Early detection of second breast cancers improves prognosis in breast cancer survivors

Early detection of second breast cancers improves prognosis in breast cancer survivors
N. Houssami, S. Ciatto, F. Martinelli, R. Bonardi, and S. W. Duffy
Ann Oncol 2009 20: 1505-1510

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Detection of second breast cancers in the asymptomatic phase leads to detection of early-stage cancer and improves relative survival by between 27% and 47%

Does confirmatory tumor biopsy alter the management of breast cancer patients with distant metastases?

Does confirmatory tumor biopsy alter the management of breast cancer patients with distant metastases?
C. Simmons, N. Miller, W. Geddie, D. Gianfelice, M. Oldfield, G. Dranitsaris, and M. J. Clemons

Ann Oncol 2009 20: 1499-1504

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This prospective study demonstrates the presence of substantial discordance in receptor status between primary tumor and metastases, which led to altered management in 20% of cases. Tissue confirmation should be considered in patients with clinical or radiological suspicion of metastatic recurrence

Follow-up may not be beneficial after treatment of grade 1 breast cancer

Follow-up may not be beneficial after treatment of grade 1 breast cancer

M. Kontos, D. Allen, D. T. Trafalis, G. Jones, H. Garmo, L. Holmberg, H. Hamed
British Journal of Surgery 2009; 96: 999 – 1004

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Identification of women treated for breast cancer who have a low risk of locoregional recurrence or contralateral breast cancer, and who can be discharged safely from follow-up, would lower costs without compromising prognosis. This study investigated the risk of locoregional recurrence and contralateral breast cancer in women treated for grade 1 breast cancer

Some 1143 women who had surgery for breast cancer were followed, and the rate of locoregional recurrence or contralateral breast cancer was determined. The risk was compared to the tumour grade

At a mean follow-up of 9·1 years, 10-year estimates of the cumulative risk of locoregional recurrence or contralateral breast cancer for grade 1, 2 and 3 breast cancer were 0·03 (95 per cent confidence interval (c.i.) 0·01 to 0·08), 0·12 (0·09 to 0·15) and 0·16 (0·13 to 0·20) respectively. Grade 1 tumours had a risk of locoregional recurrence or contralateral breast cancer of 285 (95 per cent c.i. 93 to 670) per 100 000 person-years

Women treated for grade 1 breast cancer could be discharged from follow-up after completion of the primary treatment, without compromising their quality of care

The clinical value of bilateral breast MR imaging: is it worth performing on patients showing suspicious microcalcifications on mammography?

The clinical value of bilateral breast MR imaging: is it worth performing on patients showing suspicious microcalcifications on mammography?
Ayano Akita, Akihiro Tanimoto, Hiromitsu Jinno, Kaori Kameyama, Sachio Kuribayashi
Eur Radiol (2009) 19: 2089–2096

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The purpose of this study was to evaluate the clinical value of bilateral breast magnetic resonance (MR) imaging (MRI) in patients showing suspicious microcalcifications on mammography and negative ultrasound findings. Fifty patients underwent MRI before stereotactic vacuum-assisted breast biopsy (SVAB). MR findings were classified into five types for interpretation, and types 4 and 5 were considered malignant. SVAB revealed 13 carcinomas and 37 benign lesions. Malignant lesions were more frequently found in cases of positive MRI diagnoses than in negative MRI diagnoses (P  < 0.001). Mammography had a sensitivity of 100%, a specificity of 24% and an accuracy of 44%, whereas mammography plus MRI had a sensitivity of 85%, a specificity of 100% and an accuracy of 96%. In the evaluation of mammographically detected microcalcifications, bilateral breast MRI is of good diagnostic value and may alter the indications for SVAB