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Breast surgery guidelines

Fernanda Barbosa C Rocha, Ana Beatriz Falcone, Antonio Carlos Buzaid, Juliana Martins Pimenta, Gustavo Schvartsman, Antonio Luiz Frasson
PURPOSE: Breast cancer neoadjuvant chemotherapy (NAC) consists of the administration of cytotoxic and targeted drugs prior to breast surgery, with the objective of reducing the tumor burden to allow breast conservation. NAC also aims to improve long-term treatment outcomes such as disease-free and overall survival. To optimize clinical practice with the best available evidence for breast cancer patients in the setting of neoadjuvant treatment, the Brazilian Society of Breast Surgeons (Sociedade Brasileira de Mastologia-SBM) held a consensus conference to develop this guideline...
August 11, 2018: Breast Cancer Research and Treatment
Arti Parekh, Wei Fu, Chen Hu, Colette J Shen, Sara Alcorn, Avani D Rao, Fariba Asrari, Melissa S Camp, Jean L Wright
INTRODUCTION: Many eligible women with invasive breast cancer do not receive recommended adjuvant radiation (RT), despite its role in local control and overall survival. We examined trends in RT use over 10 years, and the impact of sociodemographic factors on the receipt of standard-of-care RT, using the National Cancer Database (NCDB). MATERIALS/METHODS: Women under age 70 with invasive breast cancer who underwent BCS from 2004 to 2014 were analyzed. Receipt of RT was evaluated in the whole cohort and by time period to identify temporal trends...
August 6, 2018: Breast Cancer Research and Treatment
Anna Bozzini, Enrico Cassano, Dario Raciti, Davide Disalvatore, Oriana Pala, Andrea Vingiani, Giuseppe Renne
BACKGROUND: Ultrasound-guided vacuum-assisted breast biopsy (US-VABB) has recently replaced surgical biopsy as a result of its high diagnostic accuracy and low patient discomfort, and at present it relies mainly on 2 devices, Mammotome and, more recently, Mammotome Elite (Elite). Our purpose was to compare the efficacy of these 2 bioptical devices. PATIENTS AND METHODS: We performed US-VABB on 195 patients with Mammotome 8G or 11G in 130 patients and Elite 13G in 65 patients...
June 30, 2018: Clinical Breast Cancer
Qiancheng Hu, Xiaorong Zhong, Xu Liu, Yuxin Xie, Kejia Hu, Ping He, Donghao Lu, Hong Zheng
It is largely unclear that whether or not surgical resection of the primary tumors could confer survival benefit among patients with metastatic breast cancer at initial presentation. We thoroughly reviewed the up-to-date evidence on surgical resection of the primary lesion in metastatic breast cancer, including comparative studies (of particular interest in risk modifiers, the type, and timing of surgical procedures), Chinese and international guidelines, as well as the progress of clinical trials. Partial modified radical mastectomy and breast-conserving surgery are by far the most common choices for patients with metastatic breast cancer...
June 2018: Chinese Clinical Oncology
Jill P Stone, Rebecca L Hartley, Claire Temple-Oberle
Transgender men or Female-to-Male (FtM) patients' risk of breast cancer and screening recommendations remain unclear. The objective of this study is to perform a systematic review of the literature and document all reported cases of FtM breast cancer as well as provide research recommendations. Following PRISMA guidelines, MEDLINE, ProQuest, PubMed, and Cochrane Database of Systematic Reviews were searched from inception until September 15, 2016. Screening and data extraction were performed in duplicate by two independent reviewers (RH and JS)...
July 5, 2018: European Journal of Surgical Oncology
Melissa Amberger, Nancy Presnick, Gerard Baltazar
Introduction: Breast cancer metastasis to the gastrointestinal tract is rare and mostly limited to case reports which recommend consideration of metastasis when breast cancer patients particularly those with invasive lobular carcinoma present with new gastrointestinal complaints. Presentation of case: We report a 50-year-old female who presented with gastrointestinal symptoms of nausea and vomiting determined to be the result of large bowel obstruction secondary to rectosigmoid metastasis and carcinomatosis of breast invasive lobular carcinoma...
2018: Case Reports in Surgery
Bishara Atiye, Fadel Chahine
Breast surgery has long been viewed as an art more than a science. However, defining and objectively measuring the ideal breast morphology and aesthetic proportions are fundamental for surgical planning and to setting the goals of surgery as well as to evaluate surgical outcomes. Despite the fact that much has been written about aesthetic and reconstructive breast surgery, there is still no real consensus about what the attributes are of an ideal breast. Moreover, there are in fact no objective standard measurement systems and guidelines to describe ideal or even normal breast shape...
July 13, 2018: Aesthetic Plastic Surgery
Rebecca S Lewis, Angela George, Jennifer E Rusby
Nipple-sparing mastectomy is a valuable addition to the options available for women at high risk of developing breast cancer. In this review, we summarize current knowledge about the high-risk genes, BRCA1 , BRCA2 and TP53 and the associated guidelines with regard to risk-reducing surgery. We consider other genetic risks and high-risk lesions. We discuss the literature on bilateral mastectomy for breast cancer risk-reduction, and the results of nipple-sparing mastectomy in particular. Finally, we report on patient satisfaction with these procedures and the impact that nipple-sparing mastectomy may have on women at high-risk of breast cancer...
June 2018: Gland Surgery
Lyndsey J Kilgore, Sabrina S Korentager, Amanda N Hangge, Amanda L Amin, Christa R Balanoff, Kelsey E Larson, Melissa P Mitchell, John G Chen, Emily Burgen, Qamar J Khan, Anne P O'Dea, Lauren Nye, Priyanka Sharma, Jamie L Wagner
BACKGROUND: Breast cancer-related lymphedema (BCRL) is a chronic progressive disease that results from breast cancer treatment and nodal surgery. NCCN guidelines support baseline measurements with prospective assessment for early diagnosis and treatment. We sought to determine if baseline measurement with bioimpedance spectroscopy (BIS) and serial postoperative evaluations provide early detection amenable to conservative interventions that reduce BCRL. METHODS: Breast cancer patients with unilateral disease high-risk for BCRL from a single institution were evaluated from November 2014 to December 2017...
July 9, 2018: Annals of Surgical Oncology
Sarah M DeSnyder, Kelly K Hunt, Wenli Dong, Benjamin D Smith, Meena S Moran, Mariana Chavez-MacGregor, Yu Shen, Henry M Kuerer, Anthony Lucci
BACKGROUND: The SSO-ASTRO-ASCO consensus guideline on margins for breast-conserving surgery with whole breast irradiation in ductal carcinoma in situ (DCIS) recommended a 2-mm margin. We sought to determine the impact of guideline publication on clinician practice. METHODS: A total of 3081 members of the American Society of Breast Surgeons (ASBrS) received a survey. Respondents' clinical practice type and duration, guideline familiarity, and margin width preferences before and after publication were assessed...
July 9, 2018: Annals of Surgical Oncology
Dejan Nikolić, Miroslav Granić, Nebojša Ivanović, Darko Zdravković, Aleksandra Nikolić, Violeta Stanimirović, Marija Zdravković, Srdjan Dikić, Marko Nikolić, Miroslav Djordjević
INTRODUCTION: Lesbian, gay, and bisexuals have unique healthcare needs. Breast cancer is leading cancer in women, worldwide, accounting for 25% of all cases. Annual incidence rates increased significantly in all countries and age groups. The occurrence of breast cancer is rare in transgender population. As they have very limited access to medical care, it is much less likely to pursue breast cancer screening than in other individuals not identified as transgender. REVIEW OF THE CASES FROM LITERATURE: Up to date, only 13 cases of the breast cancer transsexuals (female to male) have been reported in six published papers worldwide...
July 5, 2018: Breast Cancer Research and Treatment
Lucas C Mendez, Alexander V Louie, Carolina Moreno, Matt Wronski, Andrew Warner, Eric Leung, Roberto Sakuraba, Juliana K Helito, Ana Rezende, Icaro T Carvalho, Eduardo Weltman
BACKGROUND: Heart-sparing techniques are time and resource intensive, although not all patients require the use of these strategies. This study evaluates the performance of different distance metrics in predicting the need for breath-hold radiotherapy in left-sided breast cancer patients receiving adjuvant radiotherapy. METHODS: Fifty left-sided breast cancer patients treated with breast conserving surgery and adjuvant radiotherapy to the breast from a single institution were retrospectively studied...
July 4, 2018: Radiation Oncology
Ines Gruber, Maja Henzel, Birgitt Schönfisch, Annette Stäbler, Florin-Andrei Taran, Markus Hahn, Carmen Röhm, Gisela Helms, Ernst Oberlechner, Benjamin Wiesinger, Konstantin Nikolaou, Christian LA Fougère, Diethelm Wallwiener, Andreas Hartkopf, Natalia Krawczyk, Tanja Fehm, Sara Brucker
BACKGROUND/AIM: Only 30-50% of patients with sentinel lymph node (SLN) metastases present with further axillary lymph node metastases. Therefore, up to 70% of patients with positive SLN are overtreated by axillary dissection (AD) and may suffer from complications such as sensory disturbances or lymphedema. According to the current S3 guidelines, AD can be avoided in patients with a T1/T2 tumor if breast-conserving surgery with subsequent tangential irradiation is performed and no more than two SLNs are affected...
July 2018: Anticancer Research
(no author information available yet)
Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times...
July 2018: American Journal of Nursing
Amita A Desai, Rafael E Jimenez, Tanya L Hoskin, Courtney N Day, Judy C Boughey, Tina J Hieken
BACKGROUND: Pleomorphic lobular carcinoma in situ (PLCIS) is an uncommon high-grade in situ lesion that shares morphologic features of both classic lobular and ductal carcinoma in situ. Data on the natural history of pure PLCIS are limited, and no evidence-based consensus guidelines for management exist. METHODS: From our prospectively maintained institutional pathology and breast surgery databases, we identified all patients with a diagnosis of PLCIS on core needle biopsy (CNB) or excisional biopsy from 2004 to 2017...
June 26, 2018: Annals of Surgical Oncology
S E Tevis, H B Neuman, E A Mittendorf, H M Kuerer, I Bedrosian, S M DeSnyder, A M Thompson, D M Black, M E Scoggins, A A Sahin, K K Hunt, A S Caudle
BACKGROUND: Successful breast-conserving surgery requires achieving negative margins. At our institution, the whole surgical specimen is imaged and then serially sectioned with repeat imaging. A multidisciplinary discussion then determines need for excision of additional margins. The goal of this study was to determine the benefit of each component of this approach in reducing the number of positive margin. METHODS: This single-institution, prospective study included ten breast surgical oncologists who were surveyed to ascertain whether they would have taken additional margins based their review of whole specimen images (WSI) and review of serially sectioned images (SSI)...
June 26, 2018: Annals of Surgical Oncology
Melissa P Mitchell, Priyanka Sharma
Ipsilateral regional nodal status is an important independent prognostic factor for patients with breast cancer. Several decisions regarding local therapy are necessary for patients found to have pathologically involved lymph node(s). This article reviews the role of completion dissection and/or radiation therapy in patients found to have positive sentinel lymph node(s), taking into consideration use of mastectomy vs lumpectomy, tumor characteristics, tumor biology, plans for systemic therapy, and patient preferences...
June 2018: Oncology (Williston Park, NY)
Naren Ramakrishna, Sarah Temin, Sarat Chandarlapaty, Jennie R Crews, Nancy E Davidson, Francisco J Esteva, Sharon H Giordano, Jeffrey J Kirshner, Ian E Krop, Jennifer Levinson, Shanu Modi, Debra A Patt, Jane Perlmutter, Eric P Winer, Nancy U Lin
Purpose To update the formal expert consensus-based guideline recommendations for practicing oncologists and others on the management of brain metastases for patients with human epidermal growth factor receptor 2-positive advanced breast cancer to 2018. Methods An Expert Panel conducted a targeted systematic literature review (for both systemic treatment and CNS metastases) and identified 622 articles. Outcomes of interest included overall survival, progression-free survival, and adverse events. In 2014, the American Society of Clinical Oncology (ASCO) convened a panel of medical oncology, radiation oncology, guideline implementation, and advocacy experts, and conducted a systematic review of the literature...
June 25, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Xiao-Wei Qi, Jun-Ze Du, Peng Tang, Xue Liu, Qing-Qing He, Ling Zhong, Xiu-Wu Bian, Jun Jiang
PURPOSE: Internal mammary nodes (IMNs) is a major pathway of lymphatic drainage for breast cancer, apart from axillary lymph node (ALN). However, owing to lack of a feasible and safe biopsy method, management of IMNs is still controversial in breast surgery. METHODS: From 2005 to 2009, a total of 337 consecutive breast cancer women patients were recruited. All patients underwent IMNs biopsy through intercostal space or endoscopic lymphatic chain resection. The ER, PR and HER-2 status were retested according to the current ASCO/CAP guidelines...
June 2018: Surgical Oncology
X Y Meng, S T Song
Osteoblastic metastasis of breast cancer is relatively rare, but there are cases of misdiagnosis and mistreatment in clinical treatment. They can only be diagnosed by X ray or CT bone scan and must be identified from bone repair after effective treatment in patients with osteolytic or mixed bone metastases. Bone metastasis is often seen in the disease-free condition of breast cancer, and very few can occur in stage Ⅳ lesions prior to surgery. Based on the analysis of clinical phenomena, we questioned the evaluation criteria of the therapeutic effect on bone metastasis of breast cancer created by the World Health Organization and the MD Anderson Cancer Center and concluded the formation mechanism of bone metastasis...
June 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
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