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Cancer breast margin surgery

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https://www.readbyqxmd.com/read/28928852/dcis-margins-and-breast-conservation-md-anderson-cancer-center-multidisciplinary-practice-guidelines-and-outcomes
#1
REVIEW
Henry M Kuerer, Benjamin D Smith, Mariana Chavez-MacGregor, Constance Albarracin, Carlos H Barcenas, Lumarie Santiago, Mary E Edgerton, Gaiane M Rauch, Sharon H Giordano, Aysegul Sahin, Savitri Krishnamurthy, Wendy Woodward, Debasish Tripathy, Wei T Yang, Kelly K Hunt
Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28917445/margin-width-and-local-recurrence-after-breast-conserving-surgery-for-ductal-carcinoma-in-situ
#2
Gregory E Ekatah, Arran K Turnbull, Laura M Arthur, Jeremy Thomas, Christine Dodds, J Michael Dixon
INTRODUCTION: Ductal Carcinoma in situ (DCIS) represents 5% of symptomatic and 20-30% of screen detected cancers. Breast conserving surgery (BCS) ± radiotherapy is performed in over 70% of women with DCIS. What constitutes an adequate margin for BCS remains unclear. METHODS: A single institution follow up study has been conducted of 466 patients with pure DCIS treated by BCS between 2000 and 2010 of whom 292 received whole breast radiotherapy and 167 did not...
September 4, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28913761/radioactive-seed-localization-versus-wire-guided-localization-for-nonpalpable-breast-cancer-a-cost-and-operating-room-efficiency-analysis
#3
Yimeng Zhang, Jean Seely, Erin Cordeiro, Joshua Hefler, Kednapa Thavorn, Mukta Mahajan, Sue Domina, Jon Aro, Andrea Marie Ibrahim, Angel Arnaout, Denis Gravel, Carolyn Nessim
BACKGROUND: This study aimed to compare the cost and resource use between our first-year experience using breast-conserving surgery (BCS) with radioactive seed localization (RSL) and the previous-year standard practice of BCS with wire-guided localization (WGL) for patients with nonpalpable breast cancer at a large Canadian tertiary center. METHODS: For this retrospective cohort study, data for BCS cases with RSL was collected from 1 April 2015 to 31 March 2016 and for BCS cases with WGL from 1 April 2014 to 31 March 2015...
September 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28900481/routine-pre-treatment-mri-for-breast-cancer-in-a-single-payer-medical-center-effects-on-surgical-choices-timing-and-outcomes
#4
Timothy J Vreeland, John S Berry Iv, Erika Schneble, Doreen O Jackson, Garth S Herbert, Diane F Hale, Jonathon M Martin, Madeline Flores, Adam R Pattyn, Kai Hata, Guy T Clifton, Aaron D Kirkpatrick, George E Peoples
Introduction: Pre-operative MRI is being used with increasing frequency to evaluate breast cancer patients, but the debate surrounding risks and benefits of this use continues. At our institution, we instituted a standardized protocol for pre-operative MRI. Here, we compare patients seen prior to routine use of MRI to those seen after and examine effects on surgical choices, timing and outcomes. Methods: This is a retrospective review of a prospectively collected database of all new invasive breast cancers seen from January 2007 to December 2012...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28878011/nondestructive-tissue-analysis-for-ex-vivo-and-in-vivo-cancer-diagnosis-using-a-handheld-mass-spectrometry-system
#5
Jialing Zhang, John Rector, John Q Lin, Jonathan H Young, Marta Sans, Nitesh Katta, Noah Giese, Wendong Yu, Chandandeep Nagi, James Suliburk, Jinsong Liu, Alena Bensussan, Rachel J DeHoog, Kyana Y Garza, Benjamin Ludolph, Anna G Sorace, Anum Syed, Aydin Zahedivash, Thomas E Milner, Livia S Eberlin
Conventional methods for histopathologic tissue diagnosis are labor- and time-intensive and can delay decision-making during diagnostic and therapeutic procedures. We report the development of an automated and biocompatible handheld mass spectrometry device for rapid and nondestructive diagnosis of human cancer tissues. The device, named MasSpec Pen, enables controlled and automated delivery of a discrete water droplet to a tissue surface for efficient extraction of biomolecules. We used the MasSpec Pen for ex vivo molecular analysis of 20 human cancer thin tissue sections and 253 human patient tissue samples including normal and cancerous tissues from breast, lung, thyroid, and ovary...
September 6, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28876635/the-surgical-management-of-central-breast-tumours-at-a-specialist-breast-unit-in-johannesburg-south-africa
#6
L Van Schalkwyk, C A Benn, K Bergstrom
BACKGROUND: Central breast tumours are defined as tumours in the retroareolar area, or within 1.5-2.0 cm from the areolar edge. In the past, breast conservation therapy (BCT) for central breast tumours was considered controversial due to concerns regarding oncologic safety and cosmesis. Recent evidence does however suggest that oncoplastic techniques offer a cosmetically acceptable and safe alternative to mastectomy in these tumours. METHOD: Patients with central breast tumours (invasive and in situ) were identified from a breast cancer database of 431 patients who presented to the Netcare Breast Care Centre in Johannesburg over a one-year period (June 2015-June 2016)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876634/clinical-vs-pathological-staging-of-breast-cancer-can-our-hands-compete-with-the-microscope
#7
L Van Schalkwyk, C A Benn, K Bergstrom
BACKGROUND: Tumour size and axillary nodal status are important predictors of prognosis in breast cancer. The clinical examination of the breast is an essential component of preoperative TNM staging, but the accuracy of this method of assessment has been called into question, especially in the determination of axillary nodal status. METHOD: Data were obtained from a database of breast cancer patients presenting to the Netcare Breast Care Centre in Johannesburg between June 2015 and June 2016...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870967/safety-for-repeat-lumpectomy-without-radiotherapy-for-ipsilateral-breast-tumor-recurrence
#8
Makoto Ishitobi, Reiko Fukui, Yoko Hashimoto, Nobuyoshi Kittaka, Takahiro Nakayama, Yasuhiro Tamaki
BACKGROUND: There is little information on the local recurrence risk of patients who undergo repeat lumpectomy without radiotherapy after salvage surgery for ipsilateral breast tumor recurrence (IBTR). PATIENTS AND METHODS: Sixty-five patients who underwent repeat lumpectomy without radiotherapy after IBTR were retrospectively analyzed. The risk factors of second IBTR, including the breast cancer subtype of IBTR defined by the estrogen receptor (ER) and HER2 status, were assessed...
September 2017: Anticancer Research
https://www.readbyqxmd.com/read/28865259/current-margin-practice-and-effect-on-re-excision-rates-following-the-publication-of-the-sso-astro-consensus-and-abs-consensus-guidelines-a-national-prospective-study-of-2858-women-undergoing-breast-conserving-therapy-in-the-uk-and-ireland
#9
Sarah Shuk-Kay Tang, Sarantos Kaptanis, James B Haddow, Giuseppina Mondani, Beatrix Elsberger, Marios Konstantinos Tasoulis, Christine Obondo, Neil Johns, Wisam Ismail, Asim Syed, Panayioti Kissias, Mary Venn, Souganthy Sundaramoorthy, Gareth Irwin, Amtul S Sami, Dalia Elfadl, Alice Baggaley, Dionysios Dennis Remoundos, Fiona Langlands, Petros Charalampoudis, Zoe Barber, Werbena L S Hamilton-Burke, Ayesha Khan, Chiara Sirianni, Louise Anne-Marie Grant Merker, Sunita Saha, Risha Arun Lane, Sharat Chopra, Sophie Dupré, Aiden T Manning, Edward R St John, Aya Musbahi, Nokwanda Dlamini, Caitlin L McArdle, Chloe Wright, James O Murphy, Ravi Aggarwal, Matei Dordea, Karen Bosch, Donna Egbeare, Hisham Osman, Salim Tayeh, Faraz Razi, Javeria Iqbal, Serena F C Ledwidge, Vanessa Albert
INTRODUCTION: There is variation in margin policy for breast conserving therapy (BCT) in the UK and Ireland. In response to the Society of Surgical Oncology and American Society for Radiation Oncology (SSO-ASTRO) margin consensus ('no ink on tumour' for invasive and 2 mm for ductal carcinoma in situ [DCIS]) and the Association of Breast Surgery (ABS) consensus (1 mm for invasive and DCIS), we report on current margin practice and unit infrastructure in the UK and Ireland and describe how these factors impact on re-excision rates...
August 29, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28862112/indications-of-the-magnetic-resonance-method-in-breast-pathology
#10
Adina Chiriţă
The high incidence of breast cancer is a known fact. The 5-year survival rate for women with correctly treated breast cancer is 90% around the world, and 50% in Romania, respectively. Correct diagnostic evaluation of the breasts allows for a competent therapeutic management. The primary diagnosis of breast cancer includes clinical examination of the breasts, breast ultrasound and mammography. Magnetic resonance imaging (MRI) examination is not a first line type of investigation, but targeted to selected patient groups...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28861382/minimalist-breast-conserving-surgical-approaches-for-inferiorly-sited-cancers
#11
Mona P Tan
Contemporary data suggests that breast conservation treatment (BCT) may confer a survival advantage when compared to mastectomy. Hence, it would be logical to adopt strategies which increase eligibility of successful BCT without compromising oncologic principles or cosmetic outcome. With respect to achieving good aesthetics, inferiorly sited breast cancers pose a particular technical challenge. A vast array of techniques, collectively referred to as oncoplastic breast surgery (OBS) have been developed to minimise post treatment distortion...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28861373/staged-approach-to-partial-breast-reconstruction-to-avoid-mastectomy-in-women-with-breast-cancer
#12
Pankaj G Roy, Alexandra A Tenovici
BACKGROUND: The lateral chest wall perforator flaps (CWPF) offer an excellent option for partial breast reconstruction (PBR) in women undergoing breast conservation surgery (BCS) for laterally placed tumours in small to moderate non-ptotic breasts. METHODS: A total of 20 patients underwent PBR with lateral CWPF over the last 4 years, as two-stage approach. This approach was undertaken for patients with high tumour to breast ratio (>30% predicted resection) in an attempt to avoid mastectomy...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28831674/performance-characteristics-of-specimen-radiography-for-margin-assessment-for-ductal-carcinoma-in-situ-a-systematic-review
#13
REVIEW
D P A Versteegden, L G G Keizer, M S Schlooz-Vries, L E M Duijm, C A P Wauters, L J A Strobbe
BACKGROUND: Reducing positive margin rate (PMR) and reoperation rate in breast-conserving operations remains a challenge, mainly regarding ductal carcinoma in situ (DCIS). Intra-operative margin assessment tools have emerged to reduce PMR over the last decades, including specimen radiography (SR). No consensus has been reached on the reliability and efficacy of SR in DCIS. OBJECTIVE: We performed a systematic literature review to assess the performance characteristics of SR for margin assessment of breast lesions with pure DCIS and invasive cancers with DCIS components...
August 22, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28831273/oncological-safety-and-cosmetic-outcomes-in-oncoplastic-breast-conservation-surgery-a-review-of-the-best-level-of-evidence-literature
#14
REVIEW
Esther Jennifer Campbell, Laszlo Romics
Oncoplastic breast conservation surgery (OBCS) is increasingly becoming part of routine breast cancer surgical management. OBCS may be viewed as an extension of standard breast conservation surgery for resecting tumors of larger sizes without compromising on cosmetic outcome, or as an alternative to mastectomy. High quality evidence to support the oncological safety and benefits of OBCS is lacking. This review will focus on the best available level of evidence and address key issues regarding oncological safety in OBCS, such as tumor resection margins and re-excision rates, local recurrence and patient outcome, postoperative complications and adjuvant therapy delivery, and briefly discuss cosmetic outcome in OBCS...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28806663/management-of-breast-ductal-carcinoma-in-situ-in-catalonia-spain-results-from-the-grup-oncologic-calal%C3%A3-occit%C3%A3-catalonia-survey-with-9-year-follow-up
#15
M J Cambra, B Farrús, F Moreno, Ll Anglada, M Arenas, R Ballester, J Casals, M Cusidó, V García, C Gutiérrez, M Mollà, A Pedro, V Reyes, X Sanz
INTRODUCTION: Reliable data on DCIS incidence and management are not available in many countries. The present study describes the management of DCIS in Catalonia, Spain in the year 2005 and compares these findings to data obtained in France. Local recurrence and late toxicity rates from 2005 through the end of 2014 are reported. MATERIALS AND METHODS: Observational survey of patients with pure DCIS (n = 270) diagnosed during 2005. A written questionnaire, the same as used in the French survey, was completed by 14 doctors at 12 cancer centres in Catalonia, Spain...
October 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28802225/the-value-of-ultrasound-guided-surgery-for-breast-cancer
#16
REVIEW
Darja Arko, Nina Čas Sikošek, Nejc Kozar, Monika Sobočan, Iztok Takač
OBJECTIVE: An increasing number of breast-conserving surgeries (BCS) has lead clinicians to the dilemma how to provide patients with the best pathological, short-term and long-term outcomes, while at the same time improving the cosmetic outcome and the patients' quality of life. A proposed solution is the use of intraoperative ultrasound (IOUS) for lesion resection in palpable as well as non-palpable breast cancer. METHODS: This review identifies and compares evidence on palpation-guided/wire-guided vs...
September 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28779963/partial-breast-radiotherapy-after-breast-conservation-surgery-for-patients-with-early-breast-cancer-uk-import-low-trial-5-year-results-from-a-multicentre-randomised-controlled-phase-3-non-inferiority-trial
#17
Charlotte E Coles, Clare L Griffin, Anna M Kirby, Jenny Titley, Rajiv K Agrawal, Abdulla Alhasso, Indrani S Bhattacharya, Adrian M Brunt, Laura Ciurlionis, Charlie Chan, Ellen M Donovan, Marie A Emson, Adrian N Harnett, Joanne S Haviland, Penelope Hopwood, Monica L Jefford, Ronald Kaggwa, Elinor J Sawyer, Isabel Syndikus, Yat M Tsang, Duncan A Wheatley, Maggie Wilcox, John R Yarnold, Judith M Bliss
BACKGROUND: Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that partial-breast radiotherapy restricted to the vicinity of the original tumour in women at lower than average risk of local relapse will improve the balance of beneficial versus adverse effects compared with whole-breast radiotherapy. METHODS: IMPORT LOW is a multicentre, randomised, controlled, phase 3, non-inferiority trial done in 30 radiotherapy centres in the UK...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28776282/trends-in-adjuvant-therapies-after-breast-conserving-surgery-for-hormone-receptor-positive-ductal-carcinoma-in-situ-findings-from-the-national-cancer-database-2004-2013
#18
Yasuaki Sagara, Rachel A Freedman, Stephanie M Wong, Fatih Aydogan, Anvy Nguyen, William T Barry, Mehra Golshan
PURPOSE: Breast-conserving surgery (BCS) followed by radiotherapy (RT) with or without endocrine therapy (ET) is a standard treatment option for ductal carcinoma in situ (DCIS). We sought to investigate national patterns in the use of adjuvant therapy after BCS for hormone receptor (HR)-positive DCIS over time. PATIENTS AND METHODS: Using data from the National Cancer Data Base, we identified patients diagnosed with DCIS and treated with BCS between 2004 and 2013...
August 3, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28766220/improved-locoregional-control-in-a-contemporary-cohort-of-nonmetastatic-inflammatory-breast-cancer-patients-undergoing-surgery
#19
Kelly J Rosso, Audree B Tadros, Anna Weiss, Carla L Warneke, Sarah DeSnyder, Henry Kuerer, Naoto T Ueno, Shane R Stecklein, Wendy A Woodward, Anthony Lucci
BACKGROUND: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer characterized by rapid progression and early metastatic dissemination. The purpose of this study was to assess contemporary rates of local regional recurrence (LRR) in the era of trimodality therapy for nonmetastatic IBC and identify risk factors leading to local failure. METHODS: A total of 114 patients with nonmetastatic IBC receiving trimodality therapy (neoadjuvant chemotherapy, surgery, and radiation therapy) were identified from a prospectively collected database from 2007 to 2015 and outcomes analyzed...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766199/a-patient-specific-3d-printed-form-accurately-transfers-supine-mri-derived-tumor-localization-information-to-guide-breast-conserving-surgery
#20
Richard J Barth, Venkataramanan Krishnaswamy, Keith D Paulsen, Timothy B Rooney, Wendy A Wells, Elizabeth Rizzo, Christina V Angeles, Jonathan D Marotti, Rebecca A Zuurbier, Candice C Black
BACKGROUND: Wire-localized excision of nonpalpable breast cancer is imprecise, resulting in positive margins 25-30% of the time. METHODS: Patients underwent preoperative supine magnetic resonance imaging (MRI). A radiologist outlined the tumor edges on consecutive images, creating a three-dimensional (3D) view of its location. Using 3D printing, a bra-like plastic form (the Breast Cancer Locator [BCL]) was fabricated, with features that allowed a surgeon to (1) mark the edges of the tumor on the breast surface; (2) inject blue dye into the breast 1 cm from the tumor edges; and (3) place a wire in the tumor at the time of surgery...
August 1, 2017: Annals of Surgical Oncology
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