Literature selections curated by Lewis Flint, MD, FACS, and reviewed by the ACS Brief editorial board.
Treatment Interruptions Affect Overall Survival in Patients with Triple Negative Breast Cancer
Chow R, Hasan S, Choi JI, et al. Effect of Treatment Interruptions on Overall Survival in Patients with Triple Negative Breast Cancer. J Natl Cancer Inst. 2023; published online ahead of print.
Available evidence shows that delays in beginning radiation therapy for breast cancer are associated with decreased overall survival. This study examined the association of interruptions during treatment with overall survival.
Data on patients (n=35,845) from the National Cancer Database were analyzed. Treatment interruptions were defined as the difference between total treatment days and the expected treatment days. The data showed that treatment interruptions were associated with decreased overall survival; overall survival decreased in a linear fashion with increasing treatment interruptions. The effects of treatment interruptions did not vary based on the type of surgical treatment prior to beginning radiation therapy.
The authors recommended that treatment interruptions to care for conditions such as skin irritation should be minimized. They also noted that use of hypofractionation techniques can result in lowered frequency of treatment interruptions and shorter overall treatment duration.
Incorrect Cuff Size Has Clear Impact on Readings of Mean Blood Pressure
Ishigami J, Charleston J, Miller ER, et al. Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial. JAMA Intern Med. 2023; published online August 7, 2023.
Lalika M, Juraschek SP, Brewer LC. There Is No 1-Size-Fits-All to Blood Pressure Measurement—Cuff Size Matters. JAMA Intern Med. 2023; published online August 7, 2023.
This randomized study evaluated the effects of incorrect cuff size on mean blood pressure (MBP) readings using automated blood pressure cuffs in public blood pressure screening events. Four sets of triplicate MBP readings were performed in 195 patients with a variety of arm sizes. Based on arm measurements, three cuff sizes (too small, too large, and correct size) were used. The final MBP value was obtained with the correct size. The data analysis showed that use of too large cuffs was associated with significantly lower MBP, while too small cuffs were associated with too high readings.
The authors recommended that cuff size be individualized and chosen based on arm measurements; use of a single sized cuff for all patients should be avoided.
