Landmark Trials in Breast Surgery: Recent Episodes
Edward St John & Hirah Rizki
We are UK Breast Surgeons who revised together for our exit exams and hope you'll find our revision notes as helpful as we did! We discuss the latest guidelines and landmark evidence behind current practices in breast surgery. This is relevant for anyone revising for FRCS, board exams, fellowship and continuing professional development. Any questions or comments - tweet us @ercstjohn @hirahrizki01 . Thank you to Professor John Benson for helping us to edit this content.
Here we discuss the landmark trials for Bisphosphonate treatment in early breast cancer. Below are the links to the papers we discuss: NICE guidance - https://www.nice.org.uk/guidance/ng101 Patterson AH et al. NSABP-B34, 2012 – Lancet Oncology - https://www.ncbi.nlm.nih.gov/pubmed/22704583 EBCTCG 2015 - Lancet - https://www.ncbi.nlm.nih.gov/pubmed/26211824 Cochrane review 2017 - Cochrane Database Syst Rev - https://www.ncbi.nlm.nih.gov/pubmed/29082518 Gralow J.R. et al. SWOG SO307 - J Natl Cancer Inst 2020 - https://pubmed.ncbi.nlm.nih.gov/31693129/ Coleman R et al. AZURE - Lancet Oncology 2014 - https://pubmed.ncbi.nlm.nih.gov/25035292/ Gnant M et al. ABCSG-12 - Lancet Oncology 2011 - https://pubmed.ncbi.nlm.nih.gov/21641868/
Here we discuss management of the node positive axilla and cover the indications and evidence behind axillary radiotherapy and de-escalation of axillary surgery. The links to the papers we mention are listed below: ABS Guidelines, 2011 - https://associationofbreastsurgery.org.uk/media/64197/final-axilla-consensus-statement.pdf Donker M et al, EORTC AMAROS, 2014, Lancet oncology - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291166/ Giuliano A et al. ACOSOG Z0011, 2010 – Annals of Surgery - https://www.ncbi.nlm.nih.gov/pubmed/21304082 Giuliano A et al. ACOSOG Z0011 10 year update, USA, 2017 - JAMA - https://www.ncbi.nlm.nih.gov/pubmed/28898379 POSNOC - https://pubmed.ncbi.nlm.nih.gov/26254841 Hansen NM et al., 2009 – Journal of Clinical Oncology - https://pubmed.ncbi.nlm.nih.gov/19720928/ IBCSG 23-01, 2013+ 2018 Lancet Oncology - · 2013, https://www.ncbi.nlm.nih.gov/pubmed/23491275, 2018, https://www.ncbi.nlm.nih.gov/pubmed/30196031
We discuss the advent of SLNB and the landmark papers. Below are the links to the paper we discuss.
Veronesi et al,2003 - New England Journal of Medicine. - https://www.ncbi.nlm.nih.gov/pubmed/12904519
Mansel et al, ALMANAC. 2006 - J Natl Cancer Inst. - https://www.ncbi.nlm.nih.gov/pubmed/16670385
Krag et al. NSABP-32, 2010 - Lancet Oncology - https://www.ncbi.nlm.nih.gov/pubmed/20863759
Boreham et al. Cochrane Review, Cochrane Database Systematic Review, 2017 - https://www.ncbi.nlm.nih.gov/pubmed/28052186
Goyal et al. ALMANAC sub-analysis, 2006 - Breast Cancer Res Treat. - https://www.ncbi.nlm.nih.gov/pubmed/16541308
ASCO Guidelines 2016 - Journal of Clinical Oncology - https://www.ncbi.nlm.nih.gov/pubmed/27937089
Green–top Guidelines - https://associationofbreastsurgery.org.uk/media/64251/z-pregnanty.pdf
Huxley N et al., 2012 - Health Technology Assessment, No. 19.2 - https://www.ncbi.nlm.nih.gov/books/NBK269043/