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Breast conserving therapy

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https://www.readbyqxmd.com/read/28938661/efficacy-and-safety-of-accelerated-partial-breast-irradiation-a-meta-analysis-of-published-randomized-studies
#1
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/28935854/comparison-of-helical-tomotherapy-and-direct-tomotherapy-in-bilateral-whole-breast-irradiation-in-a-case-of-bilateral-synchronous-grade-1-and-stage-1-breast-cancer
#2
Valentina Lancellotta, Martina Iacco, Elisabetta Perrucci, Claudio Zucchetti, Anna Concetta Dipilato, Lorenzo Falcinelli, Isabella Palumbo, Cynthia Aristei
BACKGROUND Synchronous bilateral breast cancer is rare. A case is presented where whole breast irradiation (WBI) was planned after breast conserving surgery in a patient with synchronous bilateral breast cancer. A comparison was made between the feasibility of helical tomotherapy and direct tomotherapy. CASE REPORT A 60-year-old woman was found to have bilateral breast nodules on routine mammographic screening, resulting in bilateral lumpectomy and sentinel lymph node biopsy. Histopathology showed a 6 mm diameter invasive ductal carcinoma in the right breast (Grade 1, hormone receptor positive, HER2 negative) and an 8mm diameter tubular carcinoma in the left breast (Grade 1, hormone receptor positive, HER2 negative)...
September 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28928852/dcis-margins-and-breast-conservation-md-anderson-cancer-center-multidisciplinary-practice-guidelines-and-outcomes
#3
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
#4
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...
September 8, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28923221/an-update-on-randomized-clinical-trials-in-breast-cancer
#5
REVIEW
Kayla Barnard, V Suzanne Klimberg
Numerous clinical trials reveal new innovations and therapies that continually change the treatment and prevention of breast cancer. Earlier trials have changed the standard of care from radical mastectomy to breast conservation therapy and individualized treatment based on tumor-specific biology. As research continues and long-term follow-up results become available, updated reviews on randomized clinics trials become exceedingly important in discerning the most effective and oncologically safe therapies to provide optimal outcomes...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28922685/neoadjuvant-systemic-therapy-for-breast-cancer-the-westmead-experience
#6
Annelise M Cocco, David Messer, Alexander Brown, Nina Sriram, Jenny Gilchrist, Loma Al-Mansouri, Richard Kefford, Farid Meybodi, James French, Jeremy Hsu, Elisabeth Elder
BACKGROUND: Neoadjuvant systemic therapy (NAST) can be used to treat breast cancer. Pathologic complete response (pCR) is a surrogate marker for improved survival. This study examined response in the breast and axilla to NAST and identified features associated with pCR. METHODS: Patients undergoing NAST and surgery between January 2012 and June 2016 by surgeons at Westmead Breast Cancer Institute were identified. Patients with inflammatory or metastatic disease were excluded...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922321/-patient-reported-outcomes-following-breast-conservation-therapy-and-barriers-to-referral-for-partial-breast-reconstruction
#7
Sebastian Q Vrouwe, Ron B Somogyi, Laura Snell, Catherine McMillan, Danny Vesprini, Joan E Lipa
BACKGROUND: The purpose of this study was to evaluate the self-reported aesthetic outcome of breast conservation therapy (BCT) in a generalized sample of patients, and to describe potential barriers to referral for partial breast reconstruction. METHODS: Consecutive BCT patients completing radiotherapy over a one-year period at a regional cancer centre were identified. Eligible patients were contacted via mail/email and invited to participate. Participants completed the BREAST-Q BCT module along with a questionnaire examining feelings about breast reconstruction...
September 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28920712/maximized-nanodrug-loaded-mesenchymal-stem-cells-by-a-dual-drug-loaded-mode-for-the-systemic-treatment-of-metastatic-lung-cancer
#8
Sen Yao, Xuqian Li, Jingxuan Liu, Yuqing Sun, Zhuanhe Wang, Yanyan Jiang
Mesenchymal stem cells (MSCs), exhibiting tumor-tropic and migratory potential, can serve as cellular carriers to improve the effectiveness of anticancer agents. However, several challenges, such as the safety issue, the limited drug loading, the conservation of stemness and migration of MSCs, still remain in the MSC-based delivery system. In the present study, a novel nano-engineered MSC delivery system was established by loading doxorubicin (DOX)-polymer conjugates for the systemic treatment of pulmonary metastasis of breast cancer...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28915682/systematic-review-and-meta-analysis-of-the-efficacy-of-breast-conservation-therapy-followed-by-radiotherapy-in-four-breast-cancer-subtypes
#9
Xin-Bin Pan, Rou-Jun Chen, Shi-Ting Huang, Yan-Ming Jiang, Xiao-Dong Zhu
The different molecular subtypes of breast cancer are associated with distinct outcomes. We assessed the efficacy of breast conservation therapy (BCT) followed by radiotherapy for patients with different breast cancer subtypes. We searched the MEDLINE, EMBASE, and Cochrane Library databases to identify studies published prior to April 30, 2016 that assessed the efficacy of BCT followed by radiotherapy in breast cancer patients with different molecular subtypes. A meta-analysis of seven studies that included 3,798 luminal A, 770 luminal B, 344 human epidermal growth factor receptor 2 (Her-2), and 767 triple-negative breast cancer (TNBC) patients was performed...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915209/the-expanded-use-of-auto-augmentation-techniques-in-oncoplastic-breast-surgery
#10
Albert Losken, Alexandra M Hart, James Walter Dutton, Justine S Broecker, Toncred M Styblo, Grant W Carlson
BACKGROUND: Auto-augmentation techniques have been applied to oncoplastic reductions to assist with filling larger, more remote defects and women with smaller breasts. The purpose of this report is to describe the use of auto-augmentation techniques in OR and compare the results with traditional OR. METHODS: We queried a prospectively maintained database of all women who underwent partial mastectomy and OR between 1994 and October 2015. The auto-augmentation techniques were defined as 1) extended primary nipple auto-augmentation pedicle, and 2) primary nipple pedicle and secondary auto-augmentation pedicle...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28910357/the-quality-of-invasive-breast-cancer-care-for-low-reimbursement-rate-patients-a-retrospective-study
#11
Shaofei Su, Han Bao, Xinyu Wang, Zhiqiang Wang, Xi Li, Meiqi Zhang, Jiaying Wang, Hao Jiang, Wenji Wang, Siyang Qu, Meina Liu
Though evidence-based treatments have been recommended for breast cancer, underuse of the treatments was still observed. To certain extent, patients' access to care, which can be enhanced by increasing the coverage of health insurance, could account for the current underuse in recommended care. This study aimed to examine the association between different proportions of reimbursement and quality of recommended breast cancer care, as well as length of hospital stay. In this retrospective study, 3669 patients diagnosed with invasive breast cancer between 1 June, 2011 and 30 June, 2013 were recruited...
2017: PloS One
https://www.readbyqxmd.com/read/28898379/effect-of-axillary-dissection-vs-no-axillary-dissection-on-10-year-overall-survival-among-women-with-invasive-breast-cancer-and-sentinel-node-metastasis-the-acosog-z0011-alliance-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Armando E Giuliano, Karla V Ballman, Linda McCall, Peter D Beitsch, Meghan B Brennan, Pond R Kelemen, David W Ollila, Nora M Hansen, Pat W Whitworth, Peter W Blumencranz, A Marilyn Leitch, Sukamal Saha, Kelly K Hunt, Monica Morrow
Importance: The results of the American College of Surgeons Oncology Group Z0011 (ACOSOG Z0011) trial were first reported in 2005 with a median follow-up of 6.3 years. Longer follow-up was necessary because the majority of the patients had estrogen receptor-positive tumors that may recur later in the disease course (the ACOSOG is now part of the Alliance for Clinical Trials in Oncology). Objective: To determine whether the 10-year overall survival of patients with sentinel lymph node metastases treated with breast-conserving therapy and sentinel lymph node dissection (SLND) alone without axillary lymph node dissection (ALND) is noninferior to that of women treated with axillary dissection...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28894698/paradigm-shift-toward-reducing-overtreatment-of-ductal-carcinoma-in-situ-of-breast
#13
REVIEW
Yasuaki Sagara, Wong Julia, Mehra Golshan, Masakazu Toi
The prevalence of ductal carcinoma in situ (DCIS) of the breast has increased substantially after the introduction of breast cancer screening programs, although the clinical effects of early DCIS detection and treatment remain unclear. The standard treatment for DCIS has involved local breast-conserving surgery (BCS) followed by radiotherapy (RT) or total mastectomy with/without endocrine therapy, and the choice of local treatment is not usually based on clinicopathologic or biological factors. However, we have investigated the effectiveness of local treatment using breast surgery and RT using Surveillance, Epidemiology, and End Results data, and found that the effectiveness of breast surgery was modified by the nuclear grade...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28894694/evaluation-of-partial-breast-reirradiation-with-intraoperative-radiotherapy-after-prior-thoracic-radiation-a-single-institution-report-of-outcomes-and-toxicity
#14
Christine Chin, Priya Jadeja, Bret Taback, David P Horowitz, Sheldon M Feldman, Richard Ha, Eileen P Connolly
INTRODUCTION: Mastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI). We report our single-institution experience with breast-conserving surgery (BCS) followed by intraoperative radiotherapy (IORT) as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation. METHODS: We performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28894168/the-association-of-young-age-with-local-recurrence-in-women-with-early-stage-breast-cancer-after-breast-conserving-therapy-a-meta-analysis
#15
Xiang-Ming He, De-Hong Zou
The aim of this meta-analysis is to determine the relationship between young age and local recurrence in patients with early-stage breast cancer after breast-conserving therapy. Eligible studies were retrieved from various electronic databases. Among the 19 studies included, 14 studies were analyzed for 5-year local recurrence rate and 8 studies for 10-year local recurrence rate using random effects models. Both results showed that young patients were at higher risk of local recurrence compared to old patients (5-year: RR = 2...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28893303/contrast-enhanced-spectral-mammography-in-neoadjuvant-chemotherapy-monitoring-a-comparison-with-breast-magnetic-resonance-imaging
#16
Valentina Iotti, Sara Ravaioli, Rita Vacondio, Chiara Coriani, Sabrina Caffarri, Roberto Sghedoni, Andrea Nitrosi, Moira Ragazzi, Elisa Gasparini, Cristina Masini, Giancarlo Bisagni, Giuseppe Falco, Guglielmo Ferrari, Luca Braglia, Alberto Del Prato, Ivana Malavolti, Vladimiro Ginocchi, Pierpaolo Pattacini
BACKGROUND: Neoadjuvant-chemotherapy (NAC) is considered the standard treatment for locally advanced breast carcinomas. Accurate assessment of disease response is fundamental to increase the chances of successful breast-conserving surgery and to avoid local recurrence. The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) and contrast-enhanced-MRI (MRI) in the evaluation of tumor response to NAC. METHODS: This prospective study was approved by the institutional review board and written informed consent was obtained...
September 11, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28888675/radiation-dose-and-cardiac-risk-in-breast-cancer-treatment-an-analysis-of-modern-radiation-therapy-including-community-settings
#17
Julian C Hong, Elham Rahimy, Cary P Gross, Timothy Shafman, Xin Hu, James B Yu, Rudi Ross, Steven E Finkelstein, Arie Dosoretz, Henry S Park, Pamela R Soulos, Suzanne B Evans
PURPOSE: Adjuvant radiation therapy (RT) for breast cancer improves outcomes, but prior studies have documented substantive cardiac dose and cardiac risk. We assessed the mean heart dose (MHD) of RT and estimated the risk of RT-associated cardiac toxicity in women undergoing adjuvant RT for breast cancer in contemporary (predominantly) community practice. METHODS AND MATERIALS: We identified women with left-sided breast cancer receiving adjuvant RT between 2012 and 2014 from 94 centers across 16 states...
July 20, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28884470/breast-conserving-therapy-and-mastectomy-revisited-breast-cancer-specific-survival-and-the-influence-of-prognostic-factors-in-129-692-patients
#18
Mirelle Lagendijk, Marissa C van Maaren, Sepideh Saadatmand, Luc Ja Strobbe, Philip Mp Poortmans, Linetta B Koppert, Madeleine Ma Tilanus-Linthorst, Sabine Siesling
This large population-based study compared breast-conserving surgery with radiation therapy (BCT) with mastectomy on (long-term) breast cancer-specific (BCSS) and overall survival (OS), and investigated the influence of several prognostic factors. Patients with primary T1-2N0-2M0 breast cancer, diagnosed between 1999-2012, were selected from the Netherlands Cancer Registry. We investigated the 1999-2005 (long-term outcome) and the 2006-2012 cohort (contemporary adjuvant systemic therapy). Cause of death was derived from the Statistics Netherlands (CBS)...
September 7, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28884392/socioeconomic-status-and-breast-cancer-treatment
#19
REVIEW
Marie S Dreyer, Ann B Nattinger, Emily L McGinley, Liliana E Pezzin
PURPOSE: Evidence suggests substantial disparities in breast cancer survival by socioeconomic status (SES). We examine the extent to which receipt of newer, less invasive, or more effective treatments-a plausible source of disparities in survival-varies by SES among elderly women with early-stage breast cancer. METHODS: Multivariate regression analyses applied to 11,368 women (age 66-90 years) identified from SEER-Medicare as having invasive breast cancer diagnosed in 2006-2009...
September 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28876635/the-surgical-management-of-central-breast-tumours-at-a-specialist-breast-unit-in-johannesburg-south-africa
#20
L Van Schalkwyk, C A Benn, K Bergstrom
BACKGROUND: Central breast tumours are defined as tumours in the retroareolar area, or within 1.5-2.0 cm from the areolar edge. In the past, breast conservation therapy (BCT) for central breast tumours was considered controversial due to concerns regarding oncologic safety and cosmesis. Recent evidence does however suggest that oncoplastic techniques offer a cosmetically acceptable and safe alternative to mastectomy in these tumours. METHOD: Patients with central breast tumours (invasive and in situ) were identified from a breast cancer database of 431 patients who presented to the Netcare Breast Care Centre in Johannesburg over a one-year period (June 2015-June 2016)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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