Tuesday, 19 February 2008

High rates of breast conservation for large ductal and lobular invasive carcinomas combining multimodality strategies

M A Bollet, A Savignoni, J-Y Pierga, M Lae, V Fourchotte, Y M Kirova, R Dendale, F Campana, B Sigal-Zafrani, R Salmon, A Fourquet & A Vincent-Salomon
British Journal of Cancer (2008) 98, 734-741

Link

The literature reports low rates of breast conservation after neoadjuvant chemotherapy for operable breast cancers not amenable to initial breast-conserving surgery.

Clinical response to primary chemotherapy was significantly worse for lobular than for ductal carcinomas (47 vs 60%; P=0.04), but only histological grade remained predictive in multivariate analysis. Breast conservation was high for both ductal and lobular carcinomas (65 and 54%; P=0.07), due, in part, to the use of radiotherapy, either exclusive or preoperative, for respectively 26 and 40% of patients. The lobular type had no adverse effect, neither on locoregional control nor on overall survival, even in the group of patients treated with breast conservation.

Friday, 25 January 2008

Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer

M Bhattacharyya, D Ryan, R Carpenter, S Vinnicombe & C J Gallagher
British Journal of Cancer (2008) 98, 289-293
http://www.nature.com/bjc/journal/v98/n2/full/6604171a.html

Contrast-enhanced magnetic resonance imaging (MRI) was used to monitor the response of patients undergoing neoadjuvant chemotherapy for breast cancer with the aim of undergoing breast-conserving surgery (BCS). Magnetic resonance imaging appears to be superior to conventional methods for assessing pathological response and the low rate of re-operation for positive margins indicates a valuable role in aiding the decision to undergo BCS or mastectomy.

Early onset of breast cancer in a group of British black women

R L Bowen, S W Duffy, D A Ryan, I R Hart & J L Jones
British Journal of Cancer (2008) 98, 277-281
http://www.nature.com/bjc/journal/v98/n2/abs/6604174a.html

Black women had a higher frequency of grade 3 tumours, lymph node-positive disease, negative oestrogen receptor and progesterone receptor status and basal-like (triple negative status) tumours. There were no differences in stage at presentation; however, for tumours of 2 cm, black patients had poorer survival than white patients (HR=2.90, 95% CI 0.98-8.60, P=0.05). Black women presented, on average, 21 years younger than white women. Tumours in younger women were considerably more aggressive in the black population, more likely to be basal-like, and among women with smaller tumours, black women were more than twice as likely to die of their disease. There were no disparities in socioeconomic status or treatment received. Our findings could have major implications for the biology of breast cancer and the detection and treatment of the disease in black women