Innovative Practice in Breast Health最新文献

{"title":"Techniques and complications of non-genetic risk reducing mastectomies: Guidelines of the National College of French Gynecologists and Obstetricians (CNGOF)","authors":"C Mathelin ,&nbsp;E Barranger ,&nbsp;M Boisserie-Lacroix ,&nbsp;G Boutet ,&nbsp;S Brousse ,&nbsp;N Chabbert-Buffet ,&nbsp;C Coutant ,&nbsp;E Daraï ,&nbsp;Y Delpech ,&nbsp;M Duraes ,&nbsp;M Espié ,&nbsp;F Golfier ,&nbsp;AS Hamy ,&nbsp;E Kermarrec ,&nbsp;V Lavoué ,&nbsp;M Lodi ,&nbsp;É Luporsi ,&nbsp;C Maugard ,&nbsp;S Molière ,&nbsp;JY Seror ,&nbsp;X Fritel","doi":"10.1016/j.ibreh.2024.100002","DOIUrl":"10.1016/j.ibreh.2024.100002","url":null,"abstract":"<div><h3>Objective</h3><p>Based on an updated review of the international literature covering the different surgical techniques and complications of risk reducing mastectomies (RRM) in non-genetic context, the Commission of Senology of the College National des Gynécologues et Obstétriciens Français (CNGOF) aimed to establish guidelines on techniques to be chosen and their implementation.</p></div><div><h3>Design</h3><p>The CNGOF Commission of Senology, composed of 24 experts, developed these guidelines. A policy of declaration and monitoring of links of interest was applied throughout the process of making the recommendations. Similarly, the development of these recommendations did not benefit from any funding from a company marketing a health product. The Commission of Senology adhered to and followed the AGREE II (Advancing guideline development, reporting and evaluation in healthcare) criteria and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method to assess the quality of the evidence on which the recommendations were based. The potential drawbacks of making recommendations in the presence of poor quality or insufficient evidence were highlighted.</p></div><div><h3>Methods</h3><p>The Commission of Senology considered 6 questions in 4 thematic areas, focusing on oncologic safety, risk of complications, aesthetic satisfaction and psychological impact, and preoperative modalities.</p></div><div><h3>Results</h3><p>The application of the GRADE method resulted in 7 recommendations, 6 with a high level of evidence (GRADE 1+/-) and 1 with a low level of evidence (GRADE 2+/-).</p></div><div><h3>Conclusion</h3><p>There was significant agreement among the Commission of Senology members on recommendations for preferred surgical techniques and practical implementation.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"1 ","pages":"Article 100002"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000022/pdfft?md5=86f0c5109f141e592d5d10a8d5c1f9bd&pid=1-s2.0-S2950212824000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer characteristics in elderly women: A comprehensive cohort study of 7,965 patients","authors":"Massimo Lodi ,&nbsp;Nicolas Bousquet ,&nbsp;Pablo Valverde ,&nbsp;Marc De la Ferrière ,&nbsp;Karl Neuberger ,&nbsp;Stéphane Jankowski ,&nbsp;Marie-Pierrette Chenard ,&nbsp;Nathalie Reix ,&nbsp;Damien Heitz ,&nbsp;Catherine-Laure Tomasetto ,&nbsp;Carole Mathelin","doi":"10.1016/j.ibreh.2024.100001","DOIUrl":"10.1016/j.ibreh.2024.100001","url":null,"abstract":"<div><p>Purpose Breast cancer in older women is a major public health issue as there is an age-related excess mortality. Our aim was to study the tumor characteristics at diagnosis, treatment and outcomes in order to identify possible ways of improving breast cancer management in elderly women.</p><p>Methods We conducted a single-institution retrospective analysis on a cohort of 7,965 women with invasive breast cancer or Ductal Carcinoma in situ (DCIS) who were treated between 2001 and 2017. This cohort was constituted with a machine learning-based tool called SENOMETRY (NCT02810093) which allowed us to extract structured data from unstructured Electronic Health Records. Patients were divided in 3 groups according to the age at diagnosis: younger (&lt; 49, <em>N</em> = 2001), middle-aged (50 to 74, <em>N</em> = 4859) and elderly (≥ 75, <em>N</em> = 1105).</p><p>Results In elderly women breast cancer had more favorable predictive factors (more estrogen receptors <em>P</em> &lt; 0.001, less Human Epidermal growth-factor Receptor 2 overexpression <em>P</em> = 0.009) and prognostic factors (less Ki67 &gt; 30 %, <em>P</em> = 0.001) factors. Tumors were diagnosed at a more advanced local stage (<em>P</em> &lt; 0.001). Lymph node involvement decreased before 70 (ρ -0.033, <em>P</em> = 0.027) and increased again after this threshold (ρ +0.065, <em>P</em> = 0.021). Older women underwent heavier surgical procedures (<em>P</em> &lt; 0.001 to 0.049) and more surgical abstention (<em>P</em> &lt; 0.001) for invasive carcinomas while no difference was noted for patients with DCIS only (P ranged from 0.280 to 0.440). Older women had less chemotherapy (<em>P</em> &lt; 0.001). Elderly women had higher overall mortality and lower locoregional recurrence (<em>P</em> &lt; 0.001). Specific mortality increased with age after 75 (<em>P</em> = 0.042). No difference of relapse-free or overall survival was noted for axillary lymph node dissection compared to sentinel lymph node biopsy in elderly women, after adjustement on tumor size and lymph node involvement.</p><p>Conclusion Our findings suggest that axillary surgery de-escalation and earlier diagnosis would be and accessible way of improving breast cancer management in older women.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"1 ","pages":"Article 100001"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000010/pdfft?md5=2f5b8fb5913db7fc4970d354b098b999&pid=1-s2.0-S2950212824000010-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139890584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer characteristics in elderly women: a comprehensive cohort study of 7,965 patients","authors":"M. Lodi, Nicolas Bousquet, Pablo Valverde, Marc De la Ferrière, K. Neuberger, Stéphane Jankowski, Marie-Pierrette Chenard, N. Reix, Damien Heitz, Catherine-Laure Tomasetto, Carole Mathelin","doi":"10.1016/j.ibreh.2024.100001","DOIUrl":"https://doi.org/10.1016/j.ibreh.2024.100001","url":null,"abstract":"","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"65 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}