Our panel of experts highlight the most important research articles across the spectrum of topics relevant to the field of breast cancer management.

et al . carcinoma (DCIS). Breast Cancer Res. Treat. 143, 343–350 (2014) The optimal treatment of patients with ductal carcinoma in situ (DCIS) of the breast remains controversial, with large variations in clinical management. Wong et al. report the updated results of their trial of wide local excision alone for 158 patients with DCIS. Wide negative margins of resection were required. Radiation treatment and tamoxifen were not given. The 10-year rate of local recurrence was 15.6%. Of the local recurrences, 32% were invasive. The 10-year rate of local recurrence was similar to the findings from the ECOG E5194 study. The results reported by Wong et al. demonstrate that even for patients with clinical and pathologic features suggesting favorable disease, there is a substantial and continuing rate of local recurrence, including invasive local recurrence. Because of the need to improve risk In this trial from the European Institute of Oncology, 1305 women aged 48–75 years with tumors <2.5 cm were randomly assigned to whole-breast radiation therapy delivering 50 Gy/25 fractions plus boost 10 Gy/five fractions versus intraoperative radiation therapy (IORT) delivering a single fraction of 21 Gy to the tumor bed after quadrantectomy. An equivalence margin was prespecified as 5-year in-breast tumor recurrence not exceeding 7.5% in the IORT group. At a median follow-up of 5.8 years, in-breast tumor recurrence was significantly higher in the IORT compared with the whole-breast radiation therapy group (4.4 vs 0.4%; hazard ratio: 9.3; 95% CI: 3.3–26.3). Among 876 subjects with available data, IORT was associated with fewer skin toxicity (p = 0.0002), but higher rates of fat necrosis (p = 0.04). The findings that IORT was associated with suboptimal local control teach important lessons about exercising caution in not replacing standard therapy with newer methods until results from rigorous prospective evaluation are available. signaling to dependence on growth factor-mediated pathways, such as HER2. However, the role of HER2, and the identity of other relevant factors that may be used as biomarkers or therapeutic targets remain unknown. In the present work, the investigators explored the potential role of transcription factor HIF-1 in acquired AI resistance, and its regulation by HER2. In conclusion, one of the mechanisms of AI resistance may be through the regulation of nonhypoxic HIF-1 target genes, such as BCRP, implicated in chemoresistance. Thus, HIF-1 should be explored further for its potential as a biomarker of and therapeutic target. Sclerosing adenosis (SA) is a common proliferative lesion seen in fibrocystic changes. In Jensen's ‘classic’ work (1989) [1], the relative risk of SA for breast cancer was 2.1 in the study of 349 women. SAs are detected in both premenopausal and postmenopausal women and in association with various histological features. In this large-scale study of 13,434 biopsies, the risk ratio (2.10) of SA was similar to that of Jensen. SA was associated with increased breast cancer risk in all age groups (<45, 45–55 and >55 years) and in both groups with no (0%) and partial (1–74%) lobular involution, but did not influence on the risk in specimens with proliferative lesions with or without atypia. Most women diagnosed with breast cancer in the USA are overweight or obese, and are likely to gain weight with treatment. Both factors result in increased risk of breast cancer recurrence and death; however, there is currently no standard-of-care weight management program for breast cancer survivors. This Phase II single-arm prospective trial enrolled 42 women with early-stage breast cancer and a BMI of ≥25 kg/m 2 to undergo an in-person diet and exercise weight loss intervention for 12 weeks. The 37 women who completed the study lost an average of 5.6 ± 2.0 kg, and had improvements in dietary behavior, quality of life and cardiorespiratory fitness measures. These results confirm that weight loss is feasible in