Breast

Breast Cancer News

A June 5, 2017 online publication in JAMA Oncology by Monica Morrow, MD, et al, “Trends in Reoperation After Initial Lumpectomy for Breast Cancer,” evaluates the impact of a 2014 consensus guideline on margins for breast conserving surgery by SSO and ASTRO endorsing. The population-based cohort survey study showed a significant reduction in re-operation after initial lumpectomy and more than two-thirds of surgeons endorsing a margin of “no ink on tumor.” 

Breast Cancer Resources

Trends in Reoperation After Initial Lumpectomy for Breast Cancer – Addressing Overtreatment in Surgical Management.  Morrow M et al, JAMA Oncol. Online publication June 5, 2017.

Summary: To determine the impact of a 2014 consensus guideline endorsing a margin of “no ink on tumor” for invasive breast cancer on post-lumpectomy surgery, a population-based cohort survey study was conducted by examining data from women diagnosed with invasive breast cancer during April 2013 to April 2015.  During this period, the use of breast conserving surgery increased while the use of unilateral and bilateral mastectomy decreased.


Relationship Between Margin Width and Recurrence of Ductal Carcinoma in Situ:  Analysis of 2996 Women Treated with Breast-conserving Surgery for 30 Years.  Van Zee KJ et al.  Ann Surgery 2015 » October, 2015

 Summary: Among almost 3000 patients with DCIS treated with breast-conserving surgery, margin width was significantly associated with local recurrence in women not receiving RT.  In women treated with breast-conserving surgery +RT, the association of margin width with recurrence was not significant. 

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Prospective Validation of a 21-Gene Expression Assay.  Sparano JA et al.  NEJM 2015 » September 28, 2015

Summary: TAILORx (Trial Assigning Individualized Options for Treatment) was a randomized prospective trial designed to test the noninferiority of endocrine therapy alone versus chemotherapy plus endocrine therapy in women with T1b-T2 node negative estrogen receptor positive tumors with an Oncotype Dx score of 11-25 (mid range risk).  The 4th planned interim analysis includes the results/outcomes of the low-risk group (score 0-10) treated with endocrine therapy alone.

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Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma in Situ.  Narod SA et al. JAMA Oncology 2015 » August 20, 2015

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  • View New York Times piece in response to this article here

Decreasing Recurrence Rates for Ductal Carcinoma in Situ:  Analysis of 2996 Women Treated with Breast-Conserving Surgery Over 30 Years. Subhedar P, et al.  Ann Surg Oncol 2015 » July 28, 2015

Summary:  A single institution review of almost 3,000 cases of DCIS over a 30 year period demonstrated a declining rate of local recurrence among women treated with breast conserving surgery, which was only partly explained by improvements in detection, margin assessment and adjuvant therapies.  

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Regional Nodal Irradiation in Early-Stage Breast Cancer » July 23, 2015

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Risk Prediction for Local Breast Cancer Recurrence Among Women with DCIS Treated in a Community Practice: A Nested, Case-Control Study.  Collins LC, et al.  Ann Surg Oncol 2015 » July 10, 2015

Summary: This study provides the 4th external validation of the Memorial Sloan Kettering Cancer Center DCIS nomogram, demonstrating good prediction of the 5 and 10 yr local recurrence rates in patients treated with breast conserving surgery for DCIS in a community-based practice.  

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  • View commentary here


Upcoming Meetings

3rd World Congress on Controversies in Breast Cancer (CoBrCa)   » October 26-28, 2017, Tokyo, Japan

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