Recent Publications

On this page you will find information about and links to relevant recent publications

 

Annals of Surgery: Mar 2020 - Volume 271 - Issue 3 – p574-580

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.

British Journal of Surgery: Feb 2020 

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. 

Annals of Surgical Oncology (2019) 26: 4246-4253

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.

Medication to Reduce Risk of Breast Cancer: USPS Task Force Recommendation

Journal: JAMA

Young patients with breast cancer and BRCA mutation have similar survival to sporadic breast cancer patients (POSH trial)

Journal: Lancet Oncol

TEAM study

Therapeutic mammaplasty is a safe and effective alternative to mastectomy or standard breast-conserving surgery

Journal: Brit J Surg

 Targeted axillary dissection (TAD) has a low false negative rate – removal of clipped node during sentinel node biopsy

Journal: J Clin Oncol

 RCT Quality of Life Outcomes no better with 1-stage versus 2-stage implant reconstruction  

Journal: Lancet Oncol

Quality of life improved following PMRT to autologous versus implant based reconstruction

Journal: JNCI

Complications following implant based reconstruction in the UK from iBRA group

Journal: Lancet Oncol

RCT Lymphoedema rates reduced with reverse mapping

Journal: Ann Surg Oncol

S-LYMPHA (simplified LYMPHA) may reduce rates of lymphoedema after axillary clearance

Journal: Annals of Surgery

BRASS  Jenny Banks

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.

Shave margins reduce positive margin rates

Journal: Annals of Surgery

Shave margins reducer re-excision rate by 50% but increase volume of excised tissue

Journal: NEJM