Interprofessional education in cancer care - a scoping review.

Background: Comprehensive cancer care requires effective collaboration by interprofessional healthcare teams. The need to develop educational initiatives to improve interprofessional collaboration is increasingly recognised. However, there is no agreement regarding the interprofessional competencies required for effective cancer care leading to much variation on the focus of research, planning and managing change.

An inter-specialty cancer training programme curriculum for Europe.

Introduction: Multidisciplinary and multi-professional collaboration is vital in providing better outcomes for patients The aim of the INTERACT-EUROPE Project (Wide Ranging Cooperation and Cutting Edge Innovation As A Response To Cancer Training Needs) was to develop an inter-specialty curriculum. A pilot project will enable a pioneer cohort to acquire a sample of the competencies needed.

Methods: A scoping review, qualitative and quantitative surveys were undertaken.

Multidisciplinary training of cancer specialists in Europe.

The best care for patients with cancer is most likely to be achieved when decisions about diagnosis, staging and treatment are made at multidisciplinary and multiprofessional meetings, preferably when all the professional expertise relevant to the patient's condition is gathered together. Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice.

Fat and out in Salerno and its province: Adolescent obesity and early school leaving in Southern Italy.

We examine the determinants of obesity and its role in influencing early school leaving amongst adolescents in the city of Salerno and its province in Southern Italy. A human capital investment model is employed and this provides a framework within which to analyse the interrelated 'decisions' regarding schooling and overeating, taking into account the importance of time preference and the differential effects of adolescent obesity for males and females. We find that: (a) there is a strong and robust positive association between obesity and early school leaving; (b) there is evidence to support the notion that this association is the consequence of a causal relation running from obesity to school leaving; and, (c) there are significant gender differences in the nature of this relationship.

Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.

Background: Predicting the clinical course in adhesional small bowel obstruction is difficult. There are no validated clinical or radiologic features that allow early identification of patients likely to require surgical intervention.

Methods: We conducted a retrospective review of 100 patients consecutively admitted to a tertiary level teaching hospital over a 3-year period (2002-2004) who had acute adhesional small bowel obstruction and underwent computed tomography (CT).

The value of level III clearance in patients with axillary and sentinel node positive breast cancer.

Background: The value of level III axillary clearance is contentious, with great variance worldwide in the extent and levels of clearance performed.

Objective: To determine rates of level III positivity in patients undergoing level I-III axillary clearance, and identify which patients are at highest risk of involved level III nodes.

Methods: From a database of 2850 patients derived from symptomatic and population-based screening service, 1179 patients who underwent level I-III clearance between the years 1999-2007 were identified.

Use of a panel of novel genes for differentiating breast cancer from non-breast tissues.

Existing serum markers for breast cancer such as CA 15-3, BR 27.29 and CEA lack sensitivity and specificity. The aim of this study was to evaluate the value of new putative breast-specific markers for differentiating breast cancer from non-breast tissues.

Analysis of patients with false negative mammography and symptomatic breast carcinoma.

Aim: False-negative mammograms may result in a delay in breast carcinoma diagnosis and have important implications for patient care. In this study, the characteristics of symptomatic patients with false-negative mammograms were analysed.

Methods: Patients with symptomatic breast carcinoma were identified over a 10-year period (1994-2004).

Factors affecting successful breast conservation for ductal carcinoma in situ.

Background: Successful breast-conserving therapy in DCIS is restricted by high rates of residual disease resulting in the need for radiotherapy and/or re-excision. This study identifies patients with DCIS who are most at risk of compromised margins and of residual disease.

Methods: All patients undergoing breast-conserving surgery for DCIS over a 6-year period were included.

ADAM-17 expression in breast cancer correlates with variables of tumor progression.

The ADAMs are a family of membrane proteins possessing a disintegrin and metalloprotease domain. One of their main functions is shedding of membrane proteins. The aim of this study was to test the hypothesis that ADAM-17 (also known as tumor necrosis factor-alpha converting enzyme) is involved in breast cancer progression.

Surgical e-learning: validation of multimedia web-based lectures.

Background: Distance learning has been advocated increasingly as a modern efficient method of teaching surgery. Efficiency of knowledge transfer and validity of web-based courses have not been subjected to rigorous study to date.

Methods: An entirely web-based surgical 5-week lecture course was designed.

The accuracy of combined versus largest diameter in staging multifocal breast cancer.

Background: Evaluating the size of multifocal breast cancer for staging purposes is problematic. Historically, the largest tumor focus in isolation has been used to stage multifocal disease and determine optimum adjuvant therapy. This study compared multifocal and unifocal breast cancer to determine if multifocal breast cancer presents at a higher stage.

Lipophilin B: A gene preferentially expressed in breast tissue and upregulated in breast cancer.

Lipophilin B (LPB), which is also known as BU101, is a secretoglobin which exists in vivo as a complex with the mammary-specific protein, mammaglobin A (MGA). The aim of our study was to investigate the expression of LPB in a panel of breast and nonbreast tissues and compare its expression with that of MGA. Using RT-PCR, LPB mRNA was detected in 16/25 (64%) of normal breast specimens, 23/30 (77%) of fibroadenomas, 102/156 (65%) of primary breast cancers and in 8/36 (22%) nonbreast tissues.

Predictive value of breast lesions of "uncertain malignant potential" and "suspicious for malignancy" determined by needle core biopsy.

Background: The optimum management of patients whose needle core biopsy (NCB) results are of "uncertain malignant potential" (B3) or "suspicious for malignancy" (B4) is unclear. This study correlates B3 and B4 NCB findings with excision histology to determine associated rates of malignancy.

Methods: All NCBs categorized as B3 or B4 were identified from a series of 3729 NCBs.

Needle core biopsy in the diagnosis of phyllodes neoplasm.

Background: Accurate identification of phyllodes neoplasms without surgical intervention is difficult, reducing the ability to manage "benign" lumps non-operatively and impacting on the open benign biopsy rate. Needle core biopsy is considered to be a highly accurate technique in the diagnosis of breast carcinoma. Its accuracy in the diagnosis of phyllodes neoplasm has not been established.

CA 15-3 is predictive of response and disease recurrence following treatment in locally advanced breast cancer.

Background: Primary chemotherapy (PC) is used for down-staging locally advanced breast cancer (LABC). CA 15-3 measures the protein product of the MUC1 gene and is the most widely used serum marker in breast cancer.

Methods: We retrospectively investigated the role of CA 15-3 in conjunction with other clinico-pathological variables as a predictor of response and time to disease recurrence following treatment in LABC.

The role of major duct excision and microdochectomy in the detection of breast carcinoma.

Background: The association of nipple discharge with breast carcinoma has resulted in numerous women undergoing exploratory surgery to exclude malignancy. The aim of this study was to determine whether pre-operative factors can identify those patients that are most at risk of carcinoma.

Methods: All patients over a 14-year period (1991-2005) who had a microdochectomy or subareolar exploration for the evaluation of nipple discharge were assessed.

Predictors of invasive disease in breast cancer when core biopsy demonstrates DCIS only.

Background And Objectives: Ductal carcinoma in-situ on core biopsy does not preclude invasive disease within the excision specimen, resulting in the need for further axillary surgery. We sought to identify predictors of invasion when DCIS is present on core biopsy.

Methods: From a database of 895 breast cancer patients, patients with DCIS on core biopsy who had subsequent surgical excision were identified.

Current status of combined hormone replacement therapy in clinical practice.

Approximately 20 million women worldwide use hormone replacement therapy (HRT). Formerly, it was thought to confer beneficial cardiac protection and reduce osteoporosis in addition to relieving the symptoms of menopause. However, many recent trials have contradicted these beliefs.

A pathologic assessment of adequate margin status in breast-conserving therapy.

Background: The definition of a clear margin in breast-conserving therapy is uncertain. The purpose of this study was to correlate the tumor-margin distance of the excision specimen with the presence of residual tumor at reoperation. We also analyzed predictors of compromised margins and of residual disease.

Identifying patients at risk of compromised margins following breast conservation for lobular carcinoma.

Background: The association of invasive lobular carcinoma with high rates of compromised margins in breast conservation makes choice of operation for these patients difficult. We sought to identify patients at risk of compromised margins following breast conservation surgery.

Methods: We reviewed all patients with invasive lobular and invasive ductal carcinoma over a 5-year period (1999-2004).

The accuracy of ultrasound, stereotactic, and clinical core biopsies in the diagnosis of breast cancer, with an analysis of false-negative cases.

Objective: Preoperative core biopsy in breast cancer is becoming the standard of care. The aim of this study was to analyze the various methods of core biopsy with respect to diagnostic accuracy and to examine the management and outcome of those patients with false-negative biopsies.

Methods: All patients undergoing core biopsy for breast abnormalities over a 5-year period (1999-2003) were reviewed.

Expression of the breast cancer metastasis suppressor gene, BRMS1, in human breast carcinoma: lack of correlation with metastasis to axillary lymph nodes.

The BRMS1 (breast cancer metastasis suppressor 1) gene has been found to suppress metastasis in animal models without inhibiting primary tumor growth. The aim of this study was to measure expression of BRMS1 mRNA in a panel of human breast carcinomas and compare its expression with parameters of local dissemination such as tumor size and lymph node metastasis. We also compared expression of BRMS1 mRNA in normal breast tissue, fibroadenomas, primary breast cancers and axillary nodal metastases from primary breast cancers.