Background Implant-based breast reconstruction (IBBR) remains the standard and most popular option for women undergoing breast reconstruction after mastectomy worldwide. Recently, prepectoral IBBR has resurged in popularity, despite limited data comparing prepectoral with subpectoral IBBR. Methods A systematic search of PubMed and Cochrane Library from January 1, 2011 to December 31, 2021, was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines, data were extracted by independent reviewers. Studies that compared prepectoral with subpectoral IBBR for breast cancer were included. Results Overall, 15 studies with 3,101 patients were included in this meta-analysis. Our results showed that patients receiving prepectoral IBBR experienced fewer capsular contractures (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.32–0.92; P = 0.02), animation deformity (OR, 0.02; 95% CI, 0.00–0.25; P = 0.002), and prosthesis failure (OR, 0.58; 95% CI, 0.42–0.80; P = 0.001). There was no significant difference between prepectoral and subpectoral IBBR in overall complications (OR, 0.83; 95% CI, 0.64–1.09; P = 0.19), seroma (OR, 1.21; 95% CI, 0.59-2.51; P = 0.60), hematoma (OR, 0.76; 95% CI, 0.49–1.18; P = 0.22), infection (OR, 0.87; 95% CI, 0.63–1.20; P = 0.39), skin flap necrosis (OR, 0.70; 95% CI, 0.45–1.08; P = 0.11), and recurrence (OR, 1.31; 95% CI, 0.52–3.39; P = 0.55). Similarly, no significant difference was found in Breast-Q scores between the prepectoral and subpectoral IBBR groups. Conclusions The results of our systematic review and meta-analysis demonstrated that prepectoral, implant-based, breast reconstruction is a safe modality and has similar outcomes with significantly lower rates of capsular contracture, prosthesis failure, and animation deformity compared with subpectoral, implant-based, breast reconstruction.

Randomized trials have studied bisphosphonates in the adjuvant setting of early breast cancer to investigate their ability to prevent treatment-induced bone loss. Trial results have also suggested their potential to prevent disease recurrence and metastases. These trials are summarized in this review. A recent patient-level meta-analysis by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) finds convincing evidence that adjuvant antiresorptive treatments provide persistent benefits to breast cancer patients in low-estrogen situations and should be considered an important part of the treatment algorithm.

Ein Umbruch in der chirurgischen Onkologie: Hintergründe der Pancho Studie Zusammenfassung. Grundlagen: Die neoadjuvante Therapie bringt bei Patienten mit Ö sophaguskarzinom keine eindeutige Verbesserung des Gesamtüberlebens. Einen deutlichen Ü berlebensvorteil zeigen allerdings Patienten mit kompletter pathologischer Remission.Methodik: Dieses Review fasst mehrere retrospektive klinische Studien zusammen, die p53 als potentiellen prädiktiven Marker für das Ansprechen auf Chemotherapie ausweisen. Um den Zusammenhang zwischen p53 und Chemotherapieansprechen auf hohem Evidenzniveau (Level I) zu untersuchen, wurde die Pancho Studie initiiert.Ergebnisse: In der Pancho Studie wird erstmalsprospektiv randomisiert -untersucht, ob eine Interaktion zwischen p53 und dem Ansprechen auf Chemotherapie besteht.In der vorliegenden Arbeit berichten wir ü ber das Pancho Studiendesign (Wechselwirkungsdesign), die Fallzahlberechnung, die Studienendpunkte und den Rekrutierungsstatus dieser Multizenter-Studie nach einem Jahr Laufzeit.Schlussfolgerungen: Die Pancho Studie testet erstmals in einem geeigneten Design, ob der p53 Genotyp ein valider Marker ist, um wirksame Chemotherapien zu selektieren und damit eine individuelle Krebstherapie zu ermöglichen.Schlüsselwörter: Individuelle Krebstherapie, Ö sophagus Karzinom, p53, Neoadjuvante Therapie, Prädiktiver Marker, Vorhersage des Ansprechens, Pancho.Summary. Background: In esophageal cancer patients neoadjuvant therapy failed to demonstrate a clear benefit in overall survival. A significant advantage can be seen in patients with complete pathological response.Methods: This review summarizes the results of retrospective clinical studies suggesting p53 as a predictive marker for chemotherapy response. To advance these findings to level of evidence I the Pancho trial was initiated.Results: The Pancho trial represents the first prospective randomized trial testing the interaction between p53 and response to chemotherapy.The special design of the Pancho trial (interaction design), the sample size considerations, the study endpoints and the 12 months accrual of this nationwide study are reported.Conclusions: The Pancho trial evaluates for the first time whether the p53 genotype is qualified to select patients who will respond to certain chemotherapy and to guide cancer therapy.

Bone health and breast cancer are two connected subjects, because breast cancer patients have a higher prevalence of osteopenia/osteoporosis and reduced bone health parameters than healthy woman of the same age. Therefore, the positive effect of adjuvant bisphosphonate therapy plays an important role in breast cancer treatment. Several randomized trials have studied bisphosphonates in the adjuvant setting in postmenopausal woman and demonstrated their potential to prevent treatment-induced bone loss. The prevention of fractures and the subsequent preservation of patients' quality of life are important arguments for the use of adjuvant bisphosphonates in postmenopausal breast cancer patients. In addition, trials of adjuvant bone-targeted agents showed a reduction of recurrences in and outside bone and an improved outcome in patients treated with bisphosphonates.