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https://www.readbyqxmd.com/read/27900818/healthcare-costs-reduced-after-incorporating-the-results-of-the-american-college-of-surgeons-oncology-group-z0011-trial-into-clinical-practice
#1
Michelle M Fillion, Katherine E Glass, Joe Hayek, Allison Wehr, Gary Phillips, Alicia Terando, Doreen M Agnese
The purpose of our study was to quantitate the changes in axillary lymph node dissection (ALND), frozen section (FS), and the impact on costs after the publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial. We compared axillary nodal management and cost data in breast cancer patients who met Z0011 criteria and were treated with lumpectomy and sentinel lymph nodes (SLN) biopsy from 2007 to July 2013. Of 800 patients, 67 (13.5%) and 34 (12.5%) patients in the pre- and post-Z0011 era had 1-2 positive SLN...
November 30, 2016: Breast Journal
https://www.readbyqxmd.com/read/27900811/exuberant-squamous-metaplasia-with-calcification-following-intraoperative-radiotherapy-for-breast-carcinoma-report-of-an-unusual-case-and-retrospective-review-of-cases-from-a-single-institution
#2
Paula S Ginter, John Ng, Rebecca Zhuo, Alexander J Swistel, Timothy M D'Alfonso
Intraoperative radiotherapy (IORT) is a novel and increasingly utilized radiation technique in the treatment of breast carcinoma. There are few reports on the histologic changes seen in breast tissue from patients who have undergone IORT. We sought to evaluate the histologic changes observed in specimens received following IORT, as well as report an unusual case which prompted our study. A retrospective review of patients who received IORT and subsequently had breast tissue histologically evaluated at our institution was performed...
November 30, 2016: Breast Journal
https://www.readbyqxmd.com/read/27878067/ultrasonography-findings-of-alloderm-%C3%A2-used-in-postmastectomy-alloplastic-breast-reconstruction-a-case-report-and-literature-review
#3
Young Seon Kim
AlloDerm(®) (LifeCell Corp.; Brancburg, NJ) is an acellular dermal matrix (ADM) that serves as an immunologically inert scaffold in plastic surgery. In breast reconstruction, it is used as a filler for lumpectomy defects and can be used to create the inferolateral portion of the tissue expander pocket or implant pocket in postmastectomy patients. However, there are limited reports of the radiologic findings of AlloDerm(®) in patients who have undergone postmastectomy reconstruction. Familiarity with the imaging features of AlloDerm(®) is essential for correct diagnosis...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27869081/long-term-update-of-nrg-oncology-rtog-0319-a-phase-1-and-2%C3%A2-trial-to-evaluate-3-dimensional-conformal-radiation-therapy-confined-to-the-region-of%C3%A2-the%C3%A2-lumpectomy-cavity-for-stage-i-and-ii-breast%C3%A2-carcinoma
#4
Rachel Rabinovitch, Jennifer Moughan, Frank Vicini, Helen Pass, John Wong, Susan Chafe, Ivy Petersen, Douglas W Arthur, Julia White
PURPOSE: NRG Oncology RTOG 0319 was the first cooperative group trial in the United States to evaluate 3-dimensional conformal radiation therapy (3D-CRT) accelerated partial breast irradiation (APBI). This report updates secondary endpoints of toxicity and efficacy. METHODS AND MATERIALS: Patients with stage I or II invasive breast cancer (tumor size ≤3 cm, ≤3 positive lymph nodes, negative margins) were eligible for 3D-CRT APBI: 38.5 Gy in 10 twice-daily fractions...
December 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27867721/wide-field-optical-coherence-micro-elastography-for-intraoperative-assessment-of-human-breast-cancer-margins
#5
Wes M Allen, Lixin Chin, Philip Wijesinghe, Rodney W Kirk, Bruce Latham, David D Sampson, Christobel M Saunders, Brendan F Kennedy
Incomplete excision of malignant tissue is a major issue in breast-conserving surgery, with typically 20 - 30% of cases requiring a second surgical procedure arising from postoperative detection of an involved margin. We report advances in the development of a new intraoperative tool, optical coherence micro-elastography, for the assessment of tumor margins on the micro-scale. We demonstrate an important step by conducting whole specimen imaging in intraoperative time frames with a wide-field scanning system acquiring mosaicked elastograms with overall dimensions of ~50 × 50 mm, large enough to image an entire face of most lumpectomy specimens...
October 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27864044/localization-methods-for-excisional-biopsy-in-women-with-nonpalpable-mammographic-abnormalities
#6
Christine Rodhouse, Iman Soliman, Mariah Cruse, Joseph Kastrenakes, C J Augustine, Alexis Ludy, Eric Reintgen, Alexa Hoadley, Divya Desai, Minh Nguyen, Douglas Scott Reintgen
INTRODUCTION: With the advent and proliferation of breast cancer screening programs, more women are being diagnosed with mammographic abnormalities that require tissue diagnosis. If imaged-guided biopsy is not possible or previous image-guided biopsies reveal pathologies that require more extensive surgery, guided excisional biopsy/lumpectomy may be necessary. METHODS: Fifteen women were enrolled in the study of the feasibility of off-site or day-before wire-localization excisional biopsy of the breast with mammographic abnormalities...
October 19, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/27861833/organizational-factors-affect-safety-net-hospitals-breast-cancer-treatment-rates
#7
Nina A Bickell, Alexandra DeNardis Moss, Maria Castaldi, Ajay Shah, Alan Sickles, Peter Pappas, Theophilus Lewis, Margaret Kemeny, Shalini Arora, Lori Schleicher, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
OBJECTIVE: To identify key organizational approaches associated with underuse of breast cancer care. SETTING: Nine New York City area safety-net hospitals. STUDY DESIGN: Mixed qualitative-quantitative, cross-sectional cohort. METHODS: We used qualitative comparative analysis (QCA) of key stakeholder interviews, defined organizational "conditions," calibrated conditions, and identified solution pathways. We defined underuse as no radiation after lumpectomy in women <75 years or mastectomy in women with ≥4 positive nodes, or no systemic therapy in women with tumors ≥1 cm...
November 14, 2016: Health Services Research
https://www.readbyqxmd.com/read/27860134/a-study-of-the-growth-patterns-of-breast-carcinoma-using-3d-reconstruction-a-pilot-study
#8
Andrea L Merrill, Julliette Buckley, Rong Tang, Elena Brachtel, Upahvan Rai, James Michaelson, Amy Ly, Michelle C Specht, Yukako Yagi, Barbara L Smith
Lumpectomy with microscopically clear margins is a safe and effective approach for surgical management of breast carcinoma. Margins are positive for tumor in 18-50% of lumpectomies, as it is not possible to accurately determine the shape or microscopic borders of a tumor preoperatively or intraoperatively. We examined the 3D microanatomy and growth patterns of common breast carcinoma subtypes to provide guidance for lumpectomy surgery. Prospective consent was obtained for the use of excess tissue from patients undergoing lumpectomy or mastectomy for breast carcinoma...
November 17, 2016: Breast Journal
https://www.readbyqxmd.com/read/27858093/targeted-intraoperative-radiotherapy-tumour-bed-boost-during-breast-conserving-surgery-after-neoadjuvant-chemotherapy
#9
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Cornelia Liedtke, Max Bulsara, Jayant S Vaidya
INTRODUCTION: The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). METHOD: In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost...
November 17, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27857263/the-marginprobe%C3%A2-system-an-innovative-approach-to-reduce-the-incidence-of-positive-margins-found-after-lumpectomy
#10
Sowsina Gola, Susan Doyle-Lindrud
The goal of lumpectomy surgery for breast cancer is to completely remove the tumor and have clear margins, reducing the rates of local recurrence. The MarginProbe® System is a new device that can detect microscopic tumor cells at or close to the margin of the surgical resection intraoperatively, providing the surgeon with the ability to re-excise tissue at the time of surgery, reducing the need for a second surgery to obtain clear margins.
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December 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27821330/mastotrainer-new-version-realistic-simulator-for-training-in-breast-surgery
#11
G Zucca-Matthes, Gail Lebovic, Marcos Lyra
The "Mastotrainer" was introduced as a new concept of simulators for use in surgical training. Simulators of this type are critical as the use of cadavers is limited or prohibited in some countries. The Mastotrainer has proved very useful in training various surgical techniques, with the first version of the simulator being focused on breast augmentation and reconstruction following mastectomy. This current project explores use of a new version of the surgical simulator that can facilitate a broader spectrum of procedures in the training of breast surgeons as well as plastic and reconstructive surgeons in order to achieve better outcomes...
November 4, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27819878/prognostic-factors-treatment-and-outcomes-in-early-stage-invasive-papillary-breast-cancer-a-seer-investigation-of-less-aggressive-treatment-in-a-favorable-histology
#12
Mohamad H Fakhreddine, Waqar Haque, Awad Ahmed, Mary R Schwartz, Andrew M Farach, Arnold C Paulino, Elizabeth Bonefas, Darlene Miltenburg, Polly Niravath, E Brian Butler, Bin S Teh
OBJECTIVES: Invasive papillary breast cancer (IPBCA) represents 0.5% of invasive BCA, and is thought to carry a favorable prognosis. This population-based study reports on prognostic factors, treatment, and outcomes of early-stage IPBCA to explore whether there is any evidence to support less aggressive treatment. MATERIALS AND METHODS: IPBCA cases from 1990 to 2009 of the recent Surveillance, Epidemiology, and End Results were analyzed. Inclusion criteria included patients with stage T1-2, N0 IPBCA...
November 4, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27816540/frequency-of-whole-breast-radiation-therapy-after-intraoperative-radiation-therapy-due-to-criteria-identified-by-lumpectomy
#13
Eric A Mellon, Amber Orman, Luis E Joya, Michael E Montejo, Christine Laronga, Susan J Hoover, M Catherine Lee, Nazanin Khakpour, Pamela F Kubal, Roberto Diaz
PURPOSE: For selected early breast cancers, intraoperative radiation therapy (IORT) at the time of lumpectomy can be an efficient alternative to fractionated whole breast radiation therapy (WBRT). However, some patients are later recommended WBRT after IORT due to surgical pathologic findings. To understand risk factor identification rates triggering WBRT recommendation, we analyzed adverse prognostic features based on multiple international criteria for suitability for accelerated partial breast irradiation...
November 2, 2016: Brachytherapy
https://www.readbyqxmd.com/read/27788894/neoadjuvant-systemic-therapy-use-for-younger-patients-with-breast-cancer-treated-in-different-types-of-cancer-centers-across-the-united-states
#14
Jahan J Mohiuddin, Allison M Deal, Lisa A Carey, Jennifer L Lund, Brock R Baker, Timothy M Zagar, Ellen L Jones, Lawrence B Marks, Ronald C Chen
BACKGROUND: Multiple clinical trials have shown that neoadjuvant systemic therapy has a benefit in women who are borderline lumpectomy candidates and in those with locally advanced breast cancers by reducing the mastectomy rate and making inoperable tumors operable. The study aim was to examine the patterns of neoadjuvant chemotherapy and endocrine therapy use among younger women in the United States treated at different types of cancer centers. STUDY DESIGN: Data from the National Cancer Data Base for 118,086 women younger than 65 years with clinical stage IIA (T2N0 only) to IIIC breast cancer...
November 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27783425/the-laparoscopically-harvested-omentum-as-a-free-flap-for-autologous-breast-reconstruction
#15
Tert C van Alphen, Maarten R Fechner, Jeroen M Smit, Gerrit D Slooter, Coralien L Broekhuysen
BACKGROUND: In autologous breast reconstruction, abdominal based flaps are by far the most common choice from the wide range of free flaps available. In selected cases, a laparoscopically harvested omental free flap (LHOFF) can be used. Patient satisfaction has not been reported until now. In this article, we report our experience using LHOFF in breast reconstruction including our technique, patient satisfaction, and donor/recipient site complications. PATIENTS AND METHODS: Between 2007 and 2014, six patients underwent autologous breast reconstruction with LHOFF...
October 26, 2016: Microsurgery
https://www.readbyqxmd.com/read/27780311/initiation-of-and-adherence-to-tamoxifen-and-aromatase-inhibitor-therapy-among-elderly-women-with-ductal-carcinoma-in-situ
#16
Hui Zhao, Nainan Hei, Yiling Wu, Winston Chan, Xiudong Lei, Carrie Cameron, Shine Chang, Mariana Chavez-MacGregor, Sharon H Giordano
BACKGROUND: The National Surgical Adjuvant Breast and Bowel Project B35 and International Breast Cancer Intervention Studies II Ductal Carcinoma In Situ trials showed similar treatment effects of anastrozole and tamoxifen in reducing cancer recurrence risk among ductal carcinoma in situ (DCIS) patients. Studies have shown low levels of hormone therapy drug initiation for DCIS patients, but the current body of literature lacks information on the 5-year adherence rates for these drugs from population-based studies...
October 25, 2016: Cancer
https://www.readbyqxmd.com/read/27778239/three-dimensional-conformal-versus-intensity-modulated-radiotherapy-in-breast-cancer-treatment-is-necessary-a-medical-reversal
#17
Alba Fiorentino, Ruggero Ruggieri, Niccolò Giaj-Levra, Gianluisa Sicignano, Gioacchino Di Paola, Stefania Naccarato, Sergio Fersino, Rosario Mazzola, Umberto Tebano, Francesco Ricchetti, Filippo Alongi
OBJECTIVES: Aim of the present study is to compare three-dimensional conformal RT (3D-CRT) and 4-fields intensity modulated radiation therapy (4f-IMRT) treatment plans, in terms of target dose coverage, integral dose and dose to Organs at risk (OARs) in early breast cancer (BC). METHODS: Twenty consecutive BC patients, after lumpectomy, were selected for the present analysis. A total dose of 50 Gy and a simultaneous dose of 60 Gy in 25 fractions was prescribed to Planning Target Volume of the whole breast (PTVbreast) and of the surgical bed, respectively...
October 24, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27777879/accelerated-partial-breast-irradiation-past-present-and-future
#18
Anne W Tann, Sandra S Hatch, Melissa M Joyner, Lee R Wiederhold, Todd A Swanson
Accelerated partial breast irradiation (APBI) focuses higher doses of radiation during a shorter interval to the lumpectomy cavity, in the setting of breast conserving therapy for early stage breast cancer. The utilization of APBI has increased in the past decade because of the shorter treatment schedule and a growing body of outcome data showing positive cosmetic outcomes and high local control rates in selected patients undergoing breast conserving therapy. Technological advances in various APBI modalities, including intracavitary and interstitial brachytherapy, intraoperative radiation therapy, and external beam radiation therapy, have made APBI more accessible in the community...
October 10, 2016: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27774494/optimized-siftflow-for-registration-of-whole-mount-histology-to-reference-optical-images
#19
Rushin Shojaii, Anne L Martel
The registration of two-dimensional histology images to reference images from other modalities is an important preprocessing step in the reconstruction of three-dimensional histology volumes. This is a challenging problem because of the differences in the appearances of histology images and other modalities, and the presence of large nonrigid deformations which occur during slide preparation. This paper shows the feasibility of using densely sampled scale-invariant feature transform (SIFT) features and a SIFTFlow deformable registration algorithm for coregistering whole-mount histology images with blockface optical images...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27770672/population-based-analysis-of-breast-cancer-treatment-by-intrinsic-sub-type-in-manitoba-canada
#20
Elizabeth Hammond, Emma Shu, Karagin Sawchuk, Yvonne Myal, Afshin Raouf, Thomas Klonisch, Sabine Hombach-Klonisch, Etienne Leygue, Sam Kung, Janice Safneck, Michael Mowat, Wayne Xu, Leigh Murphy, Marshall Pitz
BACKGROUND: Few descriptive epidemiological studies on the incidence, treatment and survival can accurately reflect a whole population. Manitoba, Canada has an accurate cancer registry, a drug information program network and a breast screening program since 1995. This combined with a stable population provides true population data that can accurately describe the region. METHODS: Using a retrospective cohort design all Breast Cancer cases were obtained from 2004-2010 (N=5399) and grouped by Intrinsic sub-type...
December 2016: Cancer Epidemiology
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