There's been talk of doing regular Journal Club, but as most things inertia dies down. I have started doing a journal club for my residency, and started to incorporate old faculty and residents with positive response. Without further ado, here is the most recent RBJC(just covered it this evening) with more to come if interest persists.
Original paper can be found here : The use of anastrozole for breast cancer prevention (IBIS II)): a radomized controlled trial32955-1/fulltext)
This analysis has identified a significant continuing reduction in breast cancer with anastrozole in the post-treatment follow-up period, with no evidence of new late side-effects. Further follow-up is needed to assess the effect on breast cancer mortality.
This is a long term follow up study to the initial IBIS II62292-8/fulltext) trial published in 2014 with 5 year analysis, with follow up extending to 5 years beyond the initial trial.
Postmenopausal women calculated to be at increased risk through somewhat complex metrics were placed on anastrozole versus placebo for five years. This study follows the patients out to 10 years for more long term data after the initial results were analyzed in 2014.
The trial showed a significant 49% reduction in breast cancer in the anastrozole arm that extended out to 12 years even after completing the initial 5 year course. Additionally, no major long term risks were identified such as thromboembolism or uterine cancer as have been shown with use of SERMs. Side effects were limited to hot flashes, arthralgias and hypertension.
The number needed to treat was noted to be 65 after the first five years, however with the noted persistence of benefit and increased rates of breast cancer with age, long term follow up showed that number to 29.
Interestingly, the use of anastrozole also conveyed protection from non-melanoma skin cancers at both 5 and 10 year marks, though no major changes in other cancers.
Discussion: Medications for primary prevention of breast cancer is rarely discussed, most likely due to side effects limiting use with SERM medications that have been more thoroughly studied. Aromatase inhibitors so far have shown similar reduction in risk with less side effects and might present a more palatable option to postmenopausal women at increased risk of breast cancer. More research is likely needed to replicate this data, as well as to increase the power to detect possible mortality effects.
Source: Original link