Monday 24 November 2014

Analysis of risk factors for complications in expander/implant breast reconstruction by stage of reconstruction

Analysis of risk factors for complications in expander/implant breast reconstruction by stage of reconstruction. Plastic and Reconstructive Surgery, Nov 2014, Vol. 134(5), p.692e-699e

Hirsch, E.M., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2014/11000/Analysis_of_Risk_Factors_for_Complications_in.7.aspx

Expander/implant breast reconstruction is a common approach to breast reconstruction. Although several studies evaluate risk factors for complications during the overall reconstructive process, no studies currently evaluate risk factors by stage of reconstruction. This information is important, as it can help guide physician and patient decision making.

Postmastectomy radiotherapy in patients with breast cancer

Postmastectomy radiotherapy in patients with breast cancer - author's reply. The Lancet, Nov 2014, Vol. 384(9957), p.1846-47

Early Breast Cancer Trialists' Collaborative Group 

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62240-6/fulltext?rss=yes#bib1

Our meta-analysis of individual patient data from trials in women given mastectomy and axillary clearance to at least level ll showed that radiotherapy reduced mortality from breast cancer by 20% in women with one to three positive lymph nodes (rate ratio [RR], irradiated vs not, 0·80, 95% CI 0·67—0·95; 2p=0·01) and by 13% in women with at least four positive lymph nodes (RR 0·87, 95% CI 0·77—0·99; 2p=0·04). Little reason of how radiotherapy works exists to think that this treatment for breast cancer has any appreciable abscopal effect and so, as Ismail Jatoi suggests, these results showed that a proportion of the deaths avoided by radiotherapy would have arisen from cells localised within the areas targeted by radiotherapy (ie, the chest wall and, for most trials, the regional lymph nodes).

Fertility advice

Breast cancer women 'not offered fertility advice'.  BBC News, Nov 2014

http://www.bbc.co.uk/news/health-30129324


Most young women diagnosed with breast cancer do not receive fertility advice, despite the fact their treatment could leave them unable to have children.
Chemotherapy can stop the ovaries working for a while or may bring on an early menopause.
Charity Breast Cancer Care, which surveyed 170 women under 45, wants all younger women to be referred to a fertility expert at diagnosis.

Treatment patterns and duration in post-menopausal women with HR+/HER2

Treatment patterns and duration in post-menopausal women with HR+/HER2 - metastatic breast cancer in the US: a retrospective chart review in community oncology practices.Current Medical Research and Opinion, Nov. 2014.

Macalalad, A.R., et al.

http://informahealthcare.com/doi/abs/10.1185/03007995.2014.980885

Clinical guidelines prefer endocrine therapy (ET) as initial treatment for post-menopausal women with hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2−) metastatic breast cancer (mBC). Chemotherapy (CT) should be reserved for patients who develop symptomatic visceral disease or have no clinical benefit after three sequential ET regimens. It is unclear if real-world clinical practice reflects these guidelines.

Breast reconstruction using free posterior medial thigh perforator flaps

Breast reconstruction using free posterior medial thigh perforator flaps: Intraoperative anatomical study and clinical results. Plastic and Reconstructive Surgery, Nov 2014, Vol. 134(5), p.880-91.

Satake, T., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/11000/Breast_Reconstruction_Using_Free_Posterior_Medial.5.aspx

The free posterior medial thigh perforator flap is a fasciocutaneous flap on the posterior and medial thigh, based on perforators from the deep femoral vessels. In this study, the authors evaluated the anatomical basis of posterior and medial thigh perforators from the deep femoral vessels.