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Cancer breast margin surgery

Tadayuki Yoshitake, Michael G Giacomelli, Liza M Quintana, Hilde Vardeh, Lucas C Cahill, Beverly E Faulkner-Jones, James L Connolly, Daihung Do, James G Fujimoto
Rapid histopathological evaluation of fresh, unfixed human tissue using optical sectioning microscopy would have applications to intraoperative surgical margin assessment. Microscopy with ultraviolet surface excitation (MUSE) is a low-cost optical sectioning technique using ultraviolet illumination which limits fluorescence excitation to the specimen surface. In this paper, we characterize MUSE using high incident angle, water immersion illumination to improve sectioning. Propidium iodide is used as a nuclear stain and eosin yellow as a counterstain...
March 14, 2018: Scientific Reports
Viktor Smanykó, Norbert Mészáros, Mihály Újhelyi, Georgina Fröhlich, Gábor Stelczer, Tibor Major, Zoltán Mátrai, Csaba Polgár
INTRODUCTION AND AIM: To report the clinical outcomes of second breast-conserving therapy with perioperative interstitial radiotherapy for the treatment of ipsilateral breast tumor recurrences. METHOD: Between 1999 and 2015, 33 patients, presenting with an ipsilateral breast tumor recurrence after previous breast conserving therapy, were salvaged by re-excision and perioperative high-dose-rate interstitial brachytherapy. A median of 8 (range: 4-24) catheters were implanted into the tumor bed intraoperatively...
March 2018: Orvosi Hetilap
Youichi Machida, Akiko Shimauchi, Hidemi Okuma, Mitsuhiro Tozaki, Sachiko Isobe, Eisuke Fukuma
RATIONALE AND OBJECTIVES: We aimed to investigate the relationship between shear wave speed (SWS) of the lesion on preoperative breast ultrasonography (US) and disease-free survival of patients with primary operable invasive breast cancer. MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board. The requirement for informed consent was waived. A total of 195 consecutive newly diagnosed invasive breast cancer patients (age 33-83 years; mean 54...
March 1, 2018: Academic Radiology
Hiba El Hage Chehade, Kefah Mokbel
Data derived from pathological analysis, natural history, radiological characteristics, genomic profiling, and clinical outcome indicate that ductal carcinoma in situ (DCIS) is a heterogeneous disease; meaning that no single therapeutic strategy is best, but rather that treatment should be personalised and entail a rigorous multidisciplinary approach. The role of adjuvant endocrine therapy after surgical excision has been the subject of scientific debate in view of the in situ nature of this neoplasm. We reviewed the literature and summarised the evidence regarding the need for adjuvant endocrine therapy following complete surgical excision of DCIS through the identification of the most important outcomes, evaluation of quality of evidence, and assessment of the trade-offs involved...
March 2018: Anticancer Research
Atefe Abak, Sima Amini, Mehrdad A Estiar, Vahid Montazeri, Ebrahim Sakhinia, Alireza Abhari
BACKGROUND: miRNA-221 and miRNA-222 are two homologous microRNAs, the high-expression levels of which have been commonly demonstrated in the most current human cancer types as well as breast cancer. The purpose of this research was to determine the clinical value of measuring the expression level of hsa-miR-221-3p in breast cancer tissues and evaluate its biological and prognostic importance in breast cancer (BC). METHODS: A total of 40 tumor samples and matched tumor-free margin specimens were obtained during surgery from patients with BC...
January 1, 2018: Clinical Laboratory
Anna Weiss, Rhiana S Menen, Heather Y Lin, Yu Shen, Kelly J Rosso, Simona Shaitelman, Wendy Woodward, Vicente Valero, Naoto T Ueno, Isabelle Bedrosian, Gildy Babiera
PURPOSE: Controversy exists regarding the role of locoregional therapy for stage IV inflammatory breast cancer (IBC). This study aims to determine indicators of prognosis, including primary tumor resection, for stage IV IBC patients. METHODS: Using the National Cancer Data Base, female patients diagnosed 2010-2013 with unilateral a priori metastatic T4d invasive adenocarcinoma of the breast were identified. We conducted propensity score matched analysis to balance confounders of surgery versus no-surgery...
February 19, 2018: Breast Cancer Research and Treatment
Yuanxin Liang, Stephen P Naber, Abhishek Chatterjee
Oncoplastic surgery provides breast cancer patients with greater aesthetic satisfaction without compromising disease-free survival or overall survival rate. Large volume displacement oncoplastic surgical techniques have become increasingly popular as a strategy for improving aesthetic outcomes and extending the option of breast conservation therapy. They often involve breast reduction or mastopexy reconstructive techniques to facilitate resection of large breast volumes on the side of the breast cancer and accompanied with symmetry contralateral breast reductions or mastopexies...
February 15, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Brittany L Murphy, Judy C Boughey, Michael G Keeney, Amy E Glasgow, Jennifer M Racz, Gary L Keeney, Elizabeth B Habermann
OBJECTIVE: To identify factors predicting positive margins at lumpectomy prompting intraoperative reexcision in patients with breast cancer treated at a large referral center. PATIENTS AND METHODS: We reviewed all breast cancer lumpectomy cases managed at our institution from January 1, 2012, through December 31, 2013. Associations between rates of positive margin and patient and tumor factors were assessed using χ2 tests and univariate and adjusted multivariate logistic regression, stratified by ductal carcinoma in situ (DCIS) or invasive cancer...
February 10, 2018: Mayo Clinic Proceedings
Dorin Dumitru, Michael Douek, John R Benson
Breast conserving surgery (BCS) is now the standard of care for the majority of women with early stage breast cancer. There is a finite rate of ipsilateral breast tumour recurrence (IBTR) for breast conserving therapy (BCT) with annual rates of less than 1% for specialist breast practices. There has been recent consensus on the definition of an adequate resection margin for both invasive and noninvasive breast cancer treated with BCS, although some variation in margin policy persists with definitions of 'no tumour at ink', 1 and 2 mm margin mandates...
2018: Ecancermedicalscience
Neal Bhutiani, Megan K Mercer, Katelynn C Bachman, Samantha R Heidrich, Robert C G Martin, Charles R Scoggins, Kelly M McMasters, Nicolás Ajkay
BACKGROUND: This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and healthcare costs before and after publication of 2014 Society of Surgical Oncology/American Society of Radiation Oncology consensus guideline on margins for breast conserving operation with whole-breast irradiation for stage I and II breast cancer at an academic institution. STUDY DESIGN: Patients with stage I and II invasive carcinomas who underwent partial mastectomy were divided into 2 groups based on whether they were treated before (PRE) or after (POST) guideline publication in March 2014...
February 9, 2018: Journal of the American College of Surgeons
Lejla Hadzikadic Gusic, Kendall Walsh, Teresa Flippo-Morton, Terry Sarantou, Danielle Boselli, Richard L White
Neoadjuvant chemotherapy (NAC) reduces tumor size, facilitating the use of breast conservation surgery (BCS). However, mastectomy remains the surgical outcome for certain women. The goal of this study was to determine the rationale for mastectomy after NAC, particularly in women eligible for BCS. Retrospective data were reviewed on patients who received NAC between February 2006 and August 2010 at our institution. Demographics and tumor characteristics were compared between patients who received BCS and mastectomy after NAC...
January 1, 2018: American Surgeon
Cynthia Aristei, Orit Kaidar-Person, Luca Tagliaferri, Meritxell Arenas, Charlotte E Coles, Birgitte V Offersen, Giovanni Frezza, Maria Cristina Leonardi, Vincenzo Valentini, Céline Bourgier, Philip M P Poortmans
PURPOSE: To describe the current European practise on post-mastectomy radiation therapy (PMRT) in relation to breast reconstruction. METHODS: A 21-item questionnaire was distributed online via Survey Monkey. Items referred to 1. general topics (country, centre, years of experience in breast cancer); 2. clinical decision making; 3. RT techniques and dosimetry; 4. dose fractionation. RESULTS: 283 responses were received from 19 countries. Most responders worked in public health services and in academic institutions and had 5-20 years experience...
January 12, 2018: European Journal of Surgical Oncology
Carla Pajak, JinSi Pao, Amandeep Ghuman, Elaine C McKevitt, Urve Kuusk, Carol K Dingee, Rebecca Warburton
INTRODUCTION: Breast Conserving Surgery (BCS) is considered standard of care for women with early stage breast cancer. Between 20 and 50% of women treated with BCS will require re-operation for positive or close margins and it has been suggested that routine cavity shave margins may reduce the frequency of positive margins. METHODS: Retrospective chart review of a prospectively maintained surgical database of patients undergoing BCS for early stage breast cancer, at a single institution, between January 2012 and December 2015...
January 16, 2018: American Journal of Surgery
Asako Fujiwara, Kenichi Sakurai, Shigeru Fujisaki, Hitomi Kubota, Yukiko Hara, Shuhei Suzuki, Keita Adachi, Ryouichi Tomita, Katsuhisa Enomoto, Tomohiro Hirano
We report a case of neuroendocrine ductal carcinoma in situ of the breast. The tumor was shown to be an intra-cystic tumor on performing ultrasonography. The patient was a 40-year-old woman. Amorphous calcifications were detected on her right breast on performing mammography during breast cancer screening. Ultrasonography indicated that the tumor was 9mm in diameter, and displayed features of an intra-cystic tumor. A vacuum-assisted core needle biopsy for breast tumor led to a diagnosis. The pathological diagnosis was mastopathy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Young Duck Shin, Young Jin Choi, Dae Hoon Kim, Sung Su Park, Hanlim Choi, Dong Ju Kim, Sungmin Park, Hyo Yung Yun, Young Jin Song
This study aimed to determine the efficacy of intraoperative ultrasonography-guided wire localization guided breast-conserving surgery (BCS) for nonpalpable breast cancer and compare it to conventional preoperative wire localization (PWL) guided surgery.We retrospectively analyzed the medical charts of 214 consecutive nonpalpable breast cancer patients who underwent BCS using intraoperative ultrasonography-guided wire localization by a surgeon (IUWLS) and PWL, between April 2013 and March 2017. Positive surgical margins, reexcision rates, and resection volumes were investigated...
December 2017: Medicine (Baltimore)
Sunmin Park, Seung Do Ahn, Eun Kyung Choi, Su Ssan Kim
Background: This study aims to investigate the impact of boost dose escalation on ipsilateral breast tumor recurrence (IBTR) in breast cancer patients with involved resection margins following breast-conserving surgery. Methods: Between January 1998 and December 2010, 192 patients were treated with a boost dose of over 10 Gy for involved resection margins. We retrospectively analyzed outcomes in 192 patients who underwent whole breast irradiation of 50.4 Gy followed by a median boost dose of 15...
January 29, 2018: Japanese Journal of Clinical Oncology
Luis A Riba, Ryan A Gruner, Aaron Fleishman, Ted A James
BACKGROUND: Timely administration of adjuvant chemotherapy for breast cancer is associated with a survival benefit. Specific elements of surgical management may lead to delays initiating chemotherapy, resulting in unfavorable outcomes. The purpose of this study was to determine the correlation between surgical factors and delayed chemotherapy in breast cancer patients. METHODS: A retrospective analysis of the National Cancer Database was performed. The study cohort consisted of female patients with stage 1-3 breast cancer diagnosed between 2010 and 2014...
January 30, 2018: Annals of Surgical Oncology
Xavier Pivot, Igor Bondarenko, Zbigniew Nowecki, Mikhail Dvorkin, Ekaterina Trishkina, Jin-Hee Ahn, Yuriy Vinnyk, Seock-Ah Im, Tomasz Sarosiek, Sanjoy Chatterjee, Marek Z Wojtukiewicz, Vladimir Moiseyenko, Yaroslav Shparyk, Maximino Bello, Vladimir Semiglazov, Sujeong Song, Jaeyun Lim
Purpose This phase III study compared SB3, a trastuzumab (TRZ) biosimilar, with reference TRZ in patients with human epidermal growth factor receptor 2-positive early breast cancer in the neoadjuvant setting ( identifier: NCT02149524). Patients and Methods Patients were randomly assigned to receive neoadjuvant SB3 or TRZ for eight cycles concurrently with chemotherapy (four cycles of docetaxel followed by four cycles of fluorouracil, epirubicin, and cyclophosphamide) followed by surgery, and then 10 cycles of adjuvant SB3 or TRZ...
January 26, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Masashi Sakagami, Tomohiro Hirano, Shuhei Suzuki, Keita Adachi, Hitomi Kubota, Yukiko Hara, Katsuhisa Enomoto, Ryouichi Tomita, Shigeru Fujisaki, Kenichi Sakurai
We report a case of advanced breast cancer with liver metastasis(T2N1M1, Stage IV )achieving a significant improvement of QOL by multi-disciplinary therapy. The patient was 37-year-old woman who had breast lump and axillary lymph nodes swelling with liver metastasis. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma, negative for estrogen receptor and progesterone receptor, and positive for HER2/neu protein expression. The Ki-67 positive cell index was 40%. She received 16 courses of DOC plus HER plus PER(docetaxel 75mg/m / 2, trastuzumab 6 mg/kg, pertu- zumab 450mg/body, and received 4 courses of EC(epirubicin 90mg/m / 2, cyclophosphamide 600 mg/m2)...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kenichi Sakurai, Shigeru Fujisaki, Hitomi Kubota, Yukiko Hara, Shuhei Suzuki, Keita Adachi, Ryouichi Tomita, Katsuhisa Enomoto, Tomohiro Hirano
We report an elderly patient with locally advanced breast cancer who received long-term fulvestrant therapy.The patient was a 75-year-old woman who presented with a right breast lump.She noticed the tumor 4 years and 6 months ago, but she had not visited any hospital.However, her daughter brought her to our hospital.The tumor was 73mm in diameter.A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma, positive for estrogen receptor(ER)and progesterone receptor(PgR), and negative for HER2/neu...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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