Thursday, July 14, 2011

The Breast Cancer Research Update: July 14

Today in breast cancer research news, we'll highlight recent studies in two controversial areas - nipple-sparing mastectomy and treatment for small, node-negative breast tumors.

Nipple-sparing mastectomy can be safe in properly selected patients

As the name implies, the intent of a nipple-sparing mastectomy is to remove breast tissue and spare the natural nipple area. As noted in a July 5 study published in Plastic and Reconstructive Surgery, the procedure "remains controversial and its adoption has been slow because of oncologic and surgical concerns."

The Georgetown University researchers evaluated the safety of nipple-sparing surgery in 48 women who had 49 mastectomies to treat a current breast cancer and in 80 women who had 113 mastectomies to prevent breast cancer.

In the treatment group, 80% (39/49) of the procedures included subareolar biopsies. 10% (4/39) revealed DCIS, resulting in the later removal of the nipple area. Four breasts had ischemic (blood supply) complications in the nipple area. One of those resulted in excision. On follow-up, an average of two and a half years later, no patients developed cancer in the nipple area.

In the prevention group, 71% (80/113) of the procedures included subareolar biopsy. One biopsy revealed LCIS. No DCIS or invasive cancer was found. Two nipple areas which developed ischemic complications were later excised. On follow-up, an average of three and a half years later, no primary cancers developed in the nipple area.

The authors concluded that nipple-sparing mastectomies "can be safe in properly-selected patients." Subareolar biopsies can effectively identify cancerous cells and ischemic complications can be minimized.

Treatment of early breast cancer

The treatment of early stage (small, node-negative) breast cancer often involves difficult decisions. Options included mastectomy, breast conserving surgery plus radiation and the possible addition of chemotherapy to either surgical option. Two recent studies shed light on when radiation and chemotherapy should be considered. Both can be found on the breast conserving surgery (lumpectomy) page of the website.

Breast conserving surgery plus radiation for early triple-negative breast cancer

A June 13 study in the Journal of Clinical Oncology, discovered that women with early stage(T1-T2, node-negative) triple-negative breast cancer treated with mastectomy alone had a "significant increased risk" of local recurrence when compared with those treated with breast conserving surgery plus radiation. The authors concluded that future studies of radiation therapy after mastectomy for triple-negative breast cancer are warranted.

Chemotherapy should be considered for young patients with early breast cancer

A July 5 MD Anderson study published in The Breast Journal noted that some patients with small, node-negative tumors who only undergo local therapy, such as breast conserving surgery, experience recurrences. The researchers analysed data from 273 patients to identify prognostic factors. They discovered that age at diagnosis was a significant factor in predicting recurrence. They concluded that "adjuvant systemic therapy," such as chemotherapy, "should be discussed with and considered for young patients" with small, node-negative invasive breast cancer.

Please check back tomorrow for more updates from As always, all the latest news and research on any breast cancer test or treatment option may be found on our website anytime.

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