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This Week in JAMA: May 2, 2012


In JAMA this week, researchers at the University of Texas MD Anderson Cancer Center and the University of Chicago report on the effects of brachytherapy versus whole-breast irradiation and subsequent mastectomy on the survival of older women with invasive breast cancer. The team retrospectively studied 92,735 women aged 67 and older with invasive breast cancer, 6,952 of whom were treated with brachytherapy after lumpectomy and 85 of whom were treated with whole-breast irradiation. The team found that the women treated with brachytherapy had a higher five-year incidence of subsequent mastectomy than the women treated with whole-breast irradiation. Further, brachytherapy was associated with more frequent infectious and non-infectious post-operative complications than whole-breast irradiation. Five-year overall survival rates were similar, however — 87.66 percent in patients treated with brachytherapy versus 87.04 percent in the whole-breast irradiation group. "In a cohort of older women with breast cancer, treatment with brachytherapy compared with WBI was associated worse with long-term breast preservation and increased complications but no difference in survival," the authors write.

The Scan

Researchers Compare WGS, Exome Sequencing-Based Mendelian Disease Diagnosis

Investigators find a diagnostic edge for whole-genome sequencing, while highlighting the cost advantages and improving diagnostic rate of exome sequencing in EJHG.

Researchers Retrace Key Mutations in Reassorted H1N1 Swine Flu Virus With Avian-Like Features

Mutations in the acidic polymerase-coding gene boost the pathogenicity and transmissibility of Eurasian avian-like H1N1 swine influenza viruses, a PNAS paper finds.

Genome Sequences Reveal Evolutionary History of South America's Canids

An analysis in PNAS of South American canid species' genomes offers a look at their evolutionary history, as well as their relationships and adaptations.

Lung Cancer Response to Checkpoint Inhibitors Reflected in Circulating Tumor DNA

In non-small cell lung cancer patients, researchers find in JCO Precision Oncology that survival benefits after immune checkpoint blockade coincide with a dip in ctDNA levels.