Breast care (Basel, Switzerland)最新文献

{"title":"Targeted Therapy for Early and Locally Advanced Breast Cancer.","authors":"Michael Untch","doi":"10.1159/000315047","DOIUrl":"https://doi.org/10.1159/000315047","url":null,"abstract":"<p><p>The treatment of patients with breast cancer continues to evolve, with cytotoxic chemotherapy, endocrine therapy, and molecular targeted therapies representing the backbones of modern systemic breast cancer treatment. As we learn better to understand the biology of breast cancer cells, therapies to target specific pathways continue to be developed with the goal of expanding available effective therapy in specific populations. Several targeted drugs with different molecular pathways have achieved approval for metastatic breast cancer, but for early breast cancer trastuzumab is the only one that is currently approved in combination with chemotherapy for adjuvant or neoadjuvant treatment in women with HER2-positive breast cancer. Lapatinib and bevacizumab are both approved for the treatment of metastatic breast cancer and are now investigated in phase III clinical trials testing their effectiveness in the treatment of early breast cancer. In this publication, we review the current status in the treatment of early and locally advanced breast cancer with molecular targeted therapies that are currently approved or in advanced clinical development.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"144-152"},"PeriodicalIF":2.1,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000315047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40073341","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":"Biomarkers for Early Cancer Detection - Methodological Aspects.","authors":"Paolo Verderio,&nbsp;Anita Mangia,&nbsp;Chiara M Ciniselli,&nbsp;Paola Tagliabue,&nbsp;Angelo Paradiso","doi":"10.1159/000303956","DOIUrl":"https://doi.org/10.1159/000303956","url":null,"abstract":"<p><p>The development of a new breast cancer biomarker for early detection is a process that begins with biomarker discovery, followed by a rigorous definition and evaluation of the whole process of biomarker determination (analytical validation). It terminates with the assessment of the impact of the biomarker on clinical practice (clinical validation). A 4-phase scheme for the analytical validation process of the biomarkers for early diagnosis has recently been proposed with the aim of covering the need for standardized operating procedures as well as the need for monitoring and maintaining their quality. As far as clinical validation of biomarkers for early diagnosis is concerned, however, a well established phased approach exists, and guidelines are available for both planning studies and reporting results. Although analytical and clinical validation should be logically linked, often this is not the case in real-word practice, especially in the early phases of biomarker development. This is also the case with breast cancer biomarkers for early detection.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"62-65"},"PeriodicalIF":2.1,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000303956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40073946","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":"Flap Anchoring Following Primary Breast Cancer Surgery Facilitates Early Hospital Discharge and Reduces Costs.","authors":"Laurence M Almond,&nbsp;Laura Khodaverdi,&nbsp;Belindra Kumar,&nbsp;Eamonn C Coveney","doi":"10.1159/000301586","DOIUrl":"https://doi.org/10.1159/000301586","url":null,"abstract":"<p><p>BACKGROUND: Routine drain placement after breast cancer surgery is standard practice. Anchoring the axillary and mastectomy flaps to the underlying chest wall with sutures has been advocated as a means of avoiding drainage following breast surgery. This study compares outcomes following flap fixation or routine drain placement and uniquely considers the economic implications of each technique. PATIENTS AND METHODS: Data on seroma formation and wound infection following mastectomy and axillary clearance were recorded prospectively. Patients underwent either routine drain placement or flap anchoring using subcutaneous tacking sutures without drainage. Equipment and surgical bed costs were provided by our finance department. RESULTS: Data was available for 135 patients. 76 underwent flap anchoring without drainage and 59 had routine drainage. There was no difference in seroma rates between the two groups: 49% vs. 59% (p = 0.22). However, the length of hospital stay was reduced in the flap fixation group: 1.88 vs. 2.67 days (p < 0.0001). Per patient, flap suturing equated to an estimated financial saving of £ 240. CONCLUSIONS: Flap anchoring resulted in a significantly shorter hospital stay than routine drainage, with a comparable rate of seroma formation. This technique presents a viable alternative to drain placement and could lead to a considerable economic savings.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"97-101"},"PeriodicalIF":2.1,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000301586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40073340","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":"Epigenetic Signatures in Breast Cancer: Clinical Perspective.","authors":"Paola Parrella","doi":"10.1159/000309138","DOIUrl":"https://doi.org/10.1159/000309138","url":null,"abstract":"<p><p>There is now a compelling body of evidences sustaining the importance of epigenetic mechanisms in the development and progression of cancer. DNA methylation, post-translational histone and other protein modifications, microRNA expression, and nucleosome positioning, all act together to exert their cellular effects. The epigenome is responsible for controlling gene expression thus defining cell differentiation and tissue specificity. This review will focus on DNA methylation and histone modification because these epigenetic events are widely implicated in cancer development and progression. We will in particular address the translational aspects of breast cancer epigenomics including the development of biomarkers and the prospects for epigenetic based pharmacologic treatments. The analysis of DNA methylation has the advantage over other molecular methods (e.g. single gene mutation, microsatellite analysis) that it can be detected with a very high degree of specificity even in the presence of excess unmethylated DNA. Furthermore, the presence of specific CpG methylation signatures makes methylation-based markers attractive diagnostic, prognostic, and predictive tools for better management of breast cancer patients.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"66-73"},"PeriodicalIF":2.1,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000309138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40073335","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":"Recent Trends in Breast Cancer Incidence and Mortality in Germany.","authors":"Alexander Katalinic,&nbsp;Ron Pritzkuleit,&nbsp;Annika Waldmann","doi":"10.1159/000211526","DOIUrl":"https://doi.org/10.1159/000211526","url":null,"abstract":"<p><p>SUMMARY: BACKGROUND: Breast cancer is the most common cancer among women in Germany with high public health impact. In the last decade rapid changes in risk factor patterns, early breast cancer detection, and therapy have taken place. Their effects on breast cancer epidemiology in Germany are described. MATERIALS AND METHODS: A register-based survey using recent incidence data from German cancer registries was performed. Mortality data were provided by the Central Federal Statistical Office. We calculated age-standardized rates and 5- and 10-year trends. RESULTS: Breast cancer incidence increased until the year 2002, thereafter a discreet decline occurred until 2005 (-6.8%). In the age group 50-59 years this reduction was most pronounced (-12%). Mortality declined from 1996/7 to 2004/5 by 19%, with the strongest effect in women younger than 55 years (approximately 30%). Regional patterns of breast cancer incidence and mortality revealed differences within Germany of greater than 30%. CONCLUSION: Declining hormone replacement therapy prescription is the most likely factor to explain the drop in breast cancer incidence. The reduction in mortality might be caused by better therapy and enhanced early detection during the last decade. Differences in breast cancer incidence and mortality between Eastern and Western Germany give reason for further research and discussion.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"75-80"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000211526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074647","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":"Sentinel Node Biopsy in Breast Cancer: Clinical Implication - Standard of Care - Fututre Prospects.","authors":"Anton Haid,&nbsp;Thorsten Kühn,&nbsp;Amit Goyal,&nbsp;Christoph Tausch,&nbsp;Florentina Peintinger,&nbsp;Peter Schrenk,&nbsp;Hans Gallowitsch","doi":"10.1159/000218329","DOIUrl":"https://doi.org/10.1159/000218329","url":null,"abstract":"Univ.-Doz. Dr. Anton HaidAbteilung fur Allgemein- und ThoraxchirurgieLandeskrankenhaus Feldkirch, Akademisches Lehrkrankenhaus der Universitat InnsbruckCarinagasse 47, 6800 Feldkirch, AustriaTel./Fax +43 5522 72445anton.haid@cable.vol.at© 2009 S. Karger GmbH, FreiburgAccessible online at: www.karger.com/brcFax +49 761 4 52 07 14Information@Karger.dewww.karger.com","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"195-202"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000218329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074642","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":"Cognitive Effects of Systemic Therapy in Patients with Breast Cancer.","authors":"Ute Berndt,&nbsp;Bernd Leplow,&nbsp;Eva Kantelhardt,&nbsp;Christoph Thomssen","doi":"10.1159/000221543","DOIUrl":"https://doi.org/10.1159/000221543","url":null,"abstract":"<p><p>Many patients with breast cancer complain about concentration and memory problems in connection with systemic therapy. A number of studies investigating the possible decrease in cognitive abilities were published in the 1980s. Numerous studies showed impaired performance of patients receiving chemotherapy. The results concerning profile, extent, and duration of cognitive impairments are, however, non-uniform. Increasing interest has been focused in the last years on effects of endocrine therapy on cognitive capacity - especially concerning the effects of the almost complete estrogen depletion caused by aromatase inhibitors. Often, the published studies did not evaluate particular effects of endocrine therapy without considering interference of cytotoxic treatment. Furthermore, the different endocrine medications (antiestrogens vs. aromatase inhibitors) were usually not regarded separately despite different mechanisms of action. Hence, the results of past investigations are also controversial. In the future, prospective trials with larger samples are necessary. Differentiation between chemotherapy and endocrine therapy is essential. Likewise, different types of endocrine therapy should be examined separately.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"177-182"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000221543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40075857","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":"Dense Breast Tissue as an Important Risk Factor for Breast Cancer and Implications for Early Detection.","authors":"Ingrid Schreer","doi":"10.1159/000211954","DOIUrl":"https://doi.org/10.1159/000211954","url":null,"abstract":"<p><p>More than 30 years ago, John Wolfe was the first to observe and describe the association between breast density on mammography and increased breast cancer risk. Following this pioneer work, there is now compelling evidence that density in the highest quartile represents a 4-6 times higher risk of breast cancer. This magnitude of risk is only topped by age and BRCA1/2 mutation. The density-based risk is independent of age and other risk factors. Apart from epidemiologic risk factors, additional genetic factors seem to influence density. This could be the reason behind the well-known interaction between genes and environment. Reliable and reproducible breast density measurements are a prerequisite for the use of breast density to monitor primary prevention strategies and for the use of mammographic density to define women at higher breast cancer risk who would benefit from intensified early detection and surveillance protocols.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"89-92"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000211954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074648","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":"The Epidemiology and Aetiology of Female Breast Cancer.","authors":"Andreas Stang,&nbsp;Rita K Schmutzler","doi":"10.1159/000212103","DOIUrl":"https://doi.org/10.1159/000212103","url":null,"abstract":"This issue of BREAST CARE focuses on the epidemiology and aetiology of female breast cancer. Katalinic et al. [1] provide an interesting update of the incidence and mortality patterns of breast cancer in Germany. Based on their analyses, they are able to corroborate the recent association between decrease of hormone therapy (HT) among postmenopausal women and breast cancer incidence, as has been seen in many other countries. After more than 30 years of breast cancer incidence increase, this is good news. Even nowadays, East Germany shows considerably lower incidences of breast cancer than West Germany. Katalinic et al. give some interesting insights into the explanations for these findings. \u0000 \u0000In their narrative review, Kluttig and Schmidt-Pokrzywni-ak [2] give an overview of the established risk factors of breast cancer. Their review summarises results of meta-analyses and literature reviews. It helps to condense the huge amount of available literature on the risk factors of breast cancer. They conclude that preventive action against the risk factors of breast cancer could also have a beneficial effect on other diseases, including type 2 diabetes and cardiovascular diseases. \u0000 \u0000Schreer [3] gives an update on the increasing evidence that dense breast tissue is an independent risk factor for breast cancer. Besides age and mutations in the high-risk genes BRCA1 or BRCA2, dense breast tissue constitutes one of the highest risk factors. Although the association is well established, there is a lack of standardised methods to quantitatively measure breast density as a prerequisite for the offer of intensified surveillance. Also, reliable and prospective clinical data are missing that would provide clear evidence for the effectiveness of intensified surveillance strategies such as shorter mammographic intervals or the added value of ultrasound. The explicit illustration of the current dissatisfactory situation provides a rationale for the initiation of prospective studies. \u0000 \u0000Meindl [4] summarises the current search for new susceptibility genes. Given the fact that no further high-penetrance gene was found by linkage analysis of large cohorts of BRCA1- and BRCA2-negative high-risk families within the last decade, the hypothesis emerged that low-susceptibility genes inherited in a complex genetic trait may be the underlying cause for the remaining unexplained familial risk. This hypothesis was further supported by twin studies. A proof of principle was provided last year by the identification of low-susceptibility alleles in several genome-wide association studies. Now the challenge is to identify the underlying genes, their function, the interaction, and the cumulated risks conferred by these alleles. Besides a complex genetic trait, an alternative explanation would be the existence of many more very rare genes with high penetrance transmitted by a dominant trait, thus allocating a distinct gene to only a few families. Candidate gene approaches have alr","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"73-74"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000212103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074643","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":"Established and Suspected Risk Factors in Breast Cancer Aetiology.","authors":"Alexander Kluttig,&nbsp;Andrea Schmidt-Pokrzywniak","doi":"10.1159/000211368","DOIUrl":"https://doi.org/10.1159/000211368","url":null,"abstract":"<p><p>Although a current decline in breast cancer incidence and mortality is being observed, the disease continues to be the most common malignancy among women. Breast cancer is a worldwide public health problem that causes substantial personal and social burdens. While we do not yet know exactly what causes the disease, we know a large number of risk factors that are linked to breast cancer. In particular, hormonal factors seem to play a key role in the causation of the disease. The aim of this paper is to review the current knowledge of established and suspected risk factors of breast cancer from an epidemiologic point of view.</p>","PeriodicalId":520575,"journal":{"name":"Breast care (Basel, Switzerland)","volume":" ","pages":"82-87"},"PeriodicalIF":2.1,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000211368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074646","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}