responsive breast cancer. There is evidence to and new cancers in the previously unaffected
suggest that having a break from oestrogen
outcomes for people diagnosed with breast
deprivation may re-sensitise a breast cancer
The International Breast Cancer Intervention
cancer. The aim of collecting this essential
to this treatment. This study is currently
health information is to answer the questions
above, to ensure high quality care is being
Canterbury areas. For further information
as effective, or bet er than, tamoxifen in
preventing the development of breast cancer
delivery and provision of clinical resources
ii) the LATER, or “Later adjuvant Aromatase
in the same breast as the DCIS, or in the
inhibitor Therapy for postmenopausal women opposite breast. North Shore and Waikato
with Endocrine Responsive breast cancer”,
Hospitals are centres for this research.
There are more regions considering setting
study is finding out whether taking the drug
The Trans Tasman Radiation Oncology Group up similar registers. This will enable regional,
letrozole for a year or more after finishing
is also currently investigating further the best
a summary of Breast caNcer research NatIoNally aNd INterNatIoNally.
five years treatment with hormonal therapy
(e.g. tamoxifen) can prevent or delay breast
Words: JENNI SCARLET AND IAN CAMPBELL
cancer recurring in postmenopausal women.
This study is currently only available to
Breast conserving surgery (or wide local
the Waikato Breast Cancer Trust and other
excision) is an accepted treatment option for
information please phone 0800 770 119.
most women with early breast cancer. Clinical start toward the documentation of national
trials have shown that radiotherapy to the
breast cancer statistics. Ideally, though,
Earlier research has already established
whole breast, after breast conserving surgery,
that for women with small single (unifocal)
is important to substantially reduce the risk
breast cancers the surgical removal of the
of breast cancer recurring in the breast (local
national coverage. This was a top priority
‘sentinel’ nodes (i.e. the first lymph node/s
recommendation to the Ministry of Health
draining from the region of the breast cancer)
who do not undergo radiotherapy following
provides accurate information as to whether
surgery. The current standard of care after
the multidisciplinary team who developed
axillary nodes are involved with cancer or
breast conserving surgery is radiotherapy to
the whole breast, to a dose of 50Gray (Gy)
Management (SNBM) resulted in fewer side
given in 25 daily sessions (or fractions) over a c) Access to breast cancer care study
effects than axillary clearance. However with
an SN biopsy there is a small false negative
There is ongoing international research,
rate (5.5. %), i.e. a risk of not removing a
University is looking into the role of access
lymph node with cancer spread. There is also
studying shorter treatment schedules where
a small risk for developing lymphedema.
radiotherapy to given to only part of the breast diagnosis to treatment in order to better
and treatment given is in a shorter space of
understand factors related to breast cancer
time (accelerated partial breast irradiation).
survival. The study is recruiting women were
(called the “Sentinel Node biopsy versus
Axil ary Clearance or SNAC 2” trial) seeks to
a) Regional breast cancer registers and the
evaluate the long term cancer outcomes of this
need for a national breast cancer database
woman’s surgery. The test can more precisely
technique, and in particular whether SN biopsy Breast cancer is the most significant health
date. For more information about this study,
estimate a woman’s likelihood of having her
of early breast cancer after completion of
is safe for women with larger or multi-focal
breast cancer return and predict whether
five years of hormonal treatment has, until
tumours and cancers of a more aggressive
leading cause of cancer death for women.
freephone 0800 080 078 or email l.ellison-
diagnosis, and treatment to quality of life
recently, been confined to annual checks and
biological type. This is a very important trial
after cancer. Research ranges from studies
Women with a high Oncotype DX ‘recurrence mammography.
because very few women with larger tumours,
examining certain characteristics of a tumour score’ benefit from chemotherapy. Women
and none with multi focal tumours, have been
included in other international, randomised
rate from breast cancer when compared to
The purpose of this research is to investigate
aromatase inhibitor, after five years of
other countries such as Australia, Canada
psychological and survivorship issues. We
tamoxifen, improves breast cancer outcomes. It
and the United States. Why is this so? Is it
Universities, international collaborators, the
report on some of the many research studies
‘recurrence score’, benefit from chemotherapy
is not certain if this is the case after five years
pharmaceutical industry, funding agencies
of treatment including an aromatase inhibitor.
and the courage of women who participate
b) Extending hormonal treatment beyond five
Programmes like BreastScreen Aotearoa are
other countries? Is it that cancer is detected
in research and clinical trials, that progress
1. early breast cancer clinical trials that New
years - the later use of aromatase inhibitors
commenced two clinical trials addressing
able to detect very early stage breast cancers, at a later stage here or are our treatments
is made to improve the care of future women
the important question of whether additional
called ductal carcinoma insitu (DCIS). This is
The standard length of time that hormonal
treatment with an aromatase inhibitor could
also known as non-invasive breast cancer, as
or endocrine treatment is taken (daily) is
reduce the risk of breast cancer recurrence
the cancer cells are present only in the ducts
database to assess the success or otherwise
five years. However, after reaching the end
in postmenopausal women in these later and
of the breast and have not spread to other
of the treatment of breast cancer in New
Note: If you have any questions about these
of their treatment there is still an ongoing
continued ‘at risk’ years. These are:
breast tissue or to other parts of the body.
treatments and whether they are applicable
stands for ‘Trial Assigning Individualised
risk of developing another breast cancer,
i) the SOLE or “Study Of Letrozole Extension”
Studies on invasive breast cancer (which
to your situation, please discuss with your
Options for Treatment (Rx)’. This research
or the original breast cancer returning in
trial is investigating five years continuous
Oncologist, Surgeon, Breast Physician or GP.
uses a sophisticated laboratory test called
letrozole versus nine months with a three
outside of the breast ducts) have shown that
“Oncotype DX”. This test analyses 25 factors
month break each year for post menopausal
aromatase inhibitors, including anastrozole,
established regional breast cancer registers.
on a sample of cancer taken at the time of a
year or more - this risk translates to 1 in
women with lymph node positive endocrine
are more effective in preventing recurrence
Fármacos en urgencias: Broncodilatadores y Bronquiolitis aguda. Hospital los Arcos. Santiago de la Ribera (Murcia). Introducción La bronquiolitis aguda es la infección del tracto respiratorio inferior mas frecuente en el lactante1 con una incidencia del 11% anual y una tasa de ingreso del 1-2%2-4, aunque con un incremento en los últimos años del 20-50% y un aumento de demanda a
THE VALUE OF 24 HOUR PROFILES IN CONGENITAL ADRENAL Kathy Geertsma and Peter Hindmarsh Having participated in discussions on several message boards regarding what I have learnt through my son having 24 hour profiles, many people have contacted me with questions. This prompted me to ask his Professor, Peter Hindmarsh of Great Ormond Street Hospital, London, to explain the benefits of havi