vendredi 7 août 2015
vendredi 9 septembre 2011
Lumpectomy May Be Safe Option in Young Breast Cancer Patients
Roxanne Nelson
September 8, 2011 — For younger breast cancer patients, breast-conserving surgery may be a viable option. The results of a new retrospective study found no significant difference in the rates of local recurrence between women treated with breast-conserving surgery or mastectomy.
Overall, women diagnosed with breast cancer at age 40 years or younger have low overall recurrence rates, according to the study, which was highlighted at a press briefing held in advance of the 2011 Breast Cancer Symposium.
"Women aged 40 and under diagnosed with breast cancer today have a good prognosis with a low risk of breast cancer recurrence at 5 and 10 years," said lead author Julliette Buckley, MD, a fellow in breast surgery at Massachusetts General Hospital in Boston. "We demonstrated similar rates of local recurrence after lumpectomy compared to mastectomy, suggesting that lumpectomy is a safe option for young women."
Breast cancer in women under 40 is often diagnosed at a later stage than in older women, she explained. Young age at diagnosis has been shown to be an independent risk factor for recurrence, even after controlling for stage at diagnosis.
"Prior studies have shown that younger women have higher rates of local recurrence for breast and/or axilla after lumpectomy," Dr. Buckley said.
However, in this study, the overall rates of local recurrence (breast and/or axilla) were 5.6% at 5 years and 13% at 10 years. For distant recurrence, the overall rates were 12% at 5 years and 19% at 10 years. The authors found no significant difference in the rates of local recurrence between patients who had undergone a mastectomy (12 of 161) and those who had a lumpectomy (30 of 421).
Another study highlighted at the presscast also showed positive results in young women who underwent breast-conserving therapy with lumpectomy. Young women under the age of 40 who were diagnosed with early-stage breast cancer (T1-2, N0-1, M0) had similar overall and disease-specific survival, whether they were treated with breast-conserving surgery or mastectomy.
Revisiting Conventional Wisdom
This study emphasizes the importance of periodically revisiting conventional wisdom, commented Andrew Seidman, MD, from Memorial Sloan-Kettering, New York City, and American Society of Clinical Oncology Cancer Communications Committee member.
"In this case, it is important to revisit the conventional wisdom that young women who have breast cancer need a mastectomy," said Dr. Seidman, who served as moderator for the presscast. "Certainly there are differences in the biology of the disease, between young and older women, but this contemporary series reflects management that has likely been influenced by newer modalities."
The newer modalities include the use of magnetic resonance imaging (MRI) for breast cancer screening, and thus improvements in the selection of patients who might be better candidates for breast conservation therapy, he pointed out. "There has also been a greater propensity for having BRCA testing done."
"In any case, it is reassuring to younger women that age alone does not seem to mandate need for mastectomy, that one needs to look at other variables independent of age," said Dr. Seidman.
Favorable Prognosis
In this study, Dr. Buckley and colleagues evaluated the rates of loco-regional and distant recurrence and overall survival in young patients with breast cancer, using data from the medical records of 628 women diagnosed with breast cancer at age 40 or younger between 1996 and 2008.
The median age was 37 years (range, 21 to 40 years), and median follow-up duration was 72 months (range, 5 to 177 years).
They found that at the median follow-up of 72 months, the rates of loco-regional failure did not differ between patients who underwent breast-conserving therapy (7.34%) and those who had a mastectomy (7.40%) (P = .980).
The rates of distant recurrence as a first event were 10.65% at 5 years and 14.58% at 10 years, and overall survival rates were 93.1% at 5 years and 87.26% at 10 years. Of this group, 79.1% of patients received systemic therapy.
Overall, the study results were encouraging, regardless of which surgery the women received.
"When we analyzed survival in this group, we found that 93% of all women aged 40 and younger diagnosed with breast cancer were alive at 5 years and 87% were alive at 10 years," said Dr. Buckley.
In addition, 82.5% of women were alive with no evidence of breast cancer at 5 years after their diagnosis, and 68.5% were alive with no evidence of breast cancer at 10 years after diagnosis, she added.
"We believe that awareness of the genetic risk of breast cancer, advances in screening for breast cancer, and improvements in systemic and radiation therapy have contributed to longer overall survival for young women with breast cancer," Dr. Buckley concluded.
2011 Breast Cancer Symposium, San Francisco, California. Abstract #70. To be presented September 8, 2011.
September 8, 2011 — For younger breast cancer patients, breast-conserving surgery may be a viable option. The results of a new retrospective study found no significant difference in the rates of local recurrence between women treated with breast-conserving surgery or mastectomy.
Overall, women diagnosed with breast cancer at age 40 years or younger have low overall recurrence rates, according to the study, which was highlighted at a press briefing held in advance of the 2011 Breast Cancer Symposium.
"Women aged 40 and under diagnosed with breast cancer today have a good prognosis with a low risk of breast cancer recurrence at 5 and 10 years," said lead author Julliette Buckley, MD, a fellow in breast surgery at Massachusetts General Hospital in Boston. "We demonstrated similar rates of local recurrence after lumpectomy compared to mastectomy, suggesting that lumpectomy is a safe option for young women."
Breast cancer in women under 40 is often diagnosed at a later stage than in older women, she explained. Young age at diagnosis has been shown to be an independent risk factor for recurrence, even after controlling for stage at diagnosis.
"Prior studies have shown that younger women have higher rates of local recurrence for breast and/or axilla after lumpectomy," Dr. Buckley said.
However, in this study, the overall rates of local recurrence (breast and/or axilla) were 5.6% at 5 years and 13% at 10 years. For distant recurrence, the overall rates were 12% at 5 years and 19% at 10 years. The authors found no significant difference in the rates of local recurrence between patients who had undergone a mastectomy (12 of 161) and those who had a lumpectomy (30 of 421).
Another study highlighted at the presscast also showed positive results in young women who underwent breast-conserving therapy with lumpectomy. Young women under the age of 40 who were diagnosed with early-stage breast cancer (T1-2, N0-1, M0) had similar overall and disease-specific survival, whether they were treated with breast-conserving surgery or mastectomy.
Revisiting Conventional Wisdom
This study emphasizes the importance of periodically revisiting conventional wisdom, commented Andrew Seidman, MD, from Memorial Sloan-Kettering, New York City, and American Society of Clinical Oncology Cancer Communications Committee member.
"In this case, it is important to revisit the conventional wisdom that young women who have breast cancer need a mastectomy," said Dr. Seidman, who served as moderator for the presscast. "Certainly there are differences in the biology of the disease, between young and older women, but this contemporary series reflects management that has likely been influenced by newer modalities."
The newer modalities include the use of magnetic resonance imaging (MRI) for breast cancer screening, and thus improvements in the selection of patients who might be better candidates for breast conservation therapy, he pointed out. "There has also been a greater propensity for having BRCA testing done."
"In any case, it is reassuring to younger women that age alone does not seem to mandate need for mastectomy, that one needs to look at other variables independent of age," said Dr. Seidman.
Favorable Prognosis
In this study, Dr. Buckley and colleagues evaluated the rates of loco-regional and distant recurrence and overall survival in young patients with breast cancer, using data from the medical records of 628 women diagnosed with breast cancer at age 40 or younger between 1996 and 2008.
The median age was 37 years (range, 21 to 40 years), and median follow-up duration was 72 months (range, 5 to 177 years).
They found that at the median follow-up of 72 months, the rates of loco-regional failure did not differ between patients who underwent breast-conserving therapy (7.34%) and those who had a mastectomy (7.40%) (P = .980).
The rates of distant recurrence as a first event were 10.65% at 5 years and 14.58% at 10 years, and overall survival rates were 93.1% at 5 years and 87.26% at 10 years. Of this group, 79.1% of patients received systemic therapy.
Overall, the study results were encouraging, regardless of which surgery the women received.
"When we analyzed survival in this group, we found that 93% of all women aged 40 and younger diagnosed with breast cancer were alive at 5 years and 87% were alive at 10 years," said Dr. Buckley.
In addition, 82.5% of women were alive with no evidence of breast cancer at 5 years after their diagnosis, and 68.5% were alive with no evidence of breast cancer at 10 years after diagnosis, she added.
"We believe that awareness of the genetic risk of breast cancer, advances in screening for breast cancer, and improvements in systemic and radiation therapy have contributed to longer overall survival for young women with breast cancer," Dr. Buckley concluded.
2011 Breast Cancer Symposium, San Francisco, California. Abstract #70. To be presented September 8, 2011.
dimanche 4 septembre 2011
Presentation of Middle East Tumor Institute
Based in Beirut, Lebanon. We are a Team from Western European Universities and Northern American schools willing to provide top standard of care and multidisciplinary management. As a CEO, My name is Dr Fadi Abbas, previous assistant professor in Medical oncology and lecturer in the University Pierre et Marie Curie, Paris VI.
In a non time through active public relations, I had the pleasure to meet fantastic physicians and healthcare providers here in Beirut, involved in the management of cancer, and coming from top universities, and well known worldwide and willing to work in group to provide best care for cancer patients, from the smallest detail to the biggest all with ISO standard, and high accreditation criterias (HAS criteria of all the settings we are involved for managing patients)
Involved in all aspects of cancer from diagnosis, to surgery, radiotherapy, chemotherapy, best supportive care and pain management. We cooperate will all facilities exisitng in Lebanon (Laboratories, Radiology diagnostic centers, nuclear medicine facilities, surgeons, and hospitals). I quickly understood once I have come to Beirut, that healthcare providers in Lebanon and specially those involved in combating cancer, are spread over the country, and it is for the best for patients, to create a network, rather than limited to one facility.
اهلا و سهلا في بيروت، مدينة السحر والجمال, عاصمة العلم والثقافة
It is a great pleasure to come back home and share all those years of serious works done in the biggest University Hospitals facilities in France engaged in combating cancer.
In a non time through active public relations, I had the pleasure to meet fantastic physicians and healthcare providers here in Beirut, involved in the management of cancer, and coming from top universities, and well known worldwide and willing to work in group to provide best care for cancer patients, from the smallest detail to the biggest all with ISO standard, and high accreditation criterias (HAS criteria of all the settings we are involved for managing patients)
Involved in all aspects of cancer from diagnosis, to surgery, radiotherapy, chemotherapy, best supportive care and pain management. We cooperate will all facilities exisitng in Lebanon (Laboratories, Radiology diagnostic centers, nuclear medicine facilities, surgeons, and hospitals). I quickly understood once I have come to Beirut, that healthcare providers in Lebanon and specially those involved in combating cancer, are spread over the country, and it is for the best for patients, to create a network, rather than limited to one facility.
Finaly, Beirut, the capital of the middle east, with thousands years of history, is a fantastic place specially for foreigners who are seeking, also the beauty of our nature, seaside and mountain view, the hospitality of the people, their warmth, the human size of a country,
The healthy and tasty Lebanese food, the cosmpolitan city of arts, litterature. The place where the most interesting medical conferences take place. It is a melting pot between the west and the east, and a fascinating mix.
It would be a pleasure to meet you in Beirut.
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