Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2020

01-08-2020 | Mastectomy | Review

The influence of mastectomy and reconstruction on residual upper limb function in breast cancer survivors

Authors: Meghan E. Vidt, John Potochny, Daleela Dodge, Michael Green, Kathleen Sturgeon, Rena Kass, Kathryn H. Schmitz

Published in: Breast Cancer Research and Treatment | Issue 3/2020

Login to get access

Abstract

Purpose

Breast cancer survivorship is common (90% of women survive 5 or more years), but many women are not able to return to full function and well-being after treatment due to functional limitations, persistent pain, and inability to perform daily activities. Since each surgical reconstructive option (e.g., autologous tissue flaps versus implants) can impact shoulder and arm function differently, it is important to understand how shoulder and upper limb strength, mobility, and function are influenced by the type of surgical intervention. Efforts can then focus on prehabiliation strategies to prevent the onset of limitations and on developing rehabilitation protocols that directly target shortcomings.

Methods

The current paper presents a review summarizing how shoulder and upper limb function may be affected by surgical mastectomy and breast reconstruction.

Results

Mastectomy and breast reconstruction with implants or autologous tissues present different functional outcomes for patients. Each surgical procedure is associated with unique sequelae derived from the tissues and procedures associated with each surgery. Characterizing the specific functional outcomes associated with each surgical approach will promote the development of targeted rehabilitation strategies that can be implemented into a multidisciplinary treatment planning pathway for breast cancer patients.

Conclusions

Surgical treatments for breast cancer, including mastectomy and breast reconstruction, can have negative effects. Focused efforts are needed to better understand treatment-specific effects so that targeted rehabilitation can be developed to improve patient function, QoL, and ability to return to work and life activities post-breast cancer.
Literature
1.
2.
Hwang ES, Lichtensztajn DY, Gomez SL et al (2013) Survival after lumpectomy and mastectomy for early stage invasive breast cancer. Cancer 119:1402–1411PubMedPubMedCentral
3.
van Hezewijk M, Bastiaannet E, Putter H et al (2013) Effect of local therapy on locoregional recurrence in postmenopausal women with breast cancer in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial. Radiother Oncol 108:190–196
4.
Agarwal S, Pappas L, Neumayer L et al (2014) Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. JAMA 149:267–274
5.
Boughey JC, AttaiChen DJSL et al (2016) Contralateral Prophylactic Mastectomy Consensus Statement from the American Society of breast surgeons: additional considerations and a framework for shared decision making. Ann Surg Oncol 23:2111–3106
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Myung Y, Choi B, Kwon H et al (2018) Quantitative analysis of shoulder function and strength after breast reconstruction: a retrospective cohort study. Medicine (Baltimore) 97:e10979
16.
Patel AU, Day SJ, Pencek M et al (2020) Functional return after implant-based breast reconstruction: a prospective study of objective and patient-reported outcomes. J Plast Reconstr Aesthetic Surg 73(5):850–855
17.
Ewertz M, Jensen AB (2011) Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol (Madr) 50:187–193
18.
Gartner R, Jensen M-B, Nielsen J et al (2009) Prevalence of and factors associated with persistet pain following breast cancer surgery. JAMA 302:1985–1992
19.
Miaskowski C, Paul SM, Cooper B et al (2014) Identification of patient subgroups and risk factors for persistent arm/shoulder pain following breast cancer surgery. Eur J Oncol Nurs 18:242–253PubMedPubMedCentral
20.
Brookham RL, Cudlip AC, Dickerson CR (2018) Examining upper limb kinematics and dysfunction of breast cancer survivors in functional dynamic tasks. Clin Biomech 55:86–93
21.
Boquiren VM, Hack TF, Thomas RL et al (2016) A longitudinal analysis of chronic arm morbidity following breast cancer surgery. Breast Cancer Res Treat 157:413–425
22.
Lauridsen MC, Overgaard M, Overgaard J et al (2008) Shoulder disability and late symptoms following surgery for early breast cancer. Acta Oncol (Madr) 47:569–575
23.
24.
Schmitz KH, Speck RM, Rye SA et al (2012) Prevalence of breast cancer treatment sequelae over 6 years of follow-up. Cancer 118:2217–2225
25.
Hayes SC, Johansson K, Alfano CM, Schmitz K (2011) Exercise for breast cancer survivors: bridging the gap between evidence and practice. Transl Behav Med 1:539–544PubMedPubMedCentral
26.
Buchan J, Janda M, Box R et al (2016) A Randomized Trial on the effect of exercise mode on breast cancer-related lymphedema. Med Sci Sport Exerc 48:1866–1874
27.
Cheville AL, Beck LA, Peterson TL et al (2009) The detection and treatment of cancer-related functional problems in an outpatient setting. Support Care Cancer 17:61–67
28.
Shamley D, Srinaganathan R, Oskrochi R et al (2009) Three-dimensional scapulothoracic motion following treatment for breast cancer. Breast Cancer Res Treat 118:315–322
29.
Reitman J, Dijkstra P, Hoekstra H et al (2003) Late morbidity after treatment of breast cancer in relation to daily activities and quality of life: a systematic review. Eur J Surg Oncol 29:229–238
30.
Shamley D, Srinaganathan R, Weatherall R et al (2007) Changes in muscle size and activity following treatment for breast cancer. Breast Cancer Res Treat 106:19–27
31.
Kuehn T, Klauss W, Darsow M et al (2000) Long term morbidity following axillary dissection in breast cancer patients—clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors. Breast Cancer Res Treat 64:275–286
32.
33.
34.
Crosbie J, Kilbreath SL, Dylke E et al (2010) Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Phys Ther 90:679–692
35.
Hojris I, Andersen J, Overgaard M, Overgaard J (2000) Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone. Acta Oncol (Madr) 39:355–372
36.
37.
(AHRQ) A for HR and Q, Steiner CA, Weiss AJ, et al (2016) Statistical brief #201: trends in bilateral and unilateral mastectomies in hospital inpatient and ambulatory settings, 2005–2013
38.
Silva E, Gatalica Z, Snyder C et al (2008) Hereditary breast cancer: Part II: Management of hereditary breast cancer: implications of molecular genetics and pathology. Breast J 14:14–24
39.
Silva E (2008) Genetic counseling and clinical management of newly diagnosed breast cancer patients at genetic risk for BRCA germline mutations: perspective of a surgical oncologist. Fam Cancer 7:91–95
40.
Fisher CS, Martin-Dunlap T, Ruppel MB et al (2012) Fear of recurrence and perceived survival benefit are primary motivators for choosing mastectomy over breast-conservation therapy regardless of age. Ann Surg Oncol 19:3246–3250
41.
Rosenberg SM, Sepucha K, Ruddy KJ et al (2015) Local therapy decision-making and contralateral prophylactic mastectomy in young women with early-stage breast cancer. Ann Surg Oncol 22:3809–3815PubMedPubMedCentral
42.
Donovan CA, Bao J, Gangi A et al (2017) Bilateral mastectomy as overtreatment for breast cancer in women age forty years and younger with unilateral operable invasive breast cancer. Ann Surg Oncol 24:2168–2173
43.
(NCCN) NCCN (2018) National Comprehensive Cancer Network (NCCN) Guidelines for Patients. Invasive Breast Cancer
44.
(NCCN) NCCN (2018) National Comprehensive Cancer Network (NCCN) Guidelines for Patients. Noninvasive Breast Cancer
45.
(NCCN) NCCN (2018) National Comprehensive Cancer Network (NCCN) Guidelines for Patients. Metastatic Breast Cancer. 1–48
46.
Manca G, Rubello D, Tardelli E et al (2016) Sentinel lymph node biopsy in breast cancer: Indications, contraindications, and controversies. Clin Nucl Med 41:126–213
47.
Surgeons TAS of B (2014) Performance and practice guidelines for sentinel lymph node biopsy in breast cancer patients
48.
Surgeons TAS of B (2014) Performance and practice guidelines for axillary lymph node dissection in breast cancer patients
49.
Koehler LA, Blaes AH, Haddad TC et al (2015) Movement, function, pain, and postoperative edema in axillary web syndrome. Phys Ther 95:1345–1353PubMedPubMedCentral
50.
Koehler LA, Hunter David W, Blaes AH, Haddad TC (2018) Function, shoulder motion, pain, and lymphedema in breast cancer with and without axillary web syndrome: a 18-month follow-up. Phys Ther 98:518–527PubMedPubMedCentral
51.
Moskovitz AH, Anderson BO, Yeung RS et al (2001) Axillary web syndrome after axillary dissection. Am J Surg 101:434–439
52.
53.
Sagen A, Kaaresen R, Sandvik L et al (2014) Upper limb physical function and adverse effects after breast cancer surgery: a prospective 2.5-year follow-up study and preoperative measures. Arch Phys Med Rehabil 95:875–881
54.
Jagsi R, Abrahamse P, Lee K et al (2017) Treatment decisions and employment of breast cancer patients: results of a population-based survey. Cancer 123:4791–4799PubMedPubMedCentral
55.
Lauridsen M, Torsleff K, Husted H, Erichsen C (2000) Physiotherapy treatment of late symptoms following surgical treatment of breast cancer. Breast 9:45–51
56.
Sugden E, Rezvani M, Harrison J, Hughes L (1998) Shoulder movement after the treatment of early stage breast cancer. Clin Oncol 10:173–181
57.
Haddad CAS, Saad M, del Perez MCJ, Junior FM (2013) Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphaenectomy. Einstein 11:424–426
58.
59.
Karduna AR, McClure PW, Michener LA, Sennett B (2001) Dynamic measurements of three-dimensional scapular kinematics: a validation study. J Biomech Eng 123:184–190
60.
61.
62.
Balcells-Diaz E, Daunis-i-Estadella P (2018) Shoulder strength value differences between genders and age groups. J Shoulder Elb Surg 27:463–469
63.
Roldan-Jimenez C, Vuesta-Vargas AI (2016) Age-related changes analyzing shoulder kinematics by means of inertial sensors. Clin Biomech 37:70–76
64.
Murgia A, Hortobagyi T, Wijnen A et al (2018) Effects of age and sex on shoulder biomechanics and relative effort during functional tasks. J Biomech 81:132–139
65.
Burner T, Abbott D, Huber K et al (2014) Shoulder symptoms and function in geriatric patients. J Geriatr Phys Ther 37:154–158PubMedPubMedCentral
66.
van der Windt DAWM, Koes BW, de Jong BA, Bouter LM (1995) Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis 54:959–964PubMedPubMedCentral
67.
Ostergren P-O, Hanson BS, Balogh I et al (2005) Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmo shoulder and neck study cohort. J Epidemiol Community Health 59:721–728PubMedPubMedCentral
68.
Linsell L, Dawson J, Zondervan K et al (2006) Prevalence and incidence of adults consulting for shoulder conditions in UK primary care: patterns of diagnosis and referral. Rheumatology 45:215–221
69.
Hsiao MS, Cameron KL, Tucker CJ et al (2015) Shoulder impingement in the United States military. J Shoulder Elb Surg 24:1486–1492
70.
Canivet C, Ostergren P-O, Choi B et al (2008) Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: results from a one-year follow-up of the Malmo Shoulder Neck study cohort. Int J Behav Med 15:254–262
71.
Bot SDM, van der Waal JM, Terwee CB et al (2005) Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 64:118–123PubMedPubMedCentral
72.
Ilonzo N, Tsang A, Tsantes S et al (2017) Breast reconstruction after mastectomy: a ten-year analysis of trends and immediate postoperative outcomes. Breast 32:7–12
73.
Jagsi R, Jiang J, Momoh AO et al (2014) Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. J Clin Oncol 32:919–926PubMedPubMedCentral
74.
75.
76.
77.
Kwok AC, Simpson AM, Xiangyang Y et al (2019) Immediate unilateral breast reconstruction using abdominally based flaps: analysis of 3,310 cases. J Reconstr Microsurg 35:74–82
78.
Macadam SA, Zhong T, Weichman K et al (2016) Quality of life and patient-reported outcomes in breast cancer survivors: a multicenter comparison of four abdominally based autologous reconstruction methods. Breast 137:758–771
79.
Albornoz CR, Cordeiro PG, Mehrara BJ et al (2014) Economic implications of recent trends in U.S. immediate autologous breast reconstruction. Plast Reconstr Surg 133:463–470
80.
Erdmann-Sager J, Wilkins EG, Pusic AL et al (2018) Complications and patient-reported outcomes after abdominally based breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. Plast Reconstr Surg 141:271–281PubMedPubMedCentral
81.
82.
83.
84.
Tomita K, Yano K, Nishibayashi A et al (2013) The role of latissimus dorsi myocutaneous flaps in secondary breast reconstruction after breast-conserving surgery. Eplasty 13:206–214
85.
Perdikis G, Koonce S, Collis G, Eck D (2011) Latissimus dorsi myocuteneous flap for breast reconstruction: bad rap or good flap? Eplasty 11:411–416
86.
87.
Randolph LC, Barone J, Angelats J et al (2005) Prediction of postoperative seroma after latissimus dorsi breast reconstruction. Plast Reconstr Surg 116:1287–1290
88.
Szychta P, Butterworth M, Dixon M et al (2013) Breast reconstruction with the denervated latissimus dorsi musculocutaneous flap. Breast 22:667–672
89.
Leonardis JM, Diefenbach BJ, Lyons DA et al (2018) The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer. Breast Cancer Res Treat 173(2):447–453
90.
91.
92.
93.
Bonde CT, Lund H, Fridberg M et al (2007) Abdominal strength after breast reconstruction using a free abdominal flap. J Plast Reconstr Aesthetic Surg 60:519–523
94.
Futter CM, Webster MH, Hagen S, Mitchell SL (2000) A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap. Br J Plast Surg 53:578–583
95.
Blondeel PN, Boeckx WD, Vanderstraten GG et al (1997) The fate of oblique abdominal muscles after free TRAM flap surgery. Br J Plast Surg 50:315–321
96.
Suominen S, Asko-Seljavaara S, Kinnunen J et al (1997) Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study. Ann Plast Surg 39:229–234
97.
Jonczyk MM, Jean J, Graham R, Chatterjee A (2019) Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis. Breast Cancer Res Treat 173:267–274
98.
O’Halloran N, Potter S, Kerin M, Lowery A (2018) Recent advances and future directions in postmastectomy breast reconstruction. Clin Breast Cancer 18:e571–585
99.
100.
Tasoulis M-K, Iqbal FM, Cawthorn S et al (2017) Subcutaneous implant breast reconstruction: time to reconsider? Eur J Surg Oncol 43:1636–1646
101.
Wolfram D, Rainer C, Niederegger H et al (2004) Cellular and molecular composition of fibrous capsules formed around silicone breast implants with special focus on local immune reactions. J Autoimmun 23:81–91
102.
Sinnott CJ, Persing SM, Pronovost M et al (2018) Impact of postmastectomy radiation therapy in prepectoral versus subpectoral implant-based breast reconstruction. Ann Surg Oncol 25:2899–2908
103.
Leonardis JM, Lyons DA, Giladi AM et al (2019) Functional integrity of the shoulder joint and pectoralis major following subpectoral implant breast reconstruction. J Orthop Res 37:1610–1619
104.
Hage JJ, van der Heeden JF, Lankhorst KM et al (2014) Impact of combined skin sparing mastectomy and immediate subpectoral prosthetic reconstruction on the pectoralis major muscle function: a preoperative and postoperative comparative study. Ann Plast Surg 72:631–637
105.
Casella D, Bernini M, Bencini L et al (2014) TiLoop(R) bra mesh used for immediate breast reconstruction: comparison of retropectoral and subcutaneous implant placement in a prospective single-institution series. Eur J Plast Surg 37:599–604PubMedPubMedCentral
106.
Schnarrs RH, Carman CM, Tobin C et al (2016) Complication rates with human acellular dermal matrices: retrospective review of 211 consecutive breast reconstructions. Plast Reconstr Surgery Glob Open 4:e1118
107.
Bernini M, Calabrese C, Cecconi L et al (2015) Subcutaneous direct-to-implant breast reconstruction: surgical, functional, and aesthetic results after long-term follow-up. Plast Reconstr Surgery Glob Open 3:e574
108.
Zhu L, Mohan AT, Abdelsattar JM et al (2016) Comparison of subcutaneous versus submuscular expander placement in the first stage of immediate breast reconstruction. J Plast Reconstr Aesthetic Surg 69:e77–e86
109.
Recht A, Comen EA, Fine RE et al (2016) Postmastectomy radiotherapy: an American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology focused guideline update. Pract Radiat Oncol 6:e219–e234
110.
El-Sabawi B, Mosin M, Carey JN et al (2015) Breast reconstruction and adjuvant therapy: a systematic review of surgical outcomes. J Surg Oncol 112:458–464
111.
Drucker-Zertuche M, Robles-Vidal C (2007) A 7 year experience with immediate breast reconstruction after skin sparing mastectomy for cancer. Eur J Surg Oncol 33:140–146
112.
Lee BT, Adesiyun TA, Colakoglu S et al (2010) Postmastectomy radiation therapy and breast reconstruction. Ann Plast Surg 64:679–683
113.
Riekki R, Harvima IT, Jukkola A et al (2004) The production of collagen and the activity of mast-cell chymase increase in human skin after irradiation therapy. Exp Dermatol 13:364–371
114.
115.
Kearney AM, Brown MS, Soltanian HT (2015) Timing of radiation and outcomes in implantbased breast reconstruction. J Plast Reconstr Aesthetic Surg 68:1719–1726
116.
HoZiMehrara AYHBJ, Wilkins EG (2017) Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol 18:e742–753
117.
Jagsi R, Momoh AO, Qi J et al (2018) Impact of radiotherapy on complications and patient-reported outcomes after breast reconstruction. J Natl Cancer Inst 110:157–165
118.
Kelley BP, Valero V, Yi M, Kronowitz SJ (2012) Tamoxifen increases the risk of microvascular flap complications in patients undergoing microvascular breast reconstruction. Plast Reconstr Surg 129:305–314PubMedPubMedCentral
119.
Cheville AL, McLaughlin SA, Haddad T et al (2019) Integrated rehabilitation for breast cancer survivors. Am J Phys Med Rehabil 98:154–164
120.
121.
122.
123.
Richmond H, Lait C, Srikesavan C et al (2018) Development of an exercise intervention for the prevention of musculoskeletal shoulder problems after breast cancer treatment: the prevention of shoulder problems trial (UK PROSPER). BMC Health Serv Res 18:463PubMedPubMedCentral
124.
125.
Lee SA, Kang J-Y, Kim YD et al (2010) Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial. Clin Rehabil 24:600–613
126.
Kilbreath SL, Refshauge KM, Beith JM et al (2012) Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer—a randomized controlled trial. Breast Cancer Res Treat 133:667–676
127.
Campbell KL, Winters-Stone KM, Wiskemann J et al (2019) Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sport Exerc 51:2375–2390
128.
129.
130.
Anderson RT, Kimmick GG, McCoy TP et al (2012) A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial. J Cancer Surviv 65:172–181
131.
Schmitz KH, Ahmed RL, Troxel A et al (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361:664–673
132.
Schmitz KH, Ahmed RL, Troxel AB et al (2010) Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA 304:2699–2705
133.
Lacomba MT, Sanchez MJY, Goni AZ et al (2010) Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ 340:b5396
134.
Centers NAP for B (2018) 2018 National Accreditation Program for Breast Centers Standards Manual
135.
Schmitz KH, Stout NL, Andrews K et al (2012) Prospective evaluation of physical rehabilitation needs in breast cancer survivors: a call to action. Cancer 118:2187–2190
136.
137.
Silver JK, Baima J (2013) Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. Am J Phys Med Rehabil 92:715–727
138.
Nilsson H, Angeras U, Bock D et al (2016) Is preoperative physical activity related to post-surgery recovery? A cohort study of patients with breast cancer. BMJ Open Access 6:e007997
139.
Smoot B, Paul SM, Aouizerat BE et al (2016) Predictors of altered upper extremity function during the first year after breast cancer treatment. Am J Phys Med Rehabil 95:639–655PubMedPubMedCentral
140.
Baima J, Reynolds S-G, Edmiston K et al (2017) Teaching of independent exercises for prehabilitation in breast cancer. J Cancer Educ 32:252–256
141.
142.
Singh C, De Vera M, Campbell KL (2013) The effect of prospective monitoring and early physiotherapy intervention on arm morbidity following surgery for breast cancer: a pilot study. Physiother Canada 65:183–191
143.
Treanor C, Kyaw T, Donnelly M (2018) An international review and meta-analysis of prehabilitation compared to usual care for cancer patients. J Cancer Surviv 12:64–73
144.
Khatcheressian JL, Wolff AC, Smith TJ et al (2006) American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 24:5091–5097
Metadata
Title
The influence of mastectomy and reconstruction on residual upper limb function in breast cancer survivors
Authors
Meghan E. Vidt
John Potochny
Daleela Dodge
Michael Green
Kathleen Sturgeon
Rena Kass
Kathryn H. Schmitz
Publication date
01-08-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05717-z

Other articles of this Issue 3/2020

Breast Cancer Research and Treatment 3/2020 Go to the issue

Preclinical study

The prognostic significance of BMI1 expression in invasive breast cancer is dependent on its molecular subtypes

Clinical trial

N083E (Alliance): long-term outcomes of patients treated in a pilot phase II study of docetaxel, carboplatin, trastuzumab, and lapatinib as adjuvant therapy for early-stage HER2-positive breast cancer

Epidemiology

Impact of chemotherapy, radiotherapy, and endocrine therapy on sick leave in women with early-stage breast cancer during a 5-year period: a population-based cohort study

Editorial

Purposeful surgical delay and the coronavirus pandemic: how will black breast cancer patients fare?

Letter to the Editor

Re: Risk-reducing mastectomy: a case series of 124 procedures in Brazilian patients

Review

Hormone replacement therapy and mammographic density: a systematic literature review
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits