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Sankt Gallen, Switzerland

Background:There is an ongoing debate about the relationship between breast implants and secondary malignancies.Methods:Breast cancer patients undergoing surgical reconstruction after mastectomy by either implants or autologous flap were identified in the Surveillance, Epidemiology and End Results registry between 1998 and 2002. The occurrence of secondary malignancies at least 1 year after diagnosis was compared between breast reconstruction with implants vs autologous flap.Results:Of 7955 women, 3727 underwent reconstruction using implants and 4228 using autologous flap. The incidence of secondary tumours was similar in both the groups (hazards ratio (HR)=1.02, 95% confidence interval (CI): 0.82–1.26, P=0.880). For lung cancer, a significantly increased risk for implants (HR=2.51, 95% CI: 1.28–4.95, P=0.005) was observed.Conclusions:Except for lung cancer, no association between implants and secondary malignancies including lymphomas was observed.British Journal of Cancer advance online publication, 17 May 2016; doi:10.1038/bjc.2016.108 www.bjcancer.com. © 2016 Cancer Research UK Source


Joerger M.,Cantonal Hospital | Thurlimann B.,Breast Center
Expert Review of Anticancer Therapy | Year: 2013

The addition of adjuvant chemotherapy in early breast cancer improves overall survival by approximately 10%. Recommendations favor the use of anthracyclines and taxanes in patients with luminal B disease, while the use of an anthracycline, taxane and alkylating agent is recommended in triple-negative disease. In luminal B disease, the addition of chemotherapy to endocrine treatment depends on estrogen receptor expression and overall risk. Chemotherapy is not recommended in most patients with luminal A (highly hormone-sensitive and low proliferation) breast cancer. A major controversy is the addition of adjuvant chemotherapy to endocrine treatment in patients with estrogen receptor-positive breast cancer. In some of these patients, multigene signatures such as the 21-gene recurrence score may be a useful addition to histopathology. The introduction of molecular subtypes and gene signatures improves the complexity of early breast cancer treatment, and individual institutes have to find their policy based on their histopathological information and the availability of gene signatures. © 2013 Expert Reviews Ltd. Source


Fathi A.R.,Cantonal Hospital
Current neurology and neuroscience reports | Year: 2013

Meningiomas represent the most common primary brain tumor and comprise 3 World Health Organization (WHO) grades, the most frequent being WHO grade I (90%). Surgery is mandatory to establish the diagnosis and to remove the tumor; however, complete resection can be achieved in only <50% of patients. Depending on the extent of resection, tumor location and the WHO grade radiation therapy can be applied. The issue of systemic treatment such as chemotherapy or targeted therapy (eg, somatostatin receptors, antiangiogenic agents) is yet not solved, particularly as current data are derived from small uncontrolled series in patients with long-standing disease and after several pretreatments. A more thorough understanding of molecular genetics, signaling pathways and prognostic factors in meningiomas should lead to the design of studies which stratify according to these factors. These studies have to be conducted in newly diagnosed patients after incomplete resection and in tumors of WHO grade II and III. Source


Roelcke U.,Cantonal Hospital
Handbook of Clinical Neurology | Year: 2012

Among various physiological and biochemical imaging modalities, positron emission tomography (PET) provides quantitative measures of energy metabolism, solute and drug transport, and cell proliferation. For clinical applications in patients with brain tumors, radiolabeled deoxyglucose ([ 18F]-2-fluoro-2-deoxy-d-glucose, FDG) and amino acids (e.g., [ 11C]methionine, O-2-[ 18F]fluoroethyl-l-tyrosine) are validated and widely available. To localize metabolic alterations accurately, particularly within heterogeneous lesions, the coregistration of PET images with structural imaging such as magnetic resonance imaging (MRI) is mandatory. In the diagnostic setting, PET with FDG allows the grading of gliomas, the detection of malignant transformation, and the differentiation of recurrent malignant glioma from radiation-induced necrosis. Amino acids are established to identify metabolically active regions within suspected low-grade gliomas that are suitable for stereotactic biopsy. Amino acids may also be used for treatment evaluation, as metabolic responses (PET) may occur several months before tumor volume reductions (MRI). Therefore, PET allows treatment decisions to be tailored for individual patients, and efficacy and safety to be optimized. With its broad range of diagnostic applications, PET is well suited to be integrated into multidisciplinary clinical trials and research protocols. © 2012 Elsevier B.V. Source


Fathi A.-R.,Cantonal Hospital | Roelcke U.,Brain Tumor Center | Roelcke U.,University of Basel
Current Neurology and Neuroscience Reports | Year: 2013

Meningiomas represent the most common primary brain tumor and comprise 3 World Health Organization (WHO) grades, the most frequent being WHO grade I (90 %). Surgery is mandatory to establish the diagnosis and to remove the tumor; however, complete resection can be achieved in only <50 % of patients. Depending on the extent of resection, tumor location and the WHO grade radiation therapy can be applied. The issue of systemic treatment such as chemotherapy or targeted therapy (eg, somatostatin receptors, antiangiogenic agents) is yet not solved, particularly as current data are derived from small uncontrolled series in patients with long-standing disease and after several pretreat-ments. a more thorough understanding of molecular genetics, signaling pathways and prognostic factors in meningiomas should lead to the design of studies which stratify according to these factors. These studies have to be conducted in newly diagnosed patients after incomplete resection and in tumors of WHO grade II and III. © Springer Science+Business Media New York 2013. Source

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