MedWorm: Breast Conservation Surgery

Partial breast irradiation: a review of techniques and indications.

The British Journal of Radiology — Thu, 11 Mar 2010 00:00:00 +0100

Authors: Stewart AJ, Khan AJ, Devlin PM The addition of whole-breast external beam radiotherapy (EBRT) to breast-conserving surgery results in a significant reduction in the risk of death due to breast cancer, but this may be offset by an increase in deaths from other causes and toxicity to surrounding organs. Because of this, and with a view to patterns of local recurrence, irradiation of the tumour bed has been explored in selected patients with early breast cancer using a variety of radiotherapeutic modalities. This review article explores the treatment options for partial breast irradiation and examines their role within the field of breast cancer treatment. PMID: 20223911 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

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Is there a Role for MRI in the Preoperative Assessment of Patients with DCIS?

Annals of Surgical Oncology — Wed, 10 Mar 2010 16:00:55 +0100

Conclusions MRI does not accurately predict extent of disease in patients with extensive DCIS. In patients with MRI tumor size ≤2 cm, MRI may assist in surgical planning. MRI results in patients with DCIS should be interpreted with caution; decision for mastectomy should not be made on MRI findings alone. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-010-1000-9Authors Lisa R. Allen, Drexel University College of Medicine Department of Surgery Philadelphia PA USAClaudia E. Lago-Toro, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAJenevieve H. Hughes, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAEduardo Careaga, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAAnjeanette T. B...

New study questions benefits of elective removal of ovaries during hysterectomy

EurekAlert! - Medicine and Health — Tue, 09 Mar 2010 05:00:00 +0100

(Elsevier Health Sciences) Removal of the ovaries (bilateral oophorectomy) while performing a hysterectomy is common practice to prevent the subsequent development of ovarian cancer. This prophylactic procedure is performed in 55 percent of all US women having a hysterectomy, or approximately 300,000 times each year. An article in the March/April issue of t Philadelphia, PA, March 9, 2010 - Removal of the ovaries (bilateral oophorectomy) while performing a hysterectomy is common practice to prevent the subsequent development of ovarian cancer. This prophylactic procedure is performed in 55% of all U.S. women having a hysterectomy, or approximately 300,000 times each year. An article in the March/April issue of The Journal of Minimally Invasive Gynecology suggests that this procedure may do...

Dose homogeneity in accelerated partial breast irradiation

Radiotherapy and Oncology — Mon, 08 Mar 2010 00:00:00 +0100

Firstly, we would like to thank Dr. Nairz and Sedlmayer for their valuable comments. In our review entitled “Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: A systematic review” different aspects of this new treatment were discussed, e.g. background/rationale, patient inclusion criteria, technical aspects of the various methods, and radiobiological issues. (Source: Radiotherapy and Oncology)

Delaying Post-Surgical Radiation Increases Risk Of Breast Cancer Recurrence In Older Women

Health News from Medical News Today — Thu, 04 Mar 2010 12:00:00 +0100

Older women who have had breast cancer surgery have a greater risk of the cancer returning if they delay their post-surgical radiation treatment, report Dana-Farber Cancer Institute scientists. The study, which involved more than 18,000 women age 65 and older who had breast cancer, found that those who started radiation treatment more than six weeks after breast-conserving surgery were more likely to have a local recurrence than those whose radiation treatment started within six weeks of surgery. The findings are being published online by the British Medical Journal... (Source: Health News from Medical News Today)

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis

BMJ Online First — Wed, 03 Mar 2010 00:08:11 +0100

Objectives To determine if the length of interval between breast conserving surgery and start of radiotherapy affects local recurrence and to identify factors that might be associated with delay in... (Source: BMJ Online First)

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Delayed Radiotherapy After Breast Cancer Surgery Studied

Modern Medicine — Wed, 03 Mar 2010 00:00:00 +0100

For women with breast cancer who have breast-conserving surgery, a delay of more than six weeks until follow-up radiotherapy may increase the risk for cancer recurrence, according to a study published March 2 in BMJ. (Source: Modern Medicine)

[Reflection and Reaction] Radiotherapy, antihormonal therapy, and personalised medicine

The Lancet Oncology — Mon, 01 Mar 2010 00:00:00 +0100

Two of the most important advances in oncology in the past century were the development of breast-conserving surgery plus radiotherapy as an alternative to mastectomy and the use of antihormonal therapy to reduce distant failure. Antihormonal therapy also substantially reduces the risk of local failure after breast-conserving therapy in patients with hormonally responsive tumours. For example, in the National Surgical Adjuvant Breast and Bowel B-14 trial, the 10-year actuarial local failure rate was 11% after radiotherapy alone and 4% after radiotherapy plus tamoxifen; the crude rates were 17% and 8%, respectively, with a median follow-up of 19·9 years. However, information has been scarce about how best to sequence these therapies to maximise their effectiveness and keep toxic effects to...

Survival: Breast Conservation vs. Mastectomy

Ob.Gyn. News — Mon, 01 Mar 2010 00:00:00 +0100

SAN ANTONIO — Breast conservation therapy resulted in significantly better 5-year overall survival, compared with mastectomy, investigators found in a study of 202 patients with triple receptor–negative breast cancer. (Source: Ob.Gyn. News)

Bilateral Oophorectomy versus Ovarian Conservation: Effects on Long-term Women's Health

The Journal of Minimally Invasive Gynecology — Mon, 01 Mar 2010 00:00:00 +0100

Abstract: Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced to prevent the subsequent development of ovarian cancer. Currently, bilateral oophorectomy is performed in 55% of all U.S. women having a hysterectomy, with approximately 300 000 prophylactic oophorectomies performed every year. Observational studies show that estrogen deficiency, resulting from premenopausal or postmenopausal oophorectomy, is associated with higher risks of coronary artery disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression, and anxiety. These studies suggest that bilateral oophorectomy may do more harm than good. In women not at high risk for development of ovarian or breast cancer, removing the ovaries at the time of hysterectomy shou...

Med Sci Monit 2010; 16(3):CS33-39 "Conservative treatment of a rare case of multifocal adenoid cystic carcinoma of the breast: Case report and literature review"

Medical Science Monitor — Fri, 26 Feb 2010 19:37:00 +0100

Conclusions: There is no consensus on the optimal management of this disease. A breast-conserving approach may be recommended even if mastectomy has been traditionally the treatment of choice. Chemotherapy, radiation, and hormonal therapy have been infrequently used and so far have had no defined role in this kind of neoplasm. The authors found no other reports in the literature focusing on a conservative approach to multifocal adenoid cystic carcinoma. (Source: Medical Science Monitor)

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[Recurrence and survival after breast-conserving treatment of breast cancer.]

Tidsskrift for den Norske Laegeforening — Thu, 25 Feb 2010 00:00:00 +0100

The objective of this retrospective study was to determine, within one institution, local relapse rate and survival for women with early-stage breast cancer treated with breast-conserving surgery followed by radiotherapy. Material and methods. All women with infiltrating early-stage breast cancer who underwent post-operative whole breast irradiation at our institution in the period 14.06.99-8.03.2002 were included in the study. A CT-based 3D dose calculation was performed in all patients. Results. 222 women received 50 Gy whole-breast irradiation after breast-conserving surgery in the study period. 51 patients received adjuvant systemic therapy according to national guidelines. Median age at diagnosis was 59 years (34-82 years). Median tumour size was 12 mm (1-30 mm) and 86.5 % of the pati...

Fine-needle aspiration of metastatic radiation-induced cutaneous epithelioid angiosarcoma of the breast to the liver: A diagnostic dilemma

Diagnostic Cytopathology — Wed, 24 Feb 2010 00:00:00 +0100

We present a case of metastatic radiation-induced cutaneous epithelioid angiosarcoma of the breast to the liver and a review of the literature. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

Radiotherapy and Oncology — Wed, 24 Feb 2010 00:00:00 +0100

Conclusions: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized clinical trial outcome data become available. Furthermore they should promote further clinical research focusing on controversial issues in the treatment of early-stage breast carcinoma. (Source: Radiotherapy and Oncology)

Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study

Radiotherapy and Oncology — Wed, 24 Feb 2010 00:00:00 +0100

Conclusions: Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects. (Source: Radiotherapy and Oncology)

Management of Operable Invasive Breast Cancer in Women Over the Age of 70: Long-Term Results of a Large-Scale Single-Institution Experience

Annals of Surgical Oncology — Tue, 23 Feb 2010 07:57:27 +0100

Conclusions Elderly patients with operable breast cancer who are completely and correctly treated with realistic treatment options that are based on surgery and adjuvant radiotherapy have a similar chance of being cured as younger patients. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-010-0967-6Authors Fatima Laki, Institut Curie Department of Surgery Paris FranceYoulia M. Kirova, Institut Curie Department of Radiation Oncology Paris FranceAlexia Savignoni, Institut Curie Department of Statistics Paris FranceFrancois Campana, Institut Curie Department of Radiation Oncology Paris FranceBeatrice Levu, Institut Curie Department of Medical Information Paris FranceMarc Estève, Institut Curie Department of Anaesthesiology Paris FranceBrigitte Sig...

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Cyclooxygenase-2 Inhibition Does Not Improve the Reduction in Ductal Carcinoma In situ Proliferation with Aromatase Inhibitor Therapy: Results of the ERISAC Randomized Placebo-Controlled Trial.

Clinical Breast Cancer — Tue, 23 Feb 2010 00:00:00 +0100

CONCLUSIONS: Exemestane reduces proliferation in ER-positive DCIS. Aromatase inhibition is a potential alternative to tamoxifen in patients who have undergone breast conservation for ER-positive DCIS. Clin Cancer Res; 16(5); 1605-12. PMID: 20179229 [PubMed - as supplied by publisher] (Source: Clinical Breast Cancer)

Management of breast cancer: basic principles

Surgery (Medicine Publishing) — Mon, 22 Feb 2010 16:03:44 +0100

Abstract: Breast cancer is the commonest cancer in the United Kingdom. Its incidence is increasing and although mortality from the disease is decreasing it still accounts for over 10,000 deaths a year. All women referred with breast symptoms should undergo triple assessment with clinical examination, radiological imaging and a biopsy of any abnormality found. The treatment of patients with breast cancer should be multidisciplinary and all patients should be discussed and treatment plans formulated at regular multidisciplinary meetings. Patients with breast cancer are usually treated surgically and may have a range of surgical options open to them, although for the majority this will involve breast-conserving surgery or mastectomy. A lymph node staging procedure is also performed for invasi...

The effect of high intensity focused ultrasound ablation of human breast cancer

Surgery — Mon, 22 Feb 2010 16:02:39 +0100

To the Editors: The local therapy of breast cancer has evolved from Halstedian radical mastectomy in the late 19th century (1891), modified radical mastectomy (Patey), breast conserving surgery (Fisher) through the 20th century to the current investigational and less invasive procedures such as cryotherapy, focused ultrasound, and radiofrequency ablation, etc. The main concerns and the remaining unsettled issues of these less invasive modalities of the treatment are the uncertainty of the extent (margin) of the lesion treated effectively and the viability of the tumor cells left potentially in the residual tissue afterward. The article “Increased infiltration of activated tumor-infiltrating lymphocytes after high intensity focused ultrasound ablation of human breast cancer,” by Lu et ...

Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors

Annals of Oncology — Mon, 22 Feb 2010 13:25:35 +0100

Conclusions: Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotected. (Source: Annals of Oncology)

Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009).

Mon, 22 Feb 2010 00:00:00 +0100

CONCLUSIONS: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized clinical trial outcome data become available. Furthermore they should promote further clinical research focusing on controversial issues in the treatment of early-stage breast carcinoma. PMID: 20181402 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

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Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study.

Mon, 22 Feb 2010 00:00:00 +0100

CONCLUSIONS: Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects. PMID: 20181401 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Simultaneous integrated boost in breast conserving treatment of breast cancer: A dosimetric comparison of helical tomotherapy and three-dimensional conformal radiotherapy

Radiotherapy and Oncology — Mon, 22 Feb 2010 00:00:00 +0100

Abstract: Background and purpose: To evaluate the dosimetry of helical tomotherapy (HT) and three-dimensional conformal radiotherapy (3D-CRT) in breast cancer patients undergoing whole breast radiation with simultaneous integrated boost (SIB) of the tumor bed.Material and methods: Thirteen patients with breast cancer treated by lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned using both HT and 3D-CRT using the field-in-field technique. The whole breast and tumor bed were prescribed 50.68Gy and 64.4Gy, respectively, in 28 fractions. Dosimetries for both techniques were compared.Results: Coverage of the whole breast was adequate with both techniques (V95%=96.22% vs. 96.25%, with HT and 3D-CRT, respectively; p=0.64). Adequate tumor bed coverage was also ach...

Limited benefit of inversely optimised intensity modulation in breast conserving radiotherapy with simultaneously integrated boost

Radiotherapy and Oncology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions: In breast-conserving RT, results obtained with 3D-CRT-SIB and IMRT-SIB are generally comparable. Patient characteristics could be used to identify patients that are most likely to benefit from IMRT-SIB. (Source: Radiotherapy and Oncology)

Scientists At Harvard University, Dana-Farber Cancer Institute Report Research In Breast Cancer Clinical Trial

Cancercompass News: Breast Cancer — Sat, 20 Feb 2010 00:00:00 +0100

New investigation results, 'Innovations in radiation therapy (RT) for breast cancer,' are detailed in a study published in Breast. The EBCTCG has clearly demonstrated that the use of RT after either breast conserving surgery (BCS) or after mastectomy in node-positive patients not only reduces local recurrence (LR), but also improves long-term survival. (Source: Cancercompass News: Breast Cancer)

COMICE Results on MRI Before Breast-Conserving Surgery

Medscape Medical News Headlines — Fri, 19 Feb 2010 13:31:28 +0100

Adding magnetic resonance imaging (MRI) to the work-up of breast cancer patients scheduled for wide local excision did not reduce the need for repeat surgery. Medscape Medical News (Source: Medscape Medical News Headlines)

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Simultaneous integrated boost in breast conserving treatment of breast cancer: A dosimetric comparison of helical tomotherapy and three-dimensional conformal radiotherapy.

Thu, 18 Feb 2010 00:00:00 +0100

CONCLUSIONS: In breast cancer treated with SIB, both HT and 3D-CRT provided adequate target volume coverage and low heart doses. Tumor bed coverage was slightly lower with HT, but HT avoided unnecessary breast overdosage while improving ipsilateral lung dosimetry. PMID: 20171752 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Limited benefit of inversely optimised intensity modulation in breast conserving radiotherapy with simultaneously integrated boost.

Thu, 18 Feb 2010 00:00:00 +0100

CONCLUSIONS: In breast-conserving RT, results obtained with 3D-CRT-SIB and IMRT-SIB are generally comparable. Patient characteristics could be used to identify patients that are most likely to benefit from IMRT-SIB. PMID: 20171751 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Association of single nucleotide polymorphisms in ATM, GSTP1, SOD2, TGFB1, XPD and XRCC1 with clinical and cellular radiosensitivity.

Wed, 17 Feb 2010 00:00:00 +0100

CONCLUSIONS: It is most likely that risk for radiation-induced fibrosis can be assessed by a combination of risk alleles. This finding needs to be replicated in further studies. PMID: 20170971 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Angiosarcoma after breast-conserving therapy

Cancer — Tue, 16 Feb 2010 00:00:00 +0100

With breast-conserving therapy (BCT) as the standard of care for patients with noninvasive and early stage invasive breast cancer, a small incidence of post-BCT angiosarcoma has emerged. The majority of therapeutic interventions have been unsuccessful. To the authors' knowledge, there is no consensus in the medical literature to date regarding the treatment of this malignancy. The current study was conducted to report the long-term outcomes of a novel approach using hyperfractionated and accelerated radiotherapy (HART) for angiosarcoma developing after BCT.The authors retrospectively reviewed the outcomes of 14 patients treated with HART with or without surgery at the University of Florida between November 1997 and March 2006 for angiosarcoma that developed after BCT.At the time of last fo...

Web-based nomogram predicts ipsilateral breast tumor risk with varied accuracy

MedWire News - Oncology — Mon, 15 Feb 2010 13:48:10 +0100

IBTR! version 2.0, a web-based predictive nomogram for ipsilateral breast tumor recurrence after breast conserving therapy, accurately predicts IBTR risk in most low-to-moderate risk patients but still overestimates risk in a minority of patients with higher risk features, research shows. (Source: MedWire News - Oncology)

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Web-based nomogram predicts ipsilateral breast tumor risk with varied accuracy

MedWire News - Breast Cancer — Mon, 15 Feb 2010 00:00:00 +0100

Skin-Sparing Mastectomy and Immediate Breast Reconstruction in the Management of Locally Recurrent Breast Cancer

Annals of Surgical Oncology — Fri, 12 Feb 2010 07:20:53 +0100

Conclusion IBR is a possible treatment option for patients who develop local recurrence following earlier BCT. Our local re-recurrence rate of 10% compares well with that following salvage mastectomy for IBTR. Of patients, 43% did not actually meet our selection criteria but yet appeared to fare well in terms of outcome. Therefore we should re-evaluate our selection criteria. Content Type Journal ArticleCategory Reconstructive OncologyDOI 10.1245/s10434-010-0957-8Authors A. J. Lindford, Helsinki University Central Hospital Department of Plastic Surgery and Breast Surgery Unit Helsinki FinlandT. J. Meretoja, Helsinki University Central Hospital Department of Plastic Surgery and Breast Surgery Unit Helsinki FinlandK. A. J. von Smitten, Helsinki University Central Hospit...

Shorter Radiation Course Matches Standard for Breast Cancer (CME/CE)

MedPage Today Hematology/Oncology — Thu, 11 Feb 2010 13:13:06 +0100

Breast cancer patients had similar 10-year recurrence rates and cosmetic outcomes whether they were treated with accelerated, hypofractionated whole-breast irradiation or conventional radiotherapy after breast-conserving surgery, a long-term follow-up from a randomized study showed. (Source: MedPage Today Hematology/Oncology)

Clarifying the Role of Neoadjuvant Therapy in Breast Cancer

Cancer Network — Thu, 11 Feb 2010 12:00:00 +0100

Large clinical trials have demonstrated that preoperative therapy for primary operable breast cancer improves breast-conservation rates, with equivalent disease-free (DFS) and overall survival (OS) compared to adjuvant therapy.[1] Connolly and Stearns provide an excellent review of additional benefits of neoadjuvant therapy and emphasize the importance of a multidisciplinary approach to treating patients in this setting. (Source: Cancer Network)

A Multidisciplinary Approach to Neoadjuvant Therapy for Primary Operable Breast Cancer

Cancer Network — Thu, 11 Feb 2010 12:00:00 +0100

Neoadjuvant therapy may provide advantages to some women with primary operable breast cancer. Compared to the administration of the same regimen in the adjuvant setting, neoadjuvant chemotherapy does not improve survival outcomes, but may provide other benefits. Neoadjuvant therapy is associated with improved rates of breast-conserving therapy, may offer prognostic information, and enables assessment of in vivo response to therapy. (Source: Cancer Network)

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[Radiation-induced breast angiosarcoma following breast-conserving therapy. Report of two cases.]

Gynecologie, Obstetrique & Fertilite — Thu, 11 Feb 2010 00:00:00 +0100

We report two cases of radiation-induced breast angiosarcoma in two patients having benefited from breast conserving surgery with radiation. We shall put emphasis on the etiopathogeny of these tumours and their clinical and therapeutic aspects. PMID: 20153679 [PubMed - as supplied by publisher] (Source: Gynecologie, Obstetrique & Fertilite)

Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer

New England Journal of Medicine — Wed, 10 Feb 2010 00:00:00 +0100

In this study, two groups of patients received either hypofractionated radiation or a standard schedule of radiation treatment. Ten years later, the two groups had similar risks of local recurrence and a similar appearance of the breast. (Source: New England Journal of Medicine)

Study Supports Accelerated Whole-Breast Irradiation

Modern Medicine — Wed, 10 Feb 2010 00:00:00 +0100

Whole-breast irradiation spread over fewer days (accelerated, hypofractionated radiation) following breast-conserving surgery for cancer appears non-inferior to standard radiation treatment, according to research published in the Feb. 11 issue of the New England Journal of Medicine. This adds to a study recently released Online First in The Lancet Oncology, which showed that hypofractionated radiotherapy for breast cancer patients may provide a better quality of life with no evidence of an increase in adverse effects. (Source: Modern Medicine)

Breast Conservation Treatment With Radiation: An Ongoing Success Story [EDITORIALS]

Journal of Clinical Oncology — Mon, 08 Feb 2010 23:01:39 +0100

(Source: Journal of Clinical Oncology)

Validation of a Web-Based Predictive Nomogram for Ipsilateral Breast Tumor Recurrence After Breast Conserving Therapy [Breast Cancer]

Journal of Clinical Oncology — Mon, 08 Feb 2010 23:01:39 +0100

Conclusion IBTR! version 2.0 is accurate in the majority of patients with a low to moderate risk of in-breast recurrence. The nomogram still overestimates risk in a minority of patients with higher risk features. Validation in a larger prospective data set is warranted. (Source: Journal of Clinical Oncology)

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The impact of breast reconstruction on the delivery of chemotherapy

Cancer — Mon, 08 Feb 2010 00:00:00 +0100

The purpose of this study was to evaluate the impact of postmastectomy breast reconstruction on the timing of chemotherapy.The authors included stage I-III breast cancer patients from 8 National Comprehensive Cancer Network institutions for whom guidelines recommended chemotherapy. Surgery type was categorized as breast-conserving surgery (BCS), mastectomy alone, mastectomy with immediate reconstruction (M + IR), or mastectomy with delayed reconstruction (M + DR). A Cox regression analysis was used to assess the association between surgery type and timing of chemotherapy initiation.Of the 3643 patients, only 5.1% received it [ge]8 weeks from surgery. In the multivariate analysis, higher stage, Caucasian and Hispanic race/ethnicity, lower body mass index, and absence of comorbid conditions ...

Safety of concurrent or sequential adjuvant letrozole and radiotherapy after conservative surgery for early-stage breast cancer

NeLM - News — Mon, 08 Feb 2010 00:00:00 +0100

Source: Lancet Oncology Area: News According to results from the Phase II CO-HO-RT (Concomitant HOrmono-RadioTherapy) study, letrozole can be safely delivered concomitantly with radiotherapy, shortly after surgery for early stage breast cancer. According to the authors, preclinical studies have suggested that the aromatase inhibitor letrozole may have a radiosensitising effect. They therefore designed this trial to determine whether this effect occurs in vivo, by comparing adjuvant concomitant radiotherapy and letrozole with sequential radiotherapy and letrozole in early breast cancer. A total of 150 postmenopausal women with early-stage breast cancer were randomised to open-label treatment with concurrent radiotherapy and letrozole (n=75) or sequen...

Improving Breast Cancer Surgery: A Classification and Quadrant per Quadrant Atlas for Oncoplastic Surgery

Annals of Surgical Oncology — Sat, 06 Feb 2010 08:22:55 +0100

Conclusions OPS is the “third pathway” between standard BCS and mastectomy. The OPS classification and Atlas improves patient selection and allows a uniform approach for surgeons. It proposes a specific solution for different scenarios and helps improve breast conservation outcomes. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0792-yAuthors Krishna B. Clough, The Paris Breast Center (L’Institut du Sein) Department of Surgery Paris FranceGabriel J. Kaufman, The Paris Breast Center (L’Institut du Sein) Department of Surgery Paris FranceClaude Nos, The Paris Breast Center (L’Institut du Sein) Department of Surgery Paris FranceInes Buccimazza, The Paris Breast Center (L’Institut du Sein) Department of Surgery Paris FranceIsabelle ...

Erratum to: Cosmetic Outcome and Percentage of Breast Volume Excision in Oncoplastic Breast Conserving Surgery

World Journal of Surgery — Thu, 04 Feb 2010 06:44:14 +0100

Content Type Journal ArticleCategory ErratumDOI 10.1007/s00268-010-0414-7Authors Sharon W. W. Chan, United Christian Hospital Kowloon East Cluster Breast Centre, Department of Surgery 130, Hip Wo Street, Kwun Tong Hong Kong Special Administrative Region People’s Republic of ChinaPolly S. Y. Cheung, Hong Kong Sanatorium and Hospital, Happy Valley Hong Kong Special Administrative Region People’s Republic of ChinaS. H. Lam, United Christian Hospital Kowloon East Cluster Breast Centre, Department of Surgery 130, Hip Wo Street, Kwun Tong Hong Kong Special Administrative Region People’s Republic of China Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes

JNCI — Tue, 02 Feb 2010 21:01:32 +0100

Conclusions Scientific questions deserving further investigation include the relationship between mammography use and DCIS incidence and whether imaging technologies and treatment guidelines can be modified to focus on lesions that are most likely to become clinically problematic. (Source: JNCI)

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Prognostic Value of p53 and bcl-2 Expression in Patients Treated with Breast Conservative Therapy.

J Korean Med Sci — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Kim K, Chie EK, Han W, Noh DY, Park IA, Oh DY, Im SA, Kim TY, Bang YJ, Ha SW Prognostic value of p53 and bcl-2 expression on treatment outcome in breast cancer patients has been extensively evaluated, but the results were inconclusive. We evaluated the prognostic significance of these molecular markers in patients treated with breast conserving surgery and radiotherapy. One hundred patients whose immunostaining of p53 and bcl-2 expression was available among 125 patients who underwent radiotherapy after breast conserving surgery and axillary lymph node dissection were enrolled into this study. Eighty-seven patients also received adjuvant chemotherapy and/or hormonal therapy. Conventional clinicopathologic variables and treatment-related factors were also considered. The 5-yr l...

Role of anemia prior to radiation treatment in local recurrence and survival after breast conservation treatment for early-stage breast cancer.

Clinical Genitourinary Cancer — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Radiation does not contribute significantly to anemia during breast conservation treatment, and mild anemia does not affect outcomes. It is unnecessary to obtain routine hemoglobin levels during radiation therapy. There is no difference in outcomes based on hemoglobin levels; thus, there is no reason to transfuse or provide erythropoiesis-stimulating agents for hemoglobin levels > 10 g/dL during radiation treatment of the breast. PMID: 20133262 [PubMed - in process] (Source: Clinical Genitourinary Cancer)

Clinicopathologic factors associated with involved margins after breast-conserving surgery for invasive lobular carcinoma.

Clinical Genitourinary Cancer — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Core needle biopsy is the preferred method of diagnostic biopsy before surgical intervention. With appropriate patient selection, most patients with early-stage ILC can undergo successful BCS. PMID: 20133259 [PubMed - in process] (Source: Clinical Genitourinary Cancer)

Counterview: Pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer

The Breast — Mon, 01 Feb 2010 00:00:00 +0100

Abstract: For the woman with a newly diagnosed early stage breast cancer, the routine use of pre-operative breast MRI (magnetic resonance imaging) is not indicated beyond conventional breast imaging (i.e., mammography with correlation ultrasound as indicated). There is no consistent evidence that a pre-operative breast MRI confers a benefit to the patient by improving clinical outcomes or surgical procedures. In a meta-analysis of studies reporting on the use of pre-operative breast MRI for the patient with an established index cancer, multifocal or multicentric disease was found on breast MRI in 16% of the patients, a rate substantially higher than the rate of local recurrence after breast conserving surgery plus definitive radiation treatment. In the largest retrospective study of patien...

Anaesthesia for radiation therapy - Gliwice experience.

Neoplasma — Thu, 28 Jan 2010 09:44:03 +0100

In conclusion we demonstrated the feasibility and safety of anaesthesia applied in our radiotherapy patients. The custom designed mobile anaesthesia workstation allowed us to provide safe and efficient anaesthesia in any place outside the Department of Anaesthesiology. Keywords: anaesthesia for radiotherapy, paediatric radiotherapy, brachytherapy, intraoperative radiotherapy, childhood cancers. PMID: 20099980 [PubMed - in process] (Source: Neoplasma)

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DCIS size underestimated in third of cases

MedWire News - Oncology — Wed, 27 Jan 2010 00:00:00 +0100

UK study results show that pre-operative imaging underestimates the extent of disease in a third of patients undergoing breast-conserving surgery for ductal carcinoma in situ, resulting in a need for further surgery in these patients. (Source: MedWire News - Oncology)

DCIS size underestimated in third of cases

MedWire News - Breast Cancer — Wed, 27 Jan 2010 00:00:00 +0100

Mediators of a brief hypnosis intervention to control side effects in breast surgery patients: Response expectancies and emotional distress.

Journal of Consulting and Clinical Psychology — Tue, 26 Jan 2010 15:18:03 +0100

Conclusions: The results demonstrate the mediational roles of response expectancies and emotional distress in clinical benefits associated with a hypnotic intervention for breast cancer surgical patients. More broadly, the results improve understanding of the underlying mechanisms responsible for hypnotic phenomena and suggest that future hypnotic interventions target patient expectancies and distress to improve postsurgical recovery. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: Journal of Consulting and Clinical Psychology)

The Impact of Routine Pretreatment Magnetic Resonance Imaging on the Surgical Planning and Outcome in Newly Diagnosed Breast Cancer Patients

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:33 +0100

In this study, we have critically assessed our routine use of pretreatment MRI on surgical planning and outcome. Methods: A retrospective review of our prospectively collected database of all new breast cancer patients seen in our multi-disciplinary breast cancer clinic (BC4) since 2007 was undertaken. The database includes demographic, pathologic, treatment and outcome parameters. In the past 2 years, 157 newly diagnosed breast cancer patients were seen in BC4 that received all of their pretreatment imaging at our institution. Approximately midway through this period, we implemented the routine use of pretreatment of MRI. No other significant alterations were made in our evaluation and treatment (per NCCN guidelines) of these patients during this period. Results: Of the 157 patients, 71 (...

The Use of Breast MRI Surveillance in Women with Prior Curative-Intent Therapy for Breast Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:33 +0100

Conclusion: Prospective studies are needed to determine which patients would potentially benefit from breast MRI surveillance following curative-intent treatment. The lack of standardized guidelines may result in excessive or inappropriate use, unnecessary follow-up procedures, and a concomitant low yield. (Source: Journal of Surgical Research)

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Breast Conservation Therapy Is a Viable Option for Patients with Triple-Receptor Negative Breast Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:39:42 +0100

Conclusion: Despite TNBC's aggressive behavior, breast conservation therapy is a viable surgical option for selected patients with TNBC. (Source: Journal of Surgical Research)

Accelerated hypofractionated radiotherapy as adjuvant regimen after conserving surgery for early breast cancer: interim report of toxicity after a minimum follow up of 3 years

Journal of Experimental and Clinical Cancer Research — Mon, 25 Jan 2010 00:00:00 +0100

In this study we evaluated the adverse effects at least 3 years post an accelerated hypofractionated whole breast radiotherapy schedule. Methods: From October 2004 to March 2006, 39 consecutive patients aged over 18 years with pTis, pT1-2, pN0-1 breast adenocarcinoma who underwent conservative surgery were treated with an adjuvant accelerated hypofractionated radiotherapy schedule consisting of 34 Gy in 10 daily fractions over 2 weeks to the whole breast, followed after 1 week by an electron boost dose of 8 Gy in a single fraction to the tumour bed. Skin and lung radiation toxicity was evaluated daily during therapy, once a week for one month after radiotherapy completion, every 3 months for the first year and from then on every six months. In particular lung toxicity was investigated in t...

Identification of residual breast tumour localization after neo-adjuvant chemotherapy using a radioactive 125 Iodine seed

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:57 +0100

Conclusion: This study has shown that 125I seed localization is a novel and highly successful technique in localizing the tumour bed in patients who receive neo-adjuvant chemotherapy for breast cancer leading to a high percentage of radical margins in case of breast-conserving surgery. (Source: European Journal of Surgical Oncology)

The impact of margin status in breast-conserving therapy for lobular carcinoma is age related

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:57 +0100

Conclusions: Positive margins for invasive carcinoma seem to be a strong predictor for local recurrence in particular for women≤50-years. Our study showed grade 3 and tumour size to be strong predictors of DMFS, DFS, and DSS. Margin status was not. (Source: European Journal of Surgical Oncology)

Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: A systematic review

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:55 +0100

Conclusion: Breast MRI can result in additional detection of otherwise occult lesions in occult breast cancer. Because of low specificity of malignant lesion detection by breast MRI, lesions should be histologically confirmed. This can be achieved either by MRI or ultrasound guided biopsy, as long as all MRI detected lesions are histologically checked. Routine application of breast MRI in occult breast cancer may also alter locoregional treatment by offering the possibility of breast conserving surgery in one thirds of patients. (Source: European Journal of Surgical Oncology)

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Computer-assisted analysis of breast tumors texture on sonographic images of patients submitted to breast-conserving surgery

Radiologia Brasileira — Wed, 20 Jan 2010 15:40:21 +0100

CONCLUSION: Despite the limited number of cases, the present results can be considered as promising, suggesting that texture parameters may help in the differentiation among benign lumps, atypical hyperplasias and recurrent malignant lesions. (Source: Radiologia Brasileira)

Pre-op Mammogram Reduces The Need For Mastectomy In Women With DCIS

Health News from Medical News Today — Wed, 20 Jan 2010 11:00:00 +0100

Over 60 per cent of women who have a form of breast cancer in the milk ducts (DCIS*) are spared a mastectomy, according to latest research published today in the British Journal of Cancer. Researchers for the Sloane Project** examined how the size of the DCIS - measured by both imaging and pathology - related to the surgeon's decision of whether to conserve or remove the breast. They found that, out of 2,500 women who had DCIS detected by breast screening, around 70 per cent of patients had conservation surgery to remove the disease and save the breast... (Source: Health News from Medical News Today)

Pre-op Mammogram Reduces The Need For Mastectomy In Women With DCIS

Breast Cancer News From Medical News Today — Wed, 20 Jan 2010 11:00:00 +0100

Over 60 per cent of women who have a form of breast cancer in the milk ducts (DCIS*) are spared a mastectomy, according to latest research published today in the British Journal of Cancer. Researchers for the Sloane Project** examined how the size of the DCIS - measured by both imaging and pathology - related to the surgeon's decision of whether to conserve or remove the breast... (Source: Breast Cancer News From Medical News Today)

Axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for carcinoma of the breast

Cancer — Wed, 20 Jan 2010 00:00:00 +0100

The timing and accuracy of axillary sentinel lymph node biopsy (SLNB) in patients who are receiving neoadjuvant chemotherapy (NACT) for breast cancer are controversial. To examine the accuracy of SLNB after NACT, the authors performed SLNB after chemotherapy on all of patients who received NACT at their institution starting in January 1997.Seventy-nine women who underwent NACT between 1997 and 2008 comprised this study and were divided as follows: 4 women had stage I disease, 60 women had stage II disease, and 15 women had stage III disease, including 10 women who had multicentric disease. Thirty-nine women (49.4%) had clinical evidence of axillary metastasis (N1-N2) at the time of diagnosis. The regimen, the duration of treatment, and the number of cycles of NACT depended on clinical resp...

Changing clinical presentation of angiosarcomas after breast cancer: from late tumors in edematous arms to earlier tumors on the thoracic wall

Breast Cancer Research and Treatment — Tue, 19 Jan 2010 17:45:53 +0100

Abstract Angiosarcoma is a rare complication of breast cancer treatment. In order to define predictors, clinical presentation, and outcome, we characterized a population-based 50-year cohort of angiosarcomas after breast cancer. Clinical data were collected from all females with previous breast cancer who developed angiosarcomas/lymphangiosarcomas on the thoracic wall/upper extremity between 1958 and 2008 in the Southern Swedish health care region. In total, 31 angiosarcomas developed at a median age of 71 years. The patients formed two distinct groups; 14 females treated for breast cancer with radical mastectomy and radiotherapy 1949–1988 developed angiosarcomas in edematous arms (Stewart–Treves syndrome) after median 11 years, and 17 females treated by segm...

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The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ

The Breast Journal — Tue, 19 Jan 2010 00:00:00 +0100

This study suggests that although oncoplastic reduction techniques are a reasonable approach for women with DCIS, stricter patient selection and improved confirmation of negative margins will minimize the need for either re-excisions or completion mastectomy and reconstruction. (Source: The Breast Journal)

Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches

Radiotherapy and Oncology — Mon, 18 Jan 2010 00:00:00 +0100

Abstract: Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumour relapse (LR) after breast conse...

Early distant relapse in early stage triple-negative breast cancer: usefulness of FDG-PET for diagnosis of distant metastases.

Breast Cancer — Sat, 16 Jan 2010 00:00:00 +0100

Authors: Hama Y, Nakagawa K Triple-negative breast cancer is extremely aggressive and more likely to metastasize than other subtypes of breast cancer. Better understanding of the distinct patterns of relapse and early detection will help identify patients who need aggressive treatment. Here we report a case of early stage triple-negative breast cancer with no lymph node metastasis at the time of breast-conserving surgery in a 46-year-old woman. She developed distant metastases immediately after completing adjuvant chemotherapy following surgery, which were detected by an [18F] 2-fluoro-2-deoxy-D: -glucose positron emission tomography (FDG-PET) scan. Although routine use of FDG-PET is not recommended for early stage breast cancer, FDG-PET might be useful for the early detection of dista...

Retrospective analysis of social variations in access to hospital care for patients with colorectal, breast, and lung cancer between 1999 and 2006

NeLM - News — Fri, 15 Jan 2010 00:00:00 +0100

In this study, researchers determined the extent to which type of hospital admission (emergency compared with elective) and surgical procedure (anterior resection, abdominoperineal resection, breast conserving surgery, mastectomy, and lung cancer resection) varied by socioeconomic circumstances, age, sex, and year of admission for colorectal, breast, and lung cancer. They conducted a retrospective analysis of hospital episode statistics (April 1999 to March 2006) for 564,821 patients aged 50 years ... (Source: NeLM - News)

Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches.

Fri, 15 Jan 2010 00:00:00 +0100

Authors: Kirby AM, Coles CE, Yarnold JR Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumo...

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Dune Medical Completes Enrollment In MarginProbe(TM) Pivotal Trial For Real Time Detection Of Cancer During Breast Conservation Surgery

Health News from Medical News Today — Wed, 13 Jan 2010 09:00:00 +0100

Dune Medical Devices announced the completion of patient enrollment in the MarginProbe™ pivotal clinical trial. The MarginProbe procedure provides surgeons with real-time detection of cancer at the edges of the tissue removed during breast conservation surgery (BCS), which is the only way to ensure the complete removal of the tumor from the breast. The randomized, controlled trial includes 664 women who underwent BCS at one of 21 leading medical facilities, with 18 in the US and three in Israel... (Source: Health News from Medical News Today)

Dune Medical Completes Enrollment In MarginProbe(TM) Pivotal Trial For Real Time Detection Of Cancer During Breast Conservation Surgery

Breast Cancer News From Medical News Today — Wed, 13 Jan 2010 09:00:00 +0100

Dune Medical Devices announced the completion of patient enrollment in the MarginProbe™ pivotal clinical trial. The MarginProbe procedure provides surgeons with real-time detection of cancer at the edges of the tissue removed during breast conservation surgery (BCS), which is the only way to ensure the complete removal of the tumor from the breast... (Source: Breast Cancer News From Medical News Today)

Dune Medical Completes Enrollment in MarginProbe(TM) Pivotal Trial for Real-Time Detection of Cancer During Breast Conservation Surgery

HSMN NewsFeed — Tue, 12 Jan 2010 13:27:19 +0100

NEW YORK, Jan. 12 (HSMN NewsFeed) -- Dune Medical Devices today announced the completion of patient enrollment in the MarginProbe pivotal clinical trial. The MarginProbe procedure provides surgeons with real-time detection of cancer at the edges of the ... Devices, OncologyDune Medical Devices, MarginProbe (Source: HSMN NewsFeed)

Implementation of a short-stay programme after breast cancer surgery.

The British Journal of Surgery — Tue, 12 Jan 2010 00:00:00 +0100

CONCLUSION:: Introducing a care programme incorporating short stay following breast cancer surgery in four hospitals was feasible and safe. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 20069609 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Adjuvant Regional Irradiation after Breast-conserving Therapy for Early Stage Breast Cancer: a Survey of Canadian Radiation Oncologists

Clinical Oncology — Thu, 07 Jan 2010 15:15:21 +0100

Conclusions: This survey showed that there is a wide variation of practices among radiation oncologists in Canada. These results support the need for treatment guidelines and provide guidance on which factors should be included in a decision-making algorithm. (Source: Clinical Oncology)

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Breast cancer in women under 40years of age: A series of 57 cases from Northern Ireland.

Breast — Thu, 07 Jan 2010 00:00:00 +0100

CONCLUSION: Our study reports a low familial trait rate combined with a high proportion of hormonally active tumours less than grade III which suggests that breast cancer in this series of young women from Northern Ireland may be less aggressive and more hormonally responsive than anticipated. PMID: 20060718 [PubMed - as supplied by publisher] (Source: Breast)

Updated Method May Predict Breast Cancer Recurrence

Modern Medicine — Wed, 06 Jan 2010 00:00:00 +0100

IBTR! version 2.0 -- a Web-based nomogram to predict ipsilateral breast tumor recurrence after breast-conserving therapy -- may be accurate in most patients with a low-to-moderate risk but overestimates risk in some higher-risk patients, according to a study published online Jan. 4 in the Journal of Clinical Oncology. (Source: Modern Medicine)

Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project

British Journal of Cancer AOP — Tue, 05 Jan 2010 00:00:00 +0100

Authors: J Thomas, A Evans, J Macartney, S E Pinder, A Hanby, I Ellis, O Kearins, T Roberts, K Clements, G Lawrence & H Bishop (Source: British Journal of Cancer AOP)

Research From University Of Illinois Has Provided New Information About Breast Cancer

Cancercompass News: Breast Cancer — Thu, 31 Dec 2009 00:00:00 +0100

Neoadjuvant Chemotherapy Shows Similar Response in Patients With Inflammatory or Locally Advanced Breast Cancer When Compared With Operable Breast Cancer: A Secondary Analysis of the GeparTrio Trial Data [Breast Cancer]

Journal of Clinical Oncology — Mon, 28 Dec 2009 23:31:54 +0100

Conclusion No evidence of a difference in response to neoadjuvant chemotherapy was found by tumor stage when analysis was adjusted for baseline characteristics. (Source: Journal of Clinical Oncology)

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[Local control in breast cancer: constant importance, changing radiotherapy practice.]

Orvosi Hetilap — Sat, 26 Dec 2009 08:10:12 +0100

Authors: Kahán Z Local control is of primary importance when treating operable breast cancer. Local relapse serves as a secondary source of distant metastases, and compromises survival. Postoperative radiotherapy improves local control after mastectomy or breast conserving surgery, however, sometimes it leads to overtreatment. The risk of local relapse may be estimated based on different correlated factors, such as the type of the surgery, the size and stage of the tumor, the nodal status, the histological type, multifocality and biological features of the cancer, the margin status, the age and the mammographic appearance of the lesion. Late radiogenic sequelae appearing 5-10 years after radiotherapy are sometimes fatal, but may be prevented if radiotherapy is delivered at a high ...

Is the breast-conserving treatment with radiotherapy appropriate in BRCA1/2 mutation carriers? Long-term results and review of the literature

Breast Cancer Research and Treatment — Thu, 24 Dec 2009 19:47:22 +0100

Abstract As tumours in BRCA1/2 mutation carriers might be more sensitive to radiation, we investigated after long-term follow-up whether mutation status influenced the rate of ipsilateral and contralateral breast cancers after breast-conserving treatment (BCT). BRCA1 and BRCA2 genes were screened for germline mutations in 131 patients with a family history of breast and/or ovarian cancer who had undergone BCT and radiotherapy. Patients were matched to 261 controls with sporadic breast cancer according to age at diagnosis and year of treatment. Controls were followed up for at least as long as the interval between diagnosis and genetic screening in familial cases. Rates of ipsilateral and contralateral cancer between groups were compared by the log-rank test. The BRCA1/2 muta...

Focused Microwave Thermotherapy for Preoperative Treatment of Invasive Breast Cancer: A Review of Clinical Studies

Annals of Surgical Oncology — Wed, 23 Dec 2009 22:58:58 +0100

Conclusions Wide-field adaptive phased-array FMT can be safely administered in a preoperative setting, and data from randomized studies suggest both a reduction in positive tumor margins as a heat-alone treatment for early-stage breast cancer and a reduction in tumor volume when used in combination with anthracycline-based chemotherapy for patients with large breast cancer tumors. Larger randomized studies are required to verify these conclusions. Content Type Journal ArticleCategory Medical OncologyDOI 10.1245/s10434-009-0872-zAuthors William C. Dooley, The University of Oklahoma Health Sciences Center Oklahoma City OK USAHernan I. Vargas, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center Torrance Los Angeles CA USAAlan J. Fenn, Massachusetts I...

True Recurrences and New Primary Tumors Have Different Clinical Features in Invasive Breast Cancer Patients with Ipsilateral Breast Tumor Relapse After Breast-Conserving Treatment

The Breast Journal — Mon, 21 Dec 2009 00:00:00 +0100

Abstract: Ipsilateral breast tumor relapse (IBTR) after breast-conserving treatment (BCT) may represent two distinct types of lesion, including a true recurrence (TR) or a new primary tumor (NPT). The aim of this study was to ascertain the difference between TRs and NPTs and to show the clinical significance of classifying IBTR into these two types of recurrence. Patients (n = 2,075) with unilateral invasive breast cancer who underwent BCT between 1987 and 2005 at Saitama Cancer Center were analyzed. IBTR was classified into TR and NPT, which was based on all clinical and pathological features of both a primary tumor and IBTR that can be evaluated. IBTR-free survival and the risk factors were analyzed in order to compare the findings for TR and NPT. In addition, the salvage surgical method...

[Application of neoadjuvant chemotherapy for operable breast cancer.]

Journal of Southern Medical University — Sun, 20 Dec 2009 00:00:00 +0100

CONCLUSION: Neoadjuvant chemotherapy can enhance the breast conservation rate, lower the clinical staging of the tumors and minimize the surgery area to improve the postoperative quality of life of the patients. PMID: 20034916 [PubMed - as supplied by publisher] (Source: Journal of Southern Medical University)

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Surveillance mammography for Medicaid/Medicare breast cancer patients

Journal of Cancer Survivorship — Sat, 19 Dec 2009 16:46:05 +0100

Conclusions Regardless of race and dual eligibility, there is a greater likelihood for breast cancer patients who received BCS with radiation to receive surveillance mammography and to receive it sooner than for patients who were treated with BCS alone. Implications for Cancer Survivors Dual eligible, black, and elderly patients are less likely to receive radiation following BCS, thus disparities across the treatment and surveillance continuum need to be further investigated. Content Type Journal ArticleDOI 10.1007/s11764-009-0107-0Authors Patricia Carcaise-Edinboro, Virginia Commonwealth University Department of Health Administration 1008 E. Clay Street Richmond VA 23298-0203 USACathy J. Bradley, Virginia Commonwealth University Department of Public...

Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance

Journal of Hepato-Biliary-Pancreatic Surgery — Fri, 18 Dec 2009 16:39:41 +0100

Conclusion In SpDP, a very slight elevation of the platelet count in serum may help to prevent infarction of the lungs and brain compared to DPS. Another advantage of SpDP performed according to our procedure is that the blood supply to the proximal stomach is conserved in patients with SpDP who undergo distal gastrectomy with resection of the left gastric artery. Benign lesions, as well as low-grade malignancy of the body and tail of the pancreas, may be indications for this procedure. Surgeons should know the techniques and significance of SpDP with conservation of the splenic artery and vein, which is a very safe and reliable method. Content Type Journal ArticleCategory TopicsDOI 10.1007/s00534-009-0250-zAuthors Wataru Kimura, Yamagata University Faculty of Medi...

Does Compliance with Radiation Therapy Differ in African-American Patients with Early-Stage Breast Cancer?1

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

Abstract: The worse outcomes in African-American (AA) breast cancer patients have been attributed to a variety of factors, including compliance/variations with treatment. We evaluated a large cohort of AA patients treated with breast conservation therapy (BCT) in an effort to determine if compliance with radiation or if choice of chemotherapy regimen could be a contributing factor for the worse outcomes reported in AA patients. Our two cohorts consisted of 221 AA and 2170 white patients treated with BCT. Chart reviews were conducted to document dates of treatment, treatment breaks, dose delivered, and chemotherapy delivered. The data were analyzed to detect differences between the two cohorts. The median radiation dose delivered (including cone-down) was 64 Gy in both cohorts (p = 0.9910)....

Study: Racial disparities revealed in rad onc treatment, scale varying across U.S.

Health Imaging News — Mon, 14 Dec 2009 19:02:04 +0100

A national sample of older breast cancer patients (aged 68 to 83 years) found substantial racial disparities in the use of radiotherapy (RT), a standard treatment, following breast-conserving surgery (BCS) across much of the U.S., based on a recent study published yesterday in the early edition of Cancer. (Source: Health Imaging News)

Study: Racial disparities revealed in rad onc treatment, scale varying across U.S.

Health Imaging News — Mon, 14 Dec 2009 19:02:04 +0100

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Racial disparities in the use of radiotherapy after breast-conserving surgery: A national Medicare study

Cancer — Mon, 14 Dec 2009 00:00:00 +0100

In prior studies, the use of standard breast cancer treatments has varied by race, but previous analyses were not nationally representative. Therefore, in a comprehensive, national cohort of Medicare patients, racial disparities in the use of radiotherapy (RT) after breast-conserving surgery (BCS) for invasive breast cancer were quantified.A national Medicare database was used to identify all beneficiaries (age >65 years) treated with BCS for incident invasive breast cancer in 2003. Claims codes identified RT use, and Medicare demographic data indicated race. Logistic regression modeled RT use in white, black, and other-race patients, adjusted for demographic, clinical, and socioeconomic covariates.Of 34,080 women, 91% were white, 6% were black, and 3% were another race. The mean age of th...

Lack of functional and expression homology between human and mouse aldo-keto reductase 1C enzymes: implications for modelling human cancers

Molecular Cancer — Mon, 14 Dec 2009 00:00:00 +0100

Conclusions: This study exposes significant lack of phylogenetic and functional homology between human and murine AKR1C enzymes. Therefore, we conclude that mice are not suitable to model the role of AKR1C in human cancers and leukemia. (Source: Molecular Cancer)

After conventional breast cancer treatments, half of women have lingering, long-term pain

NaturalNews.com — Thu, 10 Dec 2009 07:00:00 +0100

(NaturalNews) A Danish study published in the November 11 issue of the Journal of the American Medical Association found that women who have undergone conventional breast cancer treatment experience pain long after completing treatments. Mastectomies, breast-conserving surgeries, radiation treatments, chemotherapy, and lymph node dissection were among the treatments women in the study had received.More than 3,000 women were instructed to fill out questionnaires about whether or not they had any pain, the types of pain they were experiencing, where they were experiencing it, how often it was recurring, and how severe it was. Nearly 50 percent indicated pain in one or more areas and more than 50 percent of those in the pain group denoted moderate to severe pain.Of all the women who experienc...

Breast Cancer in Young Women in a Limited-Resource Environment

World Journal of Surgery — Tue, 08 Dec 2009 19:47:15 +0100

Conclusions Young women with breast cancer in a resource-limited environment have similar adverse clinicopathological features to those in developed countries. Their disease is more advanced at presentation with poorer outcome. Increased awareness, better systemic therapy, and more comprehensive genetic studies are essential to improve the dismal outcome. Content Type Journal ArticleDOI 10.1007/s00268-009-0299-5Authors Sarinah Basro, University of Stellenbosch Department of Surgery P.O. Box 19063 7505 Tygerberg 7505 Cape Town South AfricaJustus P. Apffelstaedt, University of Stellenbosch Department of Surgery P.O. Box 19063 7505 Tygerberg 7505 Cape Town South Africa Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal...

How does knowledge of three-dimensional excision margins following breast conservation surgery impact upon clinical target volume definition for partial-breast radiotherapy?

Radiotherapy and Oncology — Mon, 07 Dec 2009 00:00:00 +0100

Conclusions: CTVs based on 3D excision margin data are discordant with those defined using a standard uniform 15mm TB–CTV margin. In women with narrow excision margins, the standard TB–CTV margin could result in a geographical miss. Therefore, wider TB–CTV margins should be considered where re-excision does not occur. (Source: Radiotherapy and Oncology)

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How does knowledge of three-dimensional excision margins following breast conservation surgery impact upon clinical target volume definition for partial-breast radiotherapy?

Fri, 04 Dec 2009 00:00:00 +0100

CONCLUSIONS: CTVs based on 3D excision margin data are discordant with those defined using a standard uniform 15mm TB-CTV margin. In women with narrow excision margins, the standard TB-CTV margin could result in a geographical miss. Therefore, wider TB-CTV margins should be considered where re-excision does not occur. PMID: 19963294 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Quality of life and satisfaction after breast cancer operation

Archives of Gynecology and Obstetrics — Thu, 03 Dec 2009 18:20:48 +0100

Conclusion Patients with BCT have a better quality of life and higher satisfaction rate with their postoperative breasts compared to patients undergoing mastectomy or reconstructive surgery. Content Type Journal ArticleCategory Gynecologic OncologyDOI 10.1007/s00404-009-1302-yAuthors Jing Han, Hannover Medical School Department of Gynecology Hannover GermanyDirk Grothuesmann, Nord City Hospital Department of Gynecology Hannover GermanyMechthild Neises, Hannover Medical School Department of Psychology Hannover GermanyUrsula Hille, Hannover Medical School Department of Gynecology Hannover GermanyPeter Hillemanns, Hannover Medical School Department of Gynecology Hannover Germany Journal Archives of Gynecology and ObstetricsOnline ISSN 1432-0711Print ISSN 0932-0067 ...

Influence of birthplace on breast cancer diagnosis and treatment for Hispanic women

Breast Cancer Research and Treatment — Tue, 01 Dec 2009 08:33:07 +0100

Abstract Research has shown that Hispanic women in the United States are diagnosed with breast cancer at more advanced stages and initiate treatment later than non-Hispanic white women. We investigated whether stage at breast cancer diagnosis and receipt of primary therapy differ by ethnicity and birthplace among US-born Hispanic, foreign-born Hispanic, and white women. We studied 31,012 Hispanic women and 372,313 white women with a first diagnosis of invasive breast cancer during 1988 and 2005 living in a SEER area. We used multinomial logistic regression to assess the association of ethnicity and birthplace with stage at diagnosis and, among women with stage I or II cancers, primary therapy [mastectomy, breast-conserving surgery (BCS) with radiation, BCS without radiatio...

Impact of initial surgical margins and residual cancer upon re-excision on outcome of patients with localized breast cancer

American Journal of Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Conclusion: Invasive residual carcinoma found during subsequent surgery after initial compromised margins is an important prognostic marker for distant recurrence. (Source: American Journal of Surgery)

Private insurance is the strongest predictor of women receiving breast conservation surgery for breast cancer

American Journal of Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Insurance status is an important predictor determining whether a patient receives BCS or mastectomy for breast cancer. (Source: American Journal of Surgery)

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Is there a relationship between skin erythema and fatigue in women undergoing irradiation after breast conserving surgery for early breast cancer? A prospective study

Asia-Pacific Journal of Clinical Oncology — Mon, 30 Nov 2009 00:00:00 +0100

Conclusion: This study demonstrates a significant and consistent relationship between radiotherapy-induced breast erythema and fatigue, particularly in the period immediately following breast irradiation. (Source: Asia-Pacific Journal of Clinical Oncology)

Reply to Locoregional recurrence of triple-negative breast cancer after breast-conserving surgery and radiation

Cancer — Mon, 30 Nov 2009 00:00:00 +0100

No Abstract. (Source: Cancer)

Locoregional recurrence of triple-negative breast cancer after breast-conserving surgery and radiation

Cancer — Mon, 30 Nov 2009 00:00:00 +0100

No Abstract. (Source: Cancer)

Breast-conserving surgery in 201 very young patients (

The Breast — Mon, 30 Nov 2009 00:00:00 +0100

Abstract: Introduction: Surgical treatment of breast cancer in very young patients ( (Source: The Breast)

Breast-conserving surgery in 201 very young patients (

Breast — Wed, 25 Nov 2009 00:00:00 +0100

CONCLUSIONS: Breast conservation in very young patients achieves an acceptable local control rate. No prognostic factors were associated with local events. PMID: 19944605 [PubMed - as supplied by publisher] (Source: Breast)

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Mastectomy Instead of BCS: What Is the Role of the Surgeon's Recommendation?

Medscape FamilyMedicine Headlines — Tue, 24 Nov 2009 15:18:55 +0100

Mastectomy or breast-conserving surgery? Are surgeons making appropriate treatment recommendations? Journal Watch (Source: Medscape FamilyMedicine Headlines)

Cosmetic Outcome and Percentage of Breast Volume Excision in Oncoplastic Breast Conserving Surgery

World Journal of Surgery — Mon, 23 Nov 2009 16:46:52 +0100

Conclusions This study showed high patient satisfaction and good cosmetic outcome after oncoplastic breast-conserving surgery, even in small breast sized Asian women. The application of oncoplastic technique allows large volume excision, and satisfaction remains high with breast volume excision less than 20% regardless of tumor location or distance of the tumor from the nipple. More complicated oncoplastic techniques, e.g., breast replacement, might be required if breast volume excision exceeds 20%. Content Type Journal ArticleDOI 10.1007/s00268-009-0278-xAuthors Sharon W. W. Chan, United Christian Hospital Kowloon East Cluster Breast Centre, Department of Surgery 130, Hip Wo Street Kwun Tong Hong Kong Special Adminstrative Region People’s Republic of ChinaPolly S....

Discontinuation of Radiation Treatment among Medicaid-Enrolled Women with Local and Regional Stage Breast Cancer

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: For women with nonmetastatic breast cancer, radiation therapy is recommended as a necessary component of the breast conserving surgery (BCS) treatment option. The degree to which Medicaid-enrolled women complete recommended radiation therapy protocols is not known. We evaluate radiation treatment completion rates for Medicaid enrollees aged 18[ndash]64 diagnosed with breast cancer. We determine clinical and socio-demographic factors associated with not starting treatment, and with interruptions or not completing radiation treatment. Using data from the Washington State Cancer Registry linked to Medicaid enrollment and claims records, we identified Medicaid enrollees diagnosed with breast cancer from 1997 to 2003 who received BCS. Among the 402 women who met inclusion criteria, 10...

Early Response to Neo-adjuvant Chemotherapy in Carcinoma of the Breast Predicts Both Successful Breast-Conserving Surgery and Decreased Risk of Ipsilateral Breast Tumor Recurrence

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

In conclusion, the early response to neo-adjuvant chemotherapy may be a useful predictor of both selection of surgical method and IBTR risk. (Source: The Breast Journal)

Mastectomy not being overused for breast cancer treatment, study suggests

ScienceDaily Headlines — Wed, 18 Nov 2009 07:00:00 +0100

With there being a concern that mastectomy is excessively used as a treatment for breast cancer, a survey of nearly 2,000 women indicates that breast-conserving surgery was attempted as the initial therapy for about 75 percent of those surveyed, according to a new study. (Source: ScienceDaily Headlines)

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Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting

Breast Cancer Research — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: The marked increase in the 1990s in the use of adjuvant therapy for DCIS patients treated with BCS in the community setting only partially explains the 50% decline in risk of recurrence risk. Changes in pathology factors have likely also contributed to this decline. (Source: Breast Cancer Research)

MRI Versus Ultrasonography And Mammography For Preoperative Assessment Of Breast Cancer

Cancercompass News: Breast Cancer — Tue, 17 Nov 2009 00:00:00 +0100

Accurate assessment of primary tumor size is an essential part of management in breast cancer patients. Tumor size is part of the TNM system used to stage breast cancer and provide prognostic information. Adaptation of the principles of breast conservation surgery requires evaluation of tumor size to judge appropriateness and extent of surgery. Precise measurement of tumor size is also important to monitor response to neoadjuvant chemotherapy for locally advanced tumors. (Source: Cancercompass News: Breast Cancer)

Randomized Clinical Trials in Breast Cancer

Surgical Oncology Clinics of North America — Mon, 16 Nov 2009 15:37:47 +0100

Breast cancer remains the most common cancer diagnosed in women and the second leading cause of cancer-related deaths in this group. Significant advances in the treatment of breast cancer and in the ability to screen for the disease mean that it is also one of the most curable forms of cancer. Long-term updates of the trials reviewed in the previous edition of this article have demonstrated that breast-conserving therapy remains a viable option for most patients, and that local control is related to overall survival. New chemotherapeutic options and endocrine therapies are available to select subsets of patients, and the use of endocrine therapy in breast cancer prevention has been shown to be of clear benefit. The sheer number of breast cancer-related randomized, controlled trials makes i...

Science Weekly: Top 10 myths of ecological living

Guardian Unlimited Science — Mon, 16 Nov 2009 00:01:00 +0100

Duncan Clark, Guardian environment writer and author of The Rough Guide to Green Living, tells us about his top 10 eco myths. (1:25)In the newsjam we look at Britain's renewable energy targets, a new technique to regrow breasts following mastectomy, a recent spate of cancer deaths among rescuers after 9/11, and the controversy over whether dinosaurs were warm-blooded. (13:59)Guardian religious affairs correspondent Riazat Butt speaks to delegates at a summit at Windsor Castle as religious leaders are asked to help save the planet by the UN secretary general. (25:12)We air some of your recent postings on our blog, Facebook page and twitter. (29:20)Prof Graciela Chichilnisky, one of those who helped design the carbon market in the Kyoto Protocol, tells us what he believe needs to happen at t...

Intramammarian flap reconstruction (IFR) technique in breast conserving surgery

The Breast — Fri, 13 Nov 2009 00:00:00 +0100

This article presents a method, which uses the same incision as for the segmentectomy and does not lead to additional scars. First, the breast gland body is being detached from the pectoralis major muscle; then the largest part of the remaining gland body is being cut horizontally parallel to the thoracic wall, exactly in the middle between the skin and the pectoralis major muscle. The pectoral part of the gland body can then be placed into the tumor bed without tension as a flap with a length of approximately 7–14cm and a width of approximately 4–10cm.In 2007, the first author performed a total of 134 breast conserving surgeries (9 benign and 125 malignant diagnoses) which have been prospectively documented. The intramammarian flap reconstruction technique was applied 87 times (65% of...

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Intraoperative Evaluation of Breast Tumor Margins with Optical Coherence Tomography

Cancer Research — Thu, 12 Nov 2009 05:08:18 +0100

As breast cancer screening rates increase, smaller and more numerous lesions are being identified earlier, leading to more breast-conserving surgical procedures. Achieving a clean surgical margin represents a technical challenge with important clinical implications. Optical coherence tomography (OCT) is introduced as an intraoperative high-resolution imaging technique that assesses surgical breast tumor margins by providing real-time microscopic images up to 2 mm beneath the tissue surface. In a study of 37 patients split between training and study groups, OCT images covering 1 cm2 regions were acquired from surgical margins of lumpectomy specimens, registered with ink, and correlated with corresponding histologic sections. A 17-patient training set used to establish standard imaging proto...

Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: A prospective randomised multicentre trial

The Breast — Thu, 12 Nov 2009 00:00:00 +0100

ABSTRACT: Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55–75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR).After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irra...

Increased Cancer Recurrence Linked to High Breast Density

Modern Medicine — Wed, 11 Nov 2009 00:00:00 +0100

Women with invasive breast cancer and high-density breast tissue who undergo breast-conserving surgery without radiotherapy are likely at an increased risk of recurrence, according to a study published online Nov. 9 in Cancer. (Source: Modern Medicine)

Intramammarian flap reconstruction (IFR) technique in breast conserving surgery.

Breast — Wed, 11 Nov 2009 00:00:00 +0100

Authors: Rageth CJ, Tausch C PMID: 19913416 [PubMed - as supplied by publisher] (Source: Breast)

[Radiofrequency ablation of breast carcinomas: preliminary results of a clinical trial.]

Radiologia — Wed, 11 Nov 2009 00:00:00 +0100

CONCLUSION: Radiofrequency ablation of breast carcinomas is feasible, well tolerated, safe, and efficacious in nearly 90% of invasive tumors. The efficacy of the technique should be confirmed through extended follow-up of patients without subsequent surgical intervention in carefully designed and monitored phase III trials. PMID: 19913265 [PubMed - as supplied by publisher] (Source: Radiologia)

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Second CT simulation advised for whole-breast radiation

AuntMinnie.com Headlines — Tue, 10 Nov 2009 07:00:00 +0100

Women receiving whole-breast radiation therapy after breast-conserving surgery (more) (Source: AuntMinnie.com Headlines)

SAVI Brachytherapy For Breast Cancer Marks Three-Year Anniversary Of First Treatment-Shorter, Easier Radiation Treatment Available To More Women

Cancercompass News: Breast Cancer — Tue, 10 Nov 2009 00:00:00 +0100

This month marks three years since physicians began offering SAVI(TM) radiation treatment as part of breast conservation therapy for early- stage breast cancer -- a major milestone in breast brachytherapy. (Source: Cancercompass News: Breast Cancer)

Denser breasts linked to increased risk for cancer recurrence

MedWire News - Oncology — Tue, 10 Nov 2009 00:00:00 +0100

Mammographic breast density significantly affects the risk for the development of local disease recurrence after breast-conserving surgery, Canadian researchers report. (Source: MedWire News - Oncology)

Chronic Pain Can Be a Problem Years After Breast Surgery

Modern Medicine — Tue, 10 Nov 2009 00:00:00 +0100

Despite breast-conserving surgery and other advances, post-breast surgery pain and sensory disturbances remained problems for many women in a Danish survey reported in the Nov. 11 issue of the Journal of the American Medical Association. (Source: Modern Medicine)

Denser breasts linked to increased risk for cancer recurrence

MedWire News - Breast Cancer — Tue, 10 Nov 2009 00:00:00 +0100

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Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: A prospective randomised multicentre trial.

Breast — Tue, 10 Nov 2009 00:00:00 +0100

Authors: Tinterri C, Gatzemeier W, Zanini V, Regolo L, Pedrazzoli C, Rondini E, Amanti C, Gentile G, Taffurelli M, Fenaroli P, Tondini C, Sacchetto G, Sismondi P, Murgo R, Orlandi M, Cianchetti E, Andreoli C Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55-75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR). After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% i...

Increased breast density predicted local disease recurrence after breast-conserving surgery

HemOncToday.com — Mon, 09 Nov 2009 14:11:00 +0100

(Source: HemOncToday.com)

Changes in and predictors of length of stay in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England: a population-based study

BMC Health Services Research — Mon, 09 Nov 2009 00:00:00 +0100

Conclusions: The number of days spent in hospital after breast cancer surgery has continued to decline for several decades. The change from mastectomy to BCS accounts for only 9% of the overall decrease in LOS. Other explanations include the adoption of new techniques and practices, such as sentinel lymph node biopsy and early discharge. This study has identified wide variation in practice with substantial cost implications for the NHS. Further work is required to explain this variation. (Source: BMC Health Services Research)

Mammographic density and the risk of breast cancer recurrence after breast-conserving surgery

Cancer — Mon, 09 Nov 2009 00:00:00 +0100

Women with invasive breast cancer who are treated with breast-conserving surgery and radiotherapy face a cumulative risk of local disease recurrence of approximately 10% at 10 years. To the authors' knowledge, the role of mammographic density as a risk factor for the development of local recurrence has not been thoroughly evaluated to date.Medical records were reviewed for 335 patients who underwent breast-conserving surgery for invasive breast cancer and for whom a pretreatment mammogram was available. Information was recorded concerning mammographic density as well as tumor features, patient characteristics, and adjuvant treatments received. Patients were categorized for mammographic density based on the Wolfe classification as either low (50% density). A multivariate survival analysis w...

Pregnancy after breast cancer: The importance of active counselling and planning

The Breast — Fri, 06 Nov 2009 00:00:00 +0100

Conclusion: Pregnancy after breast cancer does not confer a poor prognosis. A higher rate of pregnancy than expected was found after treatment, possibly due to newer treatments including fertility preservation and also possibly due to the active counselling programme in this unit. Patients should have active counselling about fertility when planning treatment and fertility conservation can then be incorporated into a treatment plan. (Source: The Breast)

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["Scarless" surgery in the treatment of breast cancer.]

Cirugia eEspanola — Thu, 05 Nov 2009 00:00:00 +0100

This article describes four approach routes for scarless surgery (periareolar, axillary, submammary, lateral chest) in different contexts of the oncological breast disease. The application of these incisions in the conservative treatment of breast cancer requires making a wide subcutaneous dissection over the tumour location, and a local reconstruction with adjacent breast tissue, so as not to deform the breast contour, as well as moving the nipple with its areola, thus avoiding the surgical modification of the other breast to maintain symmetry between both. We describe the use of hidden incisions to perform mastectomies that try to conserve as much skin as possible, together with the nipple, as well the dissection, with the aid of an endoscope of the latissimus dorsi muscle, in the immedi...

Experiences with a specific screening instrument to identify psychosocial support needs in breast cancer patients

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Thu, 05 Nov 2009 00:00:00 +0100

Conclusions: The structured assessment of breast cancer patients’ psychosocial distress with the interviewer-administered PO-Bado assists the physician to arrive at a detailed expert evaluation. This might help to improve the psychosocial care of breast cancer patients. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

The Portuguese version of the Body Image Scale (BIS) – psychometric properties in a sample of breast cancer patients

European Journal of Oncology Nursing — Thu, 05 Nov 2009 00:00:00 +0100

Conclusions: The Portuguese BIS proved to be a reliable and valid measure of body image concerns in a sample of breast cancer patients, allowing a brief and comprehensive assessment, both on clinical and research settings. (Source: European Journal of Oncology Nursing)

Pregnancy after breast cancer: The importance of active counselling and planning.

Breast — Wed, 04 Nov 2009 00:00:00 +0100

CONCLUSION: Pregnancy after breast cancer does not confer a poor prognosis. A higher rate of pregnancy than expected was found after treatment, possibly due to newer treatments including fertility preservation and also possibly due to the active counselling programme in this unit. Patients should have active counselling about fertility when planning treatment and fertility conservation can then be incorporated into a treatment plan. PMID: 19892553 [PubMed - as supplied by publisher] (Source: Breast)

Ampk-Independent Down-Regulation Of Cflip And Sensitization To Trail-Induced Apoptosis By Ampk Activators.

Biochemical Pharmacology — Wed, 04 Nov 2009 00:00:00 +0100

Authors: García-García C, Fumarola C, Navaratnam N, Carling D, López-Rivas A The tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a TNF superfamily member that is being considered as a new strategy in anticancer therapy because of its ability to induce apoptosis, alone or in combination with other stimuli, in many cancer cells. AMP-activated protein kinase (AMPK) is an evolutionarily conserved key regulator of cellular energy homeostasis that protects the cell from energy depletion and stress by activating several biochemical pathways that lead to the conservation, as well as generation, of ATP. Here we report that a number of AMPK activators, including the small molecule activator A-769662, markedly sensitize TRAIL-resistant breast cancer cells to TRAI...

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The impact of preoperative breast MRI on the re-excision rate in invasive lobular carcinoma of the breast

Breast Cancer Research and Treatment — Tue, 03 Nov 2009 10:15:32 +0100

In conclusion, preoperative MRI in patients with ILC can reduce re-excision rates without increasing the rate of mastectomies. Content Type Journal ArticleCategory Clinical trialDOI 10.1007/s10549-009-0616-6Authors R. M. Mann, Radboud University Nijmegen Medical Centre Department of Radiology huispost 667, Geert Grooteplein 10 P.O. Box 9101 6500 HB Nijmegen The NetherlandsC. E. Loo, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital Department of Radiology Amsterdam The NetherlandsT. Wobbes, Radboud University Nijmegen Medical Centre Department of Surgery Nijmegen The NetherlandsP. Bult, Radboud University Nijmegen Medical Centre Department of Pathology Nijmegen The NetherlandsJ. O. Barentsz, Radboud University Nijmegen Medical Centre Department of Radiology huispost 66...

The Portuguese version of the Body Image Scale (BIS) - psychometric properties in a sample of breast cancer patients.

European Journal of Oncology Nursing — Tue, 03 Nov 2009 00:00:00 +0100

CONCLUSIONS: The Portuguese BIS proved to be a reliable and valid measure of body image concerns in a sample of breast cancer patients, allowing a brief and comprehensive assessment, both on clinical and research settings. PMID: 19892597 [PubMed - as supplied by publisher] (Source: European Journal of Oncology Nursing)

Obesity is a Risk Factor for Developing Postoperative Lymphedema in Breast Cancer Patients

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

Abstract: Lymphedema (LE) is a well-known postoperative complication after axillary node dissection (ALND). Although, sentinel lymph node dissection (SLND) involves more focused surgery and less disruption of the axilla, early reports show up to 13% of patients experience some symptoms of LE. The purpose of this study was to determine predictors of arm LE in our patients under going SLND with or without an ALND. One hundred and thirty-seven breast cancer patients were treated at a comprehensive cancer center. Prospective measurement of arm volume was carried every 6 months from date of diagnosis. This data base was retrospectively reviewed for tumor stage, treatment, and subjective complaints of LE. Objective LE was defined as a change greater than 200 mL compared with the control arm. Uni...

Patterns of Surgical Treatment for Women with Breast Cancer in Relation to Age

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

Abstract: Although treatment recommendations have been advocated for all women with early breast cancer regardless of age, it is generally accepted that different treatments are preferred based on the age of the patient. The aim of this study was to assess the pattern of breast cancer surgery after adjusting for other major prognostic factors in relation to patient age. Data on cancer characteristics and surgical procedures in 31,298 patients with early breast cancer reported to the National Breast Cancer Audit between 1999 and 2006 were used for the study. There was a close association between age and surgical treatment pattern after adjusting for other prognostic factors, including tumor size, histologic grade, number of tumors, lymph node positivity, lymphovascular invasion (LVI), and e...

Effective breast reconstruction in female veterans

American Journal of Surgery — Sun, 01 Nov 2009 00:00:00 +0100

Conclusions: Breast reconstruction can be effectively delivered within the Veterans Affairs system. It is essential that sufficient Veterans Affairs resources be deployed to address the increasing reconstructive needs of female veterans. (Source: American Journal of Surgery)

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Delayed radiotherapy for breast cancer patients in integrated delivery systems.

The American Journal of Managed Care — Sun, 01 Nov 2009 00:00:00 +0100

CONCLUSIONS: Timely RT should be facilitated through physician and patient education, navigation, and notification programs to improve quality of care. Queues for RT appointments should be evaluated on an ongoing basis to ensure adequate access. Future research should examine modifiable barriers to RT timeliness and whether delays impact long-term outcomes. PMID: 19895182 [PubMed - in process] (Source: The American Journal of Managed Care)

No Evidence of Mastectomy Overuse Found in Large Survey

Ob.Gyn. News — Sun, 01 Nov 2009 00:00:00 +0100

More than three-quarters of women newly diagnosed with intraductal or stage I or II breast cancer elected breast-conserving surgery as their initial surgical therapy, according to a survey of nearly 2,000 women. (Source: Ob.Gyn. News)

Initial surgical experience evaluating early tolerance and toxicities in patients undergoing accelerated partial breast irradiation using the Contura Multi Lumen Balloon breast brachytherapy catheter.

The American Surgeon — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Israel PZ, Robbins AB, Shroff P, Haile K, Pope DK We reviewed our surgical experience with the Contura Multi Lumen Balloon breast brachytherapy catheter used to deliver accelerated partial breast irradiation and determined short-term treatment efficacy, cosmesis, and toxicity. Forty-six patients undergoing breast conserving therapy, including the use of Contura catheter, were analyzed. Thirty-four Gray were delivered in 10 fractions. Fourteen patients had stage 0, 24 had stage I, and 8 had stage II breast cancer. Catheters were placed with a closed cavity technique. Median minimum skin spacing was 10 mm (range, 2-18 mm). Median maximum skin doses were 99.7 per cent of the prescription dose. Nine patients were treated with a skin spacing < or = 5 mm (2 patients with 2 mm ski...

Radiation therapy and tamoxifen after breast-conserving surgery: Updated results of a 2×2 randomised clinical trial in patients with low risk of recurrence

European Journal of Cancer — Fri, 30 Oct 2009 00:00:00 +0100

Abstract: To study the role of radiotherapy and tamoxifen after breast-conserving surgery (BCS) in patients with a favourable prognosis, a clinical trial was initiated by the German Breast Cancer Study Group (GBSG-V). Between 1991 and 1998, 361 patients (pT 1pN0M0, aged 45–75years, receptor positive, grades I and II) were randomised to radiotherapy (yes/no) and tamoxifen for 2years (yes/no) in a 2×2-factorial design; the exclusion of seven centres (14 patients) left 347 patients for the analysis. First results after a median follow-up of 5.9years were published. Herein we present updated results after a median follow-up of about 10years. Hundred and eleven events concerning event-free survival (EFS) have been observed. Since a strong interactive effect between radiotherapy and tamoxifen...

Disparities in medical care among commercially insured patients with newly diagnosed breast cancer

Cancer — Wed, 28 Oct 2009 00:00:00 +0100

African-American women have increased breast cancer mortality compared with white women. Diagnostic and treatment gaps may contribute to this disparity.In this retrospective, longitudinal cohort study, Southern US health plan claims data and linked medical charts were used to identify racial disparities in the diagnoses, treatment, and mortality of commercially insured women with newly diagnosed breast cancer. White women (n = 476) and African-American women (n = 99) with newly diagnosed breast cancer were identified by breast cancer claims codes (International Classification of Diseases, Ninth Revision, Clinical Modification codes 174, 233.0, 238.3, and 239.3) between January 2000 and December 2004. Race, diagnoses (breast cancer stage, estrogen/progesterone receptor [ER/PR]-positive stat...

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Study Suggests Mastectomy Not Being Overused For Breast Cancer Treatment

Cancercompass News: Breast Cancer — Sat, 24 Oct 2009 00:00:00 +0100

Although More Older Women Receive Breast-Conserving Therapy, Gaps In Treatment Exist

Cancercompass News: Breast Cancer — Sat, 24 Oct 2009 00:00:00 +0100

According to a new study published in the October issue of the Journal of the American College of Surgeons, although breast-conserving surgery (BCS), commonly known as lumpectomy, is increasingly being used to treat older women with nonmetastatic invasive breast cancer, there are still significant socioeconomic and geographic disparities in the use of this type of therapy. (Source: Cancercompass News: Breast Cancer)

Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: A systematic review

Radiotherapy and Oncology — Fri, 23 Oct 2009 00:00:00 +0100

We congratulate Offersen et al. for the excellent overview on partial breast irradiation (pbi) . Common for all radiation techniques is the desire for good dose homogeneity inside the target volume. We would like to draw attention to the aspect of dose homogeneity for a special subgroup of pbi techniques, namely intraoperative radiation therapy (IORT). We recently compared the dosimetric properties of four techniques : IORT with electrons (IOERT), an orthovolt system (Intrabeam), interstitial brachytherapy, and brachytherapy using the MammoSite system. (Source: Radiotherapy and Oncology)

What is an Adequate Margin for Breast-Conserving Surgery? Surgeon Attitudes and Correlates

Annals of Surgical Oncology — Thu, 22 Oct 2009 05:59:42 +0100

Conclusions Wide variation in BCS margin definition exists. Variation is similar for invasive cancer and DCIS with RT, with more specialized surgeons choosing smaller margins. In DCIS without RT, more specialized surgeons favored larger margins. A standardized margin definition may significantly affect re-excision rates. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0765-1Authors Michelle Azu, Memorial Sloan-Kettering Cancer Center Breast Service, Department of Surgery New York USAPaul Abrahamse, University of Michigan Department of Internal Medicine Ann Arbor MI USASteven J. Katz, University of Michigan Department of Internal Medicine Ann Arbor MI USAReshma Jagsi, University of Michigan Department of Radiation Oncology Ann Arbor MI USAMon...