The Breast : official journal of the European Society of Mastology
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Three recently published prospective trials on regional nodal irradiation (RNI) in early breast cancer showed a reduction on breast cancer mortality, any first breast recurrence and/or distant recurrence rate. The positive outcomes of the modern trials reflect the development in radiotherapy by being more precise nowadays in radiation dose delivery to the lymph nodes, while reducing the radiation dose to heart and lungs. The possibility of axillary radiotherapy (ART) to replace axillary node dissection (ALND) after positive sentinel node (SLNB) biopsy is explored in a few trials. ⋯ These equal results were seen despite that in 27.4% of the patients had additional positive nodes removed beyond SLN in the patients who received axillary dissection (ALND). The IBCSG 23-01 phase III trial showed that there is no need for extra treatment of the axilla after micro-metastases in SLNB, however in this trial nearly all patients received breast irradiation including part of the axilla, often combined with adjuvant therapy. The introduction of neo- adjuvant systemic treatment (NACT) may lead to less RNI in early breast cancer, especially as NACT leads to pCR in axillary lymph nodes in about one third of the patient.
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Fatigue or tiredness is one of the most commonly reported symptoms in breast cancer patients treated with radiation therapy (RT). This study aimed to identify characteristics associated with fatigue in breast cancer patients receiving adjuvant RT. ⋯ Fatigue is associated with higher disease stage and receipt of locoregional radiation. While the relationship between anxiety or depressive symptoms and fatigue is well-established, a major gap exists in our understanding of its etiology and treatment; further investigation to address this can better improve patient quality of life.
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The aim of this retrospective study is to compare surgical margins, reoperation rates and local recurrences after breast conserving surgery (BCS) using radioguided occult lesion localization (ROLL) or radioactive seed localization (RSL). ⋯ Reoperation rates and LRFS were comparable for ROLL and RSL in patients with impalpable breast cancer treated with BCS.
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Observational Study
Changes in mammographic density over time and the risk of breast cancer: An observational cohort study.
The effect of changes in mammographic density over time on the risk of breast cancer remains inconclusive. ⋯ Although a modest proportion of women changed BI-RADS density category, mammographic density changes modulated the risk of breast cancer and identified women at a differential risk. Using two longitudinal measures of BI-RADS density could help target women for risk-based screening strategies.
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We aimed to validate the clinical significance of locoregional surgery in improving the prognosis of primary metastatic breast cancer (pMBC). ⋯ The effect of locoregional surgery has been underestimated in pMBC patients. Surgical procedures should be seriously considered when planning combination treatments for pMBC patients with a single metastasis except for brain metastasis.