Our panel of experts highlight the most important research articles across the spectrum of topics relevant to the field of breast cancer management

Abstract

Breast Cancer ManagementVol. 3, No. 5 Journal WatchFree AccessJournal WatchElizabeth A Mittendorf & Lawrence J SolinElizabeth A MittendorfDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1434, Houston, TX 77030, USASearch for more papers by this author & Lawrence J SolinDepartment of Radiation Oncology, Albert Einstein Healthcare Network, Philadelphia, PA, USASearch for more papers by this authorPublished Online:27 Oct 2014https://doi.org/10.2217/bmt.14.43AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInRedditEmail Moran MS, Schnitt SJ, Giuliano AE et al. Society of Surgical Oncology–American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. This article was copublished by The Society of Surgical Oncology: Ann. Surg. Oncol. 21(3), 704–716 (2014); The American Society for Radiation Oncology: Int. J. Radiat. Oncol. Biol. Phys. 88(3), 553–564 (2014); American Society of Clinical Oncology: J. Clin. Oncol. 32(14), 1507–1515 (2014).The definition of an adequate margin for breast-conserving surgery has been debated. The recently published consensus guidelines support using “no ink on tumor” as the standard in stage I and II breast cancer patients treated with whole-breast irradiation. This recommendation is based on a meta-analysis of studies evaluating the impact of margin width on ipsilateral breast tumor recurrence (IBTR) [1]. Positive margins, defined as ink on invasive carcinoma or ductal carcinoma in situ, was associated with a twofold increased IBTR risk compared with negative margins. More widely clear margins did not reduce IBTR. The low IBTR rate (5.3% median prevalence at 79.2-month median follow-up) reported in the meta-analysis reflects improvements in imaging and pathologic assessment, as well increased understanding of tumor biology and improvements in systemic therapy and radiation delivery. In the contemporary era of multidisciplinary care of breast cancer patients, “no ink on tumor” will be adequate in most cases and implementation of these guidelines will decrease re-excision rates, thereby reducing variability and costs of care as well as improving cosmetic outcomes.– Written by EA MittendorfRueth NM, Lin HY, Bedrosian I et al. Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database. J. Clin. Oncol. 32, 2018–2024 (2014).Although uncommon, inflammatory breast cancer is a rapidly progressive and often lethal form of breast cancer. Optimal management typically includes trimodality (multimodality) treatment, beginning with neoadjuvant chemotherapy, followed by local–regional treatment, and then hormonal therapy (for hormone receptor-positive tumors).Rueth et al. report an analysis of 10,197 patients with inflammatory breast cancer using the National Cancer Data Base. While most patients (67%) received trimodality treatment, a substantial fraction of patients did not, most commonly receiving surgery plus chemotherapy but without radiation treatment.Overall survival rates were highest for those patients who had received trimodality treatment in comparison to other groups. After trimodality treatment, overall survival rates were 55.4% and 37.3% at 5 and 10 years, respectively. On multivariable analysis, trimodality treatment remained a statistically significant variable. These results demonstrate that patients with inflammatory breast cancer receiving trimodality treatment can have meaningful long-term survival.– Written by LJ SolinFinancial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.No writing assistance was utilized in the production of this manuscript.References1 Houssami N, Macaskill P, Marinovich ML, Morrow M. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann. Surg. Oncol. 21(3), 717–730 (2014).Crossref, Medline, Google ScholarFiguresReferencesRelatedDetails Vol. 3, No. 5 Follow us on social media for the latest updates Metrics Downloaded 141 times History Published online 27 October 2014 Published in print September 2014 Information© Future Medicine LtdFinancial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.No writing assistance was utilized in the production of this manuscript.PDF download