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Latest & greatest articles for breast cancer
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Methods for Development of the European Commission Initiative on BreastCancer Guidelines: Recommendations in the Era of Guideline Transparency. Neither breastcancer prevention and early-detection programs, nor their outcomes, are uniform across Europe. This article describes the rationale, methods, and process for development of the European Commission (EC) Initiative on BreastCancer Screening and Diagnosis Guidelines. To be consistent with standards set by the Institute of Medicine
-positive HER2-negative advanced breastcancer the preferred first line treatment is endocrine therapy, unless there is visceral crisis or endocrine resistance. Type of previous adjuvant endocrine therapy, response and time lapsed from end of therapy guide the choice of endocrine therapy in advanced disease. The guideline notes that the optimal sequence of endocrine-based therapy is uncertain. Options include: monotherapy with aromatase inhibitors (exemestane, letrozole, anastrozole), tamoxifen (which (...) has anti-oestrogen effects) or fulvestrant (oestrogen receptor antagonist); CDK4/6 inhibitor in combination with an aromatase inhibitor or with fulvestrant; and everolimus (a mammalian target of rapamycin [mTOR] inhibitor) in combination with an aromatase inhibitor or tamoxifen or fulvestrant. 10 Clinical experts consulted by SMC advise that women with advanced breastcancer that has progressed on endocrine therapy have a variety of treatment options. For women with higher volume disease
of available medical literature was performed using MEDLINE-Ovid, Science Direct, Web of Science and CINAHL. Keywords used included: breastcancer, breastneoplasm and seaweed. Studies were assessed for quality using GRADE criteria. Results: The systematic literature search yielded 311 articles for review. After screening the titles and abstracts, 3 articles met the eligibility criteria. Two of the studies were randomized control trials and 1 was a case-control observational study. These studies showed (...) an association between seaweed consumption and lower rates of breastcancer. Conclusion: Daily consumption of seaweed may play an important role in decreasing the incidence of breastcancer in women. Keywords: Seaweed, breastcancer, breastneoplasm Recommended Citation MouaLee, Alyssa and Pradhanang, Thanita, "Seaweed Consumption and Its Effect on BreastCancer" (2019). School of Physician Assistant Studies . 669. https://commons.pacificu.edu/pa/669 DOWNLOADS Since June 24, 2019 Share COinS Browse Search
Alpelisib (Piqray) - Breastcancer Drug Approval Package: Piqray U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Piqray Company: Novartis Pharmaceuticals Corporation Application Number: 212526 Approval Date: 05/24/2019 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created
patients live without their disease getting worse in one main study involving 431 patients with HER2-negative breastcancer with BRCA mutations whose cancer had spread. Patients treated with Talzenna lived on average for 8.6 months without their disease getting worse compared with 5.6 months for patients treated with the doctor's choice of another cancer medicine. Talzenna (talazoparib) EMA/242902/2019 Page 2/2 What are the risks associated with Talzenna? The most common side effects with Talzenna (...) not breastfeed during treatment with Talzenna and for a month after stopping treatment. For the full list of side effects and restrictions with Talzenna, see the package leaflet. Why is Talzenna authorised in the EU? Generally the outcome is poor for patients with HER2-negative breastcancer with BRCA mutations whose cancer has spread. Talzenna can increase the time these patients live without their disease getting worse. The side effects with Talzenna were generally well-tolerated and when needed
Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breastcancer Pain after surgery remains a major health problem, calling for optimized treatment regimens to maximize the efficacy of pharmacological interventions. In this randomized controlled trial, we tested in a routine surgical treatment setting whether postoperative pain can be reduced by a brief preoperative intervention, ie, positive verbal suggestions (...) in combination with sham acupuncture, designed to optimize treatment expectations. We hypothesized that the expectancy intervention as add-on to patient-controlled intravenous analgesia with morphine reduces patient-reported postoperative pain and improves satisfaction with analgesia. Ninety-six women undergoing breastcancer surgery were randomized at 2 stages: Before surgery, anesthesiologists delivered either positive or neutral verbal suggestions regarding the benefits of acupuncture needling
MRI Performance in Detecting pCR After Neoadjuvant Chemotherapy by Molecular Subtype of BreastCancer MRI performance in detecting pathologic complete response (pCR) post-neoadjuvant chemotherapy (NAC) in breastcancer has been previously explored. However, since tumor response varies by molecular subtype, it is plausible that imaging performance also varies. Therefore, we performed a literature review on subtype-specific MRI performance in detecting pCR post-NAC.Two reviewers searched Cochrane (...) , PubMed, and EMBASE for articles published between 2013 and 2018 that examined MRI performance in detecting pCR post-NAC. After filtering, ten primary research articles were included. Statistical metrics, such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were extracted per study for triple negative, HR+/HER2-, and HER2+ patients.Ten studies involving 2310 patients were included. In triple negative breastcancer, MRI showed NPV (58-100%) and PPV
NAB-Paclitaxel Improves Disease-Free Survival in Early BreastCancer: GBG 69-GeparSepto The GeparSepto trial demonstrated that weekly nanoparticle albumin-bound (NAB)-paclitaxel significantly improves the pathologic complete remission rate compared with weekly solvent-based (sb) paclitaxel followed by epirubicin plus cyclophosphamide as neoadjuvant treatment in patients with primary breastcancer (BC). Here, we report data on long-term outcomes.Patients with histologically confirmed primary BC (...) ) concurrently to chemotherapy and continued for 1 year.A total of 1,206 patients started treatment, 606 with NAB-paclitaxel and 600 with sb-paclitaxel. After a median follow-up of 49.6 months (range, 0.5 to 64.0 months), 243 invasive disease-free survival (iDFS) events were reported (143 in the sb-paclitaxel and 100 in the NAB-paclitaxel arm). At 4 years, overall patients treated with NAB-paclitaxel had a significantly better iDFS compared with sb-paclitaxel (84.0% v 76.3%; hazard ratio, 0.66; 95% CI, 0.51
Prospective, Multicenter, Randomized Phase III Trial Evaluating the Impact of Lymphoscintigraphy as Part of Sentinel Node Biopsy in Early BreastCancer: SenSzi (GBG80) Trial The aim of the current work was to clarify whether a preoperative lymphoscintigraphy (LSG) enhances staging accuracy of sentinel lymph node biopsy (SLNB).In a prospective, multicenter, randomized phase III trial, patients with cN0 early breastcancer or extensive/high-grade ductal carcinoma in situ planned for standard (...) LSG - with LSG) in the mean number of histologically detected SLNs had to be greater than -0.27 (10% noninferiority margin). Stratification was performed according to tumor focality and trial site. Additional predefined secondary end points (rates of node-positive patients and of completion axillary lymph node dissection) were analyzed to rule out differences in the reliable detection of nodal metastases.Between May 2014 and October 2015, 1,198 patients were randomly assigned in 23 German
Two-view digital breast tomosynthesis versus digital mammography in a population-based breastcancer screening programme (To-Be): a randomised, controlled trial Digital breast tomosynthesis is an advancement of mammography, and has the potential to overcome limitations of standard digital mammography. This study aimed to compare first-generation digital breast tomo-synthesis including two-dimensional (2D) synthetic mammograms versus digital mammography in a population-based screening (...) cancer, stratified by screening technique (ie, digital breast tomosynthesis and digital mammography). A log-binomial regression model was used to estimate the efficacy of digital breast tomosynthesis versus digital mammography, defined as the crude risk ratios (RRs) with 95% CIs for screen-detected breastcancer for women screened during the recruitment period. A per-protocol approach was used in the analyses. This trial is registered at ClinicalTrials.gov, number NCT02835625, and is closed
Randomized Trial of Lisinopril Versus Carvedilol to Prevent Trastuzumab Cardiotoxicity in Patients With BreastCancer Trastuzumab is highly effective for human epidermal growth factor receptor type 2 (HER2)-positive breastcancer but is associated with a decline in left ventricular ejection fraction.The purpose of this study was to determine whether angiotensin-converting enzyme inhibitors or beta-blockers reduce the rate of trastuzumab-induced cardiotoxicity (left ventricular ejection fraction (...) decrease >10%, or >5% if below 50%) and limit treatment interruptions.In this double-blind, multicenter, placebo-controlled trial, cardiotoxicity and treatment interruptions in patients with HER2-positive breastcancer treated with trastuzumab for 12 months were evaluated over a 2-year period. Patients were stratified by anthracycline use and then randomized to receive lisinopril, carvedilol, or placebo.The study included 468 women, age 51 ± 10.7 years. For the entire cohort, cardiotoxicity
6 versus 12 months of adjuvant trastuzumab for HER2-positive early breastcancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial. Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breastcancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is non (...) -inferior to the standard 12-month treatment regarding disease-free survival.This study is an open-label, randomised phase 3 non-inferiority trial. Patients were recruited from 152 centres in the UK. We randomly assigned patients with HER2-positive early breastcancer, aged 18 years or older, and with a clear indication for chemotherapy, by a computerised minimisation process (1:1), to receive either 6-month or 12-month trastuzumab delivered every 3 weeks intravenously (loading dose of 8 mg/kg followed
2019LancetControlled trial quality: predicted high
randomised trial of patients with HER2-positive early breastcancer comparing 6 months versus 12 months of trastuzumab treatment concomitant with or following standard neoadjuvant or adjuvant chemotherapy. The study was undertaken in 156 centres in France. Eligible patients were women aged 18 years or older with non-metastatic, operable, histologically confirmed adenocarcinoma of the breast and either positive axillary nodes or negative axillary nodes but a tumour of at least 10 mm. Participants must (...) 6 months versus 12 months of adjuvant trastuzumab in early breastcancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial. In 2013, the interim analysis of the Protocol for Herceptin as Adjuvant therapy with Reduced Exposure (PHARE) trial could not show that 6 months of adjuvant trastuzumab was non-inferior to 12 months. Here, we report the planned final analysis based on the prespecified number of occurring events.PHARE is an open-label, phase 3, non-inferiority
2019LancetControlled trial quality: predicted high
Investigating causal relations between sleep traits and risk of breastcancer in women: mendelian randomisation study. To examine whether sleep traits have a causal effect on risk of breast cancer.Mendelian randomisation study.UK Biobank prospective cohort study and BreastCancer Association Consortium (BCAC) case-control genome-wide association study.156 848 women in the multivariable regression and one sample mendelian randomisation (MR) analysis in UK Biobank (7784 with a breastcancer (...) diagnosis) and 122 977 breastcancer cases and 105 974 controls from BCAC in the two sample MR analysis.Self reported chronotype (morning or evening preference), insomnia symptoms, and sleep duration in multivariable regression, and genetic variants robustly associated with these sleep traits.Breast cancer diagnosis.In multivariable regression analysis using UK Biobank data on breastcancer incidence, morning preference was inversely associated with breastcancer (hazard ratio 0.95, 95% confidence
growth factor receptor 2-negative, axillary node-negative breastcancer, in whom an assay of 21 genes had been performed, and we classified the clinical risk of recurrence of breastcancer as low or high on the basis of the tumor size and histologic grade. The effect of clinical risk was evaluated by calculating hazard ratios for distant recurrence with the use of Cox proportional-hazards models. The initial endocrine therapy was tamoxifen alone in the majority of the premenopausal women who were 50 (...) Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for BreastCancer. The use of adjuvant chemotherapy in patients with breastcancer may be guided by clinicopathological factors and a score based on a 21-gene assay to determine the risk of recurrence. Whether the level of clinical risk of breastcancer recurrence adds prognostic information to the recurrence score is not known.We performed a prospective trial involving 9427 women with hormone-receptor-positive, human epidermal
then fit multivariable Cox regression models to estimate associations between phthalate exposures and incident invasive breastcarcinoma according to tumor estrogen receptor status.Over 9.99 million woman-years of follow-up, most phthalate exposures were not associated with breastcancer incidence. High-level dibutyl phthalate exposure (≥ 10,000 cumulative mg) was associated with an approximately two-fold increase in the rate of estrogen receptor-positive breastcancer (hazard ratio, 1.9; 95% CI, 1.1 (...) Phthalate Exposure and BreastCancer Incidence: A Danish Nationwide Cohort Study Phthalate exposure is ubiquitous and especially high among users of drug products formulated with phthalates. Some phthalates mimic estradiol and may promote breastcancer. Existing epidemiologic studies on this topic are small, mostly not prospective, and have given inconsistent results. We estimated associations between longitudinal phthalate exposures and breastcancer risk in a Danish nationwide cohort, using
from breast intraepithelial neoplasia but have a lower toxicity than the standard dose.We conducted a multicenter randomized trial of tamoxifen, 5 mg/d or placebo administered for 3 years after surgery in women with hormone-sensitive or unknown breast intraepithelial neoplasia, including atypical ductal hyperplasia and lobular or ductal carcinoma in situ. The primary end point was the incidence of invasive breastcancer or ductal carcinoma in situ.Five hundred women 75 years of age or younger were (...) Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Local and Contralateral Recurrence in Breast Intraepithelial Neoplasia Tamoxifen administered for 5 years at 20 mg/d is effective in breastcancer treatment and prevention, but toxicity has limited its broad use. Biomarker trials showed that 5 mg/d is not inferior to 20 mg/d in decreasing breastcancer proliferation. We hypothesized that a lower dose given for a shorter period could be as effective in preventing recurrence