Ecancermedicalscience
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Two large randomised controlled trials of intraoperative radiotherapy (IORT) in breast-conserving surgery (TARGIT-A and ELIOT) have been published 14 years after their launch. Neither the TARGIT-A trial nor the ELIOT trial results have changed the current clinical practice for the use of IORT. The in-breast local recurrence rate (LRR) after IORT met the pre-specified non-inferiority margins in both trials and was 3.3% in TARGIT-A and 4.4% in the ELIOT trial. ⋯ By carefully weighing the risks and benefits of a single-fraction radiation treatment with patients, IORT should be offered within agreed and strict protocols. Patients deemed at low risk of LR or those deemed suitable for partial breast irradiation, according to the GEC-ESTRO and ASTRO recommendations, could be considered as candidates for IORT. These guidelines apply to all partial breast irradiation techniques, and more specific guidelines for IORT would assist clinicians.
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Breast cancer is the most common malignancy in women, and its incidence increases with age, with the majority of patients diagnosed after menopause. However, in 15-25% of cases, patients are premenopausal at the time of diagnosis, and about 7% of them are below the age of 40. Therefore, a considerable amount of young women are diagnosed with breast cancer during their reproductive life. ⋯ This review aims to update the knowledge about the influence of breast cancer in fertility, the influence of pregnancy and fertility preservation techniques in breast cancer patients and assessment of ovarian reserve for a better treatment choice. A special section dedicated to BRCA-mutation carriers has been included because of their specific features. A comprehensive literature search has been conducted, including publications from the last five years.
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Ecancermedicalscience · Jan 2015
Highlights from the seventh European Multidisciplinary Colorectal Cancer Congress (EMCCC) 2014.
It is widely recognised that colorectal cancer has become a complex disease and involves many medical disciplines. The mission of the European Multidisciplinary Colorectal Cancer Congress (EMCCC), which is an initiative of the Dutch Colorectal Cancer Group (DCCG), is to facilitate the interaction between relevant disciplines on current issues of research. ⋯ On day two and three, a total of 35 established international opinion leaders presented lectures in plenary sessions on prevention and screening of early colorectal cancer, genetics, translational research, biomarkers, organ-saving treatment in rectal cancer, current controversies, and multidisciplinary management. Posters from submitted abstracts were displayed, with selected abstracts being orally presented.
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The global economic downturn has been associated with increased unemployment in many countries. Insights into the impact of unemployment on specific health conditions remain limited. We determined the association between unemployment and prostate cancer mortality in members of the Organisation for Economic Co-operation and Development (OECD). ⋯ Eight of the 21 OECD countries for which a time trend analysis was conducted, exhibited an estimated excess of prostate cancer deaths in at least one of 2008, 2009, or 2010, based on 2000-2007 trends. Rises in unemployment are associated with significant increases in prostate cancer mortality. Initiatives that bolster employment may help to minimise prostate cancer mortality during times of economic hardship.
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Ecancermedicalscience · Jan 2015
Past and future of prophylactic ablation of the cervical squamocolumnar junction.
HPV vaccination has the potential to prevent the vast majority of cervical cancer cases but cervical cancer screening remains the only prevention strategy in adult unvaccinated women. The range of primary screening tests has expanded to include, in addition to cytology, visual inspection with acetic acid (VIA) and HPV-testing. HPV-testing has the best sensitivity and negative predictive value, and a low-cost HPV test may make large-scale high-quality cervical cancer screening possible in low- and medium-income countries (LMICs). ⋯ SCJ cell elimination may avoid neoplastic transformation though not HPV reinfection. Randomised controlled trials are gold-standard, but if not feasible, an evaluation of the impact of prophylactic ablation could be done in the framework of large HPV-based screening programmes. Careful follow-up of lesion-free HPV+ women would provide much needed information on the risk-to-benefit ratio of prophylactic ablation.