Breast Cancer

Data published in the Journal of the American Medical As sociation in March indicate that for 20% of women with early-stage breast cancer, removing malignant lymph nodes from the armpit does not improve survival or prevent recurrence. Women in the phase 3 trial who underwent complete axillary lymph node dissection (ALND) had higher rates of lymphedema than those who had sentinel lymph node dissection (SLND) alone (P <.001). They also had higher rates of wound infection, axillary seromas, and paresthesias (70% vs 25%, respectively; P <.001).

Anew study shows that tamoxifen protects high-risk women against breast cancer for as long as a decade after treatment ends. Joyce Noah-Vanhoucke, PhD, Archimedes Inc, San Francisco, Cali fornia, and colleagues conducted the metaanalysis and found that using tamoxifen to prevent breast cancer in postmenopausal women aged <55 years was cost-effective and saved lives.

Trastuzumab (Herceptin) has greatly improved survival odds for women with HER2-positive breast cancer, but treatment resistance remains a problem for at least 50% of patients. A new study by a team of researchers with University of Texas MD Anderson Cancer Center indicates that the novel agent saracatinib might offer a solution. Saracatinib inhibits SRC, a proto-oncogene.
SAN ANTONIO—A re-analysis of the Women’s Health Initiative (WHI)—which found an increased risk of breast cancer and heart disease in women taking hormone replacement therapy (HRT)—suggests that estrogen alone, without progesterone, may actually be protective against breast cancer. 
SAN ANTONIO—In a trial involving women with stage II/III breast cancer (N = 3360), adding zoledronic acid (ZA) to standard adjuvant chemotherapy did not prolong overall survival (OS) or disease-free survival (DFS) after a median follow-up of 59 months, contrary to some previous reports.

MILAN—The investigative poly (ADPribose) polymerase (PARP) inhibitor iniparib (BSI-021) im proved not only progression-free survival (PFS) but also overall survival (OS) in the final analysis of a randomized phase 2 study, presented at the 35th European Society for Medical Oncology Congress by Joyce O’Shaughnessy, MD, of US Oncology and Baylor Sammons Cancer Center, Houston.

CHICAGO—Targeted intraoperative radiotherapy (TIR) for breast cancer, in which radiotherapy is confined to the area of the breast where the tumor has been removed, has been found to be as good as whole breast radiotherapy at reducing breast cancer recurrence. Most important, the new data presented at the 46th annual meeting of the American Society of Clinical Oncology showed TIR can be carried out in just one hospital visit.

As early as 3000 BC, descriptions can be found on Egyptian papyruses documenting reconstructive techniques used by priest doctors to restore altered appearances to normality. The upper echelons of Egyptian society placed great importance on appearance, and this seems to have been the stimulus for development of modern-day plastic surgery.

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