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Breasts : a natural and unnatural history
Feted and fetishized, the breast is an evolutionary masterpiece. But breasts are changing. They're getting bigger, arriving earlier, and attracting newfangled chemicals. Increasingly, the odds are stacked against us in the struggle against breast cancer, even among men. What makes breasts so mercurial and so vulnerable? Intrepid science journalist Florence Williams sets out to uncover the latest science from the fields of anthropology, biology, and medicine in an engaging expoâse about the breast and its imperiled modern fate.
Book
Inavolisib-Based Therapy in PIK3CA-Mutated Advanced Breast Cancer
In
PIK3CA
-mutated, HR-positive, HER2-negative locally advanced or metastatic breast cancer, inavolisib plus palbociclib–fulvestrant led to significantly longer progression-free survival than placebo plus palbociclib–fulvestrant.
Journal Article
Breast cancer facts, myths, and controversies : understanding current screenings and treatments
\"Using clear, reader-friendly text, this book explains this vital and ever-evolving field, with the aim of helping women make informed decisions by understanding breast cancer, associated screenings and treatments, as well as their benefits, risks, and limitations\"-- Provided by publisher.
Book
Axillary Surgery in Breast Cancer — Primary Results of the INSEMA Trial
Whether surgical axillary staging as part of breast-conserving therapy can be omitted without compromising survival has remained unclear.
In this prospective, randomized, noninferiority trial, we investigated the omission of axillary surgery as compared with sentinel-lymph-node biopsy in patients with clinically node-negative invasive breast cancer staged as T1 or T2 (tumor size, ≤5 cm) who were scheduled to undergo breast-conserving surgery. We report here the per-protocol analysis of invasive disease-free survival (the primary efficacy outcome). To show the noninferiority of the omission of axillary surgery, the 5-year invasive disease-free survival rate had to be at least 85%, and the upper limit of the confidence interval for the hazard ratio for invasive disease or death had to be below 1.271.
A total of 5502 eligible patients (90% with clinical T1 cancer and 79% with pathological T1 cancer) underwent randomization in a 1:4 ratio. The per-protocol population included 4858 patients; 962 were assigned to undergo treatment without axillary surgery (the surgery-omission group), and 3896 to undergo sentinel-lymph-node biopsy (the surgery group). The median follow-up was 73.6 months. The estimated 5-year invasive disease-free survival rate was 91.9% (95% confidence interval [CI], 89.9 to 93.5) among patients in the surgery-omission group and 91.7% (95% CI, 90.8 to 92.6) among patients in the surgery group, with a hazard ratio of 0.91 (95% CI, 0.73 to 1.14), which was below the prespecified noninferiority margin. The analysis of the first primary-outcome events (occurrence or recurrence of invasive disease or death from any cause), which occurred in a total of 525 patients (10.8%), showed apparent differences between the surgery-omission group and the surgery group in the incidence of axillary recurrence (1.0% vs. 0.3%) and death (1.4% vs. 2.4%). The safety analysis indicates that patients in the surgery-omission group had a lower incidence of lymphedema, greater arm mobility, and less pain with movement of the arm or shoulder than patients who underwent sentinel-lymph-node biopsy.
In this trial involving patients with clinically node-negative, T1 or T2 invasive breast cancer (90% with clinical T1 cancer and 79% with pathological T1 cancer), omission of surgical axillary staging was noninferior to sentinel-lymph-node biopsy after a median follow-up of 6 years. (Funded by the German Cancer Aid; INSEMA ClinicalTrials.gov number, NCT02466737.).
Journal Article
First-Line Camizestrant for Emerging ESR1-Mutated Advanced Breast Cancer
In patients with advanced breast cancer, switching to camizestrant with a CDK4/6 inhibitor after
ESR1
-mutation detection (and before disease progression) led to significantly longer progression-free survival.
Journal Article
Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer
In patients with
PIK3CA
-mutated advanced breast cancer, inavolisib added to palbociclib–fulvestrant led to a significant overall survival benefit, with a higher incidence of certain toxic effects than placebo.
Journal Article
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
Vepdegestrant, a PROTAC Estrogen Receptor Degrader, in Advanced Breast Cancer
Vepdegestrant is an oral proteolysis-targeting chimera (PROTAC) estrogen receptor (ER) degrader that directly harnesses the ubiquitin-proteasome system.
In this phase 3, open-label, randomized trial, we enrolled patients with ER-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer who had received one previous line of cyclin-dependent kinase 4 and 6 inhibitor therapy plus one line of endocrine therapy (and up to one additional line of endocrine therapy). Patients were randomly assigned in a 1:1 ratio to receive vepdegestrant at a dose of 200 mg orally once every day of each 28-day cycle or fulvestrant at a dose of 500 mg, administered intramuscularly, on day 1 and day 15 of cycle 1 and on day 1 of subsequent cycles, with randomization stratified according to
-mutation status and presence or absence of visceral disease. The primary end point was progression-free survival as assessed by blinded independent central review among the patients with
mutations and among all the patients who underwent randomization. Progression-free survival was estimated with Kaplan-Meier methods and hazard ratios with a stratified Cox proportional-hazards model.
A total of 624 patients underwent randomization; 313 were assigned to receive vepdegestrant, and 311 to receive fulvestrant. Among the 270 patients with
mutations, the median progression-free survival was 5.0 months (95% confidence interval [CI], 3.7 to 7.4) with vepdegestrant and 2.1 months (95% CI, 1.9 to 3.5) with fulvestrant (hazard ratio, 0.58 [95% CI, 0.43 to 0.78]; P<0.001). Among all the patients, the median progression-free survival was 3.8 months (95% CI, 3.7 to 5.3) with vepdegestrant and 3.6 months (95% CI, 2.6 to 4.0) with fulvestrant (hazard ratio, 0.83 [95% CI, 0.69 to 1.01]; P = 0.07). Adverse events of grade 3 or higher occurred in 23.4% of the patients in the vepdegestrant group and in 17.6% of the patients in the fulvestrant group. Adverse events led to treatment discontinuation in 2.9% and 0.7% of the patients, respectively.
Among patients with ER-positive, HER2-negative advanced breast cancer, vepdegestrant was associated with significantly longer progression-free survival than fulvestrant in the subgroup with
mutations but not in the full patient population. (Funded by Pfizer and Arvinas Estrogen Receptor; VERITAC-2 ClinicalTrials.gov number, NCT05654623.).
Journal Article