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Cancer breast margin surgery

Jintao Liu, Wenbin Guo, Meng Tong
BACKGROUND: Different techniques have been used for the guidance of nonpalpable breast cancer (NBC), but none of them has yet achieved perfect results. The aim of this study was to evaluate the feasibility of indocyanine green (ICG) fluorescence-guided nonpalpable breast cancer lesion excision (IFNLE), to introduce an alternative technique. METHODS: The data about 56 patients with preoperatively diagnosed NBCs operated with the help of intraoperative IFNLE between November of 2010 and September of 2014 were retrospectively analyzed...
October 18, 2016: World Journal of Surgical Oncology
Martine Extermann, Christiaan Leeuwenburgh, Laila Samiian, Marina Sehovic, Jinze Xu, Christopher Cubitt, Paul B Jacobsen, Marco Pahor, Stephen R Grobmyer, Todd M Manini
OBJECTIVE: Chemotherapy is less often prescribed in older individuals due to concerns about post-treatment morbidity and quality of life. We evaluated the physical performance of breast cancer survivors treated with and without adjuvant chemotherapy. MATERIALS AND METHODS: We conducted a case-control study in 56 estrogen receptor positive breast cancer survivors (BCS) on adjuvant aromatase inhibitors 1-2years after definitive surgery. Cases had received adjuvant chemotherapy (n=27; age 70...
October 13, 2016: Journal of Geriatric Oncology
L Hughes, J Hamm, C McGahan, C Baliski
BACKGROUND: Breast-conserving surgery (BCS) is the preferred surgical approach for the majority of patients with early-stage breast cancer. There are frequent issues regarding pathologic margin status, requiring margin re-excision, and, in the literature, there is significant variability in re-excision rates, suggesting this is a potential quality-of-care issue. Understanding the patient-, disease-, and physician-related factors influencing reoperation rates is of importance in an effort to minimize this occurrence...
October 7, 2016: Annals of Surgical Oncology
Michael J Cross, Gail S Lebovic, Joseph Ross, Scott Jones, Arnold Smith, Steven Harms
BACKGROUND: Techniques for accurately delineating the tumor bed after breast-conserving surgery (BCS) can be challenging. As a result, the accuracy, and efficiency of radiation treatment (RT) planning can be negatively impacted. Surgically placed clips or the post-surgical seroma are commonly used to determine target volume; however, these methods can lead to a high degree of uncertainty and variability. A novel 3-dimensional bioabsorbable marker was used during BCS and assessed for its impact on RT planning...
October 5, 2016: World Journal of Surgery
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
Dimitrios Panousis, Panagiota Kontogianni, Panagiota Ntasiou, Georgia Paraskevakou, Dimitrios Grosomanidis, Konstantinos Chatzopoulos, Efstratia Charitidou, Grigoris Xepapadakis
PURPOSE: The purpose of this retrospective single-centre study was to examine the histopathological characteristics of breast ductal carcinoma in situ (DCIS) lesions in a cohort of Greek female patients and describe our experience regarding the clinical management of the disease. METHODS: The medical records from 1995 up to mid-2014 were scanned in order to trace DCIS cases. One hundred and seventy two patients (6.8% of all breast cancer cases) were diagnosed with pure DCIS and no invasive components; 32...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Veronica F Quinn, Bettina Meiser, Judy Kirk, Kathy M Tucker, Kaaren J Watts, Belinda Rahman, Michelle Peate, Christobel Saunders, Elizabeth Geelhoed, Margaret Gleeson, Kristine Barlow-Stewart, Michael Field, Marion Harris, Yoland C Antill, Linda Cicciarelli, Karen Crowe, Michael T Bowen, Gillian Mitchell
PURPOSE: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (TFGT). As the demand for TFGT increases, streamlined methods of genetic education are needed. METHODS: In this noninferiority trial, women aged <50 years with either a strong family history (FH+) or other features suggestive of a germ-line mutation (FH-) were randomized before definitive breast cancer surgery to receive TFGT education either as brief written materials (intervention group (IG)) or during a genetic counseling session at a familial cancer clinic (usual-care group (UCG))...
September 29, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Gianluca Franceschini, Alejandro Martin Sanchez, Giuseppe Visconti, Alba Di Leone, Sabatino D'Archi, Antonino Mulè, Angela Santoro, Marzia Salgarello, Riccardo Masetti
: Oncoplastic surgery of the breast has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic procedures (OPP) associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. So, a number of conventional mammoplasty techniques have been adapted to allow reconstruction of resection defects with parenchymal flaps using a variety of different approaches...
2016: Annali Italiani di Chirurgia
Mitchell Kamrava, Robert R Kuske, Bethany Anderson, Peter Chen, John Hayes, Coral Quiet, Pin-Chieh Wang, Darlene Veruttipong, Margaret Snyder, David J Demanes
OBJECTIVES: To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy in node-positive compared with node-negative patients. MATERIALS AND METHODS: From 1992 to 2013, 1351 patients (1369 breast cancers) were treated with breast-conserving surgery and adjuvant APBI using interstitial multicatheter brachytherapy. A total of 907 patients (835 node negative, 59 N1a, and 13 N1mic) had >1 year of data available and nodal status information and are the subject of this analysis...
September 26, 2016: American Journal of Clinical Oncology
J Ben Wilkinson, Chirag Shah, Mitual Amin, Laura Nadeau, Simona F Shaitelman, Peter Y Chen, Inga S Grills, Alvaro A Martinez, Christina K Mitchell, Michelle F Wallace, Frank A Vicini
BACKGROUND: The purpose of the study was to determine outcomes for patients treated with accelerated partial breast irradiation (APBI) on the basis of breast cancer subtype (BCST). PATIENTS AND METHODS: Our single-institution, institutional review board-approved APBI database was queried for patients who had complete testing results for the estrogen (ER), progesterone (PR), and HER2/neu receptors to determine outcomes for each BCST. Women were assigned as luminal A (LA), luminal B (LB), HER2, and basal BCST using their ER, PR, and HER2/neu receptor status...
July 28, 2016: Clinical Breast Cancer
Ashley B Simpson, Devina McCray, Craig Wengler, Joseph P Crowe, Risal Djohan, Rahul Tendulkar, Colin O'Rourke, Stephen R Grobmyer, Stephanie A Valente
BACKGROUND: Inflammatory breast cancer (IBC) is an aggressive disease that is treated with trimodality therapy consisting of neoadjuvant chemotherapy, surgery, and post-mastectomy radiation therapy (PMRT). Traditionally, modified radical mastectomy without reconstruction has been the operation of choice for patients with IBC due to fears of high rates of margin positivity, risk of local recurrence, and the need for PMRT. METHODS: A retrospective review was performed to evaluate women with IBC at our institution from 2006 to 2014 who completed trimodality therapy...
September 8, 2016: Annals of Surgical Oncology
Lixin Chin, Bruce Latham, Christobel M Saunders, David D Sampson, Brendan F Kennedy
Surgical treatment of breast cancer aims to identify and remove all malignant tissue. Intraoperative assessment of tumor margins is, however, not exact; thus, re-excision is frequently needed, or excess normal tissue is removed. Imaging methods applicable intraoperatively could help to reduce re-excision rates whilst minimizing removal of excess healthy tissue. Optical coherence elastography (OCE) has been proposed for use in breast-conserving surgery; however, intraoperative interpretation of complex OCE images may prove challenging...
September 12, 2016: Journal of Biophotonics
J M Dixon, L Renshaw, O Young, D Kulkarni, T Saleem, M Sarfaty, R Sreenivasan, C Kusnick, J Thomas, L J Williams
INTRODUCTION: Breast conserving surgery (BCS) aims to remove a breast cancer completely and obtain clear margins. Complete excision is essential to reduce the risk of local recurrence. The ClearEdge™ (CE) imaging device examines margins of excised breast tissue intra-operatively. The aim of this study was to investigate the potential of the device in detecting margin involvement in patients having BCS. METHODS: In Phase-1 58 patients underwent BCS and had 334 margins assessed by the device...
August 10, 2016: European Journal of Surgical Oncology
Carolien H M van Deurzen
BACKGROUND: The purpose of this retrospective, population-based, cohort study was to identify patient and tumor characteristics that are associated with a high risk of tumor-positive margins after breast-conserving surgery (BCS) to optimize preoperative counseling. METHODS: All patients with invasive breast cancer (IBC) reported according to the synoptic reporting module in the Dutch Pathology Registry between 2009 and 2015 were included (n = 42.048 cases). Data extraction included age, type of surgery, several tumor characteristics, and resection margin status according to the Dutch indications for re-excision (free, focally positive, or more than focally positive)...
September 2, 2016: Annals of Surgical Oncology
Sea-Won Lee, Kyung Hwan Shin, Eui Kyu Chie, Jin Ho Kim, Seock-Ah Im, Wonshik Han, Dong-Young Noh, Hyeon Woo Lim, Tae Hyun Kim, Keun Seok Lee, Eun Sook Lee, Soo Yoon Sung, Kyubo Kim
PURPOSE: Accelerated whole breast irradiation (AWBI) and conventional whole breast irradiation (CWBI) were compared to determine whether AWBI is as effective as CWBI in patients with early breast cancer and adverse prognostic features. PATIENTS AND METHODS: We included 330 patients who underwent breast-conserving surgery (BCS) and post-operative radiation therapy (RT) using AWBI for pT1-2 and pN0-1a breast cancer from 2007 to 2010. These patients were matched with 330 patients who received CWBI according to stage, age (±3 years), and the year of BCS...
August 30, 2016: Oncotarget
Tomoka Hisada, Masataka Sawaki, Junko Ishiguro, Yayoi Adachi, Haruru Kotani, Akiyo Yoshimura, Masaya Hattori, Yasushi Yatabe, Hiroji Iwata
A positive resection margin is one of the most significant risk factors for local breast cancer recurrence following breast-conserving surgery (BCS). Intraoperative specimen mammography (SMMG) is routinely used to evaluate the surgical margin at our institution. The aim of the present study was to assess the adequacy of SMMG for margin assessment. The patient cohort included 174 women who underwent BCS in 2006. The sensitivity and specificity of SMMG were assessed by comparing the margins assessed by histological and radiological methods...
September 2016: Molecular and Clinical Oncology
Huiyu Zhang, Hongna Tan, Jianbo Gao, Yan Wei, Zhan Yu, Yan Zhou
The aim of the study was to investigate the value of sequential application of molybdenum target X-ray, multi-slice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in the preoperative evaluation of breast-conserving surgeries. In total, 76 patients with indications for breast-conserving surgery due to complicated breast cancer participated in the study and were assigned to either control or observation group (n=38 per group). The patients in the control group were evaluated with two sets of random combinations of molybdenum target X-ray, MSCT or MRI with ultrasound inspection, whereas the patients in the observation group were evaluated by sequential inspection methods of molybdenum target X-ray, MSCT and MRI...
September 2016: Experimental and Therapeutic Medicine
Amanda M Schulman, Jennifer A Mirrielees, Glen Leverson, Jeffrey Landercasper, Caprice Greenberg, Lee G Wilke
BACKGROUND: In February 2014 , the Society of Surgical Oncology and the American Society for Radiation Oncology released guidelines standardizing a negative margin after breast-conserving surgery (BCS) as "no ink on tumor" in patients with early-stage invasive cancer. We sought to determine whether reexcision rates after initial BCS decreased after guideline publication, using the ASBrS Mastery(SM) of Breast Surgery Program. METHODS: Between January 2013 and June 2015, data from the ASBrS Mastery(SM) database was analyzed to determine reexcision rates pre and post guideline publication...
August 31, 2016: Annals of Surgical Oncology
Simon Fitzgerald, Anya Romanoff, Almog Cohen, Hank Schmidt, Christina Weltz, Ira J Bleiweis, Shabnam Jaffer, Elisa R Port
BACKGROUND: Current guidelines state that "no ink on tumor" constitutes adequate surgical margins for lumpectomy specimens. However, there remains uncertainty when tumor is close (<1 mm) to multiple inked margins. METHODS: All local excisions for invasive breast cancer during 3 years at one center were reviewed. Tumor characteristics, margin status, patient age, reoperations, and pathology of reexcised specimen were recorded. Chi-square analysis and regression models were used to identify factors associated with residual disease upon reoperation...
August 31, 2016: Annals of Surgical Oncology
Yu W Wang, Josh D Doerksen, Soyoung Kang, Daniel Walsh, Qian Yang, Daniel Hong, Jonathan T C Liu
There is a need for intraoperative imaging technologies to guide breast-conserving surgeries and to reduce the high rates of re-excision for patients in which residual tumor is found at the surgical margins during postoperative pathology analyses. Feasibility studies have shown that utilizing topically applied surface-enhanced Raman scattering (SERS) nanoparticles (NPs), in conjunction with the ratiometric imaging of targeted versus untargeted NPs, enables the rapid visualization of multiple cell-surface biomarkers of cancer that are overexpressed at the surfaces of freshly excised breast tissues...
August 29, 2016: Small
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