On this page you will find information about and links to relevant recent publications
This study examined pathological complete response (pCR) in the breast and the axilla in 4084 patients treated with neoadjuvant chemotherapy (NACT). The data was derived from the Netherlands Cancer Registry. Overall breast pCR rate of 24.1% was observed in cT1-3N0-1 breast cancer patients treated with NACT. In patients who achieved breast pCR, 97.7% of clinically node negative (cN0) patients had no tumour in the lymph nodes (ypN0) post-NACT. Furthermore, 45% of cN1 patients had converted to ypN0 after NACT. The study findings support the need for future clinical trials to investigate potential de-escalation of axillary surgery in this patient cohort when image-guided tissue sampling identifies a breast pCR.
This study examines whether biological subtype in patients diagnosed with inflammatory breast cancer (IBC) influences their outcome using a national cancer database. Amongst 4068 patients diagnosed with IBC, 38.7% were ER+HER2-, 32.5% HER2+, and 28.8% were ER-HER2-. 84% were clinically node positive at presentation. Total pCR rates were 6.2% (ER+HER2-), 38.8% (HER2+), and 19.1% (ER-/HER2-). The 5 year overall survival was rates were 64.9% (ER+HER2-), 74% (HER2+), and 44% (ER-/HER2-). Multivariate analysis showed that ER-/HER2- subtype and the absence of pCR predicted for worse survival. The study findings support the concept that IBC is not a distinct biological entity with uniformly poor outcomes and highlights the recent improved outcomes in HER2+ IBC. However, future studies are needed to improve outcome for patients with ER-/HER2- IBC.
Women with dense breasts may have less accurate pre-operative imaging estimation of tumour size. This may in turn affect the margin re-excision rates in women receiving breast conserving surgery (BCS). This study examined the association between breast density (using the BIRADS classification) and re-excision rates in 701 patients with invasive breast cancer. 15.1% of women had at least one re-excision. Younger age was associated with increased breast density (p<0.001). Median tumour size was 1.2cm (range 0.1-4.5cm) with multifocal disease present in 19.8%. MRI was performed in 14.7% of patients, and more frequently utilised in women with denser breasts (27.6% vs. 9%; p<0.001). Extensive Intraductal Component (EIC) was seen in 7.4%.
On multivariate analysis, breast density was significantly associated with increased odds of re-excision (OR 1.37; p=0.049), as did multifocality (p<0.001) and the presence of EIC. The study findings support the need for developing techniques that can reduce re-excision rates for women with dense breasts who undergo BCS.
Therapeutic mammaplasty is a safe and effective alternative to mastectomy or standard breast-conserving surgery
Targeted axillary dissection (TAD) has a low false negative rate – removal of clipped node during sentinel node biopsy
RCT Quality of Life Outcomes no better with 1-stage versus 2-stage implant reconstruction
Quality of life improved following PMRT to autologous versus implant based reconstruction
Complications following implant based reconstruction in the UK from iBRA group
Breast Angiosarcoma Surveillance Study (BRASS) – A National Audit of Management and Outcomes of Angiosarcoma of the Breast and Chest Wall
The BRASS study is a collaborative project led by practising breast and plastic surgeons in the UK and ROI.