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Breast Conservative Surgery

Monika Brzezinska, Linda J Williams, Jeremy Thomas, J Michael Dixon
PURPOSE: Inflammatory breast cancer (IBC) is rare and associated with a poor prognosis. Following neoadjuvant chemotherapy or endocrine therapy, the multidisciplinary team selected a small number of patients for breast-conservation therapy (BCT). The aim of this study was to determine the outcome of IBC patients treated with BCT in Edinburgh. METHODS: Between January 1999 and December 2013, thirty-five women with IBC were treated by BCT. The median follow-up was 80 months...
October 18, 2016: Breast Cancer Research and Treatment
Jose Vila, Mediget Teshome, Susan L Tucker, Wendy A Woodward, Mariana Chavez-MacGregor, Kelly K Hunt, Elizabeth A Mittendorf
OBJECTIVE: The current study was undertaken to determine if the CPS+EG score could stratify patients with respect to local-regional recurrence (LRR). BACKGROUND: We previously defined and validated a novel breast cancer staging system incorporating the American Joint Committee on Cancer clinical stage (CS), final pathologic stage (PS), estrogen receptor status (E), and nuclear grade (G) (CPS+EG score). The score is associated with disease-specific survival outcomes in patients treated with neoadjuvant chemotherapy...
October 4, 2016: Annals of Surgery
John R Benson, Ismail Jatoi, Masakazu Toi
The heterogeneous nature of ductal carcinoma in situ has been emphasised by data for breast-cancer screening that show substantial increases in the detection of early-stage non-invasive breast cancer but no noteworthy change in the incidence of invasive and distant metastatic disease. Indolent non-progressive forms of ductal carcinoma in situ are managed according to similar surgical strategies as high-risk disease, with extent of resection dictated by radiological and pathological estimates of tumour dimensions...
October 2016: Lancet Oncology
M C van Maaren, L de Munck, J J Jobsen, P Poortmans, G H de Bock, S Siesling, L J A Strobbe
PURPOSE: Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category. METHODS: All women diagnosed with primary invasive T1-2N2 breast cancer in 2000-2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry...
October 11, 2016: Breast Cancer Research and Treatment
Barbara Radecka, Maria Litwiniuk
Breast cancer (BC) in young women is rare, affecting only 4-6% of women under the age of 40. Regardless, BC remains the most common malignancy among younger patients. Recently, a significant increase in BC rates has been observed among pre-menopausal subjects. Breast cancer in young women requires special attention due to its specific morphologic and prognostic characteristics and unique aspects, including fertility preservation and psychosocial issues (e.g. its impact on family life and career). Young women are more likely to have tumors with higher incidence of negative clinicopathologic features (higher histological grade, more lymph node positivity, lower estrogen receptor (ER) positivity, higher rates of Her2/neu overexpression)...
2016: Ginekologia Polska
Daniele Bordoni, Pierfrancesco Cadenelli, Giuseppe Falco, Nicola Rocco, Paola Manna, Ariel Tessone, Matteo Ornelli, Cesare Magalotti
INTRODUCTION: So called "extreme oncoplastic surgery" is emerging as a new promising concept in breast cancer surgery allowing successful breast conservation in selected patients with multicentric tumors. PRESENTATION OF CASE: We report the case of a 48-year-old woman presenting with a multicentric breast cancer and successfully treated with an oncoplastic technique consisting in three radical lumpectomies followed by breast reshaping and simultaneous contralateral symmetrization...
September 28, 2016: International Journal of Surgery Case Reports
L Hughes, J Hamm, C McGahan, C Baliski
BACKGROUND: Breast-conserving surgery (BCS) is the preferred surgical approach for the majority of patients with early-stage breast cancer. There are frequent issues regarding pathologic margin status, requiring margin re-excision, and, in the literature, there is significant variability in re-excision rates, suggesting this is a potential quality-of-care issue. Understanding the patient-, disease-, and physician-related factors influencing reoperation rates is of importance in an effort to minimize this occurrence...
October 7, 2016: Annals of Surgical Oncology
Alba Fiorentino, Umberto Tebano, Ruggero Ruggieri, Francesco Ricchetti, Filippo Alongi
AIM: For simultaneous bilateral breast cancer (SBBC) treatment, conventional radiotherapy (RT) has a number of critical shortcomings. Thus, the usefulness of volumetric arc therapy (VMAT) for SBBC is undeniable. CASE REPORT: A 34-year-old woman with SBBC received neoadjuvant chemotherapy followed by breast-conserving surgery and bilateral lymph node dissection. Given the conservative surgery and the nodal involvement after neoadjuvant chemotherapy, bilateral adjuvant RT to the breasts and regional nodes with doses of 50 Gy in 25 fractions and a simultaneous integrated boost (SIB) of 60 Gy to the surgical bed was proposed...
September 27, 2016: Tumori
Michael J Cross, Gail S Lebovic, Joseph Ross, Scott Jones, Arnold Smith, Steven Harms
BACKGROUND: Techniques for accurately delineating the tumor bed after breast-conserving surgery (BCS) can be challenging. As a result, the accuracy, and efficiency of radiation treatment (RT) planning can be negatively impacted. Surgically placed clips or the post-surgical seroma are commonly used to determine target volume; however, these methods can lead to a high degree of uncertainty and variability. A novel 3-dimensional bioabsorbable marker was used during BCS and assessed for its impact on RT planning...
October 5, 2016: World Journal of Surgery
Jennifer B Manders, Henry M Kuerer, Benjamin D Smith, Cornelia McCluskey, William B Farrar, Thomas G Frazier, Linna Li, Charles E Leonard, Dennis L Carter, Sheema Chawla, Lori E Medeiros, J Michael Guenther, Lauren E Castellini, Daniel J Buchholz, Eleftherios P Mamounas, Irene L Wapnir, Kathleen C Horst, Anees Chagpar, Suzanne B Evans, Adam I Riker, Faisal S Vali, Lawrence J Solin, Lisa Jablon, Abram Recht, Ranjna Sharma, Ruixiao Lu, Amy P Sing, E Shelley Hwang, Julia White
OBJECTIVE: The aim of this study was to determine the impact of the results of the 12-gene DCIS Score assay on (i) radiotherapy recommendations for patients with pure ductal carcinoma in situ (DCIS) following breast-conserving surgery (BCS), and (ii) patient decisional conflict and state anxiety. METHODS: Thirteen sites across the US enrolled patients (March 2014-August 2015) with pure DCIS undergoing BCS. Prospectively collected data included clinicopathologic factors, physician estimates of local recurrence risk, DCIS Score results, and pre-/post-assay radiotherapy recommendations for each patient made by a surgeon and a radiation oncologist...
October 4, 2016: Annals of Surgical Oncology
Mehra Golshan, Constance T Cirrincione, William M Sikov, Lisa A Carey, Donald A Berry, Beth Overmoyer, Nora L Henry, George Somlo, Elisa Port, Harold J Burstein, Clifford Hudis, Eric Winer, David W Ollila
OBJECTIVE: It had been previously shown that patients who receive neoadjuvant systemic therapy (NST) are more likely to undergo breast-conserving therapy (BCT) than those who have primary surgery. However, the frequency with which patients who are not BCT-eligible prior to NST convert to BCT-eligible with treatment is unknown. To document this conversion rate in a subset of patients expected to have a high clinical response rate to NST, we studied surgical assessment and management of patients enrolled on a randomized neoadjuvant trial for stage II-III HER2-positive breast cancer (HER2 + BC)(CALGB 40601)...
November 2016: Breast Cancer Research and Treatment
Fabrizio De Biasio, Nicola Zingaretti, Andrea Marchesi, Luca Vaienti, Daria Almesberger, Pier Camillo Parodi
BACKGROUND: Quadrantectomy is an oncologically safe procedure for the treatment of early-stage breast cancer, but it often results in poor aesthetic outcomes such as breast shape deformity, which is more visible if the tumour is located in the lower pole. We recommend the use of the transverse incision, which retains the oncological advantages of the quadrantectomy while leading to better aesthetical results. METHOD: We evaluated the clinical results of 24 patients with breast cancer who underwent quadrantectomy of the lower breast pole and volume replacement with remodelling through three posterior scorings from January 2012 to January 2014, with cosmetic evaluations performed according to the criteria set by the Japanese Breast Cancer Society...
October 4, 2016: Aesthetic Plastic Surgery
YaoYao G Pollock, Amanda L Blackford, Stacie C Jeter, Jean Wright, Ashley Cimino-Mathews, Melissa Camp, Susan Harvey, Fariba Asrari, Nancy L Schoenborn, Vered Stearns
PURPOSE: In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. METHODS: We identified women ≥70 years old treated at our institution from 2009 to 2014...
November 2016: Breast Cancer Research and Treatment
Gül Alço, Sefik Igdem, Sait Okkan, Maktav Dincer, Dauren Sarsenov, Ahmet Serkan Ilgun, Filiz Agacayak, Filiz Elbüken, Tulay Ercan, Derya Selamoglu, Vahit Ozmen
The aim of the present study was to evaluate the geographic variability of the tumor bed following oncoplastic breast-conserving surgery (OP-BCS), and to assess its relevance for radiotherapy planning. In this prospective study, pre- and postoperative computerized tomography (CT) scans of 22 patients with early-stage breast cancer were fused. The preoperative gross tumor volume or excisional biopsy cavity were contoured under the guidance of preoperative radiological images. Postoperative lumpectomy cavities were contoured under the guidance of surgical clips...
October 2016: Molecular and Clinical Oncology
Anqian Huang, Luoxi Zhu, Yanjuan Tan, Jian Liu, Jingjing Xiang, Qingqing Zhu, Lingyun Bao
The present is a retrospective study examining the use of automated breast volume scanner (ABVS) for guiding breast conservation surgery in ductal carcinoma in situ (DCIS). A total of 142 patients with pathologically confirmed DCIS were initially included in the study. The patients underwent preoperative examination by conventional ultrasound and by ABVS. The BI-RADS category system was used to identify benign and malignant lesions, after which breast conservation surgery was performed, and the therapeutic effects were compared...
October 2016: Oncology Letters
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
Michael H Antoni, Laura C Bouchard, Jamie M Jacobs, Suzanne C Lechner, Devika R Jutagir, Lisa M Gudenkauf, Charles S Carver, Susan Lutgendorf, Steven W Cole, Marc Lippman, Bonnie B Blomberg
PURPOSE: Cognitive behavioral stress management (CBSM) is an empirically-validated group-based psychosocial intervention. CBSM is related to decreased self-reported indicators of psychological adversity during breast cancer treatment and greater disease-free survival (DFS) vs. a control condition. This study examined relationships between CBSM, DFS, and a potential biobehavioral pathway linking these variables in breast cancer patients through a gene expression composite representing the leukocyte conserved transcriptional response to adversity (CTRA)...
September 24, 2016: Psychoneuroendocrinology
Olivera Kosovac, Nada Santrac, Ivan Markovic, Dusica Gavrilovic, Aleksandar Martinovic, Marko Jevric, Igor Spurnic, Radan Dzodic
PURPOSE: To evaluate the adverse outcomes after delayed breast reconstruction (DBR) by abdominal advancement flap (AAF) and permanent prosthesis in patients treated with mastectomy due to unilateral breast carcinoma, as well as to determine which factors are predictive for their occurrence. METHODS: The study included 155 patients operated at the Institute for Oncology and Radiology of Serbia from 1996 to 2010. All patients had total mastectomy and axillary lymph node dissection, followed by specific oncological treatment...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Sang-Won Kim, Mison Chun, Sehwan Han, Yong Sik Jung, Jin Hyuk Choi, Seok Yun Kang, Hyunsoo Jang, Sunmi Jo
PURPOSE: The role of postmastectomy radiotherapy in the treatment of T1-2 primary tumor with 1-3 positive lymph nodes is controversial. We compared treatment outcomes between breast conserving surgery followed by radiotherapy (BCS+RT) and total mastectomy alone (TM) in the setting of modern adjuvant systemic treatments. METHODS: Patients with T1-2 primary breast cancer and 1-3 positive lymph nodes who were treated between 2001 and 2011 were divided into 2 groups based on the treatment approach: BCS+RT (n = 169) and TM (n = 117)...
2016: PloS One
Yukyung Go, Minsung Chung, Yongsoon Park
Triple-negative breast cancer (TNBC) is a common subtype of breast cancer among women with dense breasts and is associated with a poor prognosis. Diet is a modifiable risk factor for breast cancer, but the association between the risk of TNBC and diet has not been studied. The present study investigated the hypothesis that a healthy dietary pattern was negatively associated with risk of TNBC in women with dense breasts (density types 3 and 4). After total mastectomy or breast conserving surgery, patients with TNBC (n = 38) and non-TNBC (n = 178) were recruited...
September 28, 2016: Nutrition and Cancer
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