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Cancer breast margin surgery

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https://www.readbyqxmd.com/read/29349483/surgical-outcomes-of-primary-versus-post-neoadjuvant-chemotherapy-breast-conservation-surgery-a-comparative-study-from-a-developing-country
#1
Gaurav Agarwal, Chaitra Sonthineni, Sabaretnam Mayilvaganan, Anjali Mishra, Punita Lal, Vinita Agrawal
INTRODUCTION: In India and other developing countries, breast conservation surgery (BCS) rates in breast cancer patients are low due to advanced disease at presentation and misconceptions about BCS outcomes. Many patients presenting with large or locally advanced breast cancers (LABC) can be offered post-neoadjuvant chemotherapy (NACT) BCS, safety of which is not as well established as that of primary BCS. This retrospective study compared pathological and surgical outcome parameters in patients undergoing primary and post-NACT BCS...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29338088/margins-in-breast-cancer-how-much-is-enough
#2
REVIEW
Melissa Pilewskie, Monica Morrow
The appropriate negative margin width for women undergoing breast-conserving surgery for both ductal carcinoma in situ (DCIS) and invasive carcinoma is controversial. This review examines the available data on the margin status for invasive breast cancer and DCIS, and highlights the similarities and differences in tumor biology and standard treatments that affect the local recurrence (LR) risk and, therefore, the optimal surgical margin. Consensus guidelines support a negative margin, defined as no ink on tumor, for invasive carcinoma treated with breast-conserving therapy...
January 16, 2018: Cancer
https://www.readbyqxmd.com/read/29321645/mri-features-predictive-of-negative-surgical-margins-in-patients-with-her2-overexpressing-breast-cancer-undergoing-breast-conservation
#3
Brittany Z Dashevsky, Jung Hun Oh, Aditya P Apte, Blanca Bernard-Davila, Elizabeth A Morris, Joseph O Deasy, Elizabeth J Sutton
Here we develop a tool to predict resectability of HER2+ breast cancer at breast conservation surgery (BCS) utilizing features identified on preoperative breast MRI. We identified patients with HER2+ breast cancer who obtained pre-operative breast MRI and underwent BCS between 2002-2013. From the contoured tumor on pre-operative MRI, shape, histogram, and co-occurrence and size zone matrix texture features were extracted. In univariate analysis, Spearman's correlation coefficient (Rs) was used to assess the correlation between each image feature and an endpoint (surgical re-excision)...
January 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29312629/fluorescence-guided-surgery-for-cancer-patients-a-proof-of-concept-study-on-human-xenografts-in-mice-and-spontaneous-tumors-in-pets
#4
Eliane Mery, Muriel Golzio, Stephanie Guillermet, Didier Lanore, Augustin Le Naour, Benoît Thibault, Anne Françoise Tilkin-Mariamé, Elizabeth Bellard, Jean Pierre Delord, Denis Querleu, Gwenael Ferron, Bettina Couderc
Surgery is often the first treatment option for patients with cancer. Patient survival essentially depends on the completeness of tumor resection. This is a major challenge, particularly in cases of peritoneal carcinomatosis, where tumors are widely disseminated in the large peritoneal cavity. Any development to help surgeons visualize these residual cells would improve the completeness of the surgery. For non-disseminated tumors, imaging could be used to ensure that the tumor margins and the draining lymph nodes are free of tumor deposits...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29304773/breast-carcinoma-with-21-gene-recurrence-score-lower-than-18-rate-of-locoregional-recurrence-in-a-large-series-with-clinical-follow-up
#5
Gulisa Turashvili, Edi Brogi, Monica Morrow, Maura Dickler, Larry Norton, Clifford Hudis, Hannah Y Wen
BACKGROUND: The 21-gene recurrence score (RS) assay determines the benefit of adding chemotherapy to endocrine therapy for patients with early stage, estrogen receptor (ER)-positive, HER2-negative breast cancer. The RS risk groups predict the likelihood of distant recurrence and have recently been associated with an increased risk of locoregional recurrence (LRR). This study analyzed clinicopathologic features of patients with low RS and LRR. METHODS: In our institutional database, we identified 1396 consecutive female patients with lymph node negative, ER+/HER2- invasive breast carcinoma and low RS (<18) results, treated at our center from 2008 to 2013...
January 6, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29302488/oncoplastic-breast-conserving-surgery-with-tailored-needle-guided-excision
#6
Fernando Hernanz, Mónica González-Noriega, Sonia Sánchez, Lucia Paz, Pedro Muñoz, Sandra Hermana
Background: Breast conserving surgery (BCS) administered with oncoplastic approach (OBCS), when it is required, is currently the gold standard for the treatment of early breast cancer. Wire-guided localization (WL) is the most popular technique used to help surgeon in breast cancer excision. Currently, a universal and undeniable goal is to minimize the rate of positive margins and re-excision operation after BCS improving cosmetic outcome and decreasing health care costs. This study is aimed to report our experience combining OBCS and tailored WL as surgical approach for early breast cancers...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29285046/the-practice-patterns-and-perceptions-of-korean-surgeons-regarding-margin-status-after-breast-conserving-surgery
#7
Tae-Kyung Yoo, Sung-Won Kim, Eunyoung Kang, Sung Gwe Ahn, Ki-Tae Hwang, Seung-Ki Kim, Sang Uk Woo, Hyuk Jai Shin, Young-Jin Song, Eun-Jung Jung, Myung-Chul Chang, Ilkyun Lee, Woo-Chan Park
Two consecutive surveys for breast surgeons in Korea were conducted to comprehend the practice patterns and perceptions on margin status after breast-conserving surgery. The surveys were conducted online in 2014 (initial) and 2016 (follow-up). A total of 126 and 88 responses were obtained in the initial and follow-up survey, respectively. More than 80% of the respondents replied to routinely apply frozen section biopsy for intraoperative margin assessment in both surveys. Re-excision recommendations of the margin for invasive cancer significantly changed from a close margin to a positive margin over time (p=0...
December 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/29282078/short-course-hypofractionated-whole-breast-irradiation-after-conservative-surgery-a-single-institution-phase-ii-study
#8
Paola Pinnarò, Carolina Giordano, Alessia Farneti, Adriana Faiella, Giuseppe Iaccarino, Valeria Landoni, Diana Giannarelli, Patrizia Vici, Lidia Strigari, Giuseppe Sanguineti
BACKGROUND: To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). METHODS: Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR)...
December 27, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/29280779/breast-cancer-does-type-of-hospital-where-you-get-surgery-affect-survival
#9
Jenny J Lin, Natalia Egorova, Rebeca Franco, Nina A Bickell
Under the Affordable Care Act (ACA), more women are insured with Medicaid, which should improve healthcare access. We sought to determine whether there are survival differences among patients with breast cancer undergoing surgery at facilities with varying proportions of Medicaid patients. We used New York State (NYS) Vital Statistics death records data linked with NYS discharge inpatient and ambulatory surgery databases to examine 90-day survival after surgery from 2008 to 2013. We used all Medicaid discharges to calculate and create quintiles of facilities based on Medicaid volume...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29229152/omission-of-radiotherapy-after-breast-conservation-surgery-in-the-postneoadjuvant-setting
#10
Andrew C Esposito, James Crawford, Elin R Sigurdson, Elizabeth A Handorf, Shelly B Hayes, Marcia Boraas, Richard J Bleicher
BACKGROUND: Breast conservation therapy (BCT) consists of breast conservation surgery (BCS) and radiotherapy (RT). Neoadjuvant chemotherapy (NACT) can downstage tumors, broadening BCS eligibility in patients requiring mastectomy. However, tumor downstaging does not obviate need for RT. This study evaluated factors that predict RT omission after NACT and BCS. METHODS: The National Cancer Database was queried for women with unilateral, clinical stage II-III breast cancer, treated with NACT and BCS between 2008 and 2012...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29227250/oncoplastic-surgery-of-multicentric-multifocal-breast-cancer-case-report
#11
I Kokhreidze
The multicentric/multifocal form of breast cancer has been considered as relative contraindicationfor breast conserving surgery. According to the results of the studies conducted in the last century, the local recurrence rate of the disease after breast conserving surgeries of multicentric/multifocal breast cancer exceeds 40%. Thus these data were considered as main argument for mastectomy advocates, as non-alternative surgical treatment in these cases. Wide clinical application of oncoplastic surgical techniques gave us possibilities to resolve dilemma: excise tumor - containing quadrant with achieving clear margins and satisfactory cosmetic outcome, without increasing risk of disease-related complications...
November 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29222935/risk-factors-for-positive-resection-margins-of-breast-cancer-tumorectomy-specimen-following-breast-conserving-surgery
#12
Niko Heiss, Valentin Rousson, Assia Ifticene-Treboux, Hans-Anton Lehr, Jean-François Delaloye
Background The aim of the study was to identify risk factors for positive surgical margins in breast-conserving surgery for breast cancer and to evaluate the influence of surgical experience in obtaining complete resection. Methods All lumpectomies for invasive breast carcinoma and ductal carcinoma in situ (DCIS) between April 2008 and March 2010 were selected from the database of a single institution. Re-excision rates for positive margins as well as patient and histopathologic tumor characteristics were analyzed...
December 9, 2017: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/29218614/18f-fluorodeoxyglucose-specimen-positron-emission-mammography-delineates-tumour-extension-in-breast-conserving-surgery-preliminary-results
#13
Gou Watanabe, M Itoh, X Duan, H Watabe, N Mori, H Tada, A Suzuki, M Miyashita, N Ohuchi, T Ishida
OBJECTIVES: We aimed to determine whether high-resolution specimen-positron emission mammography (PEM) using fluorodeoxyglucose (18F-FDG) can reveal extension of breast cancer in breast-conserving surgery (BCS), and assess the safety of radiation exposure to medical staff. METHODS: Sixteen patients underwent positron emission tomography, and then BCS with intraoperative frozen section analysis on the same day. Resected specimens with remaining 18F-FDG accumulation were scanned by high-resolution PEM...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29214416/breast-conserving-surgery-following-neoadjuvant-therapy-a-systematic-review-on-surgical-outcomes
#14
REVIEW
José H Volders, Vera L Negenborn, Pauline E Spronk, Nicole M A Krekel, Linda J Schoonmade, Sybren Meijer, Isabel T Rubio, M Petrousjka van den Tol
PURPOSE: Neoadjuvant chemotherapy (NACT) is increasingly used in breast cancer treatment. One of the main goals of NACT is to reduce the extent of local surgery of the breast and axilla. The aim of this study was to determine surgical outcomes for patients receiving breast-conserving therapy (BCT) after NACT, including margin status plus secondary surgeries, excision volumes, and cosmetic outcomes. METHODS: A systematic review was performed in accordance with PRISMA principles...
December 6, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29200846/improved-resection-and-prolonged-overall-survival-with-pd-1-irdye800cw-fluorescence-probe-guided-surgery-and-pd-1-adjuvant-immunotherapy-in-4t1-mouse-model
#15
Yang Du, Ting Sun, Xiaolong Liang, Yuan Li, Zhengyu Jin, Huadan Xue, Yihong Wan, Jie Tian
An intraoperative technique to accurately identify microscopic tumor residuals could decrease the risk of positive surgical margins. Several lines of evidence support the expression and immunotherapeutic effect of PD-1 in breast cancer. Here, we sought to develop a fluorescence-labeled PD-1 probe for in vivo breast tumor imaging and image-guided surgery. The efficacy of PD-1 monoclonal antibody (PD-1 mAb) as adjuvant immunotherapy after surgery was also assessed. PD-1-IRDye800CW was developed and examined for its application in tumor imaging and image-guided tumor resection in an immunocompetent 4T1 mouse tumor model...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/29187899/optimizing-fresh-specimen-staining-for-rapid-identification-of-tumor-biomarkers-during-surgery
#16
Connor W Barth, Jasmin M Schaefer, Vincent M Rossi, Scott C Davis, Summer L Gibbs
RATIONALE: Positive margin status due to incomplete removal of tumor tissue during breast conserving surgery (BCS) is a prevalent diagnosis usually requiring a second surgical procedure. These follow-up procedures increase the risk of morbidity and delay the use of adjuvant therapy; thus, significant efforts are underway to develop new intraoperative strategies for margin assessment to eliminate re-excision procedures. One strategy under development uses topical application of dual probe staining and a fluorescence imaging strategy termed dual probe difference specimen imaging (DDSI)...
2017: Theranostics
https://www.readbyqxmd.com/read/29132558/intraoperative-margin-assessment-in-breast-cancer-management
#17
REVIEW
Chantal Reyna, Sarah M DeSnyder
The goal of breast-conserving surgery is to excise the tumor with negative margins while achieving a successful cosmetic result. Although it is not feasible to have re-excision rates of zero, several techniques have been described to reduce the need for a return to the operating room. When rates of re-excision are high, consideration should be given to using 1 or more of these techniques. It is critical that re-excision rates are tracked when new techniques are implemented to ensure progress. In addition, attention must be paid to ensuring that cosmetic outcomes remain optimal...
January 2018: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/29131161/rapid-virtual-hematoxylin-and-eosin-histology-of-breast-tissue-specimens-using-a-compact-fluorescence-nonlinear-microscope
#18
Lucas C Cahill, Michael G Giacomelli, Tadayuki Yoshitake, Hilde Vardeh, Beverly E Faulkner-Jones, James L Connolly, Chi-Kuang Sun, James G Fujimoto
Up to 40% of patients undergoing breast conserving surgery for breast cancer require repeat surgeries due to close to or positive margins. The lengthy processing required for evaluating surgical margins by standard paraffin-embedded histology precludes its use during surgery and therefore, technologies for rapid evaluation of surgical pathology could improve the treatment of breast cancer by reducing the number of surgeries required. We demonstrate real-time histological evaluation of breast cancer surgical specimens by staining specimens with acridine orange (AO) and sulforhodamine 101 (SR101) analogously to hematoxylin and eosin (H&E) and then imaging the specimens with fluorescence nonlinear microscopy (NLM) using a compact femtosecond fiber laser...
November 13, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/29099721/automated-detection-of-breast-cancer-in-resected-specimens-with-fluorescence-lifetime-imaging
#19
Jennifer E Phipps, Dimitris Gorpas, Jakob Unger, Morgan Darrow, Richard J Bold, Laura Marcu
Re-excision rates for breast cancer lumpectomy procedures are currently nearly 25% due to surgeons relying on inaccurate or incomplete methods of evaluating specimen margins. The objective of this study was to determine if cancer could be automatically detected in breast specimens from mastectomy and lumpectomy procedures by a classification algorithm that incorporated parameters derived from fluorescence lifetime imaging (FLIm). This study generated a database of co-registered histologic sections and FLIm data from breast cancer specimens (N=20) and a support vector machine (SVM) classification algorithm able to automatically detect cancerous, fibrous, and adipose breast tissue...
November 3, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29097944/multimodal-imaging-nanoparticles-derived-from-hyaluronic-acid-for-integrated-preoperative-and-intraoperative-cancer-imaging
#20
William M Payne, Tanner K Hill, Denis Svechkarev, Megan B Holmes, Balasrinivasa R Sajja, Aaron M Mohs
Surgical resection remains the most promising treatment strategy for many types of cancer. Residual malignant tissue after surgery, a consequence in part due to positive margins, contributes to high mortality and disease recurrence. In this study, multimodal contrast agents for integrated preoperative magnetic resonance imaging (MRI) and intraoperative fluorescence image-guided surgery (FIGS) are developed. Self-assembled multimodal imaging nanoparticles (SAMINs) were developed as a mixed micelle formulation using amphiphilic HA polymers functionalized with either GdDTPA for T1 contrast-enhanced MRI or Cy7...
2017: Contrast Media & Molecular Imaging
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