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Breast conservation treatment

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https://www.readbyqxmd.com/read/29032999/a-prospective-phase-i-comparison-of-toxicity-and-cosmesis-outcomes-of-single-fraction-iort-and-hypofractionated-radiotherapy-with-iort-boost-in-early-stage-breast-cancer
#1
Tanuja Bhandari, Wesley Babaran, Afshin Forouzannia, Venita Williams, Jay Harness, Michele Carpenter, Maher Gobran, Rajesh Khanijou, Brittany Wagman, Robert Ash, Lawrence D Wagman
PURPOSE: Radiation therapy is proven to reduce local recurrence in patients with early-stage breast cancer. To reduce toxicity, treatment time, and improve accuracy, intraoperative radiation therapy was used as definitive treatment or as a boost. The study's objective was to compare the short-term toxicity and cosmesis of single-fraction (SF) IORT and hypofractionated radiotherapy with IORT boost (HfB) given as definitive treatment. METHODS AND MATERIALS: Between March 2011 and December 2013, 57 patients aged 45-91 years and 24 patients aged 43-83 years (total n = 81) with Stage 0-II were treated with SF or HfB (Mobetron, IntraOp Medical, Sunnyvale, CA)...
October 9, 2017: Brachytherapy
https://www.readbyqxmd.com/read/29031423/the-state-of-surgical-axillary-management-and-adjuvant-radiotherapy-for-early-stage-invasive-breast-cancer-in-the-modern-era
#2
Justin M Mann, Xian Wu, Paul Christos, Himanshu Nagar
BACKGROUND: For clinical T1-2N0 breast cancer, sentinel lymph node biopsy (SLNB) has been shown in American College of Surgeons Oncology Group (ACOSOG) Z0011 to be sufficient for women with 1 to 2 positive sentinel lymph nodes with no added benefit for completion axillary lymph node dissection (ALND). Z0011 specified whole breast radiotherapy (RT) using standard tangential fields; however, later analysis showed variation in field design. We assessed nationwide practice patterns and examined factors associated with patients undergoing completion ALND and subsequent radiation field design...
September 19, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29029503/slingshot-1l-a-cofilin-phosphatase-induces-primary-breast-cancer-metastasis
#3
Chen Chen, Yusufu Maimaiti, Shen Zhijun, Liu Zeming, Guo Yawen, Yu Pan, Huang Tao
Slingshot (SSH) is a member of the conserved family of cofilin phosphatases that plays a critical role in cell membrane protrusion and migration by transforming inactive phosphorylated cofilin to an active form. SSH-like protein 1 (SSH-1L) expression is detected in various types of tumors; insulin induces the phosphatases activity of SSH-1L in a phosphoinositide 3-kinase-dependent manner. However, little is known about the expression and role of SSH-1L in breast cancer. Here, we analyzed 295 human breast cancer tissue specimens for SSH-1L expression by immunohistochemistry...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28990314/female-breast-cancer-management-and-survival-the-experience-of-major-public-hospitals-in-south-australia-over-3-decades-trends-by-age-and-in-the-elderly
#4
David Roder, Gelareh Farshid, Jim Kollias, Bogda Koczwara, Christos Karapetis, Jacqui Adams, Rohit Joshi, Dorothy Keefe, Caroline Miller, Kate Powell, Kellie Fusco, Marion Eckert, Elizabeth Buckley, Kerri Beckmann, Timothy Price
BACKGROUND: Clinical registry data from major South Australian public hospitals were used to investigate trends in invasive breast-cancer treatment and survival by age. METHODS: Disease-specific survival was calculated for the 1980 to 2013 diagnostic period using Kaplan-Meier product-limit estimates, with a censoring of live cases on December 31, 2014. Cox proportional hazards regression was used to examine differences in survival by age and tumour characteristic...
October 8, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28990127/patterns-of-axillary-evaluation-in-older-patients-with-breast-cancer-and-associations-with-adjuvant-therapy-receipt
#5
Laura S Dominici, Helmneh M Sineshaw, Ahmedin Jemal, Chun Chieh Lin, Tari A King, Rachel A Freedman
PURPOSE: Although axillary lymph node status has traditionally been a key factor in informing adjuvant breast cancer therapy recommendations, this information may be less relevant as our focus shifts more towards tumor biology, particularly in older patients where comorbidity influences treatment decisions and nodal staging and/or surgery may not improve outcomes. We examined patterns of axillary surgery and associations between axillary surgery and receipt of adjuvant treatment in older breast cancer patients...
October 9, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28989927/metastatic-uterine-cancer-looking-as-cervical-fibroid-in-recurrent-breast-cancer-woman-a-case-report
#6
So Young Seo, Jin Yong Shin, Yong Il Ji
Metastasis to the female genital tract from extragenital primary cancer is uncommon. In this case, a 46-year-old woman was diagnosed with invasive lobular carcinoma of the left breast in 2011. She had left breast conserving surgery, chemotherapy, radiation, and hormonal therapy (gosereline and tamoxifen). However, she developed menorrhagia after interruption of hormonal therapy and incidentally, the ultrasonogram of her pelvis showed a solid, large mass in the cervix. It looked like leiomyoma. Because of massive vaginal bleeding requiring multiple blood transfusions, she underwent total hysterectomy with bilateral salpingo-oophorectomy...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28987136/radiation-therapy-and-early-breast-cancer-current-controversies
#7
REVIEW
John Boyages
Radiation therapy (RT) is an important component of breast cancer treatment. RT reduces local recurrence and breast cancer mortality after breast conservation for all patients and for node-positive patients after a mastectomy. Short courses of RT over 3-4 weeks are generally as effective as longer courses. A patient subgroup where RT can be avoided after conservative surgery has not been consistently identified. A radiation boost reduces the risk of a recurrence in the breast but may be omitted for older patients with good prognosis tumours with clear margins...
August 4, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28984579/follow-up-of-patients-undergoing-oncoplastic-surgery-more-palpable-masses-and-benign-biopsies
#8
Yoav Amitai, Orit Golan, Yoav Barnea, Joseph Klausner, Tehillah S Menes
BACKGROUND: Oncoplastic reconstruction is increasingly used in the management of women undergoing breast conserving surgery. We examined the findings on breast exam and imaging of patients who underwent breast conservation with or without oncoplastic reconstruction. OBJECTIVE: We hypothesized that patients undergoing immediate breast reconstruction would present with more palpable and imaging abnormalities compared to lumpectomy alone and undergo therefore more biopsies...
October 3, 2017: Breast Disease
https://www.readbyqxmd.com/read/28982848/lipofilling-outcomes-mimicking-breast-cancer-recurrence-case-report-and-update-of-the-literature
#9
REVIEW
Silvia Gigli, Maria Ida Amabile, Francesca DI Pastena, Alessandro DE Luca, Caterina Gulia, Lucia Manganaro, Massimo Monti, Laura Ballesio
Breast lipofilling uses autologous fat grafting to correct breast defects after radical or conservative surgery. After early concerns regarding its application in reconstruction after breast cancer (BC), in 2009 the American Society of Plastic Surgeons formed a task force to assess the indications, safety and efficacy of autologous fat grafting. We report the case of a woman who came to our attention for a painful swelling of the left breast. She had undergone breast-conserving therapy for BC, followed by lipofilling...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28981734/quality-of-life-of-breast-cancer-survivors-following-breast-conserving-therapy-versus-mastectomy-a-multicenter-study-in-taiwan
#10
Hsin-Yun Tsai, Raymond Nien-Chen Kuo, Kuo-Piao Chung
Background: Breast cancer is the most common female malignancy worldwide. The aim of this study was to investigate the influence of surgical procedures and quality-of-care (QoC) on quality-of-life (QoL) among breast cancer survivors who underwent breast-conserving therapy (BCT) or mastectomy, and to identify provider- and patient-related factors pertaining to QoL. Method: In this cross-sectional study, structured-questionnaires were distributed among breast cancer survivors in 19 hospitals...
October 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28974723/revisiting-the-impact-of-age-and-molecular-subtype-on-overall-survival-after-radiotherapy-in-breast-cancer-patients
#11
Jian-Hua Mao, Paul J van Diest, Jesus Perez-Losada, Antoine M Snijders
Adjuvant radiotherapy (RT) in breast cancer (BC) is often used to eradicate remaining tumor cells following surgery with the goal of maximizing local control and increasing overall survival. The current study investigated the impact of age and BC molecular subtype on overall survival after RT using a meta-analysis of the METABRIC and TCGA BC patient cohorts. We found that RT significantly prolonged survival across the whole BC patient population. The survival benefit of RT was predominantly observed in stage II BC patients treated with breast conserving surgery...
October 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28973706/genomic-assays-in-ductal-carcinoma-in-situ-implications-for-management-decisions
#12
Alexandra Gangi, Annie Topham, M Catherine Lee, Weihong Sun, Christine Laronga
OBJECTIVES: Breast cancer is the most common cancer in women and a leading cause of cancer death worldwide. The management of breast cancer depends on clinical and pathologic prognostic factors that help guide patient treatment. Ductal carcinoma in situ (DCIS) is a noninvasive form of breast cancer with an unpredictable risk of either progression to invasive disease or recurrence. To evaluate the utilization of the DCIS score in a large single-institution population and understand reasons for avoidance in eligible patients...
October 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28945885/single-fraction-radiosurgery-using-conservative-doses-for-brain-metastases-durable-responses-in-select-primaries-with-limited-toxicity
#13
Michael Cummings, Paul Youn, Derek P Bergsma, Kenneth Y Usuki, Kevin Walter, Manju Sharma, Paul Okunieff, Michael C Schell, Michael T Milano
BACKGROUND: Optimal doses for single-fraction stereotactic radiosurgery (SRS) in the treatment of brain metastases are not well established. Our institution utilized conservative dosing compared to maximum-tolerated doses from the Radiation Therapy Oncology Group 90-05 Phase I study. OBJECTIVE: To report individual lesion control (LC) from conservative single-fraction doses and determine factors affecting LC. METHODS: From 2003 to 2015, patients who underwent linear accelerator-based single-fraction SRS for cerebral/cerebellar metastases and receiving at least 1 follow-up magnetic resonance imaging (MRI) were identified...
August 12, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28943910/wound-fluids-affect-mir-21-mir-155-and-mir-221-expression-in-breast-cancer-cell-lines-and-this-effect-is-partially-abrogated-by-intraoperative-radiation-therapy-treatment
#14
Karolina Zaleska, Anna Przybyła, Katarzyna Kulcenty, Mateusz Wichtowski, Andrzej Mackiewicz, Wiktoria Suchorska, Dawid Murawa
Breast cancer is the most common malignant disease occurring in women. Conservative breast cancer surgery followed by radiation therapy is currently the standard treatment for this type of cancer. The majority of metastases occur within the scar, which initiated a series of studies. As a result, clinical trials aimed to assess whether localized radiotherapy, as intraoperative radiotherapy (IORT), may more effective in inhibiting the formation of local recurrence compared with the standard postoperative whole breast radiotherapy...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28941977/trends-in-treatment-patterns-and-clinical-outcomes-in-young-women-diagnosed-with-ductal-carcinoma-in-situ
#15
Hannah Lui Park, Jenny Chang, Gagandeep Lal, Krustina Lal, Argyrios Ziogas, Hoda Anton-Culver
BACKGROUND: Although it is known that the risk of a second breast cancer event among young women diagnosed with ductal carcinoma in situ (DCIS) is higher than in older women, the effect of current treatment options on long-term outcomes in this subgroup of women remains poorly defined. We aimed to evaluate national treatment trends and determine their effect on second breast cancer risk and overall survival among young women diagnosed with DCIS. MATERIALS AND METHODS: Surveillance, Epidemiology, and End Results data from 1998 to 2011 were used to analyze 3648 DCIS patients younger than age 40 years...
August 10, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28939351/standardization-of-nodal-radiation-therapy-through-changes-to-a-breast-cancer-clinical-pathway-throughout-a-large-integrated-cancer-center-network
#16
Brian J Gebhardt, Joel Thomas, Zachary D Horne, Colin E Champ, Gretchen M Ahrendt, Emilia Diego, Dwight E Heron, Sushil Beriwal
BACKGROUND: Studies demonstrate safety of omitting axillary nodal dissection for early-stage breast cancer with positive sentinel lymph node (+SLN) biopsy, although trial designs differed in radiation therapy (RT) fields. Regional nodal irradiation was separately shown to improve outcomes in high-risk patients. This led to lack of consensus in RT volumes. Clinical pathways (CPs) standardize care where practice varies unnecessarily. We evaluated the impact of changes to a CP guiding postoperative RT in women with +SLNs on practice patterns throughout a network...
July 20, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28938661/efficacy-and-safety-of-accelerated-partial-breast-irradiation-a-meta-analysis-of-published-randomized-studies
#17
Gengchun Liu, Zhongyi Dong, Baqun Huang, Yuelong Liu, Yan Tang, Qing Li, Yihui Zhu
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) technology has theoretical advantages in comparison with traditional adjuvant radiation therapy (whole-breast irradiation; WBI) after breast-conserving surgery. However, published randomized controlled trials have shown inconsistent outcomes. Therefore, a comprehensive assessment of the effectiveness and safety of APBI technology is needed. RESULTS: A total of 7 studies of 7452 patients were included in this analysis...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28933995/identification-assessment-and-management-of-breast-oedema-after-treatment-for-cancer
#18
Marie Todd
Advances in breast cancer management, including breast-conserving surgery, have resulted in an increase in the incidence of breast oedema. However, this is addressed by professionals less often than arm lymphoedema. Breast oedema results in significant physical and psychological morbidity, makes finding a comfortably fitting bra very difficult, and can act as a reminder of the initial breast cancer diagnosis. Psychological difficulties can be compounded by clinicians' failure to acknowledge the impact. Assessing and managing breast oedema requires a sensitive, skilled approach to ensure all the relevant issues are identified and addressed in a comprehensive care plan; taking time to listen to patients and acknowledging the impact can be very therapeutic...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28928852/dcis-margins-and-breast-conservation-md-anderson-cancer-center-multidisciplinary-practice-guidelines-and-outcomes
#19
REVIEW
Henry M Kuerer, Benjamin D Smith, Mariana Chavez-MacGregor, Constance Albarracin, Carlos H Barcenas, Lumarie Santiago, Mary E Edgerton, Gaiane M Rauch, Sharon H Giordano, Aysegul Sahin, Savitri Krishnamurthy, Wendy Woodward, Debasish Tripathy, Wei T Yang, Kelly K Hunt
Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28923310/factors-associated-with-specific-diagnostic-and-statistical-manual-of-mental-disorders-fourth-edition-sexual-dysfunctions-in-breast-cancer-survivors-a-study-of-patients-and-their-partners
#20
Susanna B Hummel, Daniela E E Hahn, Jacques J D M van Lankveld, Hester S A Oldenburg, Eva Broomans, Neil K Aaronson
BACKGROUND: Many women develop sexual problems after breast cancer (BC) treatment. Little is known about BC survivors with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sexual dysfunction and their partners, and the factors associated with their sexual functioning. AIM: To evaluate (i) patient-related and clinical factors associated with (a) specific DSM-IV sexual dysfunctions and (b) level of sexual functioning and sexual distress as reported by BC survivors and (ii) the association between the sexual functioning of BC survivors and that of their partners...
October 2017: Journal of Sexual Medicine
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