MedWorm: Breast Conservation Surgery

Recommendations for the aesthetic evaluation of breast cancer conservative treatment

Breast Cancer Research and Treatment — Fri, 03 Feb 2012 17:52:07 +0100

Abstract During the Turning Subjective Into Objective seminar held in Lisbon in May 2011, experts in the topic gathered to discuss the unsolved problems of aesthetic evaluation of breast-conserving treatment (BCT). The purpose of this study is to review the main methodological issues related to the aesthetic evaluation of BCT, to discuss currently used methods of evaluation and the lack of a gold standard, and to write a set of recommendations that can be used as guidance for the aesthetic evaluation of BCT. Content Type Journal ArticleCategory ReviewPages 1-9DOI 10.1007/s10549-012-1978-8Authors Maria João Cardoso, Breast Unit, Champalimaud Cancer Centre, Lisbon, PortugalJaime Santos Cardoso, INESC Porto Breast Research Group, Faculdade de Engenharia, Universidade do...

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Re-operation common after breast-conserving surgery

Reuters: Health — Tue, 31 Jan 2012 21:25:23 +0100

NEW YORK (Reuters Health) - One in four women who have breast-conserving surgery for cancer needs a second operation to remove more breast tissue, suggests a new study that also found the rate of re-operation varied widely by surgeon. (Source: Reuters: Health)

Re-Operation Common After Breast-Conserving Surgery

MedlinePlus Health News — Tue, 31 Jan 2012 21:25:19 +0100

One in four women who have breast-conserving surgery for cancer needs a second operation to remove more breast tissue, suggests a new study that also found the rate of re-operation varied widely by surgeon.Source: Reuters Health Related MedlinePlus Pages: Breast Cancer, Surgery (Source: MedlinePlus Health News)

Variability in Reexcision Following Breast Conservation Surgery [Original Contribution]

JAMA — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion Substantial surgeon and institutional variation were observed in reexcision following partial mastectomy in women with invasive breast cancer. (Source: JAMA)

Bifidobacterium longum subsp. infantis uses two different {beta}-galactosidases for selectively degrading type-1 and type-2 human milk oligosaccharides

Glycobiology — Fri, 27 Jan 2012 05:00:00 +0100

The breast-fed infant intestine is often colonized by particular bifidobacteria, and human milk oligosaccharides (HMOs) are considered to be bifidogenic. Recent studies showed that Bifidobacterium longum subsp. infantis can grow on HMOs as the sole carbon source. This ability has been ascribed to the presence of a gene cluster (HMO cluster-1) contained in its genome. However, the metabolism of HMOs by the organism remains unresolved because no enzymatic studies have been completed. In the present study, we characterized β-galactosidases of this subspecies to understand how the organism degrades type-1 (Galβ1-3GlcNAc) and type-2 (Galβ1-4GlcNAc) isomers of HMOs. The results revealed that the locus tag Blon_2016 gene, which is distantly located from the HMO cluster-1, encodes a...

Controversies Concerning the Use of Neoadjuvant Systemic Therapy for Primary Breast Cancer

World Journal of Surgery — Thu, 26 Jan 2012 06:56:55 +0100

Abstract The major aim of neoadjuvant systemic therapy is to improve prognosis by individualizing treatment. The proven benefits of neoadjuvant systemic therapy include reducing tumor burden, higher breast-conserving surgery, and the possibility of in vivo monitoring of response to treatment. Other goals of neoadjuvant treatment are the detection of new prognostic and predictive biomarkers and the investigation of new drugs and imaging modalities. Although many prospective trials have answered important questions regarding neoadjuvant systemic therapy, several topics remain controversial. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1424-4Authors Manfred Kaufmann, Department of Obstetrics and Gynecology and Breast Unit, Johann Wolfgang Goethe University...

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Structural/organizational characteristics of health services partly explain racial variation in timeliness of radiation therapy among elderly breast cancer patients

Breast Cancer Research and Treatment — Tue, 24 Jan 2012 07:35:09 +0100

We examined the role of surgical facility characteristics and distance to care in explaining racial/ethnic variation in timing of initiation of guideline-recommended radiation therapy (RT) after breast conserving surgery (BCS). We used Surveillance Epidemiology and End Results-Medicare data to identify women ages 65 and older diagnosed with stages I–III breast cancer and treated with BCS in 1994–2002. We used stepwise multivariate logistic regression to examine the interactive effects of race/ethnicity and facility profit status, teaching status, size, and institutional affiliations, and distance to nearest RT on timing of RT initiation, controlling for known covariates. Among 38,574 eligible women who received BCS, 39% received RT within 2 months, 52% received RT within 6&n...

SNPs in DNA Repair or Oxidative Stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation.

Journal of Experimental and Clinical Cancer Research — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions: The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity.Trials registration(NCT01316328). (Source: Journal of Experimental and Clinical Cancer Research)

Influence of Habitat Quality, Population Size, Patch Size, and Connectivity on Patch-Occupancy Dynamics of the Middle Spotted Woodpecker.

Conservation Biology — Mon, 23 Jan 2012 05:00:00 +0100

We examined these mechanisms through multiseason occupancy models that elucidated patch-occupancy dynamics of Middle Spotted Woodpeckers (Dendrocopos medius) in northwestern Spain. The number of occupied patches was relatively stable from 2000 to 2010 (15-24% of 101 patches occupied every year) because extinction was balanced by recolonization. Larger and higher quality patches (i.e., higher density of oaks >37 cm dbh [diameter at breast height]) were more likely to be occupied. Habitat quality (i.e., density of large oaks) explained more variation in patch colonization and extinction than did patch size and connectivity, which were both weakly associated with probabilities of turnover. Patches of higher quality were more likely to be colonized than patches of lower quality. Populations...

Search for a gene-expression signature of breast cancer local recurrence in young women.

Clinical Cancer Research — Mon, 23 Jan 2012 05:00:00 +0100

CONCLUSIONS: Although the previously identified LR signature was robust on another platform, we were neither able to validate it on an independent dataset, nor to define a strong GE classifier for LR using a larger dataset. We conclude that there are no significant differences in GE pattern in tumors from patients with and without LR after BCT. PMID: 22271875 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Communicating about breast cancer: Rural women's experience of interacting with their surgeon.

The Australian Journal of Rural Health — Mon, 23 Jan 2012 02:01:37 +0100

Conclusion: Rural women in Victoria Australia were largely satisfied with the interaction and communication with their surgeon during diagnosis and treatment planning for early breast cancer. Current practice was predominately in line with clinical practice guidelines. PMID: 22250873 [PubMed - in process] (Source: The Australian Journal of Rural Health)

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Breast cancer survivors lack knowledge about treatment

MedWire News - Breast Cancer — Fri, 20 Jan 2012 13:26:05 +0100

Many breast cancer survivors lack knowledge about local recurrence and mortality risks associated with breast-conserving surgery and mastectomy, results of a US survey show. (Source: MedWire News - Breast Cancer)

Reducing interobserver variation of boost-CTV delineation in breast conserving radiation therapy using a pre-operative CT and delineation guidelines.

Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: Use of a Preop-CT in BCT results in a modest but statistically significant reduction in interobserver variation of the boost-CTV delineations and in a significant reduction in the boost-CTV volume. PMID: 22265730 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Repeat Lumpectomy for Ipsilateral Breast Tumor Recurrence after Breast-Conserving Treatment.

Oncology — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: The ER status of IBTR was a significantly independent predictive factor for second IBTR-free survival. Some patients could safely undergo repeat lumpectomy for IBTR. PMID: 22269927 [PubMed - as supplied by publisher] (Source: Oncology)

The Postconservation Breast: Part 1, Expected Imaging Findings

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Imaging the treated breast presents challenges because of its limited compressibility and the overlapping features of benign posttreatment alterations and tumor recurrence. After lumpectomy and radiation therapy, mammographic findings such as breast edema, skin thickening, fluid collections, architectural distortion, and calcifications have characteristic sequences of evolution toward stability. Awareness of these normal chronologic imaging findings for the conservatively treated breast minimizes unnecessary recall from screening and permits early detection of recurrent breast carcinoma. (Source: American Journal of Roentgenology)

The Postconservation Breast: Part 2, Imaging Findings of Tumor Recurrence and Other Long-Term Sequelae

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Imaging the treated breast presents challenges because of its limited compressibility and overlapping features of benign posttreatment alterations and tumor recurrence. After lumpectomy and radiation therapy, mammographic findings such as breast edema, skin thickening, fluid collections, architectural distortion, and calcifications have characteristic sequences of evolution toward stability. Changes in the imaging appearance after stability has been achieved—including increasing asymmetry, an enlarging mass, increasing edema or skin thickening, and the development of pleomorphic calcifications within or near the operative bed—should alert the radiologist to possible tumor recurrence. When mammography or sonography is indeterminate, MRI may be useful in excluding rec...

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Communicating about breast cancer: Rural women's experience of interacting with their surgeon

Australian Journal of Rural Health — Wed, 18 Jan 2012 21:27:58 +0100

Breast cancer survivors lack knowledge about treatment

MedWire News - Oncology — Tue, 17 Jan 2012 13:23:15 +0100

Ipsilateral breast tumor recurrence (IBTR) in patients with operable breast cancer who undergo breast‐conserving treatment after receiving neoadjuvant chemotherapy

Cancer — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS:ER status and multifocality of the residual tumor after NAC were independent predictors of IBTR after BCT. The MDAPI was barely adaptable to the study patients in terms of predicting IBTR. Patients with ER‐positive and HER2‐negative tumors had a favorable prognosis, whereas patients who developed IBTR after NAC had significantly worse overall survival. The authors propose a new IBTR prognostic index using the 2 factors that were identified as predictive of IBTR: ER status and multifocality of the residual tumor. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Cancer — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS:With 5 years of follow‐up, APBI produced clinical outcomes and patterns of failure comparable to those achieved with whole breast irradiation. Patients who developed an IBTR after APBI had excellent 3‐year survival outcomes after salvage treatments. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

Influence of Surgical Technique on Mastectomy and Reexcision Rates in Breast-Conserving Therapy for Cancer

Computational Intelligence and Neuroscience — Mon, 16 Jan 2012 15:14:21 +0100

Conclusions. CSM is a technique that reduces reexcisions and mastectomy rates. (Source: Computational Intelligence and Neuroscience)

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Positive Margin Rates Following Breast-Conserving Surgery for Stage I-III Breast Cancer: Palpable Versus Non-Palpable Tumors

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:05 +0100

(Source: Journal of Surgical Research)

The Impact of Neoadjuvant Chemotherapy on Wound Complication Risk After Breast Cancer Resection and Reconstruction - A Multi-Institutional Assessment

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:04 +0100

Conclusions: in this multi-institutional analysis, neoadjuvant chemotherapy was not associated with post-operative wound complication, regardless of the type of breast surgery performed. Patients and providers can be assured that receipt of neoadjuvant therapy does not increase the risk of post-operative wound complication. (Source: Journal of Surgical Research)

Association Between Patient Age, Volume of Tissue Excised During Breast Conserving Surgery, and Local Recurrence

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

Response to “Timing of Radiotherapy and Outcome in Patients Receiving Adjuvant Endocrine Therapy.” (Int J Radiat Oncol Biol Phys 2011;80:398–402)

International Journal of Radiation Oncology * Biology * Physics — Sat, 14 Jan 2012 19:43:01 +0100

To the Editor: In their recent article, Karlsson et al. argue that in patients who receive solely hormone treatment, a delay of radiotherapy delivery of less than 20 weeks after breast-conserving surgery is irrelevant to inferior outcomes . (Source: International Journal of Radiation Oncology * Biology * Physics)

In Reply to Tsoutsou et al.

International Journal of Radiation Oncology * Biology * Physics — Sat, 14 Jan 2012 19:43:01 +0100

To the Editor: Reported studies have provided differing conclusions regarding the risks of delaying radiotherapy after breast-conserving surgery , probably because the trials have included different subtypes of breast cancer and a range of treatments, leading to an outcome that is an average effect of the delay. This average effect may not be informative for all subtypes of breast cancer. (Source: International Journal of Radiation Oncology * Biology * Physics)

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Common variants of eNOS and XRCC1 genes may predict acute skin toxicity in breast cancer patients receiving radiotherapy after breast conserving surgery.

Sat, 14 Jan 2012 05:00:00 +0100

CONCLUSIONS: As our exploratory study suggests that XRCC1 T-77C and eNOS G874T may confer an increased risk of acute skin reactions to radiotherapy in breast cancer patients, further confirmatory studies are warranted to determine the clinical significance. PMID: 22248507 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Neoadjuvant Clinical Trials for the Treatment of Primary Breast Cancer: The Experience of the German Study Groups

Current Oncology Reports — Fri, 13 Jan 2012 17:15:39 +0100

This article summarizes the results of the neoadjuvant trials that have been conducted by the German study groups, outlines ongoing clinical research projects, and discusses concepts for future clinical trials. Content Type Journal ArticleCategory Breast Cancer (KR Fox, Section Editor)Pages 1-8DOI 10.1007/s11912-011-0212-xAuthors Michael Untch, Department of Gynecology, Helios Klinikum Berlin-Buch, Berlin, GermanySibylle Loibl, German Breast Group c/o GBG Forschungs GmbH, Neu Isenburg, GermanyGottfried E. Konecny, Division of Hematology Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USAGunter von Minckwitz, German Breast Group c/o GBG Forschungs GmbH, Neu Isenburg, Germany Journal Current Oncology ReportsOnline ISSN 1534-6269Print ISSN...

Application of principal component and discriminant analyses to morpho-structural indices of indigenous and exotic chickens raised under intensive management system

Tropical Animal Health and Production — Thu, 12 Jan 2012 16:44:20 +0100

The objectives of this study were to investigate the relationships between body weight and morpho-structural indices to predict body weight from their orthogonal body shape characters using principal component analysis and to morphologically classify the chicken genotypes using multivariate discriminant analysis. Data used were from 273 randomly selected 12-weeks-old indigenous chickens of normal-feathered (NF), frizzle-feathered (FF), naked-neck (NN) and Anak Titan (AT) genotypes. Phenotypic correlation among body weight and most biometric traits ranged from 0.227–0.876, −0.7–0.901, 0.034–0.968 and −0.207–0.849 for NF, NN and AT chickens, respectively. Factor analysis with varimax rotation of interrelated traits revealed three principal components which accounted for 83....

Mucocele-like tumor associated with ductal carcinoma in situ diagnosed as mucinous carcinoma by fine-needle aspiration cytology: report of a case

Surgery Today — Thu, 12 Jan 2012 06:43:01 +0100

We report a case of MLT associated with ductal carcinoma in situ, which was initially diagnosed as fibroadenoma by mammography and ultrasonography, and as mucinous carcinoma by fine-needle aspiration cytology. We discuss the characteristic findings of imaging and the appropriate clinical treatment of this tumor. The characteristic image first signals the possibility of this tumor, following which the diagnosis can be confirmed by pathological examination of a fully excised tumor specimen. Breast-conserving surgery is recommended because of the low risk of high-grade malignancy, even when malignancy is confirmed, and lymph node dissection may be avoided. Content Type Journal ArticleCategory Case ReportPages 1-5DOI 10.1007/s00595-011-0063-yAuthors Shoichi Kikuchi, Department of S...

A comparison of quality of life and satisfaction of women with early-stage breast cancer treated with breast conserving therapy vs. mastectomy in southern China

Supportive Care in Cancer — Thu, 12 Jan 2012 06:42:54 +0100

Conclusions Patients who underwent BCT did not report better QoL than those who received MAS, but BCT patients experienced easier social adjustment. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00520-011-1364-9Authors Z.-Y. He, Department of Radiation Oncology, Cancer Centre of Sun Yat-Sen University, 651 Dongfeng Road East, Guangzhou, 510060 ChinaQ. Tong, Department of Radiation Oncology, Cancer Center, The First Affiliated Hospital of Nanhua University, Hengyang, ChinaS.-G. Wu, State Key Laboratory of Oncology in Southern China, Guangzhou, 510060 ChinaF.-Y. Li, Department of Radiation Oncology, Cancer Centre of Sun Yat-Sen University, 651 Dongfeng Road East, Guangzhou, 510060 ChinaH.-X. Lin, Department of Radiation Oncology, Cancer Cen...

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Time to Treatment for Patients Receiving BCS in a Public and a Private University Hospital in Atlanta

The Breast Journal — Thu, 12 Jan 2012 05:00:00 +0100

Abstract: Delays in treatment for breast cancer can lead to poorer patient outcome. We analyzed time to treatment among female patients receiving breast‐conserving surgery in two different hospital settings, public versus private. Retrospective chart review revealed 270 patients diagnosed during 2004–2008. Three consecutive time intervals were defined (Initial abnormal imaging [I] to core biopsy [II] to surgery /pathology staging [III] to oncology evaluation for adjuvant treatment). Multivariate analyses investigated hospital type and demographic factors. Overall median treatment time was 83 days, Interval II accounting for the longest (43 days). Only 55% of patients received the entire spectrum of care within 90 days; for each consecutive 30‐day interval, percentages varied...

MR Imaging Assessment of the Breast after Breast Conservation Therapy: Distinguishing Benign from Malignant Lesions [Breast Imaging]

Radiographics recent issues — Wed, 11 Jan 2012 05:00:00 +0100

Normal and abnormal MR imaging appearances of the breast after breast conservation therapy for breast cancer are presented, with emphasis on selection of the appropriate interpretation based on the Breast Imaging Reporting and Data System lexicon and final assessment. (Source: Radiographics recent issues)

Completeness of dictated operative reports in breast cancer—the case for synoptic reporting

Journal of Surgical Oncology — Tue, 10 Jan 2012 05:00:00 +0100

ConclusionsThe dictated operative report for breast cancer surgery does not adequately capture important data. A synoptic reporting system, which requires documentation of important elements, is a potentially beneficial tool in breast cancer surgery. J. Surg. Oncol © 2012 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

The Neoadjuvant Net: A patient- and surgeon-friendly device to facilitate safe breast-conserving surgery in patients who underwent neoadjuvant treatment.

Breast — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Taffurelli M, Montroni I, Santini D, Zamagni C, Fiacchi M, Zanotti S, Pellegrini A, Ugolini G Abstract The primary goal of the study was to describe an innovative and helpful tool in defining the minimal surgical margins necessary during breast-conserving surgery (BCS) after neoadjuvant treatment: the Neoadjuvant Net (NN). The secondary endpoint was to assess its usefulness in achieving postoperative disease-free margins and reducing Ipsilateral Breast Tumor Recurrences (IBRTs). The breast-conserving surgical technique together with the use of the Neoadjuvant Net is herein reported. Age, stage at diagnosis, clinical and pathological response, lymph node status, type of surgery, margin status, and incidence of local and distant recurrence were retrospectively analyzed. Seve...

[Modern radiotherapy after breast-conserving surgery].

Orvosi Hetilap — Sat, 07 Jan 2012 13:48:50 +0100

This article reviews the results of these studies focusing on individual risk-adapted radiotherapy after breast-conserving surgery for patients with early-stage breast carcinoma. Orv. Hetil., 2012, 153, 45-55. PMID: 22217684 [PubMed - in process] (Source: Orvosi Hetilap)

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Accelerated Partial Breast Irradiation Using Brachytherapy for Breast Cancer: Patterns in Utilization and Guideline Concordance

JNCI — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions APBIb after breast-conserving surgery has been rapidly adopted in the United States. Use varied by race, ethnicity, and widely by region, especially among patients who may not be suitable for this radiation technique. (Source: JNCI)

Defining a Place for Nipple Sparing Mastectomy in Modern Breast Care: An Evidence Based Review

The Breast Journal — Sun, 01 Jan 2012 05:00:00 +0100

This article aims to critically review the indications and limitations of NSM, discuss evidence based intra‐operative protocols and to discuss ways in which radiation therapy may be incorporated in treatment planning following NSM. A comprehensive search of the scientific literature was carried out using PubMed to access all publications related to nipple sparing mastectomy. The search focused specifically on technique, current management, safety, and complications of these procedures. Keywords searched included “Nipple sparing mastectomy,”“breast conserving surgery,”“Nipple areola complex preservation” and “skin sparing mastectomy.” NSM offers an opportunity to preserve native breast envelope without mutilation of nipple‐areola complex (NAC), and avoids multiple surgic...

[Modern breast surgery].

Orvosi Hetilap — Sun, 01 Jan 2012 04:42:22 +0100

Authors: Gulyás G, Mátrai Z, Kunos C, Pesthy P, Doleviczényi Z, Kásler M Abstract Today, as a result of the complex and coordinated medical treatment of breast malignancies the long-term survival rate reaches 80%. Modern breast surgery plays a prominent role in the multidisciplinary treatment of breast tumors. Breast surgery in the 21st century simultaneously performs medical and aesthetic procedures on the same organ. Modern day breast surgery is founded on a complex view of breast malignancies, multidisciplinary cooperation, oncoplastic practice, and selecting the optimal surgery techniques, based on state of the art tools and a detailed treatment plan. Authors present the evolution of modern breast surgery; discuss the procedures such as mastectomy, breast conservation surge...

Preoperative Breast MRI in the Surgical Treatment of Ductal Carcinoma In Situ

The Breast Journal — Fri, 30 Dec 2011 05:00:00 +0100

This study examined the accuracy of magnetic resonance imaging (MRI) for assessment of DCIS size, and evaluated the effect of preoperative breast MRI on achievement of tumor‐free surgical margins after breast‐conserving surgery (BCS). One‐hundred and fifty‐eight female patients with DCIS were identified from a prospective database: 60 patients (62 cases) had preoperative breast MRI, and 98 patients did not have MRI. The accuracy of tumor size assessed by MRI was determined by comparison with histopathologic size. All patients underwent BCS initially. The rate of involved margins after resection was compared in MRI and no‐MRI groups. The overall correlation between MRI size and histopathologic size was high (p < 0.0001). MRI assessment of size was significantly more accurat...

Multivariate analysis of sexual size dimorphism in local turkeys (Meleagris gallopavo) in Nigeria

Tropical Animal Health and Production — Thu, 29 Dec 2011 06:42:36 +0100

Abstract Sexual size dimorphism is a key evolutionary feature that can lead to important biological insights. To improve methods of sexing live birds in the field, we assessed sexual size dimorphism in Nigerian local turkeys (Meleagris gallopavo) using multivariate techniques. Measurements were taken on 125 twenty-week-old birds reared under the intensive management system. The body parameters measured were body weight, body length, breast girth, thigh length, shank length, keel length, wing length and wing span. Univariate analysis revealed that toms (males) had significantly (P < 0.05) higher mean values than hens (females) in all the measured traits. Positive phenotypic correlations between body weight and body measurements ranged from 0.445 to 0.821 in toms and 0....

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Adjuvant Therapy for Breast Cancer

Springer Medicine titles — Wed, 28 Dec 2011 12:07:20 +0100

series:Cancer Treatment and ResearchAdjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable."The adjuvant treatment ... (Source: Springer Medicine titles)

Pathological aspects of the intraductal spread of breast cancer.

Breast Cancer — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Ohtake T, Yasuda M, Ito J, Watanabe K, Gonda K, Abe N, Ishii M, Sato Y, Momma T, Takenoshita S Abstract The intraductal spread of breast cancer is a major cause of local recurrence following breast-conserving therapy. To properly understand this pathology, three-dimensional (3D) cancer localization within the mammary ductal-lobular system (MDLS) is necessary. To this end we generated computer-assisted 3D reconstructions of all MDLSs using 2-mm-thick serial sections of surgically resected specimens. We then analyzed the characteristics of intraductal spread of breast cancer. In our study of quadrantectomy specimens from patients with primary invasive breast carcinoma, the intraductal spread of breast cancer was found to be continuous from the invasive tumor and spreading al...

The detection of pCR after PST by contrast-enhanced ultrasonography for breast cancer.

Breast Cancer — Wed, 28 Dec 2011 05:00:00 +0100

CONCLUSION: Contrast-enhanced ultrasonography is suitable for the preoperative examination, especially after PST, to determine the resection margin before breast-conserving surgery and detects pCR, which can help to avoid surgical procedures in the future. PMID: 22203579 [PubMed - as supplied by publisher] (Source: Breast Cancer)

Telomere length variation in normal epithelial cells adjacent to tumor: potential biomarker for breast cancer local recurrence

Carcinogenesis — Wed, 28 Dec 2011 05:00:00 +0100

A better understanding of the risk of local recurrence (LR) will facilitate therapeutic decision making in the management of early breast cancers. In the present study, we investigated whether telomere length in the normal breast epithelial cells surrounding the tumor is predictive of breast cancer LR; 152 women who were diagnosed with breast cancer at the Lombardi Comprehensive Cancer Center were included in this nested case–control study. Cases (patients had LR) and controls (patients had no LR) were matched on year of surgery, age at diagnosis and type of surgery. Telomere fluorescent in situ hybridization was used to determine the telomere length using formalin fixed paraffin-embedded breast tissues. Small telomere length variation (TLV), defined as the coefficient variation of t...

Biologically effective dose and breast cancer conservative treatment: is duration of radiation therapy really important?

Breast Cancer Research and Treatment — Tue, 27 Dec 2011 17:03:25 +0100

Abstract To evaluate if biologically effective dose (BED), and in particular the duration of radiation treatment, has an effect on local relapse risk. Between January 2000 and December 2008 a total of 762 patients with T1-2 N0/+ breast cancer was treated with breast-conserving surgery and radiotherapy, with and without hormone therapy and chemotherapy. Adjuvant radiation therapy was administered to a total dose of 60–66 Gy in 30–33 fractions. The computed BEDs were divided in four groups: <43.1, 43.1–44.9, 45.0–46.1, and >46.1 Gy (A–D, respectively). Kaplan–Meier method was used to calculate local relapse rates. Cox regression method was used to identify prognostic factors of local relapse. Evaluated variables were age, tumor histology, tumor siz...

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Effect of Long-Term Music Therapy Intervention on Autonomic Function in Anthracycline-Treated Breast Cancer Patients

Integrative Cancer Therapies — Tue, 27 Dec 2011 05:00:00 +0100

This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviat...

Effect of hospital volume on processes of care and 5-year survival after breast cancer: A population-based study on 25 000 women.

Breast — Mon, 26 Dec 2011 05:00:00 +0100

CONCLUSION: Survival benefits reported in high-volume hospitals suggest a better application of recommended processes of care, justifying the centralization of breast cancer care in such hospitals. PMID: 22204930 [PubMed - as supplied by publisher] (Source: Breast)

Recommendations from an International Consensus Conference on the Current Status and Future of Neoadjuvant Systemic Therapy in Primary Breast Cancer

Annals of Surgical Oncology — Thu, 22 Dec 2011 16:37:01 +0100

Abstract The use of neoadjuvant systemic therapy (NST) for the treatment of primary breast cancer has constantly increased, especially in trials of new therapeutic regimens. In the 1980 s, NST was shown to substantially improve breast-conserving surgery rates and was first typically used for patients with inoperable locally advanced or inflammatory breast cancer. Investigators have since also used NST as an in vivo test for chemosensitivity by assessing pathologic complete response. Today, by using pathologic response and other biomarkers as intermediate end points, results from trials of new regimens and therapies that use NST are aimed to precede and anticipate the results from larger adjuvant trials. In 2003, a panel of representatives from various breast cancer cl...

Comparative Effectiveness of Positron Emission Mammography and MRI in the Contralateral Breast of Women With Newly Diagnosed Breast Cancer

American Journal of Roentgenology — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSION. Contralateral cancer was found in 15 of 367 women (4.1%), with MRI showing 14 (93%). Eleven contralateral cancers (73%) were visible on PEM, but only three (20%) were recognized prospectively as suspicious. Lesions that are visible on PEM should be viewed as suspicious unless known to be benign by prior breast imaging or biopsy. (Source: American Journal of Roentgenology)

Can the risk of secondary cancer induction after breast conserving therapy be reduced using intraoperative radiotherapy (IORT) with low-energy x-rays?

Radiation Oncology — Fri, 16 Dec 2011 05:00:00 +0100

Conclusions: The calculations for maximal doses and volumes of OAR suggest that the risk of secondary cancer induction after IORT is lower than compared to APBI and EBRT. (Source: Radiation Oncology)

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Intraoperative radiotherapy during breast-conserving surgery using a miniature x-ray generator (Intrabeam®): theoretical and experimental background and clinical experience

Future Medicine: Women's Health — Thu, 15 Dec 2011 16:11:46 +0100

Women's Health , January 2012, Vol. 8, No. 1, Pages 39-47. (Source: Future Medicine: Women's Health)

Preoperative CT evaluation of intraductal spread of breast cancer and surgical treatment.

Breast Cancer — Sat, 10 Dec 2011 05:00:00 +0100

Authors: Akashi-Tanaka S Abstract It is always a challenge to accurately determine the appropriate extent of resection in breast-conserving surgery (BCS), in order to reduce the need for re-excision, prevent local recurrence, and optimize cosmetic results. Detecting intraductal spread alone with high sensitivity may not be enough to realize safe BCS. Computed tomography carried out with the patient in the supine position accompanied by adequate marking is effective for preoperative determination of the optimum extent of BCS. PMID: 22161276 [PubMed - as supplied by publisher] (Source: Breast Cancer)

A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial

Journal of Cancer Survivorship — Fri, 09 Dec 2011 17:09:01 +0100

Conclusions With this early exercise intervention after breast cancer diagnosis, a significant improvement was achieved in physical function, with no decline in health-related quality of life or detrimental effect on arm volume. Implications for cancer survivors Starting a supervised exercise regimen that is tailored to an individual's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning. Content Type Journal ArticlePages 1-10DOI 10.1007/s11764-011-0208-4Authors Roger T. Anderson, Department of Public Health Sciences, College of Medicine, Penn State Milton S. Hershey Medical Center, 600 Centerview Drive, Suite 2200, P.O. Box 855, Hershey, PA 17033-0855, USAGretchen G...

Clinical review - Breast adenoid cystic carcinoma.

Breast — Fri, 09 Dec 2011 05:00:00 +0100

CONCLUSIONS: ACC of the breast has a favourable prognosis. An accurate diagnosis and appropriate treatment are therefore important. PMID: 22154460 [PubMed - as supplied by publisher] (Source: Breast)

Breast Conservation Versus Mastectomy in Triple-Negative Breast Cancer: Two Steps Forward, One Step Back? [CORRESPONDENCE]

Journal of Clinical Oncology — Thu, 08 Dec 2011 05:00:00 +0100

(Source: Journal of Clinical Oncology)

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Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype

Breast Cancer Research and Treatment — Tue, 06 Dec 2011 16:59:09 +0100

Abstract Molecular subtyping confirms that breast cancer comprises at least four genetically distinct entities based on the expression of specific genes including estrogen receptor (ER), progesterone receptor (PR), and HER2/neu receptor. The quantitative influence of subtype on ipsilateral locoregional recurrence (LRR) is unknown. The aim of this study was to systematically appraise the influence of breast cancer subtype on LRR following breast conserving therapy (BCT) and mastectomy. A comprehensive search for studies examining outcomes after BCT and/or mastectomy according to breast cancer subtype was performed using Medline and cross-referencing available data. Reviews of each study were conducted and data extracted to perform meta-analysis. Primary outcome was LRR relat...

Long-term results of breast conservation and immediate volume replacement with myocutaneous latissimus dorsi flap.

World Journal of Surgical Oncology — Mon, 05 Dec 2011 05:00:00 +0100

Conclusion: This oncoplastic volume replacement technique obtained a good local control and satisfactory and stable aesthetic results which have maintained unchanged after a long period of time. (Source: World Journal of Surgical Oncology)

Dosimetric evaluation of conventional radiotherapy, 3‐D conformal radiotherapy and direct machine parameter optimisation intensity‐modulated radiotherapy for breast cancer after conservative surgery

Australasian Radiology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: In WBI of breast cancer after conservative surgery, 3DCRT and DMPO‐IMRT improved the homogeneity and conformity of the PTV compared with CR. Meanwhile, 3DCRT reduced the irradiated volumes of OARs at all dose levels listed in our study while DMPO‐IMRT reduced the irradiated volumes of OARs in high‐dose areas but increased the irradiated volumes of OARs in low‐dose areas. (Source: Australasian Radiology)

[Neoadjuvant treatment of breast cancer: Implications for the pathologist].

Annales de Pathologie — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Le Guellec S, Perallon R, Alunni JP, Charitansky H, Leaha C, Gonzalez AM, Chateau MC, Simony-Lafontaine J, Jacot W, Gutowski M, Penault-Llorca F, Dalenc F, Lacroix-Triki M Abstract These past few years, neoadjuvant strategy has taken an increasing place in the management of breast cancer patients. This strategy is mainly indicated to obtain a tumour bulk regression allowing a breast conserving surgery in patients that otherwise would have undergone mastectomy. Of note, development of new chemotherapy agents and targeted therapies has critically helped in the progress of neoadjuvant strategy as it is currently associated with better pathological response rates. In this context, the pathologist is at the crossroad of this multidisciplinary process. First, he provides on the ...

Preoperative taxane‐based chemotherapy in a standardized protocol for locally advanced breast cancer

Asia-Pacific Journal of Clinical Oncology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: This regimen of TAC is effective and well‐tolerated and is likely to result in improved outcomes since patients can receive optimal multimodality treatments. (Source: Asia-Pacific Journal of Clinical Oncology)

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Methylene Blue Dye-Related Changes in the Breast After Sentinel Lymph Node Localization

Journal of Ultrasound in Medicine — Mon, 28 Nov 2011 05:00:00 +0100

Conclusions— After sentinel lymph node localization using methylene blue dye, breast sonography can show unexplained focal lesions in the periareolar and retroareolar regions. Although most of the changes suggest fat necrosis, an irregular parenchymal mass can develop and mimic a recurrence. (Source: Journal of Ultrasound in Medicine)

Surgical treatment of early stage breast cancer in elderly: an international comparison

Breast Cancer Research and Treatment — Sat, 26 Nov 2011 16:48:55 +0100

This study showed large international differences in treatment of elderly early stage breast cancer patients, with the most striking result the large proportion of elderly who did not undergo surgery at all. Despite large treatment differences, survival does not seem to be affected in a major way. Content Type Journal ArticleCategory EpidemiologyPages 1-8DOI 10.1007/s10549-011-1892-5Authors M. Kiderlen, Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The NetherlandsE. Bastiaannet, Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The NetherlandsP. M. Walsh, National Cancer Registry, Cork, IrelandN. L. Keating, Brigham and Women’s Hospital and Harvard Medical School, Boston, USAS. Schrodi, Munich Can...

Twenty-five year results of the national cancer institute randomized breast conservation trial

Breast Cancer Research and Treatment — Wed, 23 Nov 2011 17:36:16 +0100

Abstract Breast conservation therapy (BCT) consisting of lumpectomy and postoperative radiation has become an accepted alternative to mastectomy (MRM) for the treatment of early stage breast cancer. We currently report the 25 year outcomes of a single institution, prospective, randomized clinical trial at the National Cancer Institute. 237 women with pathologically confirmed invasive breast tumors 5 cm or less were accrued between 1979 and 1987 and randomized to receive either BCT or MRM. Overall survival was the primary endpoint. Patients with node positive disease were included and treated with doxorubicin and cyclophosphamide. Both arms received axillary dissection. BCT patients had radiation to the whole breast followed by a boost. At a median follow-up of 25...

BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ.

Breast Cancer — Wed, 23 Nov 2011 05:00:00 +0100

Authors: Tozaki M Abstract There has been dramatic progress in MRI technology during the past 20 years, and the rate of detection and diagnostic accuracy in regard to intraductal carcinoma and ductal carcinoma in situ (DCIS) have been increasing. First, we present MRI images of intraductal carcinomas and the terminology in the second edition of the BI-RADS-MRI to describe them. Next, we examined the data in our institution in regard to the following: (1) the DCIS detection rate, (2) the proportions of breast cancer and DCIS in MR-guided vacuum-assisted biopsies (VAB), (3) evaluation of the extent of intraductal carcinoma, and (4) diagnosis of extension of intraductal carcinoma into the nipple. MR images were acquired by performing a 1-min interval dynamic study with a 1.5-T MR sca...

The effect of introducing an in-theatre intra-operative specimen radiography (IOSR) system on the management of palpable breast cancer within a single unit.

Breast — Wed, 23 Nov 2011 05:00:00 +0100

CONCLUSION: Introduction of IOSR significantly reduced specimen weights without increasing re-excision rates. As volume of breast tissue removed is the most significant determinant of cosmetic outcome following breast-conserving surgery, the use of IOSR should be advocated in the surgical management of palpable breast cancer. PMID: 22119488 [PubMed - as supplied by publisher] (Source: Breast)

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Implications of HER2 Amplification in Small, Node-Negative Breast Cancers: Do Asians Differ?

World Journal of Surgery — Tue, 22 Nov 2011 06:56:28 +0100

Conclusions The decision to use trastuzumab in HER2-amplified pT1ab tumors must balance their poor outcome against intrinsic financial limitations in LMCs. Patient selection criteria needs fine-tuning, and resource-sensitive regimens must be explored. Content Type Journal ArticlePages 1-8DOI 10.1007/s00268-011-1353-7Authors Fuh Yong Wong, Department of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 SingaporeConnie Siew Poh Yip, Department of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 SingaporeEu Tiong Chua, Department of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore Journal World Journal of SurgeryOnline ISSN 1432-2...

Structural Estimates of Treatment Effects on Outcomes Using Retrospective Data: An Application to Ductal Carcinoma In Situ

Medical Care Research and Review — Mon, 21 Nov 2011 05:00:00 +0100

Analysis of observational cohort data is subject to bias from unobservable risk selection. The authors compared econometric models and treatment effectiveness estimates using the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare claims data for women diagnosed with ductal carcinoma in situ. Treatment effectiveness estimates for mastectomy and breast-conserving surgery (BCS) with or without radiotherapy were compared using three different models: simultaneous-equations model, discrete-time survival model with unobserved heterogeneity (frailty), and proportional hazards model. Overall trends in disease-free survival (DFS), or time to first subsequent breast event, by treatment are similar regardless of the model, with mastectomy yielding the highest DFS over 8 years of...

New study reveals expensive MRIs pushed on women for breast cancer screening have no medical benefit

NaturalNews.com — Fri, 18 Nov 2011 06:51:52 +0100

(NaturalNews) The use of Magnetic Resonance Imaging, better known simply as MRI, for breast cancer screening is increasing and so is its use in guiding breast surgery when cancer is discovered. Obviously, that means healthcare costs are soaring, too, as more and more women are advised to get MRIs in addition to mammograms. The push started in 2007. At that time, the New York Times reported a breast MRI cost $1,000 to $2,000, and sometimes more -- at least 10 times the cost of mammography. So for every million breast MRIs performed each year, healthcare costs spike by at least a billion dollars. Sometimes, but not always, these test are covered by Medicare and insurance.Of course, despite this enormous cost, the only reason doctors and medical centers would be urging women to have these exp...

Lymphatic mapping after previous breast surgery.

Breast — Fri, 18 Nov 2011 05:00:00 +0100

CONCLUSIONS: Lymphatic mapping seems feasible after previous BCT with axillary treatment, in spite of a relatively low identification rate. Aberrant drainage tends to be more frequent after previous treatment with ALND. PMID: 22104251 [PubMed - as supplied by publisher] (Source: Breast)

[Comment] Radiotherapy and survival in breast cancer

LANCET — Sat, 12 Nov 2011 05:00:00 +0100

Nearly 11 000 patients with early-stage breast cancer treated with breast-conserving surgery have participated in prospective phase 3 trials assessing the benefits of postoperative radiation to the breast. In The Lancet, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) update their meta-analysis of long-term outcome in these patients. They report that radiotherapy leads to significant clinical benefits, with an overall 16% absolute decrease (19% vs 35%) in the risk of breast cancer recurrence and a 4% absolute decrease (21% vs 25%, p<0·0001) in the risk of dying from breast cancer. (Source: LANCET)

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[Articles] Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials

LANCET — Sat, 12 Nov 2011 05:00:00 +0100

We describe the absolute magnitude of these reductions according to various prognostic and other patient characteristics, and relate the absolute reduction in 15-year risk of breast cancer death to the absolute reduction in 10-year recurrence risk.MethodsWe undertook a meta-analysis of individual patient data for 10 801 women in 17 randomised trials of radiotherapy versus no radiotherapy after breast-conserving surgery, 8337 of whom had pathologically confirmed node-negative (pN0) or node-positive (pN+) disease. (Source: LANCET)

The Role of Lapatinib in the Preoperative Therapy of Breast Cancer

Current Oncology Reports — Tue, 08 Nov 2011 19:12:28 +0100

Abstract Preoperative or neoadjuvant chemotherapy is a well-established modality in the treatment of nonmetastatic breast cancer. Patients initially considered inoperable may be able to achieve operable status after preoperative chemotherapy and patients initially considered not to be candidates for breast conservation may convert to breast conservation status. Human epidermal growth factor receptor 2 (Her2)–positive tumors have been shown to have a more aggressive course including early local relapse and metastasis when compared to Her2-negative breast cancers, but the optimal use of Her2-targeted agents is constantly evolving as new agents become available. Preoperative studies allow us to quickly assess the activity of new agents and combinations for particular biolog...

Dosimetric comparison of three different external beam whole breast irradiation techniques.

Advances in Therapy — Tue, 08 Nov 2011 05:00:00 +0100

CONCLUSIONS: 2D-RT could not be performed safely on the intact breast in any of the subgroups. FiF-IMRT is a superior technique for breast dosimetry, and normal tissue. For patients with large breast size or separation, further intensive techniques must be investigated. PMID: 22076811 [PubMed - as supplied by publisher] (Source: Advances in Therapy)

Influence of uncommon histology on breast conservation therapy for breast cancer‐biology dictates technique?

Journal of Surgical Oncology — Mon, 07 Nov 2011 05:00:00 +0100

ConclusionsPatients with uncommon breast cancer histologies show wide variation in the application of BCT depending on the primary tumor. This suggests that an individualized approach in the use of BCT depending on histology should be used. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Developing and measuring a set of process and outcome indicators for breast cancer.

Breast — Fri, 04 Nov 2011 04:00:00 +0100

CONCLUSION: The present study demonstrates the feasibility to develop a multidisciplinary set of quality indicators for breast cancer. Using national cancer registry data linked to claims data, 13 indicators were measurable, showing results that largely correspond to other studies in the field. PMID: 22056787 [PubMed - as supplied by publisher] (Source: Breast)

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Excessive Resections in Breast‐Conserving Surgery: A Retrospective Multicentre Study

The Breast Journal — Tue, 01 Nov 2011 04:00:00 +0100

This study clearly shows that BCS is associated with excessive resection of healthy breast tissue while clear margins are not assured. Surgical factors should be modified to improve surgical accuracy. (Source: The Breast Journal)

ACR Appropriateness Criteria® Ductal Carcinoma in Situ

The Breast Journal — Tue, 01 Nov 2011 04:00:00 +0100

This article reviews the existing scientific evidence, the controversies surrounding local management, and clinical guidelines for DCIS based on the group consensus by the ACR Breast Expert Panel. The American College of Radiology Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer‐reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatm...

BRCA Mutation Testing in Determining Breast Cancer Therapy.

Cancer Journal — Tue, 01 Nov 2011 04:00:00 +0100

This article reviews surgical options for management of affected BRCA mutation carriers with emphasis on the risks of ipsilateral recurrence and contralateral breast cancer. The roles of breast-conserving surgery, prophylactic mastectomy, and oophorectomy are reviewed. In addition, the sensitivity of BRCA mutation-associated breast cancer to endocrine therapy, platinum chemotherapy, and poly (ADP-ribose) polymerase inhibitors is reviewed. PMID: 22157293 [PubMed - in process] (Source: Cancer Journal)

The effect of junior residents on surgical quality: a study of surgical outcomes in breast surgery

American Journal of Surgery — Mon, 31 Oct 2011 04:00:00 +0100

Conclusions: Junior resident participation in BCT procedures was not associated with higher rates of inadequate margins of excision. Patients can be reassured that junior resident involvement in their BCT operations is safe and effective. (Source: American Journal of Surgery)

Characteristics Associated with the Initiation of Radiation Therapy after Breast-Conserving Surgery among African American and White Women Diagnosed with Early-Stage Breast Cancer in Maryland, 2000–2006

Annals of Epidemiology — Mon, 31 Oct 2011 04:00:00 +0100

Conclusions: Socioeconomic disparities were identified in the initiation of RT after BCS in Maryland from 2000 to 2006. In addition, racial disparities in RT after BCS were apparent for women diagnosed from 2000 to 2003. Additional research is needed to investigate uptake of prescribed treatments after BCS and develop strategies for reducing barriers to obtaining treatments among patients at risk for incomplete cancer care. (Source: Annals of Epidemiology)

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JCOG Radiation Therapy Study Group: History and Achievements

Japanese Journal of Clinical Oncology — Tue, 25 Oct 2011 04:00:00 +0100

The Radiation Therapy Study Group (RTSG) of the Japan Clinical Oncology Group (JCOG) was established in 2003. The missions of this group are to develop new standards of care with innovative, advanced technology radiation therapy, both for single- and multi-modality cancer treatment, and to improve radiation therapy quality and outcomes of JCOG trials conducted by other organ-oriented groups. In 2004, the first RTSG trial, a Phase II study of stereotactic body radiation therapy for Stage IA non-small cell lung cancer (JCOG 0403), was initiated. Four other trials are currently open for accrual. JCOG 0702 is a Phase I study of stereotactic body radiation therapy in patients with T2N0M0 non-small cell lung cancer. JCOG 0701 is a Phase III study comparing accelerated fractionation with conventi...

Postsurgery radiotherapy halves breast cancer recurrence

MedWire News - Oncology — Sat, 22 Oct 2011 00:58:35 +0100

Radiotherapy after breast-conserving surgery halves the rate of breast cancer recurrence in the following 10 years and reduces breast cancer deaths by one sixth in the following 15 years, the Early Breast Cancer Trialists’ Collaborative Group reports. (Source: MedWire News - Oncology)

Radiation reduces cancer recurrence

Health News - UPI.com — Thu, 20 Oct 2011 21:43:13 +0100

OXFORD, England, Oct. 20 (UPI) -- A meta-analysis of 10,000 women found radiation therapy after breast-conserving surgery reduced the rate of recurrence by half, British researchers say. (Source: Health News - UPI.com)

Radiation After Breast-Conserving Surgery Cuts RecurrenceRadiation After Breast-Conserving Surgery Cuts Recurrence

Medscape Today Headlines — Thu, 20 Oct 2011 20:14:39 +0100

Radiotherapy after breast-conserving surgery for breast cancer reduces recurrence by half and breast cancer deaths by one sixth. Medscape Medical News (Source: Medscape Today Headlines)

Radiation Plus Surgery Cuts Risk of Breast Cancer Return

WebMD Health — Thu, 20 Oct 2011 19:45:03 +0100

New research shows that adding radiation therapy to breast-conserving surgery halves the chance that cancer will come back and reduces the risk of dying from breast cancer, when compared to the breast-conserving surgery alone. (Source: WebMD Health)

Radiotherapy Nearly Halves Breast Cancer Recurrence After Breast Conserving Surgery

Health News from Medical News Today — Thu, 20 Oct 2011 15:00:00 +0100

An article published Online First and in an upcoming Lancet reveals that radiotherapy reduces breast cancer recurrence by 50% during the following 10-years after breast conserving surgery and reduces the risk of breast cancer mortality by one sixth over the next 15 years after surgery. In the largest study on this topic to-date, researchers from the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) analyzed data of 10,801 women with breast cancer, following each woman for an average period of 10 years... (Source: Health News from Medical News Today)

A teaspoon of RT helps keep the cancer away

Health Facts and Fears — Thu, 20 Oct 2011 04:00:00 +0100

Radiation following breast conserving surgery for women with smaller cancerous lesions is beneficial in terms of both recurrence and mortality, according to the results of a large meta-analyis of 17 studies published in The Lancet. (Source: Health Facts and Fears)

Do the CMS proposed breast cancer quality measures actually predict improved outcomes?

American Journal of Surgery — Thu, 20 Oct 2011 04:00:00 +0100

Conclusions: We believe the current CMS standards are a reasonable first step at monitoring breast cancer quality of care. Our data suggest that these may be improved by including combination chemotherapy in ER+ disease when data show a net survival benefit over hormonal therapy alone. (Source: American Journal of Surgery)

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Breast Radiation After Lumpectomy Saves Lives: Study

Cancercompass News: Breast Cancer — Thu, 20 Oct 2011 00:00:00 +0100

Recurrence rate halved compared to those who undergo breast-conserving surgery alone, research shows (Source: Cancercompass News: Breast Cancer)

Breast Radiation After Lumpectomy Saves Lives

MedlinePlus Health News — Wed, 19 Oct 2011 23:00:00 +0100

Recurrence rate halved compared to those who undergo breast-conserving surgery alone, research shows Source: HealthDay Related MedlinePlus Pages: Breast Cancer, Mastectomy, Radiation Therapy (Source: MedlinePlus Health News)

Breast Cancer Study: Radiation Slashes Recurrence, Saves Lives (CME/CE)

MedPage Today Hematology/Oncology — Wed, 19 Oct 2011 22:30:00 +0100

(MedPage Today) -- Radiation therapy following breast conserving surgery reduced the rate of disease recurrence by half, a large meta-analysis found. (Source: MedPage Today Hematology/Oncology)

Psychological evaluation of patients after breast cancer surgery and care strategies improvement

The Chinese-German Journal of Clinical Oncology — Tue, 18 Oct 2011 05:52:36 +0100

Conclusion The self-image of patients who underwent different breast cancer surgeries was influenced by different factors, and individualized nursing should be offered in accordance with the specific situation. Content Type Journal ArticlePages 584-587DOI 10.1007/s10330-011-0837-0Authors Yanjun Zhang, Breast Cancer Department, Department of Surgical Oncology, General Surgery, First Hospital of China Medical University, Shenyang, 110001 ChinaCaigang Liu, Breast Cancer Department, Department of Surgical Oncology, General Surgery, First Hospital of China Medical University, Shenyang, 110001 ChinaFeng Jin, Breast Cancer Department, Department of Surgical Oncology, General Surgery, First Hospital of China Medical University, Shenyang, 110001 China Journal The Chine...

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Thoracoscopic internal mammary lymph nodes dissection: a staging tool for internal mammary lymph nodes in breast cancer

The Chinese-German Journal of Clinical Oncology — Tue, 18 Oct 2011 05:52:35 +0100

Conclusion Thoracoscopic IMN lymphadenectomy is a safe procedure, which can be done serious additional complications or cosmetic compromise. And allow proper nodal staging, which allow proper treatment planning. Content Type Journal ArticlePages 580-583DOI 10.1007/s10330-011-0848-xAuthors Waheed Yousry Gareer, Surgical Oncology, National Cancer Institute, Cairo University, Cairo, EgyptHesham Elsebaie, Surgical Oncology, National Cancer Institute, Cairo University, Cairo, EgyptHaytham Gareer, Surgical Oncology, National Cancer Institute, Cairo University, Cairo, EgyptHytham Ahmed, Surgical Oncology, National Cancer Institute, Cairo University, Cairo, EgyptMohamed Wafa, Surgical Oncology, Tanta University Hospital, Tanta, EgyptHussein Soliman, Surgical Oncology, Nation...

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Journal of General Internal Medicine — Tue, 18 Oct 2011 05:48:49 +0100

CONCLUSIONS Annual mammography among women age 65 to 85 with DCIS declines as women get further from diagnosis. Interventions should focus on reducing disparities in the use of initial surveillance mammography, and increasing surveillance over time. Content Type Journal ArticleCategory Original ResearchPages 1-6DOI 10.1007/s11606-011-1918-zAuthors Phyllis Brawarsky, Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women’s Hospital, 1620 Tremont Street, Boston, MA 02120-1613, USABridget A. Neville, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USAGarrett M. Fitzmaurice, Laboratory for Psychiatric Biostatistics, McLean Hospital and Harvard Medical School, Belmont, USAMichael J. Hassett, Center for Outcomes and...

Predictors of Nipple–Areolar Complex Involvement by Breast Carcinoma: Histopathologic Analysis of 787 Consecutive Therapeutic Mastectomy Specimens

Annals of Surgical Oncology — Tue, 18 Oct 2011 05:47:27 +0100

Conclusions On the basis of our findings, we have developed a mathematical model that is based on the extent and location of the tumor, HER2 expression, and nuclear grade that predicts the probability of NAC involvement by breast cancer. This model may aid in preoperative planning in selecting appropriate surgical procedures based on an individual patient’s relative risk of NAC involvement. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2107-3Authors Jianli Wang, Department of Pathophysiology, Shandong University School of Medicine, Shandong, ChinaXiuli Xiao, Department of Pathology, Luzhou Medical College, Luzhou, ChinaJianmin Wang, RTI Health Solution, Research Triangle Park, NC, USANaazneen Iqbal, Departments of Pathology, U...

Age, Comorbidity, and Breast Cancer Severity: Impact on Receipt of Definitive Local Therapy and Rate of Recurrence among Older Women with Early-Stage Breast Cancer

Journal of the American College of Surgeons — Tue, 18 Oct 2011 04:00:00 +0100

Conclusions: Among these older women with early-stage breast cancer, decisions about therapy partially balanced breast cancer severity against age and comorbidity. However, even among women at low risk, omitting definitive local therapy was associated with increased recurrence. (Source: Journal of the American College of Surgeons)

A phase Ib study of preoperative lapatinib, paclitaxel, and gemcitabine combination therapy in women with HER2 positive early breast cancer

Investigational New Drugs — Mon, 17 Oct 2011 16:01:14 +0100

Summary We conducted a phase I trial to determine the feasible dose for lapatinib, a dual HER2/EGFR tyrosine kinase inhibitor, with paclitaxel and gemcitabine as a neoadjuvant treatment in HER2 positive patients. In this phase I dose-escalation study, cohorts of 3–6 HER2-positive operable breast cancer patients received lapatinib (1,000 mg/day or 1,250 mg/day PO) with paclitaxel (80 mg/m2) and gemcitabine (1,000 or 1,200 mg/m2) on days 1 and 8 every 21 days to determine the tolerable dosages. Among 13 patients enrolled, 12 (stage III; n = 11: stage II; n = 1) completed treatment and one withdrew consent. The recommended doses were 1000-mg/day lapatinib, 80-mg/m2 paclitaxel, and 1,000-mg/m2 gemcitabine. One patient developed dose-limiting gra...

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Combination of two local flaps for large defects after breast conserving surgery.

Breast — Thu, 13 Oct 2011 04:00:00 +0100

CONCLUSION: The combined local flap, consisting of a rotational local flap and a TEF is a useful oncoplastic technique for large defects after breast-conserving surgery. PMID: 22000046 [PubMed - as supplied by publisher] (Source: Breast)

Local Recurrence after Breast-Conserving Surgery: Multivariable Analysis of Risk Factors and the Impact of Young Age

Annals of Surgical Oncology — Wed, 12 Oct 2011 05:46:14 +0100

Conclusions Risk factors for LR after BCS include age <40 years, node positivity, ER negativity, and absence of adjuvant radiation therapy. Patients younger than age 40 years are at increased risk of LR after BCS. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2084-6Authors Randy C. Miles, Mayo Medical School, Mayo Clinic, Rochester, MN, USARachel E. Gullerud, Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USAChristine M. Lohse, Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USAJames W. Jakub, Department of Surgery, Mayo Clinic, Rochester, MN, USAAmy C. Degnim, Department of Surgery, Mayo Clinic, Rochester, MN, USAJudy C. Boughey, Department of Surgery, Mayo Clinic, Rochester, M...

High-frequency ultrasound for intraoperative margin assessments in breast conservation surgery: a feasibility study

BMC Cancer — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions: Results from high-frequency ultrasonic measurements of human breast tissue specimens indicate that characteristics in the ultrasonic attenuation, spectra, and cepstra can be used to differentiate between normal, benign, and malignant breast pathologies. (Source: BMC Cancer)

Variation between hospitals in surgical margins after first breast-conserving surgery in the Netherlands

Breast Cancer Research and Treatment — Mon, 10 Oct 2011 15:06:03 +0100

Abstract Surgical margin status after first breast-conserving surgery (BCS) is used as a quality indicator of breast cancer care in the Netherlands. The aim is to describe the variation in surgical margin status between hospitals. 7,345 patients with DCIS or invasive cancer (T1-2,N0-1,M0) diagnosed between July 1, 2008, and June 30, 2009, who underwent BCS as first surgery, were selected from the Netherlands Cancer Registry. Patients were treated in 96 hospitals. Maximum target values were 30% ‘focally positive’ or ‘more than focally positive’ for DCIS and 10% ‘more than focally positive’ for invasive carcinoma. Results per hospital are presented in funnel plots. For invasive carcinoma, multivariate logistic regression was used to adjust for case mix. Overall 2...

The Impact of Re-Excision and Residual Disease on Local Recurrence After Breast Conservation Treatment for Patients With Early Stage Breast Cancer.

Clinical Genitourinary Cancer — Mon, 10 Oct 2011 04:00:00 +0100

CONCLUSIONS: Despite achieving negative final resection margins, the patients with residual disease in the re-excision specimen had a higher rate of local recurrence than patients who underwent single excision or patients without residual disease on re-excision. However, local recurrence was reasonably low in all 3 subgroups, and, therefore, neither re-excision nor residual disease represent contraindications for BCT. PMID: 21993010 [PubMed - as supplied by publisher] (Source: Clinical Genitourinary Cancer)

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Re-excision rate for breast conserving surgery (BCS): A retrospective study

International Journal of Surgery — Thu, 06 Oct 2011 22:52:32 +0100

This study has shown the re-excision rate in the breast unit of a teaching hospital with some risk factors contributing to this rate. (Source: International Journal of Surgery)

Diagnosis and preoperative assessment of invasive lobular carcinoma of the breast: A retrospective audit

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Background: The detection and preoperative assessment of invasive lobular breast carcinoma (ILC) remains a challenge. NICE recommends preoperative MRI prior to breast conserving surgery. This audit examines practice in a District General Hospital and evaluates the role of preoperative MRI. (Source: International Journal of Surgery)

Management of elderly patients with breast cancer

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Background: Optimal management of breast cancer in elderly patients remains unclear. Women aged ≥70 years diagnosed with breast cancer are less likely to undergone surgery and if surgery is performed, they are less likely to recieve breast conserving surgery (BCS) or adjuvant radiotherapy (DXT). (Source: International Journal of Surgery)

How Do I Deal With the Axilla in Patients With a Positive Sentinel Lymph Node?

Current Treatment Options in Oncology — Thu, 06 Oct 2011 15:42:27 +0100

Opinion statement Optimal management of the axilla in a patient with a positive sentinel node biopsy is not yet defined. These patients usually have Breast Conserving Surgery and receive adjuvant systemic therapy and whole breast radiation. Treatment options for the axilla include: • no further surgery with or without radiation • completion axillary nodal dissection with or without radiation Radiation options in addition to whole breast radiation include • axillary and supraclavicular nodal irradiation • regional nodal irradiationincludes supraclavicular and internal mammary nodes Completion axillary dissection has been standard practice in patients with ...

Which Eligible Breast Conservation Patients Choose Mastectomy in the Setting of Newly Diagnosed Breast Cancer?

Annals of Surgical Oncology — Thu, 06 Oct 2011 06:29:19 +0100

Conclusions One in four eligible BCT patients chooses mastectomy. Factors independently associated with choosing mastectomy over BCT include findings of second-site biopsy, previous mastectomy, and absence of comorbidities but not primary tumor characteristics. Further study into a patient’s choice for mastectomy is warranted. Content Type Journal ArticleCategory Breast OncologyPages 1-8DOI 10.1245/s10434-011-2080-xAuthors Cameron D. Adkisson, Department of General Surgery, Mayo Clinic Florida, Jacksonville, USASanjay P. Bagaria, Department of General Surgery, Mayo Clinic Florida, Jacksonville, USAAlexander S. Parker, Department of General Surgery, Mayo Clinic Florida, Jacksonville, USAJillian M. Bray, Department of General Surgery, Mayo Clinic Florida, Jacksonvil...

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Age, Breast Cancer Subtype Approximation, and Local Recurrence After Breast-Conserving Therapy [Breast Cancer]

Journal of Clinical Oncology — Thu, 06 Oct 2011 04:00:00 +0100

Conclusion In the era of systemic therapy and BC subtyping, age remains an independent prognostic factor after BCT. However, the risk of LR for young women appears acceptably low. (Source: Journal of Clinical Oncology)

Ileal metastasis of breast cancer in a patient with a BRCA2 gene mutation: Report of a case

Surgery Today — Tue, 04 Oct 2011 05:59:12 +0100

This report presents a patient diagnosed with breast carcinoma metastasis in the terminal ileum. The patient underwent breast-conserving surgery on both breasts because of breast cancer at the age of 46 years. Both breast cancers were consistent with stage I invasive ductal carcinomas. Colonoscopy during an investigation for hematochezia revealed a 2-cm ulceration in the terminal ileum 22 months later, and microscopic examination of a biopsy specimen of the ulceration revealed a poorly differentiated mass that was strongly suggestive of metastatic adenocarcinoma with endolymphatic tumor emboli. She underwent hand-assisted laparoscopic ileocecectomy because of ileal metastasis. She had a family history of breast cancer (sister) and colon cancer (brother). She exhibited HER2/neu discor...

Surgical treatment of intracystic carcinoma of the breast

World Journal of Surgical Oncology — Tue, 04 Oct 2011 04:00:00 +0100

Conclusion: When it is difficult to diagnose intracystic carcinoma of the breast by fine needle aspiration, active lumpectomy is necessary. Because extramural invasion and lymph node metastasis have been reported, it is necessary to carefully determine the range of excision and rationally perform lymph node dissection, such as sentinel node biopsy. (Source: World Journal of Surgical Oncology)

[Primary systemic therapy in breast cancer patients (2007-2010)].

Magyar Sebeszet — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: NA therapy was effective primarily in decreasing tumour size; however, it was less effective on axillary lymph node metastases. Due to the presence of residual DCIS component, the volume of resection could not have been decreased as much as down-staging of the invasive cancer have permitted. PMID: 21997525 [PubMed - in process] (Source: Magyar Sebeszet)

No survival advantage for mastectomy vs breast conservation therapy.

Oncology (Williston Park, N.Y.) — Sat, 01 Oct 2011 04:00:00 +0100

Authors: PMID: 22106565 [PubMed - in process] (Source: Oncology (Williston Park, N.Y.))

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A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus whole breast irradiation in China

Breast Cancer Research and Treatment — Fri, 30 Sep 2011 05:50:08 +0100

Abstract To compare quality of life (QoL) of early breast cancer patients treated with either accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) after breast-conserving therapy in China. The functional assessment of chronic illness therapy—Breast, traditional Chinese version 4 (FACT-B) instruments were given to 84 women (31 APBI and 53 WBI) who attended the radiotherapy clinic between July 2006 and May 2009 at Cancer Center of Sun Yat-sen University. Baseline characteristics and Karnofsky performance status scores were not different between the two groups. The median follow-up period in the APBI group was 29 versus 34 months in the WBI group. The APBI group scores in the physical domain, functional domain, social domain, and breast-speci...

The Evolution of the Locoregional Therapy of Breast Cancer.

The Oncologist — Thu, 29 Sep 2011 04:00:00 +0100

Authors: Ho A, Morrow M Abstract AbstractBreast-conserving therapy (BCT) and mastectomy have equal survival outcomes. Rates of local recurrence after BCT have declined steadily, largely as a result of the widespread use of systemic therapy. Sentinel node biopsy has replaced axillary dissection for staging the axilla, and in women undergoing BCT with whole-breast irradiation (WBI), axillary dissection is not needed for local control or survival in those with fewer than three involved sentinel nodes. Alternatives to 6 weeks of WBI have been shown to be safe and effective for subsets of breast cancer patients, and the use of preoperative chemotherapy allows BCT in some women who require mastectomy if surgery is the initial step in treatment. The combination of the smaller cancers dete...

The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

Japanese Journal of Clinical Oncology — Wed, 28 Sep 2011 04:00:00 +0100

Conclusions A significant rate of axillary metastases occurred in the patients with T1mi breast carcinoma in this study. The comedo subtype of ductal carcinoma in situ, a high histologic grade, the presence of necrosis and the Van Nuys group 3 were significant predictors of axillary lymph node metastasis in patients with T1mi breast cancer. Thus, the patients with T1mi breast disease are indicated to a careful evaluation of axillary lymph node metastasis, if they have the earlier-mentioned unfavorable factors. (Source: Japanese Journal of Clinical Oncology)

Omission of radiation therapy after breast‐conserving surgery in the United States

Cancer — Tue, 27 Sep 2011 04:00:00 +0100

CONCLUSIONS:The omission of RT after BCS was more common in recent years, especially among women who had an increased risk of breast cancer recurrence. This trend represents a serious health care concern because of the potential increased risk of local recurrence and breast cancer mortality. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

High resolution intra-operative two-dimensional specimen mammography and its impact on second operation for re-excision of positive margins at final pathology after breast conservation surgery

American Journal of Surgery — Mon, 26 Sep 2011 15:52:45 +0100

Abstract: Background: In the United States, about 50% to 66% of women undergoing breast conservation surgery for cancer undergo subsequent mastectomy for positive margins on initial lumpectomy. This is despite the fact that screening mammography has resulted in a decrease in the size of newly diagnosed breast cancer to (Source: American Journal of Surgery)

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Accelerated Hypofractionated Adjuvant Whole Breast Radiotherapy with Concomitant Photon Boost after Conserving Surgery for Early Stage Breast Cancer: A Prospective Evaluation on 463 Patients

The Breast Journal — Wed, 21 Sep 2011 04:00:00 +0100

Abstract: The current standard therapeutic option for early stage breast cancer (EBC) employs a multimodality treatment approach including conservative surgery, radiotherapy, chemotherapy, and hormone therapy. The most common adjuvant radiotherapeutic strategy consists of external beam radiation therapy (EBRT) delivered to the whole breast using 1.8–2 Gy fractions given five times a week, up to a total dose of 45–50 Gy over a period of 5 weeks. In recent years, altered schedules employing larger dose per fraction delivered in fewer treatment sessions over a shorter overall treatment time began to be explored. We herein present clinical data on accelerated hypofractionated adjuvant whole‐breast radiotherapy delivered on a daily basis for a total treatment time of 20 fractions...

Breast-Volume Displacement Using an Extended Glandular Flap for Small Dense Breasts

Computational Intelligence and Neuroscience — Tue, 20 Sep 2011 19:47:23 +0100

Conclusion. This technique is useful for performing the breast-conserving reconstruction of small dense breasts. (Source: Computational Intelligence and Neuroscience)

Supine breast MRI

Journal of Magnetic Resonance Imaging — Fri, 16 Sep 2011 04:00:00 +0100

Conclusion:The presented supine breast MRI achieved an image quality comparable to diagnostic breast MRI. Since supine positioning is common in many clinical applications such as ultrasound‐guided breast biopsy or breast‐conserving surgery, the registration of the supine images will aid these applications. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc. (Source: Journal of Magnetic Resonance Imaging)

Oncoplastic surgery for Japanese patients with breast cancer of the lower pole

Surgery Today — Thu, 15 Sep 2011 15:52:45 +0100

This report presents the results of oncoplastic surgery in three Japanese patients with breast cancer lesions involving the lower pole of the breast. Their breasts were ptotic, and their lesions were considered to be suitable for breast conservation surgery. There were treated with partial mastectomy resection using vertical-scar mammaplasty, with reduction surgery and recentralization of the nipple-areola complex. Two patients underwent a mirror-image biopsy on the contralateral breasts to determine the symmetry. The remaining patient had periareolar incision mastopexy without reduction added for the contralateral breast. A large surgical margin was used to remove excessive skin and parenchymal tissue. Ideal symmetry was achieved by performing reduction and/or mastopexy on the contr...

Disparities in receipt of adjuvant radiation therapy after breast‐conserving surgery among the cancer‐reporting regions of California

Cancer — Wed, 14 Sep 2011 04:00:00 +0100

CONCLUSIONS:Racial disparities in the receipt of RT after BCS exist only in LA, where African American and Hispanic women are less likely to receive this form of adjuvant treatment. Lower SES was also associated with a reduced likelihood of receipt of RT in LA. Women age 70 years and older are less likely to receive RT after BCS in all regions of California. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

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Preoperative radio-chemotherapy in early breast cancer patients: Long-term results of a phase II trial

Radiotherapy and Oncology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusion: Preoperative concurrent administration of RT and CT is an effective regimen. Long-term toxicity is moderate. This association deserves further evaluations in prospective trials. (Source: Radiotherapy and Oncology)

Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial

Radiotherapy and Oncology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed. (Source: Radiotherapy and Oncology)

Immediate Breast Reconstruction After Skin- or Nipple-Sparing Mastectomy for Previously Augmented Patients: A Personal Technique

Aesthetic Plastic Surgery — Sat, 10 Sep 2011 06:12:45 +0100

Conclusion A valid immediate one-stage implant reconstruction can be obtained for previously augmented patients by placing the implant in a submuscular–subfascial pocket reinforced by the periprosthetic capsule of the previous prosthesis. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00266-011-9809-6Authors Marzia Salgarello, Department of Plastic and Reconstructive Surgery, Breast Unit, Catholic University of “Sacro Cuore”—University Hospital “A. Gemelli”, Largo A. Gemelli 8, 00168 Rome, ItalyDario Rochira, Department of Plastic and Reconstructive Surgery, Breast Unit, Catholic University of “Sacro Cuore”—University Hospital “A. Gemelli”, Largo A. Gemelli 8, 00168 Rome, ItalyLiliana Barone-Adesi, Department of Plas...

ASCO Breast: No Survival Advantage for Mastectomy vs Breast Conservation Therapy

Cancer Network — Fri, 09 Sep 2011 12:00:00 +0100

A new study presented at the American Society of Clinical Oncology Breast Cancer Symposium in San Francisco shows that there is no survival difference between having a mastectomy or breast conservation therapy in women under the age of 40. (Source: Cancer Network)

Chemotherapy Is As Effective Before Breast Cancer Surgery As After

Health News from Medical News Today — Fri, 09 Sep 2011 09:00:00 +0100

Whether chemotherapy is given before or after breast-conserving therapy (BCT) does not have an impact on long-term local-regional outcomes, suggesting treatment success is due more to biologic factors than chemotherapy timing, according to a study by researchers at The University of Texas MD Anderson Cancer Center... (Source: Health News from Medical News Today)

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Chemotherapy is as Effective Before Breast Cancer Surgery as After

M. D. Anderson Cancer Center - News Releases — Fri, 09 Sep 2011 04:00:00 +0100

[Treatment of infected breast implant in reconstructive surgery.]

Annales de Chirurgie Plastique et Esthetique — Fri, 09 Sep 2011 04:00:00 +0100

CONCLUSION: This preliminary study provides encouraging results in a selected patient population improving the possibility of a conservative treatment according to a precise and rigourous protocol. PMID: 21908090 [PubMed - as supplied by publisher] (Source: Annales de Chirurgie Plastique et Esthetique)

Young Women With Early Breast Cancer Have Similar Survival With Breast Conservation, Mastectomy

Health News from Medical News Today — Thu, 08 Sep 2011 10:00:00 +0100

Young women with early-stage breast cancer have similar survival rates with a lumpectomy and radiation treatment, known as breast-conservation therapy, as with mastectomy, a new study conducted at the University of Maryland has found. The results of the analysis of nearly 15,000 patients listed in a nationwide cancer registry will be presented at the 2011 Breast Cancer Symposium to be held Sept. 8-11 in San Francisco. Steven J. Feigenberg, M.D... (Source: Health News from Medical News Today)

Chemotherapy is as effective before breast cancer surgery as after

EurekAlert! - Cancer — Thu, 08 Sep 2011 04:00:00 +0100

(University of Texas M. D. Anderson Cancer Center) Whether chemotherapy is given before or after breast-conserving therapy (BCT) does not have an impact on long-term local-regional outcomes, suggesting treatment success is due more to biologic factors than chemotherapy timing, according to a study by researchers at the University of Texas MD Anderson Cancer Center. (Source: EurekAlert! - Cancer)

Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial.

Thu, 08 Sep 2011 04:00:00 +0100

CONCLUSIONS: Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed. PMID: 21907439 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

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Preoperative radio-chemotherapy in early breast cancer patients: Long-term results of a phase II trial.

Thu, 08 Sep 2011 04:00:00 +0100

CONCLUSION: Preoperative concurrent administration of RT and CT is an effective regimen. Long-term toxicity is moderate. This association deserves further evaluations in prospective trials. PMID: 21907436 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Breast-Conserving Therapy Gets Boost for Younger Women

WebMD Health — Wed, 07 Sep 2011 19:02:18 +0100

Younger women with early breast cancer who have breast-conserving surgery do just as well as those who undergo mastectomy, two new studies suggest. (Source: WebMD Health)

For Young Breast Cancer Patients, Breast-Conserving Therapy Appears Effective

MedicineNet Cancer General — Wed, 07 Sep 2011 07:00:00 +0100

Title: For Young Breast Cancer Patients, Breast-Conserving Therapy Appears EffectiveCategory: Health NewsCreated: 9/6/2011 8:06:00 PMLast Editorial Review: 9/7/2011 (Source: MedicineNet Cancer General)

Breast Conservation Therapy in the 21st Century

The Breast Journal — Thu, 01 Sep 2011 04:00:00 +0100

(Source: The Breast Journal)

What are safe margins of resection for invasive and in situ breast cancer?

Oncology (Williston Park, N.Y.) — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Revesz E, Khan SA Abstract Adequate surgical margins in breast-conserving surgery are an important predictor of local recurrence (LR) rates. The definition of tumor-free margins in National Surgical Adjuvant Breast and Bowel Project (NSABP) trials requires that tumor cells do not touch ink, but subsequent retrospective single-institution studies have suggested that wider margins confer greater protection against LR. Particularly wide margins have been proposed for ductal carcinoma in situ. However, wider margin requirements lead to higher re-excision rates, with attendant economic, psychological, and cosmetic costs, and perhaps increased mastectomy rates. Juxtaposed against these concerns about optimal margin width, a meta-analysis of clinical trials has demonstrated the s...

Intraoperative assessment of surgical margins during breast conserving surgery of ductal carcinoma in situ by use of radiofrequency spectroscopy

The Breast — Thu, 01 Sep 2011 04:00:00 +0100

We present results for 22 patients, from those enrolled in our institution. The device was used as an adjunctive tool to current practice. Based on permanent histology reporting, the rate of successful procedures was 86%. The improvement in intraoperative assessment with device use was associated with a reduction in re-excision rates, from 38.8 to 18%. (Source: The Breast)

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Adjuvant trastuzumab reduces locoregional recurrence in women who receive breast‐conservation therapy for lymph node‐negative, human epidermal growth factor receptor 2‐positive breast cancer

Cancer — Wed, 31 Aug 2011 23:00:00 +0100

CONCLUSIONS:Even among women with lower risk breast cancer, the relatively high locoregional failure rates associated with positive HER2 status could be reduced markedly with adjuvant trastuzumab chemotherapy. Within 3 years, a 10% LRR rate without trastuzumab and a 1% LRR rate with trastuzumab were observed in women with lymph node‐negative disease who received BCT. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

Light‐guided lumpectomy: first clinical experience

Journal of Biophotonics — Wed, 31 Aug 2011 23:00:00 +0100

We report on the early use of light‐guided lumpectomy. Eight patients with non‐palpable breast cancer undergoing lumpectomy for biopsy‐proven and radiographically identifiable cancer were enrolled in the study. An optical wire was designed that incorporated a standard hook‐wire with an optical fiber. The optical wire was placed in the same manner as a standard hook‐wire. During light‐guided lumpectomy, an eye‐safe laser illuminated the optical wire and created a sphere of light surrounding the cancer. The light was visible at the beginning of each surgery and facilitated approaching the cancer without using the wire. Dissection around the sphere of light kept the wire tip within the surgical specimen. Three of eight initial surgical specimens had focally positive margins. Add...

Radiation field design and regional control in sentinel lymph node‐positive breast cancer patients with omission of axillary dissection

Cancer — Tue, 30 Aug 2011 23:00:00 +0100

CONCLUSIONS:Regional control was high (99% at 4 years) in patients who had low‐volume SLN disease who did not undergo axillary dissection, regardless of whether the axilla was irradiated. Whole‐breast radiation alone, including in the prone position, is sufficient treatment after breast‐conserving surgery for select patients with tumor‐containing SLNs who omit axillary dissection. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Intraoperative assessment of surgical margins during breast conserving surgery of ductal carcinoma in situ by use of radiofrequency spectroscopy.

Breast — Tue, 30 Aug 2011 04:00:00 +0100