7 results on '"Fentiman IS"'
Search Results
2. Treatment of breast cancer in older women.
- Author
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Bernardi D, Errante D, Gallligioni E, Crivellari D, Bianco A, Salvagno L, and Fentiman IS
- Subjects
- Age Factors, Aged, Antineoplastic Agents, Hormonal therapeutic use, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Chemotherapy, Adjuvant, Clinical Trials as Topic, Europe, Evidence-Based Medicine, Female, Humans, Mammaplasty, Neoadjuvant Therapy methods, Neoplasm Staging, Quality of Life, Radiotherapy, Adjuvant, Sentinel Lymph Node Biopsy, Antineoplastic Agents therapeutic use, Breast Neoplasms therapy, Mastectomy methods
- Abstract
Background: Breast carcinoma management in the elderly often differs from the management in younger women and there is considerable controversy about what constitutes appropriate cancer care for older women. This controversy is reflected in the persistence of age-dependent variations in care over time, with older women being less likely to receive definitive care for breast cancer. There has been a significant increase in the last years in the number of studies conducted in older patients with breast cancer. Although available age-specific clinical trials data demonstrate that treatment efficacy is not modified by age, this evidence is limited by the lack of inclusion of substantial numbers of older women, particularly those of advanced age and those with comorbidities., Method: The literature-based evidence of the last 10 years was extensively reviewed on the main issues concerning the treatment of breast cancer in older women., Results: Surgical treatment in older patients has evolved from avoidance to mastectomy to breast-conserving surgery, similarly to younger patients. Given its negative effect on the quality of life, in the last few years the role of adjuvant radiotherapy has been questioned in elderly patients with breast cancer. Adjuvant chemotherapy benefit in older patients applies mainly to Estrogen-receptor-negative patients, while in Estrogen-receptor-positive patients a major role is played by endocrine treatment. New "elderly-friendly" drugs, that can help clinicians to reduce toxicity, are now available for breast cancer. more...
- Published
- 2008
- Full Text
- View/download PDF
Catalog
3. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853--a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group.
- Author
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Bijker N, Meijnen P, Peterse JL, Bogaerts J, Van Hoorebeeck I, Julien JP, Gennaro M, Rouanet P, Avril A, Fentiman IS, Bartelink H, and Rutgers EJ
- Subjects
- Adult, Aged, Analysis of Variance, Breast Neoplasms pathology, Disease-Free Survival, Europe epidemiology, Female, Follow-Up Studies, Humans, Mastectomy, Modified Radical, Mastectomy, Segmental, Middle Aged, Neoplasm Recurrence, Local prevention & control, Proportional Hazards Models, Radiotherapy, Adjuvant, Risk Factors, Salvage Therapy, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Carcinoma, Intraductal, Noninfiltrating radiotherapy, Carcinoma, Intraductal, Noninfiltrating surgery, Neoplasm Recurrence, Local epidemiology
- Abstract
Purpose: The European Organisation for Research and Treatment of Cancer conducted a randomized trial investigating the role of radiotherapy (RT) after local excision (LE) of ductal carcinoma-in-situ (DCIS) of the breast. We analyzed the efficacy of RT with 10 years follow-up on both the overall risk of local recurrence (LR) and related to clinical, histologic, and treatment factors., Patients and Methods: After complete LE, women with DCIS were randomly assigned to no further treatment or RT (50 Gy). One thousand ten women with mostly (71%) mammographically detected DCIS were included. The median follow-up was 10.5 years., Results: The 10-year LR-free rate was 74% in the group treated with LE alone compared with 85% in the women treated by LE plus RT (log-rank P < .0001; hazard ratio [HR] = 0.53). The risk of DCIS and invasive LR was reduced by 48% (P = .0011) and 42% (P = .0065) respectively. Both groups had similar low risks of metastases and death. At multivariate analysis, factors significantly associated with an increased LR risk were young age (< or = 40 years; HR = 1.89), symptomatic detection (HR = 1.55), intermediately or poorly differentiated DCIS (as opposed to well-differentiated DCIS; HR = 1.85 and HR = 1.61 respectively), cribriform or solid growth pattern (as opposed to clinging/micropapillary subtypes; HR = 2.39 and HR = 2.25 respectively), doubtful margins (HR = 1.84), and treatment by LE alone (HR = 1.82). The effect of RT was homogeneous across all assessed risk factors., Conclusion: With long-term follow-up, RT after LE for DCIS continued to reduce the risk of LR, with a 47% reduction at 10 years. All patient subgroups benefited from RT. more...
- Published
- 2006
- Full Text
- View/download PDF
4. 14. Breast cancer prevention.
- Author
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Salih AK and Fentiman IS
- Subjects
- Breast Neoplasms genetics, Europe, Female, Genes, BRCA1, Genes, BRCA2, Humans, Italy, Life Style, Mass Screening, Mutation, Randomized Controlled Trials as Topic, Selective Estrogen Receptor Modulators therapeutic use, Tamoxifen therapeutic use, Breast Neoplasms prevention & control
- Abstract
Increased risk of breast cancer may result from potentially modifiable causes such as endogenous hormone levels, obesity, HRT, and non-lactation, or non-modifiable factors including genetic susceptibility and increasing age. The Gail model, based on known factors, may be useful for estimating lifetime risk in some individuals, but those risk factors that are easier to modify may have a limited impact on the totality of breast cancer. Tamoxifen prevention still remains contentious, with a significant reduction in risk of breast cancer in women given tamoxifen in the NSABP P1 study but no effect in the Italian and Royal Marsden trials. Raloxifene, tested in the MORE trial, reduced the incidence of breast cancer by 65% but this was restricted to oestrogen receptor positive tumours. Lifestyle factors such as diet, obesity, exercise and age at first full term pregnancy and number of pregnancies have a mild to moderate impact on risk, so may have little effect on the incidence of breast cancer. Reduction of alcohol intake could lead to a modest reduction in the risk of breast cancer but possibly adversely affect other diseases. Fat reduction and GnRH analogue reduce mammographic density but have not yet been shown to affect risk. For women with BRCA1/2 mutation, options include unproven surveillance and prophylactic mastectomy with an unquantified risk reduction. Interesting new candidates for chemoprevention include aromatase inhibitors, new generation SERMs, demethylating agents, non-selective COX inhibitors, tyrosine kinase inhibitors and polyamine synthetic inhibitors. more...
- Published
- 2002
5. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial.
- Author
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van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, van der Schueren E, Helle PA, van Zijl K, and Bartelink H
- Subjects
- Breast Neoplasms radiotherapy, Europe, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Radiotherapy, Adjuvant, Risk, Survival Analysis, Time Factors, Treatment Outcome, Breast Neoplasms pathology, Breast Neoplasms surgery, Mastectomy, Modified Radical, Mastectomy, Segmental
- Abstract
Background: Breast-conserving therapy (BCT) has been shown to be as effective as mastectomy in the treatment of tumors 2 cm or smaller. However, evidence of its efficacy, over the long term, in patients with tumors larger than 2 cm is limited. From May 1980 to May 1986, the European Organization for Research and Treatment of Cancer carried out a randomized, multicenter trial comparing BCT with modified radical mastectomy for patients with tumors up to 5 cm. In this analysis, we investigated whether the treatments resulted in different overall survival, time to distant metastasis, or time to locoregional recurrence., Methods: Of 868 eligible breast cancer patients randomly assigned to the BCT arm or to the modified radical mastectomy arm, 80% had a tumor of 2.1-5 cm. BCT comprised lumpectomy with an attempted margin of 1 cm of healthy tissue and complete axillary clearance, followed by radiotherapy to the breast and a supplementary dose to the tumor bed. The median follow-up was 13.4 years. All P values are two-sided., Results: At 10 years, there was no difference between the two groups in overall survival (66% for the mastectomy patients and 65% for the BCT patients; P =.11) or in their distant metastasis-free rates (66% for the mastectomy patients and 61% for the BCT patients; P =.24). The rate of locoregional recurrence (occurring before or at the same time as distant metastasis) at 10 years did show a statistically significant difference (12% of the mastectomy and 20% of the BCT patients; P =. 01)., Conclusions: BCT and mastectomy demonstrate similar survival rates in a trial in which the great majority of the patients had stage II breast cancer. more...
- Published
- 2000
- Full Text
- View/download PDF
6. Randomized clinical trial to assess the value of breast-conserving therapy in stage I and II breast cancer, EORTC 10801 trial.
- Author
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van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, van der Schueren E, Sylvester R, Winter J, and van Zijl K
- Subjects
- Adult, Breast Neoplasms mortality, Breast Neoplasms pathology, Combined Modality Therapy, Europe, Humans, Middle Aged, Neoplasm Recurrence, Local therapy, Neoplasm Staging, Prospective Studies, Salvage Therapy, Survival Rate, Breast Neoplasms therapy, Mastectomy, Modified Radical, Mastectomy, Segmental
- Abstract
In a prospective randomized clinical trial conducted by the European Organization for Research and Treatment of Cancer (EORTC), mastectomy was compared with breast-conserving therapy in 903 stage I and stage II breast cancer patients entering the study between 1980 and 1986. The main participating centers were: Guy's Hospital, London; The Netherlands Cancer Institute, Amsterdam; University Hospital, Leuven; Radiotherapy Institute, Rotterdam; Breast Unit, Tijgerberg, S.A. The data were collected in the EORTC Data Center, Brussels. Treatment in the study arm consisted of lumpectomy, axillary clearance, and radiotherapy to the breast (50 Gy external irradiation in 5 weeks followed by boost with iridium implant of 25 Gy). Important in this study is the large number of TNM stage II patients (755). Most patients were stage II because of the size of the tumor (2-5 cm). The patient and tumor characteristics in the study and control groups were well balanced. So far the survival curves and local recurrence rates are not statistically different for the two study arms. Tumor size was found in univariate analysis to be a significant risk factor for local recurrence in the breast-conserving therapy group but not in the mastectomy group. Results of salvage treatment for local recurrence were not better for the breast-conserving therapy group compared with the mastectomy group. Measurements of quality of life and cosmesis show a clear benefit for the breast-conserving therapy group. more...
- Published
- 1992
7. In-situ breast cancer: the EORTC consensus meeting.
- Author
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van Dongen JA, Fentiman IS, Harris JR, Holland R, Peterse JL, Salvadori B, and Stewart HJ
- Subjects
- Clinical Trials as Topic, Combined Modality Therapy, Europe, Female, Humans, Mammography, Mastectomy, Neoplasm Recurrence, Local radiotherapy, Neoplasm Recurrence, Local surgery, Prognosis, Reoperation, Breast Neoplasms pathology, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Carcinoma in Situ pathology, Carcinoma in Situ radiotherapy, Carcinoma in Situ surgery, Carcinoma, Intraductal, Noninfiltrating pathology, Carcinoma, Intraductal, Noninfiltrating radiotherapy, Carcinoma, Intraductal, Noninfiltrating surgery
- Published
- 1989
- Full Text
- View/download PDF
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