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Breast Conservative Surgery

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https://www.readbyqxmd.com/read/28105873/loco-regional-morbidity-after-breast-conservation-and-axillary-lymph-node-dissection-for-early-breast-cancer-with-or-without-regional-nodes-radiotherapy-perspectives-in-modern-breast-cancer-treatment-the-skagen-trial-1-is-active
#1
Hanne Melgaard Nielsen, Rasmus Blechingberg Friis, Søren Linnet, Birgitte Vrou Offersen
BACKGROUND: Axillary lymph node dissection (ALND) and adjuvant radiotherapy (RT) in early breast cancer are associated with a risk of morbidity, including lymphedema and impaired shoulder mobility. The aim of this study was to evaluate loco-regional morbidity after breast conserving surgery (BCS), ALND, taxane-based chemotherapy and whole breast irradiation (WBI) with or without regional nodes RT. MATERIAL AND METHODS: Eligible patients had BCS and ALND from 2007 to 2012 followed by adjuvant taxane-based chemotherapy and if indicated, trastuzumab and endocrine treatment...
January 20, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28105662/preoperative-mri-of-the-breast-and-ipsilateral-breast-tumor-recurrence-long-term-follow-up
#2
Mai-Kim Gervais, Ellen Maki, Dan E Schiller, Pavel Crystal, David R McCready
BACKGROUND: Local recurrence after breast conserving surgery is reported in 5-10% of cases. This study aims to determine if preoperative MRI is associated with reduced IBTR rates in the longer term and evaluate IBTR rates of a high risk (TN and Her-2 positive) subgroup in those receiving MRI or not. METHODS: Between 1999 and 2005, patients with invasive breast cancer undergoing BCS and radiation were identified. Primary endpoint was IBTR rate. RESULTS: The cohort consisted of 470 cases: 27% underwent MRI and 73% did not...
January 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28099081/controversies-in-the-treatment-of-ductal-carcinoma-in-situ
#3
Andrea V Barrio, Kimberly J Van Zee
Ductal carcinoma in situ (DCIS) accounts for 20% of all newly diagnosed breast cancers. Mastectomy was once the gold standard for the treatment of DCIS; however, breast-conserving surgery (BCS) has been adopted as the treatment of choice for patients with small, screen-detected lesions. Both adjuvant radiation and hormonal therapy following BCS have been demonstrated in randomized trials to reduce the risk of both invasive and DCIS recurrence, but neither affects survival. With the variety of surgical and adjuvant treatment options available, there has been great interest in tailoring the treatment to the individual, with the goal of optimizing the balance of risks and benefits according to the values and priorities of the woman herself...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28095342/orthognathic-surgery-during-breast-cancer-treatment-a-case-report
#4
Tsuyoshi Shimo, Norie Yoshioka, Masahiro Nakamura, Soichiro Ibaragi, Tatsuo Okui, Yuki Kunisada, Masanori Masui, Mayumi Yao, Koji Kishimoto, Shoko Yoshida, Akiyoshi Nishiyama, Hiroshi Kamioka, Akira Sasaki
INTRODUCTION: In recent years, patients with orthognathic surgery in middle-aged and elderly people have come to be a more frequent occurrence. Breast cancer is the most frequently diagnosed cancer in woman worldwide, and its prevalence rate is steadily increasing. PRESENTATION OF CASE: We report a case of a 47-year-old Japanese woman in whom left-side breast cancer (Stage 1) was unexpectedly found just before orthognathic surgery in April 2012. Breast-conserving surgery was performed (estrogen receptor+, progesterone receptor+, HER2 -, surgical margin+, sentinel lymph node +) that May...
January 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28095159/validation-and-modification-of-a-prediction-model-for-acute-cardiac-events-in-patients-with-breast-cancer-treated-with-radiotherapy-based-on-three-dimensional-dose-distributions-to-cardiac-substructures
#5
Veerle A B van den Bogaard, Bastiaan D P Ta, Arjen van der Schaaf, Angelique B Bouma, Astrid M H Middag, Enja J Bantema-Joppe, Lisanne V van Dijk, Femke B J van Dijk-Peters, Laurens A W Marteijn, Gertruida H de Bock, Johannes G M Burgerhof, Jourik A Gietema, Johannes A Langendijk, John H Maduro, Anne P G Crijns
Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors for ACEs than MHD. Patients and Methods The cohort consisted of 910 consecutive female patients with BC treated with radiotherapy (RT) after breast-conserving surgery. The primary end point was cumulative incidence of ACEs within 9 years of follow-up...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28094198/late-side-effects-and-cosmetic-results-of-accelerated-partial-breast-irradiation-with-interstitial-brachytherapy-versus-whole-breast-irradiation-after-breast-conserving-surgery-for-low-risk-invasive-and-in-situ-carcinoma-of-the-female-breast-5-year-results
#6
Csaba Polgár, Oliver J Ott, Guido Hildebrandt, Daniela Kauer-Dorner, Hellen Knauerhase, Tibor Major, Jaroslaw Lyczek, José Luis Guinot, Jürgen Dunst, Cristina Gutierrez Miguelez, Pavel Slampa, Michael Allgäuer, Kristina Lössl, Bülent Polat, György Kovács, Arnt-René Fischedick, Rainer Fietkau, Alexandra Resch, Anna Kulik, Leo Arribas, Peter Niehoff, Ferran Guedea, Annika Schlamann, Richard Pötter, Christine Gall, Wolfgang Uter, Vratislav Strnad
BACKGROUND: We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. METHODS: We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries...
January 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28087389/evaluation-of-local-oncologic-safety-in-nipple-areola-complex-sparing-mastectomy-after-primary-chemotherapy-a-propensity-score-matched-study
#7
Roberto Agresti, Marco Sandri, Massimiliano Gennaro, Giulia Bianchi, Ilaria Maugeri, Mario Rampa, Giuseppe Capri, Maria Luisa Carcangiu, Giovanna Trecate, Egidio Riggio, Laura Lozza, Filippo de Braud
BACKGROUND: Nipple-areola complex-sparing mastectomy (NSM), extending the concept of skin-sparing mastectomy, allows for the provision of a better cosmetic result. Large operable T2-T3 breast cancer might theoretically appear suitable for this surgical option as an alternative to conventional mastectomy or breast-conserving surgery, when a good response to primary chemotherapy has been achieved. PATIENTS AND METHODS: From January 2009 to May 2013, 422 patients with invasive breast cancer were progressively accrued to NSM...
December 24, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28079816/a-comparison-study-between-gross-tumor-volumes-defined-by-preoperative-magnetic-resonance-imaging-postoperative-specimens-and-tumor-bed-for-radiotherapy-after-breast-conserving-surgery
#8
Aiping Zhang, Jianbin Li, Wei Wang, Yongsheng Wang, Dianbin Mu, Zhaoqiu Chen, Qian Shao, Fengxiang Li
BACKGROUND: The identification and contouring of target volume is important for breast-conserving therapy. The aim of the study was to compare preoperative magnetic resonance imaging (MRI), postoperative pathology, excised specimens' (ES) size, and tumor bed (TB) delineation as methods for determining the gross tumor volume (GTV) for radiotherapy after breast-conserving surgery (BCS). METHODS: Thirty-three patients with breast cancer who underwent preoperative MRI and radiotherapy after BCS were enrolled...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071617/role-of-frozen-section-in-the-intra-operative-margin-assessment-during-breast-conserving-surgery
#9
K R Anila, K Chandramohan, A Mathews, T Somanathan, K Jayasree
BACKGROUND: Breast conserving surgery (BCS) is increasingly done for early breast cancers in many countries since it has been demonstrated by randomized trials that survival rates after BCS followed by adjuvant therapy are equivalent to those obtained after mastectomy. Frozen section analyses (FSA) is a technique used for intra-operative assessment of margin status in BCS. The aim of this study was to assess the concordance of margin status assessment by FSA and permanent sections and to assess correlation with local recurrence...
April 2016: Indian Journal of Cancer
https://www.readbyqxmd.com/read/28069398/objective-decision-making-between-conventional-and-oncoplastic-breast-conserving-surgery-or-mastectomy-an-aesthetic-and-functional-prospective-cohort-study
#10
D Pukancsik, P Kelemen, M Újhelyi, E Kovács, N Udvarhelyi, N Mészáros, I Kenessey, T Kovács, M Kásler, Z Mátrai
BACKGROUND: Breast-conserving surgery (BCS) is considered the standard treatment for early-stage breast cancer. However, fair to poor cosmetic outcomes following conventional BCS have been observed in as many as one-third of cases. The aim of this study was to determine the critical tumor-to-breast volume ratio for each quadrant of the breast beyond which conventional BCS would no longer offer acceptable cosmetic and functional results or satisfactory quality of life for the patient. METHODS: A prospective cohort study was performed between December 2011 and December 2013 involving 350 patients younger than 70 years with early-stage unifocal (T ≤ 30 mm) breast cancer who underwent wide excision and axillary sentinel lymph node biopsy followed by whole-breast irradiation...
December 5, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28068854/breast-cancer-care-in-california-and-ontario
#11
Kevin M Gorey, Caroline Hamm, Isaac N Luginaah, Guangyong Zou, Eric J Holowaty
BACKGROUND: Better health care among Canada's socioeconomically vulnerable versus America's has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. METHODS: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists...
January 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28064235/outcomes-in-patients-with-pt1-t2-pn0-n1-breast-cancer-after-conservative-surgery-and-whole-breast-radiotherapy
#12
Marianna Trignani, Clelia DI Carlo, Carmen Cefalogli, Marianna Nuzzo, Lucia Anna Ursini, Luciana Caravatta, Francesca Perrotti, Marta DI Nicola, Ambra Pamio, Domenico Genovesi
AIM: To evaluate locoregional recurrence, overall survival, disease-free survival and prognostic influence of the number of positive lymph nodes and other variables in breast cancer treatment. PATIENTS AND METHODS: A total of 377 patients with pT1-T2, pN0-N1 invasive breast carcinoma treated from 2005 to 2013 were retrospectively evaluated. Patients underwent conservative surgery followed by whole-breast radiotherapy. Clavicular region irradiation was not performed...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28063695/ipsilateral-axillary-recurrence-after-breast-conservative-surgery-the-protective-effect-of-whole-breast-radiotherapy
#13
Oreste Gentilini, Edoardo Botteri, Maria Cristina Leonardi, Nicole Rotmensz, Jose Vila, Nickolas Peradze, Maria Virginia Thomazini, Barbara Alicja Jereczek, Viviana Galimberti, Alberto Luini, Paolo Veronesi, Roberto Orecchia
BACKGROUND AND PURPOSE: Whole breast radiotherapy (WBRT) is one of the possible reasons for the low rate of axillary recurrence after breast-conserving surgery (BCS). PATIENTS AND METHODS: We retrospectively collected data from 4,129 consecutive patients with breast cancer ⩽2cm and negative sentinel lymph node who underwent BCS between 1997 and 2007. We compared the risk of axillary lymph node recurrence between patients treated by WBRT (n=2939) and patients who received partial breast irradiation (PBI; n=1,190) performed by a single dose of electron intraoperative radiotherapy...
January 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28059961/use-of-quantile-regression-to-determine-the-impact-on-total-health-care-costs-of-surgical-site-infections-following-common-ambulatory-procedures
#14
Margaret A Olsen, Fang Tian, Anna E Wallace, Katelin B Nickel, David K Warren, Victoria J Fraser, Nandini Selvam, Barton H Hamilton
OBJECTIVE: To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. BACKGROUND: Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. METHODS: We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28058563/long-term-satisfaction-and-body-image-after-contralateral-prophylactic-mastectomy
#15
Chelsea Anderson, Jessica Y Islam, M Elizabeth Hodgson, Susan A Sabatino, Juan L Rodriguez, Clara N Lee, Dale P Sandler, Hazel B Nichols
BACKGROUND: Contralateral prophylactic mastectomy (CPM) rates have been increasing in the US, and although high levels of satisfaction with CPM have been reported, few studies have evaluated the long-term effects on body image, comparing CPM with breast-conserving surgery (BCS) and unilateral mastectomy (UM). METHODS: We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n = 1176)...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28058560/intraoperative-margin-management-in-breast-conserving-surgery-a-systematic-review-of-the-literature
#16
Richard J Gray, Barbara A Pockaj, Erin Garvey, Sarah Blair
BACKGROUND: Breast surgeons have a wide variety of intraoperative techniques available to help achieve low rates for positive margins of excision, with variable levels of evidence. METHODS: A systematic review of the medical literature from 1995 to July 2016 was conducted, with 434 abstracts identified and evaluated. The analysis included 106 papers focused on intraoperative management of breast cancer margins and contained actionable data. RESULTS: Ultrasound-guided lumpectomy for palpable tumors, as an alternative to palpation guidance, can lower positive margin rates, but the effect when used as an alternative to wire localization (WL) for nonpalpable tumors is less certain...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28054926/a-literature-review-of-burns-in-reconstructed-breasts-after-mastectomy
#17
Marie Jaeger, Yonathan Wagman, Alon Liran, Moti Harats, Eyal Winkler, Josef Haik, Ariel Tessone
OBJECTIVE: The goal of this literature review is to review and combine case studies of accidental burns to the breast, following mastectomy and immediate breast reconstruction with autologous tissue, implants, or tissue expanders. METHODS: The authors searched PubMed and Cochrane Library and reviewed cases of burns of reconstructed breasts after mastectomy from July 1985 to May 2015. Only studies in the English language were included in their search. They also report 5 new cases of burns in patients with burns to the breast, which were either reconstructed with implants or tissue expanders at Sheba Medical Center (Ramat Gan, Israel)...
December 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28054359/towards-a-personalized-surgical-margin-for-breast-conserving-surgery-implications-of-field-cancerization-in-local-recurrence
#18
REVIEW
Katarina Lebya, Randi Garcia-Smith, Radha Swaminathan, Anna Jones, John Russell, Nancy Joste, Marco Bisoffi, Kristina Trujillo
The amount of normal tissue that should be excised during breast conserving surgery is widely debated. Tissue adjacent to breast tumors, although histologically normal, possesses many of the molecular abnormalities found in tumor tissues. Here, we propose that the ideal physical distance for a surgical margin may not be universal. Rather, an adequate surgical margin likely varies from patient to patient, depending on the biology of the tissue that remains after surgery. J. Surg. Oncol. © 2017 Wiley Periodicals, Inc...
January 5, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28053630/displacement-of-surgical-clips-during-postoperative-radiotherapy-in-breast-cancer-patients-who-received-breast-conserving-surgery
#19
SooYoon Sung, Joo Hwan Lee, Jong Hoon Lee, Sung Hwan Kim, Yoo-Kang Kwak, Sea-Won Lee, Ye Won Jeon, Young Jin Suh
PURPOSE: Surgical clips are used as a target for postoperative breast radiotherapy, and displacement of surgical clips would result in inaccurate delivery of radiation. We investigated the displacement range of surgical clips in the breast during postoperative radiotherapy following breast-conserving surgery. METHODS: A total of 178 patients who received breast-conserving surgery and postoperative radiation of 59.4 Gy in 33 fractions to the involved breast for 6...
December 2016: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28053627/prognostic-significance-of-inner-quadrant-involvement-in-breast-cancer-treated-with-neoadjuvant-chemotherapy
#20
Ji Hyun Chang, Wan Jeon, Kyubo Kim, Kyung Hwan Shin, Wonshik Han, Dong-Young Noh, Seock-Ah Im, Tae-You Kim, Yung-Jue Bang
PURPOSE: In the present study, we aimed to evaluate the initial tumor location as a prognostic factor in breast cancer patients treated with neoadjuvant chemotherapy (NAC). METHODS: Between March 2002 and January 2007, a total of 179 patients with stage II/III breast cancer underwent NAC followed by breast surgery. Using physical and radiologic findings, patients were grouped by their initial tumor location into inner/both quadrant (upper/lower inner quadrant involvement +/- multicentric tumor involving outer quadrant; n=97) and outer quadrant (n=82) tumor groups...
December 2016: Journal of Breast Cancer
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