News & Comment

In the setting where the ongoing evolution of management of the axilla in breast cancer is being driven by better understanding of different sub-types of the disease, and of how these respond to chemotherapy, here we discuss management of the axilla in breast cancer patients who present with T1 or T2 N1 disease, while making the distinction between triple negative and HER2 positive tumors as one group, and hormone receptor positive/HER2 negative tumors as a second group.

PARP inhibitors have been approved for the treatment of metastatic breast cancer in germline BRCA mutation (gBRCAm) carriers. The recent OlympiA trial demonstrated improved progression-free and distant disease-free survival with adjuvant olaparib for gBRCAm carriers with HER2-negative high-risk early-stage breast cancer. The current article addresses some for the questions raised by OlympiA regarding how to incorporate PARP inhibitors into the treatment of early-stage breast cancer as well as future directions for PARP inhibitors in breast cancer treatment and prevention.

In recent years, several trials of breast cancer treatment have failed to demonstrate a survival benefit for some previously routine surgical therapies in selected patient groups. As each of these therapeutic approaches has been deemed of low value deimplementation has varied significantly. This demonstrates that effective de-escalation in breast cancer surgery relies on more than the availability of data from randomized controlled trials and other high-quality evidence, but is also influenced by various stakeholders, social expectations, and environmental contexts.