Adding ovarian function suppression to tamoxifen provides long term survival benefit

Long term follow up has confirmed that the addition of two years of ovarian function suppression (OFS) to tamoxifen significantly improves disease-free survival (DFS) in patients with hormone receptor–positive breast cancer who remain in a premenopausal state or resume ovarian function after chemotherapy.

Eight year results from the ASTRRA trial have shown that there continued to be a statistically significant reduction in DFS event rate in favour of ovarian function suppression and tamoxifen over tamoxifen alone.

In the study which randomly assigned 1,298 patients with breast cancer to receive tamoxifen only or ovarian function suppression and tamoxifen, the estimated DFS rates were 85.4% compared to 80.2% (HR 0.67; 95% CI, 0.51 to 0.87).

The finding of a 5.2% increase in DFS suggested that adding ovarian function suppression to tamoxifen should be considered for those who remain in a premenopausal state or resume ovarian function after chemotherapy, the study investigators said.

Radiologists to target contrast-enhanced CT scan ‘frequent flyers’

To conserve scarce stocks of contrast media for CT scans, radiologists will be targeting clinicians and departments who are  ‘frequent flyers’ who order the most contrast-enhanced CT scans (CECT).

The temporary global shortage of iodinated contrast medium (ICM) due to the Covid -19 pandemic. Means that some public hospitals in Australia have less than a week’s supply, they say in an article in the Journal of Medical Imaging and Radiation Oncology.

They therefore suggest several guidance points to preserve ICM, “to conserve ICM for those diagnostic tests and interventions which are time -critical, and without which patients would suffer death or significant morbidity.”

The most frequently performed CECTs at Monash Health were CT abdomen and pelvis and CT pulmonary angiogram, they noted.

Meanwhile, MOGA has released advice that oncologists can give to patients about the impact of the shortage on cancer scans. The information advises patients that there may be a need to undergo an alternative scans and what this means for imaging bookings.

My Health Record remains underused despite $2 billion spend

The digital My Health Record remains rarely used by either patients or doctors, despite more than $2 billion being spent on it since it was launched in 2012.

Research shows it was accessed during just 2% of ED presentations and a survey of 40 emergency medicine clinicians in Victoria also found nearly half had never used the multi-billion dollar system.

First reported in Guardian Australia this week, the survey was compiled by Monash University PhD candidate Alex Mullins, who said problems included lack of trust and records that were outdated.

She told the publication: “Areas for improvement include both technical improvements to the system itself … and more data flowing into the system, and improvements with respect to clinician engagement with the system.”

Some 2.7 million patients, or just of 10% of those registered for a My Health Record opened their file in 2020-21, according to the Australian Digital Health Agency.

While this was an increase of 14% on the previous year, it was most driven by patients accessing their vaccination records, the agency said in its most recent annual report.