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Nitika Paudel, Kevin P Bethke, Lilian C Wang, Jonathan B Strauss, John P Hayes, Eric D Donnelly
PURPOSE: The current standard of care for women diagnosed with early stage breast cancer is breast-conserving surgery (BCS) followed by external beam radiation therapy, commonly delivered over 3-6 weeks. As an alternative, select patients can undergo intra-operative radiation therapy (IORT) at the time of BCT. This technique delivers a single fraction of radiation at the time of surgery, enabling patients to undergo both surgery and radiation in a single session. Our current study analyzed the value of incorporating breast MRI into the routine work-up of patients deemed eligible for IORT, to quantify the impact on patient eligibility and requirement for additional work-up...
March 2018: Surgical Oncology
Xu Chen Huang, Xu Hua Hu, Xiao Ran Wang, Chao Xi Zhou, Fei Fei Wang, Shan Yang, Gui Ying Wang
BACKGROUND: Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM). AIMS: It is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method. METHODS: Articles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library...
March 16, 2018: Irish Journal of Medical Science
Yu-Mee Sohn, Mirinae Seo
PURPOSE: To compare breast stiffness based on shear-wave elastography (SWE) quantitative parameters with histopathologic results diagnosed by ultrasound (US)-guided core needle biopsy (CNB) to determine their association with upgrade rates after surgical excision or follow-up US as well as clinico-radiologic differences between upgrade and non-upgrade groups. MATERIALS AND METHODS: This retrospective study enrolled 225 breast lesions from 225 patients, including 159 benign lesions, 38 high risk lesions and 28 ductal carcinoma in situ (DCIS) diagnosed by US-guided CNB...
March 3, 2018: Clinical Imaging
Anees B Chagpar, Theodore N Tsangaris, Donald R Lannin
BACKGROUND: Positive margins have been reported in 20-40% of patients undergoing a partial mastectomy (PM), often resulting in re-excision. How often the re-excision yields further cancer and whether there are predictors of residual disease remains unknown. STUDY DESIGN: Patients who had a positive margin (defined as tumor at ink for patients with invasive disease or within 1 mm for patients with DCIS) in the SHAVE trial prior to randomization were evaluated to determine the rate of additional disease either in cavity shave margins (CSM) or at re-excision...
March 7, 2018: Journal of the American College of Surgeons
William J Gradishar, Benjamin O Anderson, Ron Balassanian, Sarah L Blair, Harold J Burstein, Amy Cyr, Anthony D Elias, William B Farrar, Andres Forero, Sharon H Giordano, Matthew P Goetz, Lori J Goldstein, Steven J Isakoff, Janice Lyons, P Kelly Marcom, Ingrid A Mayer, Beryl McCormick, Meena S Moran, Ruth M O'Regan, Sameer A Patel, Lori J Pierce, Elizabeth C Reed, Kilian E Salerno, Lee S Schwartzberg, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, George Somlo, Melinda L Telli, John H Ward, Rashmi Kumar, Dorothy A Shead
Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
March 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Joshua A Sloan, Ramzi Mulki, Naemat Sandhu, Solomon Samuel, Philip O Katz
GOALS: The aim of our study was to characterize jackhammer esophagus symptoms and their relationship with the distal contractile integral (DCI) and bolus transit. BACKGROUND: Jackhammer esophagus is defined by the Chicago Classification version 3.0. This diagnosis is relatively new, with the most current definition being established in 2014. The forerunners of this diagnosis, nutcracker (or hypercontractile) esophagus, have been associated with noncardiac chest pain (NCCP)...
March 7, 2018: Journal of Clinical Gastroenterology
Marta Román, Martin Caicoya, Josep Espinàs, Maria Sala, Isabel Torá-Rocamora, Maria J Quinta, Mar Vernet, Francina Saladié, Anabel Romero, Mar Sánchez, Marisa Baré, Carmen Vidal, S Servitja, Carmen Natal, Joosep Corominas, Joana Ferrer, Ana Rodríguez-Arana, Xavier Castells
Women with a benign breast disease (BBD) have an increased risk of subsequent breast carcinoma. Information is scarce regarding the characteristics of breast carcinomas diagnosed after a BBD. Our aim was to point out the differences in clinical and histologic characteristics of breast carcinomas diagnosed in women with and without a previous pathologic diagnosis of BBD in the context of population-based mammography screening. Retrospective cohort study of all women aged 50-69 years who were screened at least once in a population-based screening program in Spain, between 1994 and 2011 and followed up until December 2012...
March 8, 2018: Breast Journal
Brigid K Killelea, Jessica B Long, Weixiong Dang, Sarah S Mougalian, Suzanne B Evans, Cary P Gross, Shi-Yi Wang
PURPOSE: To examine the associations between sentinel lymph node biopsy (SLNB) and complications among older patients who underwent breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). METHODS: We identified women from the Surveillance, Epidemiology, and End Results-Medicare dataset aged 67-94 years diagnosed during 1998-2011 with DCIS who underwent BCS as initial treatment. We assessed incidence of complications, including lymphedema, wound infection, seroma, or pain, within 9 months of diagnosis...
March 7, 2018: Annals of Surgical Oncology
G T Vondeling, G L Menezes, E P Dvortsin, F G A Jansman, I R Konings, M J Postma, M H Rozenbaum
BACKGROUND: The aim of this study was to estimate the total economic and health related burden of breast cancer in the Netherlands. METHODS: Data on incidence, prevalence, mortality and survival were extracted from the Dutch National Cancer Registry and were used to calculate the economic and health related burden of breast cancer for overall, DCIS (stage 0), early- (stage I), locally advanced- (stage II-III) and metastatic- (stage IV) breast cancer by age groups and by year (if applicable)...
March 7, 2018: BMC Cancer
Amy Voci, Bradley Bandera, Emily Ho, Jihey Lee, Melanie Goldfarb, Maggie DiNome
NCCN guidelines recommend tamoxifen (TAM) for adjuvant treatment of ductal carcinoma in situ (DCIS). TAM has side effects that can potentially complicate treatment recommendations and patient acceptance. It is unknown how well-accepted this recommended therapy is for the adolescent and young adult (AYA) patient population with DCIS. The NCDB was used to identify patients aged 15-39 with DCIS treated between 2000 and 2012. Patient demographic, socioeconomic, and treatment data were collected. Chi-squared test and multivariate analysis were used for statistical assessment...
March 2, 2018: Breast Journal
Hiba El Hage Chehade, Kefah Mokbel
Data derived from pathological analysis, natural history, radiological characteristics, genomic profiling, and clinical outcome indicate that ductal carcinoma in situ (DCIS) is a heterogeneous disease; meaning that no single therapeutic strategy is best, but rather that treatment should be personalised and entail a rigorous multidisciplinary approach. The role of adjuvant endocrine therapy after surgical excision has been the subject of scientific debate in view of the in situ nature of this neoplasm. We reviewed the literature and summarised the evidence regarding the need for adjuvant endocrine therapy following complete surgical excision of DCIS through the identification of the most important outcomes, evaluation of quality of evidence, and assessment of the trade-offs involved...
March 2018: Anticancer Research
Olaronke Oshilaja, Laila Nomani, Benjamin C Calhoun, Alberto J Montero, Charles D Sturgis
Mammary ductal carcinoma in situ (DCIS) is classically treated by combinations of excision, radiation, and endocrine therapy, based upon the specific needs of individual patients. Estrogen receptor (ER) status is generally assessed by immunohistochemistry (IHC) in newly diagnosed cases of DCIS, and endocrine therapy in this setting is thought to be chemopreventive. The potential impact of androgens on mammary carcinogenesis has been studied in recent years, and several authors have proposed androgen receptor (AR) IHC testing and targeted antiandrogenic therapy in patients with locally advanced or metastatic triple-negative invasive breast cancer (ie, negative for ER and progesterone receptor and HER-2)...
March 13, 2018: Applied Immunohistochemistry & Molecular Morphology: AIMM
Carolyn J Kushner, Wei-Ting Hwang, Shiyu Wang, Lawrence J Solin, Neha Vapiwala
PURPOSE: Women with ductal carcinoma in situ (DCIS) or early-stage breast cancer have an excellent prognosis, but their risk of developing second malignant neoplasms (SMNs) is not well established. We analyzed SMNs in a large cohort with long follow-up after breast conservation therapy. METHODS: The study population comprised 755 women with DCIS (n = 135) or stage I-II breast carcinoma (n = 620). Subjects were aged 25-89 (median 55) years when they underwent breast-conserving surgery followed by radiotherapy to the entire breast (60-68Gray) between 1992 and 2001...
February 27, 2018: Breast Cancer Research and Treatment
Dean B Percy, Jin-Si Pao, Elaine McKevitt, Carol Dingee, Urve Kuusk, Rebecca Warburton
BACKGROUND AND OBJECTIVES: The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. METHODS: A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. RESULTS: One thousand six hundred and three patients were included...
February 26, 2018: Journal of Surgical Oncology
Saed Ramzi, Elaine L Hyett, Abigail S Wheal, Peter J Cant
True invasive tubular breast carcinoma (TBC) is unlikely to metastasize to axillary nodes, yet it is routinely subjected to sentinel lymph node biopsy (SLNB), even if the diagnosis was suspected preoperatively. The positive predictive value (PPV) of core biopsy for TBC and the incidence and predictors of axillary metastasis in invasive breast carcinomas identified as tubular-rich on core biopsy are unknown. Prospective patient and tumor data regarding postoperatively confirmed TBCs, and tubular-rich carcinoma identified on preoperative core biopsy between January 2005 and May 2016 was analyzed retrospectively...
February 24, 2018: Breast Journal
Tamera J Lillemoe, Michaela L Tsai, Karen K Swenson, Barbara Susnik, Janet Krueger, Kendra Harris, Natasha Rueth, Erin Grimm, Joseph W Leach
Clinical management of microinvasive breast cancer (Tmic) remains controversial. Although metastases are infrequent in Tmic carcinoma patients, surgical treatment typically includes lymph node sampling. The objective of this study was to determine the rate and predictors of lymph node metastases, recurrence, and survival in a large series of Tmic breast carcinomas. Consecutive cases of Tmic were identified within our health care system from 2001 to 2015. We reviewed results of lymph node sampling and other pathologic factors including hormone receptor/HER2 status, associated in situ tumor size/grade, margin status, number of invasive foci, surgical/adjuvant therapies, and recurrence/survival outcomes...
February 24, 2018: Breast Journal
Ahmadreza Ghaffarizadeh, Randy Heiland, Samuel H Friedman, Shannon M Mumenthaler, Paul Macklin
Many multicellular systems problems can only be understood by studying how cells move, grow, divide, interact, and die. Tissue-scale dynamics emerge from systems of many interacting cells as they respond to and influence their microenvironment. The ideal "virtual laboratory" for such multicellular systems simulates both the biochemical microenvironment (the "stage") and many mechanically and biochemically interacting cells (the "players" upon the stage). PhysiCell-physics-based multicellular simulator-is an open source agent-based simulator that provides both the stage and the players for studying many interacting cells in dynamic tissue microenvironments...
February 23, 2018: PLoS Computational Biology
Peh Joo Ho, Mikael Hartman, Danny A Young-Afat, Sofie A M Gernaat, Soo Chin Lee, Helena M Verkooijen
Little research has been done into cosmetic outcomes in non-Western breast cancer populations. We aimed to study the prevalence and determinants of dissatisfaction with cosmetic outcome after breast cancer surgery of Asian breast cancer survivors, and its association with patient-reported anxiety, depression, and quality of life. In a hospital-based cross-sectional study, 384 breast cancer survivors of at least 12 months after diagnosis completed questionnaires on satisfaction with cosmetic appearance, quality of life (EORTC-QLQ-C30) and anxiety and depression (HADS)...
2018: PloS One
R F D van la Parra, A B Tadros, C M Checka, G M Rauch, A Lucci, B D Smith, S Krishnamurthy, V Valero, W T Yang, H M Kuerer
BACKGROUND: Patients with triple-negative breast cancer (TNBC) and a pathological complete response (pCR) after neoadjuvant chemotherapy may be suitable for non-surgical management. The goal of this study was to identify baseline clinicopathological variables that are associated with residual disease, and to evaluate the effect of neoadjuvant chemotherapy on both the invasive and ductal carcinoma in situ (DCIS) components in TNBC. METHODS: Patients with TNBC treated with neoadjuvant chemotherapy followed by surgical resection were identified...
February 21, 2018: British Journal of Surgery
Ayca Gucalp, Xi K Zhou, Elise D Cook, Judy E Garber, Katherine D Crew, Julie R Nangia, Priya Bhardwaj, Dilip D Giri, Olivier Elemento, Akanksha Verma, Hanhan Wang, J Jack Lee, Lana A Vornik, Carrie Mays, Diane Weber, Valerie Sepeda, Holly O'Kane, Margaret Krasne, Samantha Williams, Patrick G Morris, Brandy M Heckman-Stoddard, Barbara K Dunn, Clifford A Hudis, Powel H Brown, Andrew J Dannenberg
Obesity, a cause of subclinical inflammation, is a risk factor for the development of postmenopausal breast cancer (BC) and is associated with poorer cancer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment with DHA would reduce the expression of proinflammatory genes and aromatase, the rate-limiting enzyme for estrogen biosynthesis, in benign breast tissue of overweight/obese women. A randomized, placebo-controlled, double-blind phase II study of DHA given for 12 weeks to overweight/obese women with a history of stage I-III BC, DCIS/LCIS, Paget's disease, or proliferative benign breast disease was carried out...
February 16, 2018: Cancer Prevention Research
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