Leczenie przedoperacyjne chorych na raka piersi i jego wpływ na postępowanie operacyjne oraz radioterapeutyczne (część 2.)

Abstract

Neoadjuvant therapy (NAT) is increasingly applied in patients with initially inoperable breast cancers and, frequently, in those with tumours that are initially operable, too. In most cases, the response to the applied NAT affects the scope of surgical treatment and radiotherapy, and in some situations also the complementary systemic postoperative treatment. The available studies indicate importance of response to NAT within the breast and regional lymph nodes. Assessment of response to treatment allows personalization of treatment and in some cases a change of therapy, which improves long-term outcomes. This article summarizes the current rules of conduct in patients with early breast cancer qualified for neoadjuvant therapy, paying attention to the practical aspects and possibilities of national health insurance-covered therapies in Poland. It discusses in detail the applied regimens of systemic therapy, surgical techniques, eligibility rules and complementary radiotherapy. Systems for assessing response to neoadjuvant treatment are also presented.

Retrospective analysis of the treatment of BRCA1 and BRCA2 mutation carriers – the experience of a single-center tertiary institution

“…Present oncoplastic surgery focuses on providing oncologically safe procedures with possibly the best aesthetic outcomes. Techniques such as NSM, concentrated on preserving the NAC (nipple-areolar complex), and SSM, where NAC is excised with glandular tissue (but may be reconstructed in a subsequent procedure), are considered to achieve the above-mentioned goals [16,17]. As was reported, the patients involved in our study received various types of surgical operations for breast cancer, including NSM, SSM, BCT, and radical mastectomy with or without delayed reconstruction.…”

The molecular portrait of triple-negative breast cancer: the LAG3 gene single nucleotide polymorphism rs2365094 has no impact on the clinical picture

“…TNBC accounts for 20% of overall breast cancers [1]. A key prognostic factor for this type of breast cancer comprises a complete pathological response to first-line neoadjuvant therapy and primary chemosensitivity [2] but high risk of recurrence [3]. Even so, unlike other breast cancers, TNBC demonstrates a much higher likelihood of metastasis to the brain or lung rather than bone.…”

“…The 2016 Lehmann et al classification [4] divides TNBC into four subgroups based on genomic analysis of BRCA1/2, STAT4, TP53, APC, BRAF, MAP2, MAPK13, MDC1, PTEN, RB1, CDKN2A, UTX, CTNNA, DDX18, HUWE1, NFKBIA, PIK3CA, KRAS, HRAS: basal-like immunosuppressed, basal-like immune-activated, luminal androgen receptor and mesenchymal types [3]. The classification of TNBC decides on the treatment strategy [4,5].…”