Could Perimenopausal Estrogen Prevent Breast Cancer? Exploring the Differential Effects of Estrogen-Only Versus Combined Hormone Replacement Therapy

Breast cancer is the commonest cancer among women in the western world, accounting for up to 30% of all cancers in women. There is a long-standing controversy about the potential link to hormone replacement therapy (HRT), with large observational studies suggesting that HRT increases the risk, while the Women’s Health Initiative (WHI), a prospective, randomized placebo-controlled trial, has reported several times over a period of 20 years that combined (estrogen and progestogen) HRT increases the risk, while estrogen-only HRT given to women who have had a prior hysterectomy, is associated with a significantly reduced risk of developing breast cancer. Evidence from the randomized trial shows a significant reduction in both incidence of and mortality from breast cancer in women who took estrogen replacement therapy; this message needs to be presented clearly and robustly so that it can help women with decision making when considering HRT for menopause

A case of unilateral keloid after bilateral breast reduction

Keloid scar is a manifestation of abnormal wound healing in predisposed individuals. Many treatment modalities have been tried with varying degrees of success. Radiotherapy is one such modality that is widely recognised. We present a case report and literature review based on a patient who developed unilateral keloid scarring following bilateral breast reduction surgery. Some 4 years previously, she had undergone breast conserving surgery followed by adjuvant radiotherapy for breast cancer. After her breast reduction surgery, she developed keloid scarring on the non-irradiated breast only. This case highlights a possible 'preventative' effect of radiotherapy in keloid formation

Crossing boundaries:bras, lingerie and rape myths in postcolonial urban middle-class India

With the processes of modernization, urbanization and the entry of women in the formal labour market in Indian metropolitan spaces, this paper examines how the modern middle-class woman’s sartorial choices become enmeshed in popular rape myths (false beliefs) that serve to blame her for the wearing of western clothing. The paper articulates the ways in which middle-class women’s social realities are shaped by historical, colonial and nationalist ideologies of modernization, constructed and mediated through moral codes of dressing. By drawing upon original and contemporary empirical narratives from the urban spaces of Delhi and Mumbai, we emphasise how everyday sartorial choices, in relation to particularly the bra and lingerie, can reveal the nuanced ways in which Urban Indian Professional Women (UIPW) seek to understand, negotiate, and resist patriarchal power. Our findings shed light on conflicting and contradictory spatial experiences, where some women internalize and negotiate moral codes of dressing, out of fear, and others who transgress are subject to sanctions. Given the paucity of scholarly literature in this area, the paper makes an important theoretical and empirical contribution with its focus on postcoloniality and everyday discursive material spaces of gendered and sexualized dress practices. It argues for the consciousness raising of everyday urban geographies of dress that reveal complicated structures of power that are often deemed hidden

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown