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Breast Neoplasms HELP
Based on 99,988 articles published since 2007
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These are the 99988 published articles about Breast Neoplasms that originated from Worldwide during 2007-2017.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Role of Bone-Modifying Agents in Metastatic Breast Cancer: An American Society of Clinical Oncology-Cancer Care Ontario Focused Guideline Update. 2017

Van Poznak, Catherine / Somerfield, Mark R / Barlow, William E / Biermann, J Sybil / Bosserman, Linda D / Clemons, Mark J / Dhesy-Thind, Sukhbinder K / Dillmon, Melissa S / Eisen, Andrea / Frank, Elizabeth S / Jagsi, Reshma / Jimenez, Rachel / Theriault, Richard L / Vandenberg, Theodore A / Yee, Gary C / Moy, Beverly. ·Catherine Van Poznak, J. Sybil Biermann, and Reshma Jagsi, University of Michigan, Ann Arbor, MI; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; William E. Barlow, Cancer Research and Biostatistics, Seattle, WA; Linda D. Bosserman, City of Hope, Duarte, CA; Mark J. Clemons, The Ottawa Hospital Cancer Centre, Ottawa; Sukhbinder K. Dhesy-Thind, Juravinski Hospital and Cancer Centre, Hamilton; Andrea Eisen, Theodore A. Vandenberg, London Regional Cancer Program, London, Ontario, Canada; Melissa S. Dillmon, Harbin Clinic, Rome, GA; Elizabeth S. Frank, Dana-Farber Cancer Institute; Rachel Jimenez, Beverly Moy, Massachusetts General Hospital, Boston, MA; Richard L. Theriault, MD Anderson Cancer Center, Houston, TX; and Gary C. Yee, University of Nebraska Medical Center, Omaha, NE. ·J Clin Oncol · Pubmed #29035643.

ABSTRACT: Purpose To update, in collaboration with Cancer Care Ontario (CCO), key recommendations of the American Society of Clinical Oncology (ASCO) guideline on the role of bone-modifying agents (BMAs) in metastatic breast cancer. This focused update addressed the new data on intervals between dosing and the role of BMAs in control of bone pain. Methods A joint ASCO-CCO Update Committee conducted targeted systematic literature reviews to identify relevant studies. Results The Update Committee reviewed three phase III noninferiority trials of dosing intervals, one systematic review and meta-analysis of studies of de-escalation of BMAs, and two randomized trials of BMAs in control of pain secondary to bone metastases. Recommendations Patients with breast cancer who have evidence of bone metastases should be treated with BMAs. Options include denosumab, 120 mg subcutaneously, every 4 weeks; pamidronate, 90 mg intravenously, every 3 to 4 weeks; or zoledronic acid, 4 mg intravenously every 12 weeks or every 3 to 4 weeks. The analgesic effects of BMAs are modest, and they should not be used alone for bone pain. The Update Committee recommends that the current standard of care for supportive care and pain management-analgesia, adjunct therapies, radiotherapy, surgery, systemic anticancer therapy, and referral to supportive care and pain management-be applied. Evidence is insufficient to support the use of one BMA over another. Additional information is available at www.asco.org/breast-cancer-guidelines and www.asco.org/guidelineswiki .

2 Guideline Quality indicators in breast cancer care: An update from the EUSOMA working group. 2017

Biganzoli, Laura / Marotti, Lorenza / Hart, Christopher D / Cataliotti, Luigi / Cutuli, Bruno / Kühn, Thorsten / Mansel, Robert E / Ponti, Antonio / Poortmans, Philip / Regitnig, Peter / van der Hage, Jos A / Wengström, Yvonne / Rosselli Del Turco, Marco. ·Nuovo Ospedale di Prato, Prato, Italy. Electronic address: laura.biganzoli@uslcentro.toscana.it. · Eusoma, Florence, Italy. · Nuovo Ospedale di Prato, Prato, Italy; St. Vincent's Hospital, Melbourne, Victoria, Australia. · Bccert and Senonetwork, Florence, Italy. · Institut du Cancer Courlancy, Reims, France. · Klinikum Esslingen, Esslingen, Germany. · Cardiff University, Cardiff, United Kingdom. · CPO Piemonte, AOU Città della Salute e della Scienza, Turin, Italy. · Institut Curie, Paris, France. · Medical University of Graz, Graz, Austria. · Antoni van Leeuwenhoek, The Netherland Cancer Institute, Amsterdam, The Netherlands. · Karolinska Institutet, Stockholm, Sweden. · Radiology, Rome, Italy. ·Eur J Cancer · Pubmed #28963914.

ABSTRACT: In 2010, EUSOMA published a position paper, describing a set of benchmark quality indicators (QIs) that could be adopted by breast centres to allow standardised auditing and quality assurance and to establish an agreed minimum standard of care. Towards the end of 2014, EUSOMA decided to update the paper on QIs to consider and incorporate new scientific knowledge in the field. Several new QIs have been included to address the need for improved follow-up care of patients following primary treatments. With regard to the management of elderly patients, considering the complexity, the expert group decided that, for some specific quality indicators, if centres fail to meet the minimum standard, older patients will be excluded from analysis, provided that reasons for non-adherence to the QI are specified in the clinical chart and are identified at the review of the clinical records. In this way, high standards are promoted, but centres are able to identify and account for the effect of non-standard treatment in the elderly. In the paper, there is no QI for outcome measurements, such as relapse rate or overall survival. However, it is hoped that this will be developed in time as the databases mature and user experience increases. All breast centres are required to record outcome data as accurately and comprehensively as possible to allow this to occur. In the paper, different initiatives undertaken at international and national level to audit quality of care through a set of QIs have been mentioned.

3 Guideline Practice Bulletin No 182: Hereditary Breast and Ovarian Cancer Syndrome. 2017

Anonymous5210917. · ·Obstet Gynecol · Pubmed #28832484.

ABSTRACT: Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome characterized by multiple family members with breast cancer, ovarian cancer, or both. Based on the contemporary understanding of the origins and management of ovarian cancer and for simplicity in this document, ovarian cancer also refers to fallopian tube cancer and primary peritoneal cancer. Clinical genetic testing for gene mutations allows more precise identification of those women who are at an increased risk of inherited breast cancer and ovarian cancer. For these individuals, screening and prevention strategies can be instituted to reduce their risks. Obstetrician-gynecologists play an important role in the identification and management of women with hereditary breast and ovarian cancer syndrome. If an obstetrician-gynecologist or other gynecologic care provider does not have the necessary knowledge or expertise in cancer genetics to counsel a patient appropriately, referral to a genetic counselor, gynecologic or medical oncologist, or other genetics specialist should be considered (1). More genes are being discovered that impart varying risks of breast cancer, ovarian cancer, and other types of cancer, and new technologies are being developed for genetic testing. This Practice Bulletin focuses on the primary genetic mutations associated with hereditary breast and ovarian cancer syndrome, BRCA1 and BRCA2, but also will briefly discuss some of the other genes that have been implicated.

4 Guideline Practice Bulletin No. 182 Summary: Hereditary Breast and Ovarian Cancer Syndrome. 2017

Anonymous5130917. · ·Obstet Gynecol · Pubmed #28832475.

ABSTRACT: Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome characterized by multiple family members with breast cancer, ovarian cancer, or both. Based on the contemporary understanding of the origins and management of ovarian cancer and for simplicity in this document, ovarian cancer also refers to fallopian tube cancer and primary peritoneal cancer. Clinical genetic testing for gene mutations allows more precise identification of those women who are at an increased risk of inherited breast cancer and ovarian cancer. For these individuals, screening and prevention strategies can be instituted to reduce their risks. Obstetrician-gynecologists play an important role in the identification and management of women with hereditary breast and ovarian cancer syndrome. If an obstetrician-gynecologist or other gynecologic care provider does not have the necessary knowledge or expertise in cancer genetics to counsel a patient appropriately, referral to a genetic counselor, gynecologic or medical oncologist, or other genetics specialist should be considered (1). More genes are being discovered that impart varying risks of breast cancer, ovarian cancer, and other types of cancer, and new technologies are being developed for genetic testing. This Practice Bulletin focuses on the primary genetic mutations associated with hereditary breast and ovarian cancer syndrome, BRCA1 and BRCA2, but also will briefly discuss some of the other genes that have been implicated.

5 Guideline AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON MENOPAUSE-2017 UPDATE. 2017

Cobin, Rhoda H / Goodman, Neil F / Anonymous4100913. · ·Endocr Pract · Pubmed #28703650.

ABSTRACT: EXECUTIVE SUMMARY This American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) Position Statement is designed to update the previous menopause clinical practice guidelines published in 2011 but does not replace them. The current document reviews new clinical trials published since then as well as new information regarding possible risks and benefits of therapies available for the treatment of menopausal symptoms. AACE reinforces the recommendations made in its previous guidelines and provides additional recommendations on the basis of new data. A summary regarding this position statement is listed below: New information available from randomized clinical trials and epidemiologic studies reported after 2011 was critically reviewed. No previous recommendations from the 2011 menopause clinical practice guidelines have been reversed or changed. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, selective estrogen-receptor modulators (SERMs), and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, SERMs, and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. New recommendations in this position statement include: 1. RECOMMENDATION: the use of menopausal hormone therapy in symptomatic postmenopausal women should be based on consideration of all risk factors for cardiovascular disease, age, and time from menopause. 2. RECOMMENDATION: the use of transdermal as compared with oral estrogen preparations may be considered less likely to produce thrombotic risk and perhaps the risk of stroke and coronary artery disease. 3. RECOMMENDATION: when the use of progesterone is necessary, micronized progesterone is considered the safer alternative. 4. RECOMMENDATION: in symptomatic menopausal women who are at significant risk from the use of hormone replacement therapy, the use of selective serotonin re-uptake inhibitors and possibly other nonhormonal agents may offer significant symptom relief. 5. RECOMMENDATION: AACE does not recommend use of bioidentical hormone therapy. 6. RECOMMENDATION: AACE fully supports the recommendations of the Comité de l'Évolution des Pratiques en Oncologie regarding the management of menopause in women with breast cancer. 7. RECOMMENDATION: HRT is not recommended for the prevention of diabetes. 8. RECOMMENDATION: In women with previously diagnosed diabetes, the use of HRT should be individualized, taking in to account age, metabolic, and cardiovascular risk factors. ABBREVIATIONS: AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CAC = coronary artery calcification; CEE = conjugated equine estrogen; CEPO = Comité de l'Évolution des Pratiques en Oncologie; CAD = coronary artery disease; CIMT = carotid intima media thickness; CVD = cardiovascular disease; FDA = Food and Drug Administration; HDL = high-density lipoprotein; HRT = hormone replacement therapy; HT = hypertension; KEEPS = Kronos Early Estrogen Prevention Study; LDL = low-density lipoprotein; MBS = metabolic syndrome; MPA = medroxyprogesterone acetate; RR = relative risk; SERM = selective estrogen-receptor modulator; SSRI = selective serotonin re-uptake inhibitor; VTE = venous thrombo-embolism; WHI = Women's Health Initiative.

6 Guideline Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Focused Update. 2017

Krop, Ian / Ismaila, Nofisat / Andre, Fabrice / Bast, Robert C / Barlow, William / Collyar, Deborah E / Hammond, M Elizabeth / Kuderer, Nicole M / Liu, Minetta C / Mennel, Robert G / Van Poznak, Catherine / Wolff, Antonio C / Stearns, Vered. ·Ian Krop, Dana-Farber Cancer Institute, Boston, MA; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Fabrice Andre, Institute Gustave Roussy, Paris, France; Robert C. Bast, The University of Texas MD Anderson Cancer Center, Houston; Robert G. Mennel, Baylor University Medical Center, Texas Oncology PA, Dallas, TX; William Barlow, Cancer Research and Biostatistics, Seattle, WA; Deborah E. Collyar, Patient Advocates in Research, Danville, CA; M. Elizabeth Hammond, University of Utah and Intermountain Health Care, Salt Lake City, UT; Nicole M. Kuderer, University of Washington Medical Center, Seattle, WA; Minetta C. Liu, Mayo Clinic College of Medicine, Rochester, MN; Catherine Van Poznak, University of Michigan, Ann Arbor, MI; and Antonio C. Wolff and Vered Stearns, Johns Hopkins University, Baltimore, MD. ·J Clin Oncol · Pubmed #28692382.

ABSTRACT: Purpose This focused update addresses the use of MammaPrint (Agendia, Irvine, CA) to guide decisions on the use of adjuvant systemic therapy. Methods ASCO uses a signals approach to facilitate guideline updates. For this focused update, the publication of the phase III randomized MINDACT (Microarray in Node-Negative and 1 to 3 Positive Lymph Node Disease May Avoid Chemotherapy) study to evaluate the MammaPrint assay in 6,693 women with early-stage breast cancer provided a signal. An expert panel reviewed the results of the MINDACT study along with other published literature on the MammaPrint assay to assess for evidence of clinical utility. Recommendations If a patient has hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-negative breast cancer, the MammaPrint assay may be used in those with high clinical risk to inform decisions on withholding adjuvant systemic chemotherapy due to its ability to identify a good-prognosis population with potentially limited chemotherapy benefit. Women in the low clinical risk category did not benefit from chemotherapy regardless of genomic MammaPrint risk group. Therefore, the MammaPrint assay does not have clinical utility in such patients. If a patient has hormone receptor-positive, HER2-negative, node-positive breast cancer, the MammaPrint assay may be used in patients with one to three positive nodes and a high clinical risk to inform decisions on withholding adjuvant systemic chemotherapy. However, such patients should be informed that a benefit from chemotherapy cannot be excluded, particularly in patients with greater than one involved lymph node. The clinician should not use the MammaPrint assay to guide decisions on adjuvant systemic therapy in patients with hormone receptor-positive, HER2-negative, node-positive breast cancer at low clinical risk, nor any patient with HER2-positive or triple-negative breast cancer, because of the lack of definitive data in these populations. Additional information can be found at www.asco.org/breast-cancer-guidelines and www.asco.org/guidelineswiki .

7 Guideline Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women. 2017

Anonymous5480911. · ·Obstet Gynecol · Pubmed #28644335.

ABSTRACT: Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the scope of this document and are addressed in other publications of the American College of Obstetricians and Gynecologists (ACOG) (5-7).

8 Guideline Practice Bulletin No. 179 Summary: Breast Cancer Risk Assessment and Screening in Average-Risk Women. 2017

Anonymous5420911. · ·Obstet Gynecol · Pubmed #28644328.

ABSTRACT: Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the scope of this document and are addressed in other publications of the American College of Obstetricians and Gynecologists (ACOG) (5-7).

9 Guideline Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer: A Cancer Care Ontario and American Society of Clinical Oncology Clinical Practice Guideline. 2017

Dhesy-Thind, Sukhbinder / Fletcher, Glenn G / Blanchette, Phillip S / Clemons, Mark J / Dillmon, Melissa S / Frank, Elizabeth S / Gandhi, Sonal / Gupta, Rasna / Mates, Mihaela / Moy, Beverly / Vandenberg, Ted / Van Poznak, Catherine H. ·Sukhbinder Dhesy-Thind, Juravinski Cancer Centre; Sukhbinder Dhesy-Thind and Glenn G. Fletcher, McMaster University, Hamilton, Ontario; Phillip S. Blanchette, Sunnybrook Odette Cancer Centre; Sonal Gandhi, Sunnybrook Health Sciences, Toronto, Ontario; Mark J. Clemons, The Ottawa Hospital Cancer Centre, Ottawa, Ontario; Rasna Gupta, Windsor Regional Cancer Program, Windsor, Ontario; Mihaela Mates, Kingston General Hospital, Kingston, Ontario; Ted Vandenberg, London Health Sciences Centre, London, Ontario, Canada; Melissa S. Dillmon, Harbin Clinic, Rome, GA; Elizabeth S. Frank, Lexington; Beverly Moy, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA; and Catherine H. Van Poznak, University of Michigan, Ann Arbor, MI. ·J Clin Oncol · Pubmed #28618241.

ABSTRACT: Purpose To make recommendations regarding the use of bisphosphonates and other bone-modifying agents as adjuvant therapy for patients with breast cancer. Methods Cancer Care Ontario and ASCO convened a Working Group and Expert Panel to develop evidence-based recommendations informed by a systematic review of the literature. Results Adjuvant bisphosphonates were found to reduce bone recurrence and improve survival in postmenopausal patients with nonmetastatic breast cancer. In this guideline, postmenopausal includes patients with natural menopause or that induced by ovarian suppression or ablation. Absolute benefit is greater in patients who are at higher risk of recurrence, and almost all trials were conducted in patients who also received systemic therapy. Most studies evaluated zoledronic acid or clodronate, and data are extremely limited for other bisphosphonates. While denosumab was found to reduce fractures, long-term survival data are still required. Recommendations It is recommended that, if available, zoledronic acid (4 mg intravenously every 6 months) or clodronate (1,600 mg/d orally) be considered as adjuvant therapy for postmenopausal patients with breast cancer who are deemed candidates for adjuvant systemic therapy. Further research comparing different bone-modifying agents, doses, dosing intervals, and durations is required. Risk factors for osteonecrosis of the jaw and renal impairment should be assessed, and any pending dental or oral health problems should be dealt with prior to starting treatment. Data for adjuvant denosumab look promising but are currently insufficient to make any recommendation. Use of these agents to reduce fragility fractures in patients with low bone mineral density is beyond the scope of the guideline. Recommendations are not meant to restrict such use of bone-modifying agents in these situations. Additional information at www.asco.org/breast-cancer-adjuvant-bisphosphonates-guideline , www.asco.org/guidelineswiki , https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/breast .

10 Guideline Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology (SIRM) and the Italian Group for Mammography Screening (GISMa). 2017

Bernardi, Daniela / Belli, Paolo / Benelli, Eva / Brancato, Beniamino / Bucchi, Lauro / Calabrese, Massimo / Carbonaro, Luca A / Caumo, Francesca / Cavallo-Marincola, Beatrice / Clauser, Paola / Fedato, Chiara / Frigerio, Alfonso / Galli, Vania / Giordano, Livia / Giorgi Rossi, Paolo / Golinelli, Paola / Morrone, Doralba / Mariscotti, Giovanna / Martincich, Laura / Montemezzi, Stefania / Naldoni, Carlo / Paduos, Adriana / Panizza, Pietro / Pediconi, Federica / Querci, Fiammetta / Rizzo, Antonio / Saguatti, Gianni / Tagliafico, Alberto / Trimboli, Rubina M / Zappa, Marco / Zuiani, Chiara / Sardanelli, Francesco. ·U.O. Senologia Clinica e Screening Mammografico, Dipartimento di Radiologia, APSS, Centro per i Servizi Sanitari, Pal. C, viale Verona, 38123, Trento, Italy. · Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. · Zadig Scientific Communication Agency, Via Arezzo 21, 00161, Rome, Italy. · Struttura Complessa di Senologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via Cosimo il Vecchio 2, 50139, Florence, Italy. · Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, Via Piero Maroncelli 40, Meldola, 47014, Forlì, Italy. · UOC Senologia Diagnostica, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy. · Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. · UOSD Breast Unit ULSS 20, Piazza Lambranzi 1, 37142, Verona, Italy. · Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-patologiche, Policlinico Umberto I, Sapienza Università di Roma, Viale Regina Elena 324, 00161, Rome, Italy. · Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna/General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. · Regional Screening Coordinating Centre, Veneto Region, Venice, Italy. · Regional Reference Centre for Breast Cancer Screening, Turin, Italy. · Mammography Screening Centre, Local Health Authority, Modena, Italy. · Epidemiology Unit, Centre for Cancer Prevention, Turin, Italy. · Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, and Arcispedale S. Maria Nuova, Reggio Emilia, Italy. · Medical Physics Service, Local Health Authority, Modena, Italy. · Radiologia 1U, Dipartimento di Diagnostica per Immagini, Università di Torino, A. O. U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy. · U.O. Radiodiagnostica, Candiolo Cancer Institute, FPO, IRCCS, Strada Provinciale 142, km 3.95, Candiolo, 10060, Turin, Italy. · DAI Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Piazzale A. Stefani 1, 37126, Verona, Italy. · Department of Health, Emilia-Romagna Region, Bologna, Italy. · U.O. Radiologia Senologica, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy. · Department of Prevention, Screening Centre, Local Health Authority, Sassari, Italy. · Pathology Department, Local Health Authority, Asolo, Treviso, Italy. · Senology Unit, Local Health Authority, Bologna, Italy. · Department of Experimental Medicine, DIMES, Institute of Anatomy, University of Genova, Via de Toni 14, 16132, Genoa, Italy. · Department of Biomedical Science for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. · UOC Epidemiologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy. · Institute of Radiology, University of Udine, Piazzale S. M. della Misericordia 15, 33100, Udine, Italy. · Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. francesco.sardanelli@unimi.it.; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. francesco.sardanelli@unimi.it. ·Radiol Med · Pubmed #28540564.

ABSTRACT: This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7‰ and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery.

11 Guideline Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. 2017

Greenlee, Heather / DuPont-Reyes, Melissa J / Balneaves, Lynda G / Carlson, Linda E / Cohen, Misha R / Deng, Gary / Johnson, Jillian A / Mumber, Matthew / Seely, Dugald / Zick, Suzanna M / Boyce, Lindsay M / Tripathy, Debu. ·Assistant Professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.; Member, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY. · Doctoral Fellow, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. · Associate Professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, MB, Canada. · Professor, Department of Oncology, University of Calgary, Calgary, AB, Canada. · Adjunct Professor, American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA.; Clinic Director, Chicken Soup Chinese Medicine, San Francisco, CA. · Medical Director, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. · Post-Doctoral Scholar, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA. · Radiation Oncologist, Harbin Clinic, Rome, GA. · Executive Director, Ottawa Integrative Cancer Center, Ottawa, ON, Canada.; Executive Director of Research, Canadian College of Naturopathic Medicine, Toronto, ON, Canada. · Research Associate Professor, Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.; Research Associate Professor, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI. · Research Informationist, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York, NY. · Professor, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. ·CA Cancer J Clin · Pubmed #28436999.

ABSTRACT: Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.

12 Guideline NCCN Guidelines Insights: Breast Cancer, Version 1.2017. 2017

Gradishar, William J / Anderson, Benjamin O / Balassanian, Ron / Blair, Sarah L / Burstein, Harold J / Cyr, Amy / Elias, Anthony D / Farrar, William B / Forero, Andres / Giordano, Sharon Hermes / Goetz, Matthew P / Goldstein, Lori J / Isakoff, Steven J / Lyons, Janice / Marcom, P Kelly / Mayer, Ingrid A / McCormick, Beryl / Moran, Meena S / O'Regan, Ruth M / Patel, Sameer A / Pierce, Lori J / Reed, Elizabeth C / Salerno, Kilian E / Schwartzberg, Lee S / Sitapati, Amy / Smith, Karen Lisa / Smith, Mary Lou / Soliman, Hatem / Somlo, George / Telli, Melinda / Ward, John H / Shead, Dorothy A / Kumar, Rashmi. ·From Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; UCSF Helen Diller Family Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; University of Alabama at Birmingham Comprehensive Cancer Center; The University of Texas MD Anderson Cancer Center; Mayo Clinic Cancer Center; Fox Chase Cancer Center; Massachusetts General Hospital Cancer Center; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute; Duke Cancer Institute; Vanderbilt-Ingram Cancer Center; Memorial Sloan Kettering Cancer Center; Yale Cancer Center/Smilow Cancer Hospital; University of Wisconsin Carbone Cancer Center; University of Michigan Comprehensive Cancer Center; Fred & Pamela Buffett Cancer Center; Roswell Park Cancer Institute; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Research Advocacy Network; Moffitt Cancer Center; City of Hope Comprehensive Cancer Center; Stanford Cancer Institute; Huntsman Cancer Institute at the University of Utah; and National Comprehensive Cancer Network. ·J Natl Compr Canc Netw · Pubmed #28404755.

ABSTRACT: These NCCN Guidelines Insights highlight the important updates/changes to the surgical axillary staging, radiation therapy, and systemic therapy recommendations for hormone receptor-positive disease in the 1.2017 version of the NCCN Guidelines for Breast Cancer. This report summarizes these updates and discusses the rationale behind them. Updates on new drug approvals, not available at press time, can be found in the most recent version of these guidelines at NCCN.org.

13 Guideline NCCN Consensus Guidelines for the Diagnosis and Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma. 2017

Clemens, Mark W / Horwitz, Steven M. ·Associate Professor, Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA. · Attending Medical Oncologist of Lymphoma, Department of Hematology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. ·Aesthet Surg J · Pubmed #28184418.

ABSTRACT: Published case series demonstrate a lack of treatment standardization for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) with a wide variety of therapeutic strategies being employed at all stages of disease. The National Comprehensive Cancer Network (NCCN) annually publishes Clinical Practice Guidelines for Non-Hodgkin Lymphomas. For the first time, BIA-ALCL management will be included which signifies an important and needed guideline addition. The new BIA-ALCL guideline was achieved by a consensus of lymphoma oncologists, plastic surgeons, radiation oncologists, and surgical oncologists. NCCN guidelines focus on the diagnosis and management throughout the stages of many lymphoma subtypes based upon the most current data available. This article summarizes the essential recommendations and optimal therapeutic strategies of the NCCN guidelines critical to the plastic surgery community. We encourage international adoption of these BIA-ALCL treatment standards by our specialty societies across the oncology and surgery disciplines.

14 Guideline The American College of Radiology and the American Brachytherapy Society practice parameter for the performance of low-dose-rate brachytherapy. 2017

Viswanathan, Akila N / Erickson, Beth A / Ibbott, Geoffrey S / Small, William / Eifel, Patricia J. ·The Johns Hopkins Oncology Center, Boston, MA, USA. Electronic address: njamiolkowski@acr.org. · Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. · Department of Radiation Physics, Anderson Cancer Center, Houston, TX, USA. · Loyola University, Chicago, IL. ·Brachytherapy · Pubmed #28109633.

ABSTRACT: Brachytherapy is the use of radionuclides to treat malignancies or benign conditions by means of a radiation source placed close to or into the tumor or treatment site. This practice parameter refers only to the use of radionuclide brachytherapy. Brachytherapy alone or combined with external beam therapy plays an important role in the management and treatment of patients with cancer. Low-dose-rate (LDR) brachytherapy has traditionally been used for treating prostate, head and neck, breast, cervical, and endometrial cancers as well as obstructive bile duct, esophageal, or bronchial lesions. It has been practiced for over a century with a variety of sources including radium-226, cesium-137, and, more recently, iridium- 192, iodine-125, and palladium-103. Low-dose-rate (LDR) brachytherapy can be given as interstitial, intracavitary, intraluminal, and/or plesiotherapy to a wide variety of treatment sites. This practice parameter addresses sealed sources as they are used for LDR brachytherapy. It is recognized that unsealed sources (e.g., yttrium-90) are also a form of LDR brachytherapy.

15 Guideline Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. 2017

Lyman, Gary H / Somerfield, Mark R / Bosserman, Linda D / Perkins, Cheryl L / Weaver, Donald L / Giuliano, Armando E. ·Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Linda D. Bosserman, City of Hope, Duarte, CA; Cheryl L. Perkins, Dallas, TX; Donald L. Weaver, University of Vermont and Vermont Cancer Center, Burlington, VT; and Armando E. Giuliano, Cedars-Sinai Medical Center, Los Angeles, CA. ·J Clin Oncol · Pubmed #27937089.

ABSTRACT: Purpose To provide current recommendations on the use of sentinel node biopsy (SNB) for patients with early-stage breast cancer. Methods PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from 2012 through July 2016. An Update Panel reviewed the identified abstracts. Results Of the eight publications identified and reviewed, none prompted a change in the 2014 recommendations, which are reaffirmed by the updated literature review. Conclusion Women without sentinel lymph node (SLN) metastases should not receive axillary lymph node dissection (ALND). Women with one to two metastatic SLNs who are planning to undergo breast-conserving surgery with whole-breast radiotherapy should not undergo ALND (in most cases). Women with SLN metastases who will undergo mastectomy should be offered ALND. These three recommendations are based on randomized controlled trials. Women with operable breast cancer and multicentric tumors, with ductal carcinoma in situ, who will undergo mastectomy, who previously underwent breast and/or axillary surgery, or who received preoperative/neoadjuvant systemic therapy may be offered SNB. Women who have large or locally advanced invasive breast cancer (tumor size T3/T4), inflammatory breast cancer, or ductal carcinoma in situ (when breast-conserving surgery is planned) or are pregnant should not undergo SNB.

16 Guideline 3rd ESO-ESMO international consensus guidelines for Advanced Breast Cancer (ABC 3). 2017

Cardoso, F / Costa, A / Senkus, E / Aapro, M / André, F / Barrios, C H / Bergh, J / Bhattacharyya, G / Biganzoli, L / Cardoso, M J / Carey, L / Corneliussen-James, D / Curigliano, G / Dieras, V / El Saghir, N / Eniu, A / Fallowfield, L / Fenech, D / Francis, P / Gelmon, K / Gennari, A / Harbeck, N / Hudis, C / Kaufman, B / Krop, I / Mayer, M / Meijer, H / Mertz, S / Ohno, S / Pagani, O / Papadopoulos, E / Peccatori, F / Penault-Llorca, F / Piccart, M J / Pierga, J Y / Rugo, H / Shockney, L / Sledge, G / Swain, S / Thomssen, C / Tutt, A / Vorobiof, D / Xu, B / Norton, L / Winer, E. ·European School of Oncology & Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal. Electronic address: fatimacardoso@fundacaochampalimaud.pt. · European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland. · Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland. · Breast Center, Genolier Cancer Center, Genolier, Switzerland. · Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France. · Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil. · Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden. · Department of Medical Oncology, Fortis Hospital, Kolkata, India. · Medical Oncology Department, Hospital of Prato, Prato, Italy. · Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal. · Department of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center, USA. · METAvivor Research and Support, Annapolis, USA. · Division of Experimental Therapeutics, European Institute of Oncology, Milan, Italy. · Department of Medical Oncology, Institut Curie, Paris, France. · NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut, Beirut, Lebanon. · Department of Breast Tumors, Cancer Institute 'I. Chiricuta', Cluj-Napoca, Romania. · Brighton & Sussex Medical School, University of Sussex, Falmer, UK. · Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta. · Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia. · BC Cancer Agency, Vancouver Cancer Centre, Vancouver, Canada. · Department of Medical Oncology, Galliera Hospital, Genoa, Italy. · Brustzentrum der Universitat München, Munich, Germany. · Breast Medicine Service, Memorial Sloan-Kettering Cancer Centre, New York, USA. · Sheba Medical Center, Tel Hashomer, Israel. · Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA. · Advanced BC.org, New York, USA. · Department of Radiation Oncology, Radvoud University Medical Center, Nijmegen, The Netherlands. · Metastatic Breast Cancer Network US, Inversness, USA. · Breast Oncology Centre, Cancer Institute Hospital, Tokyo, Japan. · Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland. · Europa Donna, Nicosia, Cyprus. · Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France. · Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. · Department of Medical Oncology, Institut Curie-Université Paris Descartes, Paris, France. · Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA. · Department of Surgery and Oncology, Johns Hopkins Breast Center, Baltimore, USA. · Indiana University Medical CTR, Indianapolis, USA. · Lombardi Comprehensive Cancer Center, Georgetown University, Washington, USA. · Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, DE, Germany. · Breakthrough Breast Cancer Research Unit, King's College London and Guy's and St Thomas's NHS Foundation Trust, London, UK. · Sandton Oncology Centre, Johannesburg, South Africa. · Department of Medical Oncology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. · Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York, USA. ·Breast · Pubmed #27927580.

ABSTRACT: -- No abstract --

17 Guideline Osteoporosis management in patients with breast cancer: EMAS position statement. 2017

Trémollieres, Florence A / Ceausu, Iuliana / Depypere, Herman / Lambrinoudaki, Irene / Mueck, Alfred / Pérez-López, Faustino R / van der Schouw, Yvonne T / Senturk, Levent M / Simoncini, Tommaso / Stevenson, John C / Stute, Petra / Rees, Margaret. ·Menopause and Metabolic Bone Disease Unit, Hôpital Paule de Viguier, CHU Toulouse, Toulouse, France. Electronic address: tremollieres.fr@chu-toulouse.fr. · Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, and Department of Obstetrics and Gynecology, 'Dr. I. Cantacuzino' Hospital, Bucharest, Romania. · Breast Clinic and Menopause Clinic, University Hospital, De Pintelaan 185, 9000 Gent, Belgium. · Second Department of Obstetrics and Gynecology, National and Kapodestrian University of Athens, Greece. · University Women's Hospital of Tuebingen, Calwer Street 7, 72076 Tuebingen, Germany. · Department of Obstetrics and Gynecology, Zaragoza University Faculty of Medicine, Lozano-Blesa University Hospital, Zaragoza 50009, Spain. · Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. · Istanbul University Cerrahpasa School of Medicine. Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology, IVF Unit, Istanbul, Turkey. · Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy. · National Heart and Lung Institute, Imperial College London, Royal Brompton Campus Hospital, London SW3 6NP, UK. · Department of Obstetrics and Gynecology, University Women's Hospital, Bern, Switzerland. · Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. ·Maturitas · Pubmed #27802892.

ABSTRACT: Aromatase inhibitors (AIs) are the first-line recommended standard of care for postmenopausal estrogen receptor-positive breast cancer. Because they cause a profound suppression of estrogen levels, concerns regarding their potential to increase the risk of fracture were rapidly raised. There is currently a general consensus that a careful baseline evaluation is needed of the risk of fracture in postmenopausal women about to start treatment with AIs but also in all premenopausal women with early disease. Bisphosphonates have been shown in several phase III trials to prevent the bone loss induced by cancer treatment, although no fracture data are available. Even though they do not have regulatory approval for this indication, their use must be discussed with women at high risk of fracture. Accordingly, several guidelines recommend considering treatment in women with a T-score ≤-2 or those with two or more clinical risk factors. Moreover, recent data suggest that bisphosphonates, especially intravenous zoledronic acid, may have an anticancer effect, in that they reduce bone recurrence as well as extra-skeletal metastasis and breast cancer mortality in postmenopausal women. The anti-RANK ligand antibody denosumab is also emerging as a new adjuvant therapeutic option to prevent AI-induced bone loss. It has been shown to extend the time to first fracture in postmenopausal women treated with AIs. Several issues still need to be addressed regarding the use of these different agents in an adjuvant setting. The purpose of this position statement is to review the literature on antifracture therapy and to discuss the current guidelines for the management of osteoporosis in women with early breast cancer.

18 Guideline 2015 GIPaM Recommendations (developed in 2013; updated December, 2014; updated December, 2015). 2016

Balmativola, Davide / Maletta, Francesca. ·Dipartimento di Scienze Mediche-Università di Torino. · AOU Città della Salute e della Scienza di Torino. ·Pathologica · Pubmed #28195243.

ABSTRACT: -- No abstract --

19 Guideline Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update. 2016

Recht, Abram / Comen, Elizabeth A / Fine, Richard E / Fleming, Gini F / Hardenbergh, Patricia H / Ho, Alice Y / Hudis, Clifford A / Hwang, E Shelley / Kirshner, Jeffrey J / Morrow, Monica / Salerno, Kilian E / Sledge, George W / Solin, Lawrence J / Spears, Patricia A / Whelan, Timothy J / Somerfield, Mark R / Edge, Stephen B. ·Beth Israel Deaconess Medical Center, Boston, MA. · Memorial Sloan Kettering Cancer Center, New York. · West Clinic Comprehensive Breast Center, Germantown, TN. · University of Chicago Medical Center, Chicago, IL. · Shaw Regional Cancer Center, Edwards, CO. · Duke University Medical Center, Durham, NC. · Hematology Oncology Associates of Central New York, East Syracuse. · Roswell Park Cancer Institute, Buffalo, NY. · Stanford University Medical Center, Palo Alto, CA. · Albert Einstein Healthcare Network, Philadelphia, PA. · North Carolina State University, Raleigh, NC. · Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada. · American Society of Clinical Oncology, Alexandria, VA. Electronic address: mark.somerfield@asco.org. ·Pract Radiat Oncol · Pubmed #27659727.

ABSTRACT: A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT). METHODS: A recent systematic literature review by Cancer Care Ontario provided the primary evidentiary basis. The joint panel also reviewed targeted literature searches to identify new, potentially practice-changing data. RECOMMENDATIONS: The panel unanimously agreed that available evidence shows that PMRT reduces the risks of locoregional failure (LRF), any recurrence, and breast cancer mortality for patients with T1-2 breast cancer with one to three positive axillary nodes. However, some subsets of these patients are likely to have such a low risk of LRF that the absolute benefit of PMRT is outweighed by its potential toxicities. In addition, the acceptable ratio of benefit to toxicity varies among patients and physicians. Thus, the decision to recommend PMRT requires a great deal of clinical judgment. The panel agreed clinicians making such recommendations for individual patients should consider factors that may decrease the risk of LRF, attenuate the benefit of reduced breast cancer-specific mortality, and/or increase risk of complications resulting from PMRT. When clinicians and patients elect to omit axillary dissection after a positive sentinel node biopsy, the panel recommends that these patients receive PMRT only if there is already sufficient information to justify its use without needing to know additional axillary nodes are involved. Patients with axillary nodal involvement after neoadjuvant systemic therapy should receive PMRT. The panel recommends treatment generally be administered to both the internal mammary nodes and the supraclavicular-axillary apical nodes in addition to the chest wall or reconstructed breast.

20 Guideline Fertility drugs and cancer: a guideline. 2016

Anonymous330880 / Anonymous340880. ·American Society for Reproductive Medicine, Birmingham, Alabama. · ·Fertil Steril · Pubmed #27573989.

ABSTRACT: Methodological limitations in studying the association between the use of fertility drugs and cancer include the inherent increased risk of cancer in women who never conceive, the low incidence of most of these cancers, and that the age of diagnosis of cancer typically is many years after fertility drug use. Based on available data, there does not appear to be a meaningful increased risk of invasive ovarian cancer, breast cancer, or endometrial cancer following the use of fertility drugs. Several studies have shown a small increased risk of borderline ovarian tumors; however, there is insufficient consistent evidence that a particular fertility drug increases the risk of borderline ovarian tumors, and any absolute risk is small. Given the available literature, patients should be counseled that infertile women may be at an increased risk of invasive ovarian, endometrial, and breast cancer; however, use of fertility drugs does not appear to increase this risk.

21 Guideline [Radiotherapy of breast cancer]. 2016

Hennequin, C / Barillot, I / Azria, D / Belkacémi, Y / Bollet, M / Chauvet, B / Cowen, D / Cutuli, B / Fourquet, A / Hannoun-Lévi, J M / Leblanc, M / Mahé, M A. ·Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France. Electronic address: christophe.hennequin2@aphp.fr. · Centre universitaire de cancérologie Henry-S.-Kaplan, CHU de Tours, 37000 Tours, France. · Institut régional du cancer, 208, avenue des Apothicaires Parc Euromédecine, 34298 Montpellier cedex 5, France. · CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France. · Institut Hartmann, 4, rue Kléber, CS 90004, 92309 Levallois-Perret cedex, France. · Institut Saint-Catherine, 250, chemin de Baigne-Pieds, 84918 Avignon cedex 9, France. · CHU Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France. · Clinique Courlancy, 38 bis, rue de Courlancy, 51100 Reims, France. · Institut Curie, 26, rue d'Ulm, 75005 Paris, France. · Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06100 Nice, France. · Centre René-Gauducheau, boulevard Professeur-Jacques-Monod, 44805 Saint-Herblain, France. ·Cancer Radiother · Pubmed #27522187.

ABSTRACT: In breast cancer, radiotherapy is an essential component of the treatment. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. Partial breast irradiation could not be proposed routinely but only in very selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neo-adjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra and infra-clavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit/risk ratio (cardiac toxicity). Dose to the chest wall or the breast must be between 45-50Gy with a conventional fractionation. A boost dose over the tumour bed is required if the patient is younger than 60 years old. Hypofractionation (42.5 Gy in 16 fractions, or 41.6 Gy en 13 or 40 Gy en 15) is possible after tumorectomy and if a nodal irradiation is not mandatory. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in case of specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with radiotherapy.

22 Guideline NCCN Guidelines Update: Breast Cancer. 2016

Gradishar, William / Salerno, Kilian E. ·Presented by William Gradishar, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, and Kilian E. Salerno, MD, Roswell Park Cancer Institute, Buffalo, New York. ·J Natl Compr Canc Netw · Pubmed #27226503.

ABSTRACT: The updates to management of early invasive breast cancer in 2016 are minor but have important treatment implications for patients. The NCCN Guidelines Panel for Breast Cancer has added endocrine therapy to its recommendations for the neoadjuvant treatment of patients with ER-rich tumors. For women who are premenopausal at diagnosis, the NCCN Guidelines suggest tamoxifen for 5 years, with or without ovarian suppression, or an aromatase inhibitor for 5 years combined with ovarian suppression or ablation. For HER2-positive patients, neoadjuvant pertuzumab is acceptable, and in advanced estrogen receptor-positive disease, palbociclib can be given with endocrine therapy. Hypofractionation is now the preferred approach for whole-breast irradiation after breast-conserving therapy. Regional nodal irradiation should be strongly considered for women with 1 to 3 positive lymph nodes and is indicated for those with 4 or more positive nodes.

23 Guideline Endocrine Therapy for Hormone Receptor-Positive Metastatic Breast Cancer: American Society of Clinical Oncology Guideline. 2016

Rugo, Hope S / Rumble, R Bryan / Macrae, Erin / Barton, Debra L / Connolly, Hannah Klein / Dickler, Maura N / Fallowfield, Lesley / Fowble, Barbara / Ingle, James N / Jahanzeb, Mohammad / Johnston, Stephen R D / Korde, Larissa A / Khatcheressian, James L / Mehta, Rita S / Muss, Hyman B / Burstein, Harold J. ·Hope S. Rugo, University of California San Francisco Comprehensive Cancer Center; Barbara Fowble, University of California San Francisco, San Francisco; Rita S. Mehta, University of California Irvine, Orange, CA; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Erin Macrae, Columbus Oncology and Hematology Associates, Columbus, OH; Debra L. Barton, University of Michigan School of Nursing, Ann Arbor, MI; Hannah Klein Connolly, Patient Representative, Edina, MN; Maura N. Dickler, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Lesley Fallowfield, Sussex Health Outcomes Research and Education in Cancer, Brighton and Sussex Medical School, University of Sussex, Sussex; Stephen R.D. Johnston, Royal Marsden Hospital, London, United Kingdom; James N. Ingle, Mayo Clinic, Rochester, MN; Mohammad Jahanzeb, University of Miami Sylvester Comprehensive Cancer Center, Deerfield Beach, FL; Larissa A. Korde, University of Washington, Seattle, WA; Hyman B. Muss, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; and Harold J. Burstein, Dana-Farber Cancer Center, Boston, MA. ·J Clin Oncol · Pubmed #27217461.

ABSTRACT: PURPOSE: To develop recommendations about endocrine therapy for women with hormone receptor (HR) -positive metastatic breast cancer (MBC). METHODS: The American Society of Clinical Oncology convened an Expert Panel to conduct a systematic review of evidence from 2008 through 2015 to create recommendations informed by that evidence. Outcomes of interest included sequencing of hormonal agents, hormonal agents compared with chemotherapy, targeted biologic therapy, and treatment of premenopausal women. This guideline puts forth recommendations for endocrine therapy as treatment for women with HR-positive MBC. RECOMMENDATIONS: Sequential hormone therapy is the preferential treatment for most women with HR-positive MBC. Except in cases of immediately life-threatening disease, hormone therapy, alone or in combination, should be used as initial treatment. Patients whose tumors express any level of hormone receptors should be offered hormone therapy. Treatment recommendations should be based on type of adjuvant treatment, disease-free interval, and organ function. Tumor markers should not be the sole criteria for determining tumor progression; use of additional biomarkers remains experimental. Assessment of menopausal status is critical; ovarian suppression or ablation should be included in premenopausal women. For postmenopausal women, aromatase inhibitors (AIs) are the preferred first-line endocrine therapy, with or without the cyclin-dependent kinase inhibitor palbociclib. As second-line therapy, fulvestrant should be administered at 500 mg with a loading schedule and may be administered with palbociclib. The mammalian target of rapamycin inhibitor everolimus may be administered with exemestane to postmenopausal women with MBC whose disease progresses while receiving nonsteroidal AIs. Among patients with HR-positive, human epidermal growth factor receptor 2-positive MBC, human epidermal growth factor receptor 2-targeted therapy plus an AI can be effective for those who are not chemotherapy candidates.

24 Guideline Practice Bulletin No. 164: Diagnosis and Management of Benign Breast Disorders. 2016

Anonymous1970869. · ·Obstet Gynecol · Pubmed #27214189.

ABSTRACT: Breast-related symptoms are among the most common reasons women present to obstetrician-gynecologists. Obstetrician-gynecologists are in a favorable position to diagnose benign breast disease in their patients. The purpose of a thorough understanding of benign breast disease is threefold: 1) to alleviate, when possible, symptoms attributable to benign breast disease, 2) to distinguish benign from malignant breast disease, and 3) to identify patients with an increased risk of breast cancer so that increased surveillance or preventive therapy can be initiated. Obstetrician-gynecologists may perform diagnostic procedures when indicated or may make referrals to physicians who specialize in the diagnosis and treatment of breast disease. The purpose of this Practice Bulletin is to outline common benign breast disease symptoms in women who are not pregnant or lactating and discuss appropriate evaluation and management. The obstetrician-gynecologist's role in the screening and management of breast cancer is beyond the scope of this document and is addressed in other publications of the American College of Obstetricians and Gynecologists ().

25 Guideline Committee Opinion No. 663 Summary: Aromatase Inhibitors in Gynecologic Practice. 2016

Anonymous1930869. · ·Obstet Gynecol · Pubmed #27214185.

ABSTRACT: Aromatase inhibitors have been used for the treatment of breast cancer, ovulation induction, endometriosis, and other estrogen-modulated conditions. For women with breast cancer, bone mineral density screening is recommended with long-term aromatase inhibitor use because of risk of osteoporosis due to estrogen deficiency. Based on long-term adverse effects and complication safety data, when compared with tamoxifen, aromatase inhibitors are associated with a reduced incidence of thrombosis, endometrial cancer, and vaginal bleeding. For women with polycystic ovary syndrome and a body mass index greater than 30, letrozole should be considered as first-line therapy for ovulation induction because of the increased live birth rate compared with clomiphene citrate. Lifestyle changes that result in weight loss should be strongly encouraged. Aromatase inhibitors are a promising therapeutic option that may be helpful for the management of endometriosis-associated pain in combination therapy with progestins.

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