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Dcis removal

S Asioli, L Morandi, C Cavatorta, M C Cucchi, M P Foschini
AIM: Aim of the present study is to evaluate the risk of residual neoplastic foci, in patients treated with breast conservative surgery, based on duct carcinoma in situ (DCIS) grading. MATERIALS AND METHODS: The study is based on a retrospective analysis of 419 resection specimens relative to 161 patients. All these patients underwent surgical re-excision when the first specimen had shown one or more margins involved by DCIS. Margins were oriented and the side of margin involved was recorded...
December 2016: European Journal of Surgical Oncology
Rita Y K Chang, Polly S Y Cheung
BACKGROUND: Breast carcinoma presented with nipple discharge is a rare condition. There is theoretical concern about preserving nipple in these patients since the risk of nipple-areolar complex involvement may be greater, but not many studies in the literature have addressed on this issue. The aim of the current study was to determine the incidence and outcome of nipple preservation in breast cancer associated with nipple discharge. METHODS: Medical records of patients who were diagnosed to have breast carcinoma and presented with nipple discharge from May 2009 to October 2014 were retrospectively reviewed...
January 2017: World Journal of Surgery
Rong Tang, Suzanne B Coopey, Andrea L Merrill, Upahvan Rai, Michelle C Specht, Michele A Gadd, Amy S Colwell, William G Austen, Elena F Brachtel, Barbara L Smith
BACKGROUND: When a nipple margin of a nipple-sparing mastectomy (NSM) contains malignancy, current practice includes removal of the nipple or nipple areola complex (NAC). We evaluated rates and trends of positive nipple margins, subsequent management, and oncologic outcomes. STUDY DESIGN: A retrospective chart review of all NSM at our institution from 2007 to 2014 was performed. A descriptive analysis was performed of patients with positive nipple/subareolar margins...
June 2016: Journal of the American College of Surgeons
Hao Li, Bo Li, Wenjian Huang, Li Dong, Jue Zhang
PURPOSE: To develop and validate a dual-contrast image subtraction (DCIS) strategy for eliminating the flow artifacts in black-blood carotid MRI. METHODS: Twelve patients with carotid stenosis and eight healthy volunteers were imaged using the black and gray-blood dual-contrast imaging based on the relaxation-enhanced compressed sensing three-dimensional motion-sensitizing driven equilibrium prepared rapid-gradient-echo (RECS-3D MERGE) sequence. Subtraction of black-blood images (BBIs) and gray-blood images (GBIs), together with a preweighting procedure, was performed to eliminate the residual blood signal in BBIs...
March 28, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Gustavo Machado Badan, Decio Roveda Júnior, Sebastião Piato, Eduardo de Faria Castro Fleury, Mário Sérgio Dantas Campos, Carlos Alberto Ferreira Pecci, Felipe Augusto Trocoli Ferreira, Camila D'Ávila
OBJECTIVE: To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. MATERIALS AND METHODS: Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system...
January 2016: Radiologia Brasileira
Aidan T Manning, Virgilio S Sacchini
Demand for conservative mastectomies continues to increase as more patients choose to undergo breast reconstruction, often with simultaneous contralateral prophylactic mastectomy (CPM). In addition, the increasing use of risk-reducing surgery in high-risk groups has contributed to the increased use of these techniques. We have reviewed the indications and outcomes of a large group of patients undergoing nipple-sparing mastectomy (NSM) at this institution. In total, 728 nipple-sparing mastectomies (NSMs) were performed in 413 patients between 2000 and 2013, for treatment of breast cancer (n=269) or risk reduction (n=459)...
February 2016: Gland Surgery
Sara B Edwards, I Michael Leitman, Aaron J Wengrofsky, Marley J Giddins, Emily Harris, Christopher B Mills, Shinichi Fukuhara, Sebastiano Cassaro
Breast conservation therapy (BCT) has a reported incidence of positive margins ranging widely in the literature from 20% to 70%. Efforts have been made to refine standards for partial mastectomy and to predict which patients are at highest risk for incomplete excision. Most have focused on histology and demographics. We sought to further define modifiable risk factors for positive margins and residual disease. A retrospective study was conducted of 567 consecutive partial mastectomies by 21 breast and general surgeons from 2009 to 2012...
May 2016: Breast Journal
Kirsten McCaffery, Brooke Nickel, Ray Moynihan, Jolyn Hersch, Armando Teixeira-Pinto, Les Irwig, Alexandra Barratt
OBJECTIVE: There have been calls to remove 'carcinoma' from terminology for in situ cancers such as ductal carcinoma in situ (DCIS), to reduce overdiagnosis and overtreatment. We investigated the effect of describing DCIS as 'abnormal cells' versus 'pre-invasive breast cancer cells' on women's concern and treatment preferences. SETTING AND PARTICIPANTS: Community sample of Australian women (n=269) who spoke English as their main language at home. DESIGN: Randomised comparison within a community survey...
2015: BMJ Open
Hatice Gümüş, Philippa Mills, David Fish, Metehan Gümüş, Karina Cox, Haresh Devalia, Sue Jones, Peter Jones, Ali R Sever
PURPOSE: The aim of this study was to determine the incidence of invasive breast carcinoma in patients with preoperative diagnosis of ductal carcinoma in situ (DCIS) by stereotactic vacuum-assisted biopsy (SVAB) performed for microcalcification-only lesions, and to identify the predictive factors of invasion. METHODS: From 2000 to 2010, the records of 353 DCIS patients presenting with microcalcification-only lesions who underwent SVAB were retrospectively reviewed...
January 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
A Lafaille, W A A Tjalma
CASE: A 58-year old woman presented with microcalcifications in her left breast. A biopsy showed a low-grade ductal carcinoma in situ. A tumorectomy was performed using a harpoon-shaped guide wire to remove the entire lesion. No additional therapy was given. Six months later during follow-up the mammography revealed that the distal end of the guide wire was still present in the left breast. CONCLUSION: When performing a tumorectomy using a guide wire, the completeness of the wire should be checked during surgery...
2015: European Journal of Gynaecological Oncology
J Bauwens, H Azaïs, P Devouge, J Phalippou, L Boulanger, P Collinet
DCIS (Ductal carcinoma in situ) constitutes 15,2% of breast cancers. Conservative surgery coupled with adjuvant radiotherapy is often recommended. The rate of revision surgery is high, from 30 to 60%. The concern is a high quality resection within clear margins with a satisfactory aesthetic result. The objective of this review is to precise the place of oncoplastic surgery in DCIS care. Among risk factors of recurrence, tumoral invasion of surgical margins is capital. In histology, clear margins usually adopted for DCIS are 2mm, even though there is no international consensus...
November 2015: Gynécologie, Obstétrique & Fertilité
Brooke Nickel, Alexandra Barratt, Jolyn Hersch, Ray Moynihan, Les Irwig, Kirsten McCaffery
OBJECTIVE: There are increasing rates of mastectomy and bi-lateral mastectomy in women diagnosed with ductal carcinoma in situ (DCIS). To help women avoid decisions that lead to unnecessary aggressive treatments, there have been recent calls to remove the cancer terminology from descriptions of DCIS. We investigated how different proposed terminologies for DCIS affect women's perceived concern and management preferences. MATERIALS AND METHODS: Qualitative study using semi-structured interviews with a community sample of 26 Australian women varying by education and cancer screening experience...
October 2015: Breast: Official Journal of the European Society of Mastology
A T Manning, C Wood, A Eaton, M Stempel, D Capko, A Pusic, M Morrow, V Sacchini
BACKGROUND: Nipple-sparing mastectomy (NSM) is associated with improved cosmesis and is being performed increasingly. Its role in BRCA mutation carriers has not been well described. This was a study of the indications for, and outcomes of, NSM in BRCA mutation carriers. METHODS: BRCA mutation carriers who underwent NSM were identified. Details of patient demographics, surgical procedures, complications, and relevant disease stage and follow-up were recorded. RESULTS: A total of 177 NSMs were performed in 89 BRCA mutation carriers between September 2005 and December 2013...
October 2015: British Journal of Surgery
Anees B Chagpar, Brigid K Killelea, Theodore N Tsangaris, Meghan Butler, Karen Stavris, Fangyong Li, Xiaopan Yao, Veerle Bossuyt, Malini Harigopal, Donald R Lannin, Lajos Pusztai, Nina R Horowitz
BACKGROUND: Routine resection of cavity shave margins (additional tissue circumferentially around the cavity left by partial mastectomy) may reduce the rates of positive margins (margins positive for tumor) and reexcision among patients undergoing partial mastectomy for breast cancer. METHODS: In this randomized, controlled trial, we assigned, in a 1:1 ratio, 235 patients with breast cancer of stage 0 to III who were undergoing partial mastectomy, with or without resection of selective margins, to have further cavity shave margins resected (shave group) or not to have further cavity shave margins resected (no-shave group)...
August 6, 2015: New England Journal of Medicine
J Valente, T Stybio, S Hyde, J Lipscomb, T W Gillespie
Despite lack of survival benefit, an increasing number of women diagnosed with ductal carcinoma in situ (DCIS) opt for removal of the unaffected breast in addition to the breast with known pathology, i.e. contralateral prophylactic mastectomy (CPM). Little is known about women's decision-making processes that contribute to this rising trend, particularly for DCIS. Further obscuring the decision is the highly variable terminology used to discuss breast cancer pathologies and treatments. The purpose of this study was to investigate factors impacting risk comprehension and decision-making related to increased risk for breast cancer or DCIS...
April 2015: Cancer Epidemiology, Biomarkers & Prevention
Saki Nagashima, Kenichi Sakurai, Shuhei Suzuki, Masashi Sakagami, Katsuhisa Enomoto, Sadao Amano, Tsugumichi Koshinaga
We report 2 cases of invasive ductal carcinoma of the breast occurring near a phyllodes tumor. The first case was ofa 58- year-old woman who had a tumor in her right breast and visited our hospital. Following a core needle biopsy (CNB), a malignant phyllodes tumor was diagnosed. We performed a lumpectomy for the phyllodes tumor, with 1.5-cm surgical margins. Pathological diagnosis of the resected specimen confirmed the malignant phyllodes tumor. A ductal carcinoma in situ (DCIS) was also discovered near the phyllodes tumor...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
N Cheurfa, S Giard
OBJECTIVE: Despite the standard management of non-palpable breast cancer (needle core biopsy diagnostic, accurate preoperative localization), there are differences in some cases between the malignant histo-pathological finding in diagnostic biopsy results and negative histo-pathological finding after surgical excision. The aim of this study is to evaluate this incidence and classifying them under three category: failure of surgical excision after preoperative identification; removal of the tumor was already completed by percutaneous biopsy; percutaneous biopsy true false positive...
January 2015: Gynécologie, Obstétrique & Fertilité
Eline Boghaert, Derek C Radisky, Celeste M Nelson
Ductal carcinoma in situ (DCIS) is a heterogeneous group of non-invasive lesions of the breast that result from abnormal proliferation of mammary epithelial cells. Pathologists characterize DCIS by four tissue morphologies (micropapillary, cribriform, solid, and comedo), but the underlying mechanisms that distinguish the development and progression of these morphologies are not well understood. Here we explored the conditions leading to the emergence of the different morphologies of DCIS using a two-dimensional multi-cell lattice-based model that incorporates cell proliferation, apoptosis, necrosis, adhesion, and contractility...
December 2014: PLoS Computational Biology
S Nicholson, A Hanby, K Clements, O Kearins, G Lawrence, D Dodwell, H Bishop, A Thompson
The diagnosis and surgical management of screen-detected Ductal Carcinoma In Situ (DCIS) remains controversial including a range of axillary approaches and consequent morbidity. This study examined the management of the axilla in all patients with DCIS presenting through the United Kingdom National Health Service Breast Screening Programme (UK NHS BSP). Retrospective analysis of the UK NHS BSP identified 26,696 women initially diagnosed with DCIS over the 8 years 1 April 2003-31 March 2011. The final breast pathology of these women was upgraded to invasive ductal cancer in 5564 (20...
January 2015: European Journal of Surgical Oncology
Benjamin Wolfson, Gabriel Eades, Qun Zhou
An increasing body of evidence supports a stepwise model for progression of breast cancer from ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC). Due to the high level of DCIS heterogeneity, we cannot currently predict which patients are at highest risk for disease recurrence or progression. The mechanisms of progression are still largely unknown, however cancer stem cell populations in DCIS lesions may serve as malignant precursor cells intimately involved in progression. While genetic and epigenetic alterations found in DCIS are often shared by IDC, mRNA and miRNA expression profiles are significantly altered...
November 26, 2014: World Journal of Stem Cells
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