds ratio was 0.53 (95 % CI 0.32-0.87; p = 0.01). Among women with four or more years of tamoxifen use the odds ratio was 0.83 (95 % CI 0.44-1.55; p = 0.55). Short-term use of tamoxifen for chemoprevention in BRCA1 and BRCA2 mutation carriers may be as effective as a conventional 5-year course of treatment.