Fadila Kouhen: Practice changing insight for local treatment of breast cancer
Fadila Kouhen, Associate Professor at Cheikh Khalifa International University Hospital, posted the following on LinkedIn:
“Practice changing insight for local treatment of breast cancer from the San Antonio Symposium.
COMET trial ( JAMA) : Women with low-risk DCIS randomized to active monitoring ( follow-up every 6 months with breast imaging and physical examination ) did not have a higher rate of invasive cancer in the same breast at 2 years compared with those randomized to guideline-concordant care. More follow up is needed
INSEMA trial (NEJM) : patients with clinically node-negative, T1 or T2 invasive breast cancer , omission of surgical axillary staging was noninferior to sentinel-lymph-node biopsy after a median follow-up of 6 years.
EUROPA trial ( Lancet oncology ) aims to compare the effects of radiotherapy and endocrine therapy as single-modality treatments on health-related quality of life (HRQOL) and ipsilateral breast tumour recurrence (IBTR) outcomes in this population: Endocrine therapy was associated with a greater reduction in HRQOL, compared with radiotherapy at 24 months with similar IBTR
The SUPREMO trial supports a tailored, de-escalated approach to radiation therapy in intermediate-risk breast cancer patients after mastectomy :
1. pT1-2, N1 Disease: Tumors ≤50 mm with 1-3 positive axillary lymph nodes.
2. pT3, N0 Disease: Tumors >50 mm with no nodal involvement.
3. High-Risk Features in Node-Negative Disease: Tumors >20 mm but ≤50 mm with grade 3 histology and/or lymphovascular invasion (LVI).”
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