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Metastasic breast cancer surgical management

Yihong Wang, Shaolei Lu, Theresa Graves, Madhu M Ouseph, Murray B Resnick, Evgeny Yakirevich
BACKGROUND: Papillary carcinoma (PC) of the breast represents ∼0.5% of all newly diagnosed cases of breast cancer and usually has an indolent course. The current data suggest lack of a consensus in the surgical management of this disease. Because patients can occasionally develop metastatic disease, sentinel lymph node (SLN) biopsy is often performed during surgery. MATERIALS AND METHODS: In the present study, we retrospectively evaluated the histologic characteristics of 99 cases of PC with or without associated frank invasive carcinoma, including 43 encapsulated or intracystic PCs, 24 solid PCs, and 32 intraductal PCs, and correlated these with the incidence of nodal metastasis...
September 8, 2016: Clinical Breast Cancer
K Harano, X Lei, A M Gonzalez-Angulo, R K Murthy, V Valero, E A Mittendorf, N T Ueno, G N Hortobagyi, M Chavez-MacGregor
Trastuzumab-based treatment has dramatically improved the outcomes of HER2-positive (HER2+) metastatic breast cancer (MBC) patients, with some patients achieving prolonged survival times. In this study, we aim to identify factors that are associated with long-term survival. Patients with HER2+ MBC treated with anti-HER2 target therapy were identified. Patients were grouped according to overall survival (OS) and categorized as long-term survivors (LTS, OS ≥ 5 years), or non-long-term survivors (non-LTS, OS < 5 years)...
September 2016: Breast Cancer Research and Treatment
C Rory Goodwin, Nancy Abu-Bonsrah, Laurence D Rhines, Jorrit-Jan Verlaan, Mark H Bilsky, Ilya Laufer, Stefano Boriani, Daniel M Sciubba, Chetan Bettegowda
STUDY TYPE: A review of the literature. OBJECTIVE: The aim of this study was to discuss the evolution of molecular signatures and the history and development of targeted therapeutics in metastatic tumor types affecting the spinal column. SUMMARY OF BACKGROUND DATA: Molecular characterization of metastatic spine tumors is expected to usher in a revolution in diagnostic and treatment paradigms. Molecular characterization will provide critical information that can be used for initial diagnosis, prognosticating the ideal treatment strategy, assessment of treatment efficacy, surveillance and monitoring recurrence, and predicting complications, clinical outcome, and overall survival in patients diagnosed with metastatic cancers to the spinal column...
October 15, 2016: Spine
Georgios A Margonis, Stefan Buettner, Kazunari Sasaki, Yuhree Kim, Francesca Ratti, Nadia Russolillo, Alessandro Ferrero, Nickolas Berger, T Clark Gamblin, George Poultsides, Thuy Tran, Lauren M Postlewait, Shishir Maithel, Alex D Michaels, Todd W Bauer, Hugo Marques, Eduardo Barroso, Luca Aldrighetti, Timothy M Pawlik
BACKGROUND: Data on surgical management of breast liver metastasis are limited. We sought to determine the safety and long-term outcome of patients undergoing hepatic resection of breast cancer liver metastases (BCLM). METHODS: Using a multi-institutional, international database, 131 patients who underwent surgery for BCLM between 1980 and 2014 were identified. Clinicopathologic and outcome data were collected and analyzed. RESULTS: Median tumor size of the primary breast cancer was 2...
August 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Giovanni Paolino, Chiara Panetta, Dario Didona, Michele Donati, Pietro Donati
Dear Editor, Cutaneous metastases (CM) are detected in about 0.6-10.4% of patients with an internal malignancy (1-3). Excluding melanoma, breast and lung carcinomas are the main source of CM in women and men, respectively (1,4,5). CM can have different clinical features, and a diagnosis of CM is usually suspected before performing a biopsy. However, this can be a pitfall for clinicians when the clinical presentation is not the typical inflammatory nodule or mass. Herein we report 2 cases of cutaneous metastases of breast carcinoma, initially treated as a common skin infection...
June 2016: Acta Dermatovenerologica Croatica: ADC
H Portha, C Jankowski, M Cortet, I Desmoulins, E Martin, V Lorgis, L Arnould, C Coutant
Triple-negative breast cancer (TN), as defined by the triple negativity in immunohistochemistry: the absence of estrogen receptor, progesterone receptor and the absence of overexpression or amplification of HER2, corresponds to 15 % of invasive breast cancers. This is a very heterogeneous group of tumors both at the genomic and transcriptomic level and at morphological, clinical and prognostic level. Although there are some good prognosis forms, the majority of TN tumors is characterized by a poor prognosis with a greater frequency of visceral metastases and a maximum risk of relapse in the first two years after diagnosis...
September 2016: Gynécologie, Obstétrique & Fertilité
Emanuela Esposito, Viviana Sollazzo, Rosa Di Micco, Maria Cervotti, Gaetano Luglio, Giacomo Benassai, Pasquale Mozzillo, Stefano Perrotta, Vincenzo Desiato, Bruno Amato, Pietro Forestieri, Gennaro Limite
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is a minimally invasive technique to stage the axillary lymph node status. The burden of nodal metastasis is of great concern, as the clinical relevance and therapeutic implications of pN1mi and pN0(i+) in the sentinel lymph node (SLN) remain a matter of debate. MATERIALS AND METHODS: We examined the pathological features of 901 patients above the age of 65 presenting with clinical T1-T2 N0M0 breast tumours (<3 cm), detecting tumours related to llary non-sentinel node (NSN) metastases when the SLN was minimally involved...
September 2016: International Journal of Surgery
M Onorati, P Uboldi, C L Bianchi, M Nicola, G M Corradini, S Veronese, A I Fascì, F Di Nuovo
Thyroid gland is one of the most vascularized organs of the body, nevertheless clinical and surgical series report an incidence of secondary malignancies in this gland of only 3%. Colorectal carcinoma metastatic to the thyroid gland is not as uncommon as previously believed, infact the number of cases seems to be increased in recent years due to the more frequent use of fine-needle aspiration cytology (FNAC) guided by ultrasonography. Although kidney, breast and lung metastases to the thyroid are frequent, metastasis from colon cancer is clinically rare with 52 cases reported in the literature in the last 5 decades and three cases described as solitary thyroid metastasis from the colon cancer without any other visceral metastases...
September 2015: Pathologica
Rezvan Rostami, Shivam Mittal, Pooya Rostami, Fattaneh Tavassoli, Bahman Jabbari
This comprehensive review provides information on epidemiology, size, grade, cerebral localization, clinical symptoms, treatments, and factors associated with longer survival in 14,599 patients with brain metastasis from breast cancer; the molecular features of breast cancers most likely to develop brain metastases and the potential use of these predictive molecular alterations for patient management and future therapeutic targets are also addressed. The review covers the data from 106 articles representing this subject in the era of modern neuroimaging (past 35 years)...
May 2016: Journal of Neuro-oncology
J D Stevenson, M McNair, G L Cribb, W P Cool
AIMS: Surgical intervention in patients with bone metastases from breast cancer is dependent on the estimated survival of the patient. The purpose of this paper was to identify factors that would predict survival so that specific decisions could be made in terms of surgical (or non-surgical) management. METHODS: The records of 113 consecutive patients (112 women) with metastatic breast cancer were analysed for clinical, radiological, serological and surgical outcomes...
February 2016: Bone & Joint Journal
Gaurav Agarwal, Gitika Nanda, Punita Lal, Anjali Mishra, Amit Agarwal, Vinita Agrawal, Narendra Krishnani
BACKGROUND: Triple-negative breast cancer (TNBC) is associated with aggressive tumor behavior and worse outcomes. In a study at a tertiary care breast unit in a developing country, clinico-pathological attributes and outcomes of patients with TNBC were compared with (c.w.) ER, PR, and/or HER2 expressing tumors (non-TNBC). PATIENTS AND METHODS: Medical records of 1213 consecutive breast cancer patients managed during 2004-2010 were reviewed. An evaluable cohort of 705 patients with complete treatment and follow-up (median 36 months) information was thus identified...
June 2016: World Journal of Surgery
Kara K Rossfeld, William E Carson
As patients with ovarian cancer are living longer, surgeons will be faced with the management of metastatic lesions amenable to resection more frequently. We present two patients with ovarian cancer metastatic to the breast who underwent resection for their metastases, but their outcomes differed significantly. After reviewing the literature, we propose that there can be definite benefit to resection in the appropriately selected patients and discuss factors to consider prior to proceeding with surgery.
November 2015: Journal of Surgical Oncology
Filiz Oezkan, Amir Maqbul Khan, Thomas Hager, Lutz Freitag, Daniel Christoph, Kaid Darwiche
BACKGROUND: Lung cancer is the major cause of cancer death worldwide. Mediastinal lymph node staging is important for pretreatment lung cancer management. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well established method for mediastinal lymph node staging. Although EBUS-TBNA samples are much smaller than surgical lymph node biopsies, histopathological evaluation and molecular testing can successfully be performed. One step nucleic acid amplification (OSNA), which measures cytokeratin 19 (CK19) mRNA concentration, is a target marker that is gaining importance in quick detection of lymph node metastases in breast cancer and other cancers...
September 21, 2015: Clinical Lung Cancer
J Khalil, F Elomrani, M Benoulaid, H Elkacemi, T Kebdani, H Errihani, N Benjaafar
INTRODUCTION: Cancer metastasis to the thyroid is extremely rare. The most common sites that have been reported to metastasize to the thyroid gland are breast and kidney. As to primary lung cancer metastasizing to the thyroid gland, only a few cases have been described in the literature. CASE PRESENTATION: We report a case of a 37-year-old white Arabian woman who had never smoked tobacco products for whom a malignant thyroid mass revealed a primary lung tumor. She had a surgical excision for both the thyroid and the pulmonary tumors, and received adjuvant chemotherapy...
2015: Journal of Medical Case Reports
Flavia Neri, Giorgio Ercolani, Paolo Di Gioia, Massimo Del Gaudio, Antonio Daniele Pinna
Liver resection is integrated in the oncological surgical management of metastatic gastrointestinal and neuroendocrine tumours. However, the good prognosis reached in these cases has not been obtained for metastatic tumours of other histological types. In this review, we analysed the published case reports and series of hepatectomies in patients with metastatic breast cancer, melanoma, sarcoma, genitourinary tumours, pulmonary and adrenocortical tumours. From the reported data the surgical resection of oligometastases yields good results in terms of improved survival, in particular when the disease-free time period is longer than 1 year...
September 2015: Updates in Surgery
Judit Tamás, Ildikó Vereczkey, Erika Tóth
The ovary is a common site of metastases. Secondary tumors account for 3-40% of all ovarian malignancies. Most ovarian metastases arise from the colon, although tumors of the breast, stomach and endometrium are also common places of origin. Clinical and histological features of metastatic tumors frequently mimic primary ovarian malignancies, causing serious diagnostic problems for the surgical pathologist. However, differentiation between primary ovarian cancer and ovarian metastasis is important in order to prevent inappropriate management and suboptimal treatment...
September 2015: Magyar Onkologia
Bożenna Karczmarek-Borowska, Agnieszka Bukala, Karolina Syrek-Kaplita, Mariusz Ksiazek, Justyna Filipowska, Monika Gradalska-Lampart
Phyllodes tumors are rare breast neoplasms. Surgery is the treatment of choice. The role of postoperative radiotherapy and chemotherapy is still under dispute, as there are no equivocal prognostic factors. Treatment failure results in the occurrence of distant metastasis-mainly to the lungs, bones, liver, and brain. We have described the case of a woman with a malignant phyllodes tumor of the breast that was surgically treated. She did not receive adjuvant therapy because there is no consensus on the role of postoperative chemotherapy and radiotherapy...
August 2015: Medicine (Baltimore)
Alexander Augustyn, Sunati Sahoo, Rachel D Wooldridge
Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old. The importance in managing fibroepithelial lesions lies in distinguishing fibroadenomas, which are benign, from phyllodes tumors, which can be malignant and require complete surgical excision. We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple...
May 5, 2015: Rare Tumors
Tomasz Nowikiewicz, Adam Nowak, Magdalena Wiśniewska, Michał Wiśniewski, Wojciech Zegarski
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is a standard procedure in the therapeutic management of patients with non-advanced breast cancer. AIM: To analyse the utility of ultrasound scan (USS) examination in the process of patient qualification for SLNB and to estimate the optimal time to perform USS in the clinical preoperational assessment of axillary lymph nodes. MATERIAL AND METHODS: A prospective analysis of 702 patients with invasive breast cancer treated with SLNB between 7...
July 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
C Criscitiello, M Giuliano, G Curigliano, M De Laurentiis, G Arpino, N Carlomagno, S De Placido, M Golshan, M Santangelo
Approximately five percent of all breast cancer patients in developed countries present with distant metastases at initial diagnosis. Due to its incurability, metastatic breast cancer is generally treated with systemic therapies to achieve disease control and reduce tumor-related symptoms. Primary treatments for metastatic breast cancer are chemotherapy, endocrine- and biologic therapy, whereas surgery with or without radiotherapy is usually performed to treat impending wound issues. Since 2002, several retrospective non-randomized clinical studies have shown that extirpation of the primary tumor correlates with a significantly improved survival in patients with primary metastatic breast cancer...
October 2015: European Journal of Surgical Oncology
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