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Cancer breast margin surgery

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https://www.readbyqxmd.com/read/29132558/intraoperative-margin-assessment-in-breast-cancer-management
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/29094250/impact-of-an-in-situ-component-on-outcome-after-in-breast-tumor-recurrence-in-patients-treated-with-breast-conserving-therapy
#5
James Laird, Benjamin Lok, Chun Siu, Oren Cahlon, Atif J Khan, Beryl McCormick, Simon N Powell, Hiram Cody, Hannah Yong Wen, Alice Ho, Lior Z Braunstein
BACKGROUND: Among all in-breast tumor recurrences (IBTR) following breast-conserving therapy (BCT), some comprise metachronous new primaries (NPs) while others are true recurrences (TRs). Establishing this distinction remains a challenge. METHODS: We studied 3932 women who underwent BCT for stage I-III breast cancer from 1998 to 2008. Of these, 115 (2.9%) had an IBTR. Excluding patients with inoperable/unresectable recurrences or simultaneous distant metastases, 81 patients with isolated IBTR comprised the study population...
November 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29089571/in-vivo-near-infrared-imaging-of-erbb2-expressing-breast-tumors-with-dual-axes-confocal-endomicroscopy-using-a-targeted-peptide
#6
Zhenghong Gao, Gaoming Li, Xue Li, Juan Zhou, Xiyu Duan, Jing Chen, Bishnu P Joshi, Rork Kuick, Basma Khoury, Dafydd G Thomas, Tina Fields, Michael S Sabel, Henry D Appelman, Quan Zhou, Haijun Li, Ken Kozloff, Thomas D Wang
ErbB2 expression in early breast cancer can predict tumor aggressiveness and clinical outcomes in large patient populations. Accurate assessment with physical biopsy and conventional pathology can be limited by tumor heterogeneity. We aim to demonstrate real-time optical sectioning using a near-infrared labeled ErbB2 peptide that generates tumor-specific contrast in human xenograft breast tumors in vivo. We used IRDye800CW as the fluorophore, validated performance characteristics for specific peptide binding to cells in vitro, and investigated peak peptide uptake in tumors using photoacoustic tomography...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29074088/the-american-brachytherapy-society-consensus-statement-for-accelerated-partial-breast-irradiation
#7
Chirag Shah, Frank Vicini, Simona F Shaitelman, Jaroslaw Hepel, Martin Keisch, Douglas Arthur, Atif J Khan, Robert Kuske, Rakesh Patel, David E Wazer
PURPOSE: Adjuvant radiation after breast-conserving surgery remains the standard-of-care treatment for patients with ductal carcinoma in situ and early-stage invasive breast cancer. Multiple alternatives to standard whole-breast irradiation exist including accelerated partial-breast irradiation (APBI). Therefore, the purpose of this APBI guideline is to provide updated data for clinicians as well as recommendations regarding appropriate patient selection and techniques to deliver APBI...
October 23, 2017: Brachytherapy
https://www.readbyqxmd.com/read/29058926/-breast-angiosarcoma-induced-by-radiotherapy-surgical-treatment-options-and-review-of-literature
#8
O Kubala, J Prokop, L Petráš, P Ihnát, P Jelínek, P Ostruszka
INTRODUCTION: Radiation-induced angiosarcoma is a rare but very aggressive tumour. The highest risk of sarcoma development is in patients after breast-conserving surgery.Case 1: The 66 years old patient underwent radical mastectomy with axillary dissection because of ductal carcinoma with consequent radiotherapy, chemotherapy and hormonal therapy. After 6 years, high-grade angiosarcoma was diagnosed and resected with negative resection margins. Within subsequent 24 months, additional three radical re-excisions were performed because of repeated sarcoma recurrence...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29058923/-microscopic-tumor-cells-in-re-excision-tissue-by-conservative-surgery-in-breast-cancer
#9
J Gatěk, P Vážan, D Vrána, B Dudešek, J Duben
INTRODUCTION: Conservative procedures in early breast carcinoma are a safe alternative to mastectomy. The resection line is controversial, as well as the presence of residual malignant cells in the breast after excision and their influence on local recurrence. The aim of the study was to assess the presence of residual cells in re-excised tissues near positive resection lines, in the distance up to 2 mm, and 2-5 mm. The distance of more than 5 mm was evaluated as free margin. METHOD: All patients operated on in Atlas Hospital from 2004 to 2008 using conservative surgery were included in study...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29051521/evaluating-feasibility-of-an-automated-3-dimensional-scanner-using-raman-spectroscopy-for-intraoperative-breast-margin-assessment
#10
G Thomas, T-Q Nguyen, I J Pence, B Caldwell, M E O'Connor, J Giltnane, M E Sanders, A Grau, I Meszoely, M Hooks, M C Kelley, A Mahadevan-Jansen
Breast conserving surgery is the preferred treatment for women diagnosed with early stage invasive breast cancer. To ensure successful breast conserving surgeries, efficient tumour margin resection is required for minimizing tumour recurrence. Currently surgeons rely on touch preparation cytology or frozen section analysis to assess tumour margin status intraoperatively. These techniques have suboptimal accuracy and are time-consuming. Tumour margin status is eventually confirmed using postoperative histopathology that takes several days...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29044578/factors-associated-with-local-recurrence-after-surgery-for-bone-metastasis-to-the-extremities
#11
Chandra Kumar Krishnan, Han-Soo Kim, Ji Yeon Yun, Hwan Seong Cho, Jong Woong Park, Ilkyu Han
BACKGROUND AND OBJECTIVES: With increasing life expectancy of patients with bone metastasis, durable surgical stabilization of bone metastasis is necessary. Local recurrence (LR) can compromise surgical stabilization and necessitate retreatment. We analyzed LR rate and factors associated with LR in patients undergoing surgery for bone metastasis. METHODS: Patients (n = 301) who underwent surgery for bone metastasis to the extremities were reviewed. Possible factors that might be associated with LR were investigated...
October 16, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29043992/correlation-of-the-ultrasound-imaging-of-breast-cancer-and-the-expression-of-molecular-biological-indexes
#12
Jie Xu, Feng Li, Fengling Chang
This paper aims to 137 cases of breast malignant tumors confirmed by surgery and pathology were collected. All patients received ultrasound examination and were not treated by radiotherapy or chemotherapy before operation. The preoperative ultrasound images of breast cancer patients and postoperative pathological characteristics of paraffin sections were retrospectively observed. Ultrasound indicators included tumor size, shape, ratio of the longest/shortest dimension, edge of the spiculation and peripheral hyperechoic halo sign, internal echo types, micro calcification, posterior echo types, blood flow and signs of lymph node metastasis...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28987136/radiation-therapy-and-early-breast-cancer-current-controversies
#13
REVIEW
John Boyages
Radiation therapy (RT) is an important component of breast cancer treatment. RT reduces local recurrence and breast cancer mortality after breast conservation for all patients and for node-positive patients after a mastectomy. Short courses of RT over 3-4 weeks are generally as effective as longer courses. A patient subgroup where RT can be avoided after conservative surgery has not been consistently identified. A radiation boost reduces the risk of a recurrence in the breast but may be omitted for older patients with good prognosis tumours with clear margins...
August 4, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28974314/re-excision-rates-after-breast-conserving-surgery-following-the-2014-sso-astro-guidelines
#14
Alicia A Heelan Gladden, Sharon Sams, Ana Gleisner, Christina Finlayson, Nicole Kounalakis, Patrick Hosokawa, Regina Brown, Tae Chong, David Mathes, Colleen Murphy
BACKGROUND: In 2014, SSO-ASTRO published guidelines which recommended "no ink on tumor" as adequate margins for patients undergoing breast conservation for invasive breast cancer. In 2016, new SSO-ASTRO-ASCO guidelines recommended 2 mm margins for DCIS. We evaluated whether these guidelines affected re-excision rates at our institution. METHODS: Patients treated with breast conservation surgery from January 1, 2010-March 1, 2016 were identified. Re-excision rates, tumor characteristics, and presence of residual disease were recorded...
September 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28973708/early-postoperative-complications-after-oncoplastic-reduction
#15
Anne E Mattingly, Zhenjun Ma, Paul D Smith, John V Kiluk, Nazanin Khakpour, Susan J Hoover, Christine Laronga, M Catherine Lee
BACKGROUND: Breast-conserving surgery with adjuvant radiation therapy (BCT) has been established as safe oncologically. Oncoplastic breast surgery uses both oncologic and plastic surgery techniques for breast conservation to improve cosmetic outcomes. We evaluated the risk factors associated with complications after oncoplastic breast reduction. METHODS: A single-institution, institutional review board-approved, retrospective review of electronic medical records of female patients with breast cancer who underwent oncoplastic breast reduction from 2008 to 2014...
October 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28967564/multidisciplinary-international-survey-of-post-operative-radiation-therapy-practices-after-nipple-sparing-or-skin-sparing-mastectomy
#16
Gustavo Nader Marta, Philip Poortmans, Alfredo C de Barros, José Roberto Filassi, Ruffo Freitas Junior, Riccardo A Audisio, Max Senna Mano, Sarkis Meterissian, Sarah M DeSnyder, Thomas A Buchholz, Tarek Hijal
PURPOSE/OBJECTIVE(S): Skin sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) have entered routine surgical practice for breast cancer, though their oncologic safety has not been established in randomized controlled trials. The aim of this study was to evaluate and compare radiation oncologists' and breast surgeons' opinions concerning the indications of post-operative radiation therapy (PORT) after SSM and NSM. MATERIALS/METHODS: Radiation oncologists and breast surgeons from North America, South America and Europe were invited to contribute in this study...
September 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28958980/favorable-outcome-with-close-margins-in-patients-undergoing-nipple-skin-sparing-mastectomy-with-immediate-breast-reconstruction-5-year-follow-up
#17
Enver Özkurt, Mustafa Tükenmez, Erdem Güven, Burcu Çelet Özden, Gizem Öner, Mahmut Müslümanoğlu, Abdullah İğci, Vahit Özmen, Seden Küçücük, Neslihan Cabioğlu
BACKGROUND: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast specific surgeons and plastic surgeons. AIMS: The aim of this study is to explore the significant clinicopathological factors associated with long term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction (IBR) with tissue expander (TE) or implant after mastectomy. STUDY DESIGN: Retrospective cohort Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent IBR with TE or implant were retrospectively analyzed...
September 29, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28954713/lateral-oncoplastic-breast-surgery-lobs-a-new-surgical-technique-and-short-term-results
#18
Gurpreet Singh, Pavneet Singh Kohli, Dinesh Bagaria
BACKGROUND: We present a new approach for BCS which we have named as the Lateral Oncoplastic Breast Surgery (LOBS) approach. METHODS: Patients with biopsy proven breast cancer or phyllodes tumors in the outer quadrants of the breast were selected. The patients were operated in the lateral position using the principles of a Level 1 oncoplastic technique. RESULTS: 106 patients (93 breast cancer; 13 phyllodes tumor) were operated using this technique...
September 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28947271/radioactive-seed-localization-for-breast-conservation-surgery-low-positive-margin-rate-with-no-learning-curve
#19
Cristine S Velazco, Nabil Wasif, Barbara A Pockaj, Richard J Gray
BACKGROUND: Radioactive seed localization (RSL) is an alternative to wire localization. We compared the rate of positive margins for evidence of a learning curve in implementing RSL. METHODS: A retrospective review of RSL by three surgeons at a single institution from 2002 to 2016. Positive margins were defined as ink on tumor. RESULTS: Surgeon experience with RSL for ranged from 142 to >500 cases. The positive margin rate among the first 100 of each surgeons' experience (n = 300) was 2...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28945991/the-introduction-of-radioactive-seed-localisation-improves-the-oncological-outcome-of-image-guided-breast-conservation-surgery
#20
A Pieri, R Milligan, A Critchley, J M O'Donoghue, N Sibal, R Peace, G Petrides, R Howitt, S Nicholson, H Cain
INTRODUCTION: Radioactive seed localisation (RSL) has become increasingly popular for localisation of non-palpable breast tumours. This is largely due to advantages it offers in terms of practicality and convenience when compared to guide wire localisation (WL). This institute switched from using WL to RSL in September 2014. The primary aim was to assess whether this change improved the accuracy of excision with regards to inadequate margin rates and weight of excision specimens. The secondary aim was to establish whether there is a "learning curve" associated with RSL technique...
December 2017: Breast: Official Journal of the European Society of Mastology
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