Breast Surgery
M-A | Evolution and refinement of magnetically guided sentinel lymph node detection in breast cancer
4 Apr, 2023 | 13:30h | UTC
SR | Adding ultrasound to mammography increases breast cancer detection, but increases false-positives and biopsies
3 Apr, 2023 | 13:55h | UTCSummary: The systematic review examined the effectiveness and safety of combining mammography with breast ultrasonography versus mammography alone for breast cancer screening in women at average risk. The research included one randomized controlled trial, two prospective cohort studies, and five retrospective cohort studies, involving a total of 209,207 women.
High certainty evidence from one trial indicated that combining mammography with ultrasonography led to the detection of more breast cancer cases than mammography alone (5 vs. 3 per 1000 women). However, this combination also led to a higher number of false-positive results and biopsies. For every 1000 women screened with the combined approach, 37 more received a false-positive result, and 27 more women underwent a biopsy.
Secondary analysis of the trial data revealed that in women with dense breasts, the combined screening detected more cancer cases than mammography alone, while cohort studies for women with non-dense breasts showed no statistically significant difference between the two screening methods.
The included studies did not analyze whether the higher number of detected cancers with the combined screening method resulted in lower mortality rates compared to mammography alone. Further research, including randomized controlled trials or prospective cohort studies with longer observation periods, is needed to assess the impact of the two screening interventions on morbidity and mortality.
M-A | Impact of axillary lymph node dissection and sentinel lymph node biopsy on upper limb morbidity in breast cancer patients
31 Mar, 2023 | 13:30h | UTC
Study shows a slight breast cancer risk increase with progestogen-only birth control, comparable to combined oral methods
29 Mar, 2023 | 13:35h | UTCSummary: A UK study and meta-analysis examined breast cancer risk linked to hormonal contraceptives, emphasizing progestagen-only contraceptives in premenopausal women. Utilizing a nested case-control design with the Clinical Practice Research Datalink (CPRD), a primary care database, the study included 9,498 women under 50 diagnosed with invasive breast cancer between 1996 and 2017, and 18,171 closely matched controls. The meta-analysis merged CPRD findings with 12 observational studies on progestagen-only preparations.
The results revealed that current or recent use of combined oral contraceptives, oral progestagen-only contraceptives, injectable progestagen, and progestagen intrauterine devices all led to a similar increase in breast cancer risk. The 15-year absolute excess risk associated with five years of oral combined or progestagen-only contraceptive use ranged from 8 per 100,000 users aged 16-20 to 265 per 100,000 users aged 35-39. The study concluded that both contraceptive types were linked to a slight breast cancer risk increase, and these risks must be weighed against the benefits of contraceptive use during childbearing years.
News Release: Study finds similar association of progestogen-only and combined hormonal contraceptives with breast cancer risk – PLOS
FDA issues new information on cases of squamous cell carcinoma and lymphomas around breast implants
16 Mar, 2023 | 13:28h | UTCSummary: The US Food and Drug Administration (FDA) has provided an update on reports of squamous cell carcinoma (SCC) in the scar tissue (capsule) that forms around breast implants. The FDA is aware of 19 cases of SCC in the capsule around the breast implant from published literature, including 3 reports of deaths from the disease.
While the FDA continues to believe that occurrences of SCC in the capsule around the breast implant may be rare, the cause, incidence, and risk factors remain unknown. Health care providers and people who have or are considering breast implants should be aware that cases of SCC and various lymphomas in the capsule around the breast implant have been reported to the FDA and in the literature.
The FDA continues to ask health care providers and people with breast implants to report cases of SCC, lymphomas, or any other cancers around breast implants.
FDA Safety Communication: Reports of Squamous Cell Carcinoma (SCC) in the Capsule Around Breast Implants – FDA Safety Communication – U.S. Food & Drug Administration
Related:
FDA Report: 660 Cases of Breast Implant-Associated Anaplastic Large Cell Lymphoma
Study: Long-term Outcomes of Silicone Breast Implants
M-A | Supplemental breast cancer screening in women with dense breasts and negative mammography
10 Mar, 2023 | 14:12h | UTCSupplemental Breast Cancer Screening in Women with Dense Breasts and Negative Mammography: A Systematic Review and Meta-Analysis – Radiology (link to abstract – $ for full-text)
News Release: Breast MRI effective at detecting cancer in dense breasts – Radiological Society of North America
Commentary on Twitter
Compared with other supplemental modalities, MRI was superior in detecting breast cancer in a systematic review and meta-analysis. @JDMIRadiologist @UHN @UHN_Research https://t.co/NiZIFO5z9K pic.twitter.com/f9xzVXN9LJ
— Radiology (@radiology_rsna) February 1, 2023
M-A | Tailoring the optimal duration of the extended adjuvant endocrine therapy in patients with early-stage breast cancer
9 Mar, 2023 | 14:06h | UTC
Cohort Study | Risk of endometrial polyps, hyperplasia, carcinoma, and uterine cancer after tamoxifen treatment in premenopausal women with breast cancer
2 Mar, 2023 | 12:56h | UTCCommentary: Risk of Uterine Diseases, Cancers Up With Tamoxifen Treatment – HealthDay
Commentary on Twitter
Use of tamoxifen as an adjuvant hormone therapy for breast cancer was associated with an increased risk of endometrial polyps, hyperplasia, carcinoma, and other uterine cancers in Korean premenopausal women. https://t.co/JqnKjemjoW
— JAMA Network Open (@JAMANetworkOpen) November 29, 2022
RCT | US-assisted carbon nanoparticle suspension mapping vs. dual tracer-guided sentinel lymph node biopsy in patients with early breast cancer
1 Mar, 2023 | 13:42h | UTC
SR | Psychological interventions for women with non‐metastatic breast cancer
23 Feb, 2023 | 13:19h | UTCPsychological interventions for women with non‐metastatic breast cancer – Cochrane Library
RCT | Breast-conserving surgery without irradiation may be an option for older patients with early breast cancer
17 Feb, 2023 | 13:25h | UTCSummary: The article reports a phase 3 randomized trial that investigated the efficacy of omitting irradiation after breast-conserving surgery in women aged 65 years or older with hormone receptor-positive, node-negative, T1 or T2 primary breast cancer, and tumors ≤3 cm in the largest dimension, who received adjuvant endocrine therapy. A total of 1326 women were enrolled, with 658 receiving whole-breast irradiation and 668 receiving no irradiation. The results showed that the omission of radiotherapy led to an increased incidence of local breast cancer recurrence but had no negative effect on distant recurrence as the first event or overall survival. The study suggests that omission of radiotherapy could be a viable treatment option for older women with low-risk, hormone receptor–positive early breast cancer who receive adjuvant endocrine therapy.*
Article: Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
For many older breast cancer patients, study finds radiation doesn’t affect survival – STAT
Do Older Patients Need Radiation Rx After Breast Cancer Surgery? – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
SR | Antipsychotic exposure is an independent risk factor for breast cancer
17 Feb, 2023 | 12:41h | UTC
RCT | Laser treatment does not improve sexual dysfunction in survivors of breast cancer
16 Feb, 2023 | 15:19h | UTCInvited commentary: Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy – JAMA Network Open
Related:
RCT | Laser no better than sham treatment for genitourinary syndrome of menopause
M-A | Carbon dioxide laser vs. vaginal estrogen for genitourinary syndrome of menopause.
Perspective: From vaginal laser treatment to spa breaks – it’s the great menopause gold rush.
Commentary on Twitter
The LIGHT Trial RCT: Vaginal laser therapy does not improve sexual dysfunction/genitourinary syndrome of menopause in breast cancer survivors receiving aromatase inhibitors when added to first line therapy based on moisturizers and vibrator stimulation. https://t.co/jdVDgHe9HC
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
Reconstructive burnout after mastectomy: implications for patient selection
16 Feb, 2023 | 15:02h | UTCCommentary: One in Four Patients Experience Breast Reconstruction Burnout – HealthDay
Development and validation of a genomic profile for the omission of local adjuvant radiation in breast cancer
16 Feb, 2023 | 14:39h | UTC
RCT | Preoperative MRI in breast cancer did not influence local relapse-free survival, overall survival, or reoperation rates
15 Feb, 2023 | 15:57h | UTCSummary: This study investigated the impact of preoperative magnetic resonance imaging (MRI) on survival and surgical outcomes in conservative surgery for breast cancer. The randomized controlled trial included female participants with stage 0-III breast cancer, eligible for breast-conserving surgery. The study found that preoperative MRI increased the rate of mastectomies by 8% compared to routine radiologic exams using mammography and ultrasound. However, preoperative MRI did not impact the rates of local relapse-free survival, overall survival, or reoperation.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
M-A | Risk of second primary cancer among breast cancer patients
6 Feb, 2023 | 13:10h | UTC
SR | Partial breast irradiation for breast cancer
3 Feb, 2023 | 14:06h | UTCPartial Breast Irradiation for Breast Cancer – Agency for Healthcare Research and Quality
SR | Immediate breast reconstruction uptake in older women with primary breast cancer
1 Feb, 2023 | 13:04h | UTC
SR | Present and future of machine learning in breast surgery
1 Feb, 2023 | 13:03h | UTC
Commentary on Twitter
Open Access in BJS' November issue: Present and future of machine learning in breast surgery: systematic review https://t.co/mdE94BzOIt @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @paulo_sutt @robhinchliffe1 @young_bjs pic.twitter.com/XVPwgZaVIm
— BJS (@BJSurgery) November 20, 2022
Perspective | Endocrine treatment for 5 years or radiation for 5 days for patients with early breast cancer older than 65 years
26 Jan, 2023 | 12:04h | UTC
Commentary from the author on Twitter
?Hot off the press @JCO_ASCO: For decades we have been offering RT omission for early #bcsm patients, here we discuss how tides have changed and its time to omit hormonal therapy and treat with RT instead @TaghianAlphonse @MGHBreastOnc @LurieCancer
— George E. Naoum, MD, MMSCI (@George_E_Naoum) December 20, 2022
RCT | Breast-cancer–related lymphedema after reverse lymphatic mapping and selective axillary dissection vs. standard surgical treatment of axilla
24 Jan, 2023 | 14:15h | UTC
Commentary on Twitter
New & available #OpenAccess | Occurrence of breast-cancer–related #lymphedema after reverse lymphatic mapping and selective axillary dissection versus standard surgical treatment of axilla: A two-arm randomized clinical trial https://t.co/fXB7PfysCH @OncoAlert pic.twitter.com/wWNhC9BMvY
— ACS Journal Cancer (@JournalCancer) October 20, 2022
Cohort Study | Contralateral breast cancer risk among carriers of germline pathogenic variants in ATM, BRCA1, BRCA2, CHEK2, and PALB2
13 Jan, 2023 | 13:14h | UTC
Post-trial follow-up | Radiotherapy vs. surgery of the axilla after a positive sentinel node in breast cancer.
14 Dec, 2022 | 14:42h | UTCRadiotherapy or Surgery of the Axilla After a Positive Sentinel Node in Breast Cancer: 10-Year Results of the Randomized Controlled EORTC 10981-22023 AMAROS Trial – Journal of Clinical Oncology (link to abstract – $ for full-text)
Commentary: ART Preferred Over ALND in Sentinel Node-Positive Early Breast Cancer – Cancer Therapy Advisor
Post-trial follow-up | Long-term outcomes of adjuvant denosumab in breast cancer.
22 Nov, 2022 | 13:14h | UTCLong-Term Outcomes of Adjuvant Denosumab in Breast Cancer – NEJM Evidence
Original Study: Adjuvant denosumab in breast cancer (ABCSG-18): a multicentre, randomised, double-blind, placebo-controlled trial – The Lancet (link to abstract – $ for full-text)