Catalogue Search | MBRL
هل أنت متأكد أنك تريد إزالة الكتاب من الرف؟
{{itemTitle}}
581,567
نتائج ل
"Breast cancer"
صنف حسب:
From Pink to Green
From the early 1980s, the U.S. environmental breast cancer movement has championed the goal of eradicating the disease by emphasizing the importance of reducing-even eliminating exposure to chemicals and toxins.From Pink to Greenchronicles the movement's disease prevention philosophy from the beginning.Challenging the broader cultural milieu of pink ribbon symbolism and breast cancer \"awareness\" campaigns, this movement has grown from a handful of community-based organizations into a national entity, shaping the cultural, political, and public health landscape. Much of the activists' everyday work revolves around describing how the so called \"cancer industry\" downplays possible environmental links to protect their political and economic interests and they demand that the public play a role in scientific, policy, and public health decision-making to build a new framework of breast cancer prevention.
From Pink to Greensuccessfully explores the intersection between breast cancer activism and the environmental health sciences, incorporating public and scientific debates as well as policy implications to public health and environmental agendas.
eBook
A breast cancer alphabet
Madhulika Sikka's Breast Cancer Alphabet offers a new way to live with and plan past the hardest diagnosis that most women will ever receive: a personal, practical, and deeply informative look at the road from diagnosis to treatment and beyond. What Madhulika Sikka didn't foresee when initially diagnosed, and what this book brings to life so vividly, are the unexpected and minute challenges that make navigating the world of breast cancer all the trickier. This book is an inspired reaction to what started as a personal predicament. As a prominent news executive, Madhulika had access to the most cutting edge data on the disease's reach and impact. At the same time, she craved the community of frank talk and personal insight that we rely on in life's toughest moments. This inventive book navigates the world of science and story, bringing readers into Madhulika's mind and experience in a way that demystifies breast cancer and offers new hope for those living with it.-- From publisher description.
Book
Avelumab, an anti-PD-L1 antibody, in patients with locally advanced or metastatic breast cancer: a phase 1b JAVELIN Solid Tumor study
Purpose
Agents targeting programmed death receptor 1 (PD-1) or its ligand (PD-L1) have shown antitumor activity in the treatment of metastatic breast cancer (MBC). The aim of this study was to assess the activity of avelumab, a PD-L1 inhibitor, in patients with MBC.
Methods
In a phase 1 trial (JAVELIN Solid Tumor; NCT01772004), patients with MBC refractory to or progressing after standard-of-care therapy received avelumab intravenously 10 mg/kg every 2 weeks. Tumors were assessed every 6 weeks by RECIST v1.1. Adverse events (AEs) were graded by NCI-CTCAE v4.0. Membrane PD-L1 expression was assessed by immunohistochemistry (Dako PD-L1 IHC 73-10 pharmDx).
Results
A total of 168 patients with MBC, including 58 patients with triple-negative breast cancer (TNBC), were treated with avelumab for 2–50 weeks and followed for 6–15 months. Patients were heavily pretreated with a median of three prior therapies for metastatic or locally advanced disease. Grade ≥ 3 treatment-related AEs occurred in 13.7% of patients, including two treatment-related deaths. The confirmed objective response rate (ORR) was 3.0% overall (one complete response and four partial responses) and 5.2% in patients with TNBC. A trend toward a higher ORR was seen in patients with PD-L1+ versus PD-L1− tumor-associated immune cells in the overall population (16.7% vs. 1.6%) and in the TNBC subgroup (22.2% vs. 2.6%).
Conclusion
Avelumab showed an acceptable safety profile and clinical activity in a subset of patients with MBC. PD-L1 expression in tumor-associated immune cells may be associated with a higher probability of clinical response to avelumab in MBC.
Journal Article
Survival with metastatic breast cancer based on initial presentation, de novo versus relapsed
Purpose
We hypothesized different Overall Survival (OS) in metastatic breast cancer (MBC) after relapse vs de novo presentation.
Methods
We identified women in British Columbia with MBC diagnosed between 01/2001 and 12/2009. OS from MBC was calculated for relapsed vs de novo cohorts in 3 subgroups, based on hormone receptors (HR) and HER2 status. Age at MBC, disease-free interval (DFI), de novo vs relapsed, year of MBC diagnosis, and systemic treatment were entered into univariable and multivariable analyses.
Results
We identified 3645 pts with known HR of which 2796 had known HER2. Median follow-up was 91 months. Median OS was longer for de novo vs relapsed MBC: HR+/HER2- 34 versus 23 months (mos) (
p
< 0.0001), HR−/HER2- (TN) 11 versus 8 mos (
p
= 0.02), HER2+ 29 versus 15 mos (
p
< 0.0001). For TN disease, no variable independently discriminated a group with increased risk of death. For both the HR +/HER2- and the HER2 + groups, relapsed vs de novo status (HzR 1.4 [95% CI 1.2–1.5;
p
< 0.0001], and HzR 1.6 [95% CI 1.4–1.9;
p
< 0.0001], respectively) and age >50 (HzR 1.2 [95% CI 1.1–1.4;
p
= 0.001] and HzR 1.3 [95% CI 1.1–1.5;
p
= 0.01], respectively) were associated with increased risk of death on multivariable analysis.
Conclusion
These data provide information that may guide discussions about prognosis between physicians and patients with MBC. In addition, it highlights the importance of stratifying for initial stage at diagnosis in future MBC therapeutic trials.
Journal Article
Immune Checkpoint Inhibitors and Novel Immunotherapy Approaches for Breast Cancer
Purpose of Review
To critically review the existing evidence on immune checkpoint inhibitors (ICIs) in early-stage and metastatic breast cancer and discuss emerging strategies in the different breast cancer subtypes.
Recent Findings
Immunotherapy has become one of the major milestones in contemporary oncology, revolutionizing the treatment of multiple solid tumors. ICI agents combined with chemotherapy have demonstrated significant efficacy in both early-stage and metastatic triple-negative breast cancer. However, only a subgroup of patients responds to those agents and some associated toxicities, although infrequent, can be life-disabling. Emerging data from immunotherapy studies in advanced hormone receptor–positive (HR +) breast cancer as well as HER2-positive disease are arising with mixed results.
Summary
Although breast cancer has not classically been considered a hot tumor, ICIs have proven to be effective in a subset of breast cancer patients. However, much remains to be learned, and the identification of new biomarkers beyond PD-L1 expression is essential not only to improve the efficacy of ICI but also to identify patients who can avoid them, together with their toxicities and costs.
Journal Article
Increasing Role of Oncoplastic Surgery for Breast Cancer
Purpose of Review
The goals of surgery for breast cancer have remained the same over the years, to eliminate breast cancer from the breast with the least degree of deformity. With the current expectation of long-term survival after breast cancer treatment, more attention has turned to the cosmetic result of the surgical treatment. Whether lumpectomy or mastectomy, the need for aesthetic improvement was recognized by surgeons both in and outside the USA.
Recent Findings
Oncoplastic surgery combines the skills of the cancer surgeon with those of the plastic surgeon. Sometimes, this means a team approach with a breast surgeon and a plastic surgeon both performing their mutual skills for the patient. Other times, the properly trained breast surgeon may perform some of the plastic techniques at the time of cancer surgery. Breast surgeons are rapidly gaining the ability to improve the post-cancer treatment appearance. To simplify the classification of oncoplastic techniques, we have used lower level, upper level, and highest level. The assignment of techniques to levels is based on both the technique and the surgeon’s training and experience. Much data has accumulated demonstrating the safety and efficacy of the “aesthetic cancer cure.” We describe the development of oncoplastic surgery, the techniques available, matching the right candidate with the right technique, and some comments about the future.
Summary
It is clear from both clinical benefit and patient satisfaction that oncoplastic breast cancer procedures are here to stay. Plastic surgeons will likely focus on the upper- and highest-level procedures while breast/general surgeons will learn lower-level procedures and some of upper-level procedures as needed by their locale. Opportunities to educate breast/general surgeons in these techniques will continue to increase over the next several years. Formal education in oncoplastic surgery during breast fellowships will be necessary to catch up with the rest of the surgical world outside the USA.
Journal Article