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Nathan Goodyear

Axillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and ... - 1 views

jama.ama-assn.org/...569.full

lymph node dissection breast cancer axillary

shared by Nathan Goodyear on 15 Feb 11 - No Cached
  • Nathan Goodyear on 15 Feb 11
     
    axillary lymph node dissection not needed in many breast cancer clients
Nathan Goodyear

Axillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and ... - 0 views

jama.ama-assn.org/...569.abstract

axillary dissection breast cancer node

shared by Nathan Goodyear on 14 Apr 11 - No Cached
  • Nathan Goodyear on 14 Apr 11
     
    axillary lymph node dissection in breast cancer patients did not change survival rate when compared to sentinal Lymph node removal
Nathan Goodyear

Axillary dissection versus no axillary dissection in patients with breast cancer and se... - 0 views

www.thelancet.com/...fulltext

cancer breast cancer

shared by Nathan Goodyear on 13 Sep 18 - No Cached
  • Nathan Goodyear on 13 Sep 18
     
    study finds no disease free survival difference in those women with breast cancer and sentinel node metastasis for axillary lymph node dissection versus no disecction; no difference in overall survival at 10 years also observed.
Nathan Goodyear

Evolving landscape of human epidermal growth factor receptor 2-positive breast cancer t... - 0 views

www.sciencedirect.com/...S0960977617300103

HER-2 breast cancer cancer herceptin Perjeta

shared by Nathan Goodyear on 06 Aug 18 - No Cached
  • 15%–20%
  • key mediator of cell growth, differentiation, and survival
  • of higher histological grade and are more likely to invade axillary lymph nodes
  • ...15 more annotations...
  • shortened survival and an increased risk of disease recurrence and metastasis
  • Currently, four HER2-directed agents are approved for the treatment of patients with HER2+ breast cancer: trastuzumab, pertuzumab, lapatinib, and ado-trastuzumab emtansine (T-DM1)
  • biosimilars
  • trastuzumab may provide greater benefit when administered concurrently with chemotherapy rather than after, and this has become the standard approach
  • concurrent use of anthracyclines (ie, doxorubicin or epirubicin) and trastuzumab is not recommended because of an increased risk for cardiac toxicity
    • Nathan Goodyear
      Nathan Goodyear on 06 Aug 18
       
      avoid herceptin in conjuction with antracyclines i.e. doxorubicin
  • Sequential doxorubicin plus cyclophosphamide followed by concomitant paclitaxel or docetaxel and trastuzumab is recommended for most patients
    • Nathan Goodyear
      Nathan Goodyear on 06 Aug 18
       
      top recommended regimen combination
  • Guidelines also recommend trastuzumab in combination with paclitaxel, docetaxel and carboplatin, or docetaxel and cyclophosphamide, particularly for patients with increased risk for cardiac toxicity or those with small (≤1 cm), node-negative HER2+ tumors
    • Nathan Goodyear
      Nathan Goodyear on 06 Aug 18
       
      good alternative in patients with increased risk of cardiac toxicity.
  • guidelines recommend up to 1 year of adjuvant trastuzumab
  • Neoadjuvant chemotherapy with trastuzumab is associated with higher rates of pathologic complete response (pCR) than chemotherapy alone or in combination with lapatinib
  • the combination of trastuzumab, lapatinib, and chemotherapy is not recommended because it failed to demonstrate noninferiority versus trastuzumab and chemotherapy in the adjuvant setting
  • recommend the combination of trastuzumab, pertuzumab, and chemotherapy as neoadjuvant treatment for patients with locally advanced HER2+ breast cancer and for some patients (node-positive or tumor ≥2 cm) with early-stage disease
  • neoadjuvant chemotherapy in combination with pertuzumab and trastuzumab reduced the risk of progression or death by 31% and recurrence or death by 40% versus trastuzumab alone
  • Concurrent chemotherapy and HER2-directed therapy improves survival outcomes over chemotherapy alon
  • dual inhibition of HER2 with trastuzumab and pertuzumab in combination with paclitaxel reduced the risk of death or progression by approximately 40% compared with concurrent trastuzumab and paclitaxel
  • the combination of trastuzumab, pertuzumab, and taxane chemotherapy is the preferred first-line regimen
  • Nathan Goodyear on 06 Aug 18
     
    HER-2 + breast cancer = appx 15-20% of all breast cancers and is a marker of worse prognosis and an indication for targeted immunotherapy blockade.
Nathan Goodyear

Adjuvant Treatment and Onset of Menopause Predict Weight Gain After Breast Cancer Diagn... - 0 views

jco.ascopubs.org/...120.full

chemotherapy breast cancer weight gain obesity weight age menopause cancer

shared by Nathan Goodyear on 26 Aug 15 - No Cached
  • Menopausal status, nodal status, and adjuvant treatment were significant univariate predictors of weight gain
  • The greater weight gain seen in women with involved axillary nodes seems to have been due to the administration of systemic adjuvant therapy
  • An association of adjuvant chemotherapy and weight gain has been noted previously
  • Nathan Goodyear on 26 Aug 15
     
    Older study, but adjuvant chemotherapy and age associated with weight gain after diagnosis.
Nathan Goodyear

The implication of neuroactive steroids in Tourette syndrome pathogenesis: a ... - 0 views

www.ncbi.nlm.nih.gov/...PMC3849218

tourette's syndrome hormones 5-alpha reductase

shared by Nathan Goodyear on 08 Dec 15 - No Cached
  • The typical onset of TS occurs at 6–7 years of age and is characterized by the appearance of simple, recurrent motor tics, followed by the manifestation of phonic tics after several months [12]. In most children, TS symptoms undergo a progressive exacerbation, which reaches its zenith at the beginning of puberty (11–12 years of age), and is then followed by a gradual remission in the majority of patients
  • 30–40% of TS-affected children retain their symptoms in adulthood
  • Multiple neurotransmitters have been implicated in TS, including dopamine (DA), serotonin, norepinephrine, acetylcholine, glutamate and γ-amino-butyric acid (GABA)
  • ...11 more annotations...
  • female gender may predict greater tic severity in adulthood
  • male gender is a major risk factor for TS (with a male:female prevalence ratio estimated at ~4:1)
  • the typical age of onset coincides with adrenarche (6–7 years old); symptoms increase in severity until the beginning of puberty (12 years old) and then undergo a spontaneous amelioration, which becomes apparent with the end of puberty (at 18–19 years of age)
  • TS is diagnosed later in females than males
  • ample evidence supports the involvement of DAergic dysfunctions in TS
  • a number of clinical observations showed that tics in TS patients could be exacerbated by anabolic androgens
  • steroidogenic enzymes and androgen receptors may serve as putative therapeutic targets for this disorder
  • Unlike males, tic severity is typically increased after puberty in females
  • 26% of females were found to experience exacerbation of tics in the estrogenic phase of the menstrual cycle, and this phenomenon was found to be correlated with increased tic severity at menarche
  • biochemical hallmark of adrenarche is the acquisition of 17,20 lyase activity by cytochrome P450 C17 (CYP17A1)
  • increased synthesis of dehydroepiandrosterone (DHEA) and androstenedione, which leads to the growth of axillary and pubic hair as well as enhancement in the oiliness of the skin
  • Nathan Goodyear on 08 Dec 15
     
    interesting read on hormones and tourette's.. Proposed that 5 alpha reductase activity is involved in worsening of tics.  This makes sense as Testosterone in men with low T is known to increase dopamine and dopaminergic dysfunction is known to play a role in tourette's;  the clinical presentation of girls vs boys is very different.  The authors of this article propose that 5 alpha reductase activity controls a back door method where by progesterone is converted to androgens.
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