Patients with hereditary mutations in BRCA1 or BRCA2 (gBRCA1/2) and breast cancer have distinct tumor biology, and encompass a predilection for brain metastasis (BM). We looked into baseline risk of BMs among gBRCA1/2 patients. Patients with gBRCA1/2, stage I-III invasive breast cancer seen between 2000–2017 with parenchymal BMs. Among gBRCA1 with distant breast cancer recurrence, 34 of 76 (44.7%) were diagnosed with brain metastases compared to 7 of 42 (16.7%) patients with gBRCA2. In the comparator group, 65 of 182 (35.7%) noncarrier triple-negative breast cancer (TNBC) and a distant recurrence experienced BM’s. In a competitive risk analysis using death as a competing factor, the cumulative incidence of BMs was similar between gBRCA1 and noncarrier TNBC patients. The time from primary breast cancer diagnosis to detection of BMs was similar between gBRCA1 and noncarrier TNBC patients (2.4 vs 2.2 years). Survival was poor after BMs (7.8 months for gBRCA1 patients vs. 6.2 months for TNBC noncarriers). Brain was a more common site of initial distant recurrence in gBRCA1 patients versus TNBC noncarriers (26.3% vs. 12.1%). Importantly, the presence of BMs, adversely impacted overall survival across groups (HR 1.68 (95% CI 1.12–2.53), hazard ratio for death if a patient had BMs at the time of initial breast cancer recurrence vs. not). In conclusion, breast cancer BMs is common and is similarly frequent among gBRCA1 and noncarrier patients with recurrent TNBC. Our study highlights the importance of improving the prevention and treatment of BMs in patients with TNBC, gBRCA1 carriers, and noncarriers.
This paper questions Harley's (1989) specific way of interpreting and dealing with 'the map'. Contrasting Harley's perspective with Derrida's approach of deconstruction provides a more detailed understanding of the potentials and limits of Harley's practice for a critical understanding of maps. Moreover, this paper offers an alternative practice for a critical reading of maps, rooted in Adorno's concept of Mündigkeit and Derrida's deconstruction.
Across Europe, and probably the world, messages of the extreme right surface with increasing and alarming regularity in both public and virtual space. Within the virtual space, geomedia are increasingly used in nationalist propaganda, a trend which is embedded in a wider development in public discourse, election results, and policies. In Austria and Germany, particular sensibilities due to the responsibility for the Holocaust have developed, leading to various specific education initiatives that address this part of history. This paper presents an activist learning environment using geomedia to deconstruct right-wing extremist discourses, and has been tested used in university settings in Salzburg and Vienna. Using a combination of Instagram and geospatial technologies not visible to learners, results of reflection and learning processes are analyzed qualitatively across two slightly different enactments of the learning environment. Experiences suggest an encouraging potential of geomedia use in critical learning processes, as long as the technology is hidden from learners, forming an incentive, support, and contextualization of the learning process.
In diesem Artikel wird dem Begriff und dem Phänomen Neoliberalismus überblicksartig nachgegangen. Ziel dieser Diskussion ist es, einen Begriff des Neoliberalen herzuleiten, der sich auch zur Analyse von Bildungsinhalten eignet, um entsprechende Tendenzen herausarbeiten zu können.
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