MedWorm: Breast Lumpectomy

Does size matter? Comparison study between MRI, gross, and microscopic tumor sizes in breast cancer in lumpectomy specimens.

International Journal of Clinical and Experimental Pathology — Sun, 14 Mar 2010 20:24:03 +0100

This study was conducted to assess accuracy in estimating tumor size by MRI and gross using microscopy as gold standard. A retrospective study was done on 33 patients, 30-75 years, who underwent MRI of breasts with subsequent lumpectomy, 2002-2006, for invasive breast cancer. Size of lesion(s) on MRI and gross were compared with histological size. Of 37 lesions, 27 (73%) were invasive ductal (IDC) and 10 (27%) invasive lobular carcinoma (ILC). Tumor size by MRI matched histological size in 3%, underestimated 27%, and overestimated 70% of cases. Tumor size by gross matched histological size in 22%, underestimated 57%, and overestimated 22% of cases. MRI as an imaging modality and gross pathology both have significant limitations in measuring tumor size particularly in cases of invasive brea...

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Technology May Reduce Need For Repeat Cancer Surgery

Medical Devices News From Medical News Today — Fri, 12 Mar 2010 11:00:00 +0100

Technology May Reduce Need For Repeat Cancer Surgery

Health News from Medical News Today — Fri, 12 Mar 2010 11:00:00 +0100

Every year more than 100,000 women in the United States undergo a lumpectomy, a conservative procedure to remove cancerous tumors while preserving the breast. The surgeon's goal is to attain a tumor-free, or negative, surgical margin the first time they operate. Current surgical tools may cause heat damage to the tissue samples needed for examination by a pathologist in order to identify the presence of cancerous cells on the edges of tumors... (Source: Health News from Medical News Today)

Mammary fat necrosis following radiotherapy in the conservative management of localized breast cancer: Does it matter?

Thu, 11 Mar 2010 00:00:00 +0100

CONCLUSIONS: Fat necrosis is a common complication of radiotherapy which rarely requires therapeutic intervention. However, post-therapeutic clinical imaging such as mammography, ultrasound and magnetic resonance imaging are affected which may result in additional diagnostic procedures up to and including biopsy. PMID: 20227125 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

[Conservative treatment for breast cancer: Optimization of the tumor bed localization.]

Cancer Radiotherapie — Tue, 02 Mar 2010 00:00:00 +0100

CONCLUSION: The placement of surgical clips by the surgeon is helpful, primarily when oncoplastic techniques are used. In many situations, these clips may cause problems of interpretation. In order to optimize the delineation of the boost, we propose a multidisciplinary approach and methodology to be used at the Henri Becquerel Cancer Centre. PMID: 20202881 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)

A mimic of breast lymphoma: extranodal rosai-dorfman disease.

The American Journal of the Medical Sciences — Mon, 01 Mar 2010 00:00:00 +0100

We present a case of Rosai-Dorfman disease misdiagnosed as lymphoma involving the right breast. Initially, the patient was diagnosed as malignant lymphoma, mucosa-associated lymphoid tissue type. After lumpectomy, she did not receive further management. Five months later, she developed a local recurrence in the right breast. She underwent incisional biopsy of the recurrent right breast lesion. Pathology demonstrated Rosai-Dorfman disease. She was prescribed oral prednisolone of 5 mg daily for 4 weeks. However, the lump persisted and did not respond to the therapy. She was treated with lumpectomy of the recurrent right breast lesion at her request for cosmetic reasons and has regular postoperative follow-up for the last 2 years. PMID: 20220338 [PubMed - in process] (Source: The American...

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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...

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...

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)

MammoSite Brachytherapy

About.com Breast Cancer — Mon, 15 Feb 2010 00:00:00 +0100

MammoSite breast brachytherapy is an alternative radiation treatment to external beam radiation of the breast. MammoSite breast brachytherapy takes 5 days to completely treat early stage breast cancer with radiation after a lumpectomy. Learn more about MammoSite breast brachytherapy here. (Source: About.com Breast Cancer)

Synchronous Ovarian Cancer in a Patient with Pleomorphic Lobular Breast Cancer: A Therapeutic Dilemma

Clinical Oncology — Wed, 03 Feb 2010 15:36:35 +0100

Sir — A 49-year-old premenopausal female patient presented with a breast lump and abdominal distention. Her personal history was unremarkable and a family history revealed ovarian cancer in her aunt and thyroid cancer in her brother. On physical examination, a 4cm mass in her right breast and an axillary fixed lymphadenopathy of 2cm were palpated and ascites was detected. Biopsy from the breast lump showed pleomorphic lobular carcinoma, grade 3, oestrogen receptor and progesterone receptor were both positive with HER2 overexpression immunohistochemically. Abdominal computed tomography revealed peritoneal carcinomatosis, ascites and a 15mm left ovarian cyst. A chest X-ray and a bone scan were normal. Diagnostic paracentesis was carried out to rule out a second intra-abdominal malignancy a...

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Attitudes of Canadian Radiation Oncologists towards Post-lumpectomy Radiotherapy for Elderly Women with Stage I Hormone-responsive Breast Cancer

Clinical Oncology — Wed, 03 Feb 2010 15:36:34 +0100

Conclusions: Although there is significant variation in practice patterns and attitudes among radiation oncologists regarding post-lumpectomy radiotherapy for elderly, low-risk breast cancer patients, the vast majority value patient choice and would be willing to use a decision aid designed for this population in their practice. (Source: Clinical Oncology)

[Adenoid cystic carcinoma of the breast: Clinical, histological and immunohistochemical characterization.]

Annales de Pathologie — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSIONS: The mammary ACC is made of two cell types and is of good prognosis despite its triple negative phenotype, similar to the basal-like infiltrating carcinoma NOS. Axillary lymph node dissection is not recommended. Good local control by at least large lumpectomy with long-term follow-up is necessary. PMID: 20223349 [PubMed - as supplied by publisher] (Source: Annales de Pathologie)

Routine Preoperative MRI for Breast Carcinoma

Journal of the American College of Surgeons — Wed, 27 Jan 2010 15:29:19 +0100

The article published by Bleicher and colleagues regarding the role of routine MRI on newly diagnosed breast carcinoma and its impact on time of operation, mastectomy rate, and margin of lumpectomy status is highly commendable. (Source: Journal of the American College of Surgeons)

[Lobular intra-epithelial neoplasia: Atypical lobular hyperplasia and lobular carcinoma in situ.]

Journal de Gynecologie, Obstetrique et Biologie de la Reproduction — Wed, 27 Jan 2010 00:00:00 +0100

Authors: Ansquer Y, Santulli P, Colas C, Jamali M, Tournigand C, Duperray L, Duperray B, Jannet D, Carbonne B OBJECTIVE: To review main knowledge about lobular intra-epithelial neoplasia with special interest for daily practice management. MAIN RESULTS: Intra-epithelial lobular neoplasias (ILN) are non invasive proliferations within the terminal ducto-lobular unit of monomorphic loosely cohesive small cells. A lack of expression of the E-cadherin adhesion molecule is often observed as in invasive lobular breast cancer. ILN are infrequent, however, a rise in incidence partly, due to the generalization of mammographic screening, is observed. Actually ILN are usually asymptomatic and diagnosed after breast biopsy for unspecified microcalcifications. ILN are associated with an increased ri...

Cryoablation FA Visica

About.com Breast Cancer — Tue, 26 Jan 2010 00:00:00 +0100

Cryoablation is an alternative way to remove breast fibroadenomas. Instead of having a lumpectomy to remove a fibroadenoma, cryoablation uses intense cold to freeze the unwanted tissue to death. Learn more about cryoablation of breast fibroadenomas here. (Source: About.com Breast Cancer)

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Tamoxifen Malabsorption After Roux-en-Y Gastric Bypass Surgery: Case Series and Review of the Literature

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Tue, 26 Jan 2010 00:00:00 +0100

Pharmacotherapy 30(2): 217-217 Abstract Roux-en-Y gastric bypass is a gastric reduction duodenal switch with a combination of restrictive and malabsorptive procedures. It is the most common gastric bypass procedure performed in the United States. Malabsorption causing nutritional deficiencies does occur, yet a PubMed literature search (1955-2009) returned no reports of malabsorption of anticancer agents after gastric bypass. To our knowledge, this is the first report of three cases of malabsorption of the anticancer agent tamoxifen after this procedure. The first patient was a 58-year-old woman who underwent Roux-en-Y bypass for morbid obesity. Two years later, she developed estrogen receptor-positive ductal carcinoma in situ of the breast, underwent lumpectomy and irradiation, and tamoxif...

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)

Histology after lumpectomy in women with epithelial atypia on stereotactic vacuum-assisted breast biopsy

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

Conclusion: ADH diagnosed by vacuum-assisted breast biopsy frequently corresponds to cancer on open surgical biopsy. Surgical excision of all breast lesions containing atypical hyperplasia on percutaneous biopsy can be recommended. (Source: European Journal of Surgical Oncology)

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)

The effect of intraoperative specimen inking on lumpectomy re-excision rates

World Journal of Surgical Oncology — Mon, 18 Jan 2010 00:00:00 +0100

Conclusions: Intraoperative inking in this practice offered a simple way to reduce re-excision rates after lumpectomy and affect an improvement in quality of patient care (Source: World Journal of Surgical Oncology)

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Novilase Procedure

About.com Breast Cancer — Tue, 12 Jan 2010 00:00:00 +0100

Breast fibroadenomas are usually removed by lumpectomy if they are troublesome. A new procedure called Novilase destroys fibroadenomas using a laser. Novilase laser ablation of breast fibroadenomas is being tested in clinical trials. Learn more about laser ablation of breast fibroadenomas here. (Source: About.com Breast Cancer)

Novilase

About.com Breast Cancer — Thu, 07 Jan 2010 00:00:00 +0100

In a clinical trial of Novilase Laser Ablation techonology, breast fibroadenomas can be effectively treated without a lumpectomy. Breast fibroadenomas can be bothersome if they are large or swell, but laser ablation destroys this benign breast tumor. Learn more about laser ablation of breast fibroadenomas here. (Source: About.com Breast Cancer)

Smile! You've got cancer | Barbara Ehrenreich

Guardian Unlimited Science — Sat, 02 Jan 2010 00:18:43 +0100

Cancer is not a problem or an illness – it's a gift. Or so Barbara Ehrenreich was told repeatedly after her diagnosis. But the positive thinkers are wrong, she says: sugar-coating illnesses can exact a dreadful costIf you had asked me, just before the diagnosis of cancer, whether I was an optimist or a pessimist, I would have been hard-pressed to answer. But on health-related matters, as it turned out, I was optimistic to the point of delusion. Nothing had so far come along that could not be controlled by diet, stretching, painkillers or, at worst, a prescription. So I was not at all alarmed when a routine mammogram aroused some "concern" on the part of my gynaecologist.How could I have breast cancer? I had no known risk factors, there was no breast cancer in the fami...

Initial margin status for invasive ductal carcinoma of the breast and subsequent identification of carcinoma in reexcision specimens.

Archives of Pathology and Laboratory Medicine — Fri, 01 Jan 2010 00:00:00 +0100

CONCLUSIONS: Frequency of residual invasive carcinoma was related to margin status of the original lumpectomy/biopsy. Even when margins were positive, most reexcisions were free of carcinoma. Residual invasive carcinoma was found in greater than 25% of patients with margins less than 2 mm, supporting reexcision for patients with margins of less than 2 mm. Sixteen percent of cases with margins greater than 2 mm harbored residual invasive carcinoma. Evaluation of margin status was complicated by tissue distortion and fragmentation. PMID: 20073613 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

3D-conformal Accelerated Partial Breast Irradiation treatment planning: the value of surgical clips in the delineation of the lumpectomy cavity

Radiation Oncology — Thu, 31 Dec 2009 00:00:00 +0100

Conclusions: The placement of surgical clips improved the accuracy of lumpectomy cavity delineation in 3D-APBI. However, a learning curve is needed to improve the conformity index of the lumpectomy cavity. (Source: Radiation Oncology)

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Cyclophosphamide, Epirubicin, and Fluorouracil Versus Dose-Dense Epirubicin and Cyclophosphamide Followed by Paclitaxel Versus Doxorubicin and Cyclophosphamide Followed by Paclitaxel in Node-Positive or High-Risk Node-Negative Breast Cancer [Breast Cancer]

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

Conclusion Three-weekly AC/T is significantly inferior to CEF or EC/T in terms of RFS. It is too early to detect any difference between CEF and dose-dense EC/T. (Source: Journal of Clinical Oncology)

Teresa Heinz Kerry Treated For Breast Cancer

About.com Breast Cancer — Sat, 26 Dec 2009 00:00:00 +0100

Teresa Heinz KerryPhoto ©Getty Images/Jeff Swensen Teresa Heinz Kerry and Elizabeth Edwards now have more in common than being part of the 2004 presidential campaign. While John Kerry and John Edwards ran for office, Elizabeth discovered a lump in her breast and was eventually treated for metastatic breast cancer. Nine years later, Teresa Heinz Kerry, heiress to the Heinz ketchup fortune, has announced that she has breast cancer. Kerry, 71, said that her lump was detected during a routine screening mammogram. "The cancer was detected at an early stage thanks to a mammogram and the work of a remarkable physician who insisted on investigating beyond what the mammogram could show," said Kerry. Stage one breast cancer was found in both breasts, for which Kerry had lumpectomies. After surger...

Study Finds Racial Disparities Exist In Radiation Therapy Rates For Early Stage Breast Cancer

Cancercompass News: Breast Cancer — Wed, 23 Dec 2009 00:00:00 +0100

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...

Racial Disparities in Radiation Therapy

Medical Headlines From Ivanhoe.com — Wed, 16 Dec 2009 05:00:00 +0100

After a lumpectomy, black women are far less likely than white women to receive radiation therapy, the standard of care for early stage breast cancer. (Source: Medical Headlines From Ivanhoe.com)

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Breast Radiation Less Likely For Blacks

WDSU.com - Health — Mon, 14 Dec 2009 14:17:25 +0100

Black women don't get radiation after lumpectomy as often as white women, especially in certain parts of the country. (Source: WDSU.com - Health)

After Lumpectomy, Radiation Rates Lower for Black Women

Forbes.com Health News — Mon, 14 Dec 2009 14:00:00 +0100

Racial disparities seen for 'standard-of-care' breast cancer treatment, study finds (Source: Forbes.com Health News)

After Lumpectomy, Radiation Rates Lower for Black Women

MedlinePlus Health News — Mon, 14 Dec 2009 14:00:00 +0100

Racial disparities seen for 'standard-of-care' breast cancer treatment, study finds Source: HealthDay Related MedlinePlus Topics: Health Disparities, Mastectomy, Radiation Therapy (Source: MedlinePlus Health News)

Racial Disparities Exist In Radiation Therapy Rates For Early Stage Breast Cancer

Radiology / Nuclear Medicine News From Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

Black women are less likely than white women to receive radiation therapy after a lumpectomy, the standard of care for early stage breast cancer, according to a new study by researchers at The University of Texas M. D. Anderson Cancer Center. The largest of its kind and the first to examine such racial disparities in radiation therapy, the study was published today in Cancer... (Source: Radiology / Nuclear Medicine News From Medical News Today)

Promising Results Reported In Cell-Enriched Breast Reconstruction Trial

Health News from Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

Interim results from a European clinical trial, RESTORE 2, demonstrate that cell-enriched breast reconstruction achieved a high rate of patient and physician satisfaction and improvements in overall breast deformity in lumpectomy patients. These results are based on six-month follow up from the first 32 women enrolled and treated. The results were presented at the 32nd Annual CTRC-AACR San Antonio Breast Cancer Symposium (Poster #4123) by Dr. Eva Weiler-Mithoff, M.D., co-principal investigator for the Restore 2 Trial at the Glasgow Royal Infirmary... (Source: Health News from Medical News Today)

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Racial Disparities Exist In Radiation Therapy Rates For Early Stage Breast Cancer

Health News from Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

Black women are less likely than white women to receive radiation therapy after a lumpectomy, the standard of care for early stage breast cancer, according to a new study by researchers at The University of Texas M. D. Anderson Cancer Center. The largest of its kind and the first to examine such racial disparities in radiation therapy, the study was published today in Cancer. It was first presented at the 2008 American Society of Clinical Oncology (ASCO) Breast Cancer Symposium. Led by Grace Li Smith, M.D., Ph.D., a postdoctoral fellow in M. D... (Source: Health News from Medical News Today)

Benefits Of Shortened Breast Radiation Course Presented At SABCS

Health News from Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

New research being presented this week at the 32nd Annual CTRC-AACR San Antonio Breast Cancer Symposium by an investigator at The Cancer Institute of New Jersey (CINJ) highlights the benefit of a shortened radiation course to patients with the most common type of non-invasive breast cancer. Sharad Goyal, MD, instructor of radiation oncology at UMDNJ-Robert Wood Johnson Medical School, is the lead researcher on a poster discussion, which focuses on patients with ductal carcinoma in situ (DCIS), who have had a lumpectomy... (Source: Health News from Medical News Today)

Promising Results Reported In Cell-Enriched Breast Reconstruction Trial

Breast Cancer News From Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

Racial Disparities Exist In Radiation Therapy Rates For Early Stage Breast Cancer

Radiology / Nuclear Medicine News From Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

Study finds racial disparities exist in radiation therapy rates for early stage breast cancer

EurekAlert! - Medicine and Health — Mon, 14 Dec 2009 05:00:00 +0100

(University of Texas M. D. Anderson Cancer Center) Black women are less likely than white women to receive radiation therapy after a lumpectomy, the standard of care for early stage breast cancer, according to a new study by researchers at the University of Texas M. D. Anderson Cancer Center. (Source: EurekAlert! - Medicine and Health)

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M. D. Anderson Study Finds Racial Disparities Exist in Radiation Therapy Rates for Early Stage Breast Cancer

M. D. Anderson Cancer Center - News Releases — Mon, 14 Dec 2009 00:00:00 +0100

Clinical Experience With Image-Guided Radiotherapy in an Accelerated Partial Breast Intensity-Modulated Radiotherapy Protocol: In Regard to Leonard CE et al. (Int J Radiat Oncol Biol Phys Epub May 19, 2009)

International Journal of Radiation Oncology * Biology * Physics — Thu, 10 Dec 2009 15:06:02 +0100

To the Editor: We read with great interest the recent paper by Leonard et al. where they described their experience with image-guided external beam accelerated partial breast irradiation (APBI). Leonard et al. describe a protocol that used implanted markers as fiducials for megavoltage image localization. We take issue with several statements from their paper, namely that there has been little to no reported experience in image guidance for APBI and that their paper is the first publication concerning the use of implanted fiducials for APBI. Rather, we submit that several publications describing a wide range of image-guidance techniques for APBI, including reports of implanted fiducial markers, have previously been published. Weed et al. studied the validity of clips as a surrogate for ...

Erratum to: Axillary Recurrence Rate Following Negative Sentinel Node Biopsy for Invasive Breast Cancer: Long-Term Follow-Up

Annals of Surgical Oncology — Thu, 03 Dec 2009 12:53:30 +0100

Conclusion These data confirm that SLN biopsy is an effective and safe alternative to ALND for detection of nodal metastases in patients with invasive breast cancer and validates its use as the standard tool for nodal staging. Content Type Journal ArticleCategory ErratumDOI 10.1245/s10434-009-0800-2Authors John V. Kiluk, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USAQuan P. Ly, University of Nebraska Medical Center Omaha NE USAAlfredo A. Santillan, University of Texas Health Science Center at San Antonio Division of Surgical Oncology San Antonio TX 78229 USATammi Meade, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USADaniel Ramos, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USADouglas S. Reintgen, Lak...

Abstract IA-14: Molecular alterations that predict premalignancy in breast cancer

Cancer Research — Wed, 02 Dec 2009 04:15:38 +0100

Approximately 15–30% of women diagnosed with ductal carcinoma in situ (DCIS) develop a subsequent tumor event within 10 years after surgical lumpectomy. To date, little is known about the molecular pathways that confer this differential risk for developing subsequent disease. Since DCIS is non-obligate precursor of invasive carcinoma, the majority of DCIS lesions are not associated with subsequent invasive tumors. Likely, many women diagnosed with DCIS who opt for surgery, with or without adjuvant treatment, are being overtreated. Identification of characteristics of DCIS that predict subsequent tumor development would advance our understanding of breast cancer and allow us to stratify a woman's individual risk for subsequent invasive tumors and avoid over- and undertreatment of wome...

Study Explores How Women Make Decisions About Breast Cancer Surgery

Cancercompass News: Breast Cancer — Sat, 21 Nov 2009 00:00:00 +0100

For women just diagnosed with breast cancer, one of the important decisions confronting them is whether to have a lumpectomy or mastectomy. A diagnosis of breast cancer will affect one in every eight women in the United States, according to the American Cancer Society, causing them to have to decide quickly about treatment. (Source: Cancercompass News: Breast Cancer)

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Silicone implant and primary breast ALK1-negative anaplastic large cell lymphoma, fact or fiction?

International Journal of Clinical and Experimental Pathology — Thu, 19 Nov 2009 10:38:02 +0100

In this report, we describe an additional case of primary breast ALK1-negative ALCL in the fibrous capsule and cystic fluid of silicone breast implant in a 58 year old woman who underwent breast reconstructive surgery after lumpectomy for her infiltrating breast adenocarcinoma. Morphologically and immunohistochemically, the lymphoma cells may be confused with recurrent infiltrating breast adenocarcinoma or other non-hematolymphoid malignancies. Molecular studies were needed to determine T-lineage differentiation of the malignant lymphoma cells. We will also review the case reports and case series published in the English literature and discuss our current understanding of silicone implant in primary breast ALK1-negative ALCL. PMID: 19918336 [PubMed - in process] (Source: International ...

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...

SAVI Breast Cancer Radiation Therapy Is A Unique Solution, Study Finds

Cancercompass News: Breast Cancer — Sat, 14 Nov 2009 00:00:00 +0100

The SAVI 6-1Mini breast brachytherapy applicator is the only brachytherapy solution for patients with small breasts, hard-to-reach lumpectomy cavities, or cavities close to the skin surface, according to a new study. (Source: Cancercompass News: Breast Cancer)

Study: Lumpectomy cavity volume decreases during whole-breast irradiation

Health Imaging News — Fri, 13 Nov 2009 12:34:07 +0100

Patients who undergo lumpectomy will likely have their lumpectomy cavity decrease in volume during whole-breast irradiation, according to a study in this month's International Journal of Radiation Oncology*Biology*Physics. (Source: Health Imaging News)

Study: Lumpectomy cavity volume decreases during whole-breast irradiation

Health Imaging News — Fri, 13 Nov 2009 12:34:07 +0100

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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...

Pain: A lasting problem for breast cancer survivors

CNN.com - Health — Wed, 11 Nov 2009 20:42:01 +0100

Almost half of women who have breast cancer surgery still have pain or numbness two to three years later, according to a new study. Women younger than 40 who receive lumpectomies are at the greatest risk. (Source: CNN.com - Health)

Pain lingers for some breast cancer survivors

CNN.com - Health — Wed, 11 Nov 2009 20:42:01 +0100

Dense breasts linked to return of breast cancer

Reuters: Health — Mon, 09 Nov 2009 22:22:26 +0100

NEW YORK (Reuters Health) - Women with dense breasts who have had lumpectomies for breast cancer are at a higher risk of a recurrence, according to a new study. (Source: Reuters: Health)

Dense Breasts Linked To Cancer Recurrence

WDSU.com - Health — Mon, 09 Nov 2009 14:28:04 +0100

Women with more breast tissue may need more therapy than just a lumpectomy, according to researchers. (Source: WDSU.com - Health)

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Dense Breasts at Higher Risk of Cancer Recurrence (CME/CE)

MedPage Today Hematology/Oncology — Mon, 09 Nov 2009 04:01:00 +0100

Breast cancer patients with dense breasts may be more likely to see their disease return after lumpectomy, researchers found. (Source: MedPage Today Hematology/Oncology)

SAVI Breast Cancer Radiation Therapy Is A 'Unique Solution,' Study Finds

Health News from Medical News Today — Sat, 07 Nov 2009 06:00:00 +0100

SAVI Breast Cancer Radiation Therapy Is A 'Unique Solution,' Study Finds

Breast Cancer News From Medical News Today — Sat, 07 Nov 2009 06:00:00 +0100

The SAVI™ 6-1Mini breast brachytherapy applicator is the only brachytherapy solution for patients with small breasts, hard-to-reach lumpectomy cavities, or cavities close to the skin surface, according to a new study. Physicist and lead researcher Serban Morcovescu, MS, DABR, presented these findings on the 6-1Mini device at the recent annual conference of the American Society for Radiation Oncology (ASTRO). (Source: Breast Cancer News From Medical News Today)

ASTRO: Post-lumpectomy breast cancer RT can be safely reduced to four weeks

Health Imaging News — Fri, 06 Nov 2009 12:18:25 +0100

Post-lumpectomy radiation treatment for early-stage breast cancer can be safely reduced to four weeks by delivering a higher daily dose according to the five-year results of a phase II study presented Wednesday at the 2009 American Society for Radiation Oncology (ASTRO) in Chicago. (Source: Health Imaging News)

ASTRO: Post-lumpectomy breast cancer RT can be safely reduced to four weeks

Health Imaging News — Fri, 06 Nov 2009 12:18:25 +0100

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Radiation Therapy After Lumpectomy For Breast Cancer Can Be Safely Reduced To 4 Weeks

Radiology / Nuclear Medicine News From Medical News Today — Thu, 05 Nov 2009 12:00:00 +0100

Researchers at Fox Chase Cancer Center found that radiation treatment for women who had a lumpectomy for early-stage breast cancer can be safely reduced to four weeks, instead of the usual six to seven weeks, by delivering a higher daily dose - greatly reducing the length of treatment time. The five-year results of the phase II study were presented at the annual meeting of the American Society for Radiation Oncology. (Source: Radiology / Nuclear Medicine News From Medical News Today)

Radiation Therapy After Lumpectomy For Breast Cancer Can Be Safely Reduced To 4 Weeks

Health News from Medical News Today — Thu, 05 Nov 2009 12:00:00 +0100

Radiation therapy after lumpectomy for breast cancer can be safely reduced to 4 weeks

EurekAlert! - Cancer — Wed, 04 Nov 2009 05:00:00 +0100

(Fox Chase Cancer Center) Researchers at Fox Chase Cancer Center found that radiation treatment for women who had a lumpectomy for early-stage breast cancer can be safely reduced to four weeks, instead of the usual six to seven weeks, by delivering a higher daily dose -- greatly reducing the length of treatment time. The five-year results of the phase II study will be presented today at the annual meeting of the American Society for Radiation Oncology. (Source: EurekAlert! - Cancer)

Technique Can Reduce Sentinel Node Biopsies in Early Breast Ca

Internal Medicine News — Sun, 01 Nov 2009 00:00:00 +0100

Adding ultrasound examination of axillary nodes and fine-needle aspiration of suspicious nodes prior to lumpectomy in women with early-stage breast cancer spared 17 (30%) of 57 women the need for sentinel node biopsy and a second surgery, a study of 274 patients found. (Source: Internal Medicine News)

Technique May Reduce Biopsies in Early Breast Ca

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

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Hemangiomas, Angiosarcomas, and Vascular Malformations Rep-resent the Signaling Abnormalities of Pathogenic Angiogenesis.

Current Molecular Medicine — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Arbiser JL, Bonner MY, Berrios RL Angiogenesis is a major factor in the development of benign, inflammatory, and malignant processes of the skin. Endothelial cells are the effector cells of angiogenesis, and understanding their response to growth factors and inhibitors is critical to understanding the pathogenesis and treatment of skin disease. Hemangiomas, benign tumors of endothelial cells, represent the most common tumor of childhood. In our previous studies, we have found that tumor vasculature in human solid tumors expresses similarities in signaling to that of hemangiomas, making the knowledge of signaling in hemangiomas widely applicable. These similarities include expression of reactive oxygen, NFkB and akt in tumor vasculature. Furthermore, we have studied malignant v...

Local Recurrence of Invasive Micropapillary Breast Cancer After MammoSite Brachytherapy: A Case Report and Literature Review.

Clinical Breast Cancer — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Fowler AM, Andersen JJ, Conway PD Controversy exists over the optimal patient selection criteria for accelerated partial-breast irradiation (APBI), which has been introduced as an alternative to whole-breast irradiation. The goal is to select patients with the lowest risk for tumor spread outside of the original lumpectomy bed targeted by the local internal radiation dose. Therefore, patients with more aggressive types of breast cancer might not be ideal candidates for partial breast irradiation. We discuss the case of a 67-year-old woman who presented with local recurrence of invasive micropapillary breast cancer, a rare aggressive tumor type, 5 years after MammoSite brachytherapy. The patient's primary tumor possessed all favorable indicators except for the histology of inva...

Author's Response

Journal of the American College of Radiology : JACR — Wed, 28 Oct 2009 15:20:03 +0100

I would like to thank Schmitz et al for their comments on my article on MR-guided focused ultrasound (MRgFUS) as a disruptive technology []. Although it is hard to argue against having surgical margins for the resection of a malignant tumor, in fact, most lumpectomies for breast cancer today are followed by radiation therapy, reducing the recurrence at 4 years from 24% to 6% []. This would imply that 25% of the time surgeons think that they have margins, they don't. Lumpectomy, even with apparent margins, is really a debulking procedure and is not curative in its own without follow-up radiation therapy. (Source: Journal of the American College of Radiology : JACR)

How Women Make Decisions About Breast Cancer Surgery

Health News from Medical News Today — Wed, 28 Oct 2009 07:00:00 +0100

Surgery for Breast Cancer: Complex Options, Difficult Decisions

U.S. News - Health — Tue, 27 Oct 2009 21:25:00 +0100

Choosing between a lumpectomy and mastectomy isn't as easy as looking at a few study findings. (Source: U.S. News - Health)

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UB study explores how women make decisions about breast cancer surgery

EurekAlert! - Social and Behavioral Science — Mon, 26 Oct 2009 04:00:00 +0100

(University at Buffalo) For women just diagnosed with breast cancer, one of the important decisions confronting them is whether to have a lumpectomy or mastectomy. A diagnosis of breast cancer will affect one in every eight women in the United States, according to the American Cancer Society, causing them to have to decide quickly about treatment. (Source: EurekAlert! - Social and Behavioral Science)

Breast cancer patients: Consider all your options

CNN.com - Health — Sat, 24 Oct 2009 18:14:57 +0100

Mastectomy or lumpectomy? Breast reconstruction or not? What type of chemo? There are lots of questions when faced with a breast cancer diagnosis, and some advocates fear women aren't being given all the options. (Source: CNN.com - Health)

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)

Intraoperative placement of MammoSite for breast brachytherapy treatment and seroma incidence

Brachytherapy — Fri, 23 Oct 2009 00:00:00 +0100

Conclusions: Meticulous wound care and postoperative antibiotics prevented acute infection. Infection was not a contributing factor for seroma formation in these patients. Placement of the MammoSite catheter by OCT did not increase the risk of CSS development, in postmenopausal breast cancer patients. (Source: Brachytherapy)

Breast cancer patients: Know your options!

CNN.com - Health — Thu, 22 Oct 2009 16:26:37 +0100

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Learn the secret to optimal breast cancer care

CNN.com - Health — Thu, 22 Oct 2009 14:55:00 +0100

Breast cancer patients need to know options

CNN.com - Health — Thu, 22 Oct 2009 13:49:20 +0100

Substantial chest-wall deformity following tissue expansion after radiotherapy

European Journal of Plastic Surgery — Wed, 21 Oct 2009 09:04:41 +0100

We present the case of a 54-year-old woman who underwent a two-stage breast reconstruction with a tissue expander after sustaining a lumpectomy and local radiotherapy for breast cancer. During expansion, the woman developed an abnormal concave deformity of the chest wall. Although respiratory or aesthetic consequences were expected, our patient reported only pain and was satisfied with the end result. Osteoporosis or local recurrence was excluded as predisposing factors, and radiotherapy was considered to be the causal factor in our patient. On the basis of this finding, we advise surgeons to take the risk of chest-wall deformity into consideration when planning a reconstruction with tissue expanders, especially in patients with a history of radiotherapy, and we recommend an alternat...

Lumpectomy

MayoClinic.com Full Feed — Sat, 17 Oct 2009 18:41:00 +0100

— Overview covers definition, preparation, risks, results of this breast-conserving surgical procedure. Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)

What are the predictive factors of positive resection margin in infiltrating lobular carcinoma treated by breast conserving surgery?

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:47:04 +0100

Aims: To determine whether infiltrating lobular carcinoma (ILC) is associated with high positive margin rates for single stage lumpectomy procedures. To define clinical or histological characteristics that might influence the positive margin rate,thereby affecting treatment decisions. To identify factors predictive of margin involvement and the need for re-operation. (Source: European Journal of Surgical Oncology)

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The Allegheny General Modification of the Harvard Breast Cosmesis Scale for the Retreated Breast

Cancer Network — Tue, 13 Oct 2009 12:00:00 +0100

Repeat lumpectomy and retreatment radiotherapy following ipsilateral breast tumor recurrence (IBTR) by either external-beam irradiation or brachytherapy in lieu of salvage mastectomy is an area of significant recent clinical interest. Multiple authors have reported their results, with encouraging numbers of patients avoiding mastectomy. (Source: Cancer Network)

Geography, Education And Economic Status Affect Treatment For Early Invasive Breast Cancer

Health News from Medical News Today — Mon, 12 Oct 2009 08:00:00 +0100

Invasive Breast Carcinoma Arising in Microglandular Adenosis: A Case Report and Review of the Literature

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

We reported a case of invasive carcinoma arising in microglandular adenosis. A lumpectomy was performed on a 42-year-old female because of a mass in the right breast. Grossly, the lesion was ill-defined with thickened areas. Histologically, this case was consistent with carcinoma arising in microglandular adenosis and showed clear transition from microglandular adenosis through atypical microglandular adenosis to in situ and invasive carcinoma. All the epithelial cells were positive for cytokeratin7, S-100 protein, but negative for estrogen receptor, progesterone receptor, and Her2/Neu. No myoepithelial cells were demonstrable with immunohistochemical staining for smooth muscle actin, muscle-specific antigen or P63. Periodic acid-Schiff staining showed the presence of a basement membrane i...

Although more older women receive breast-conserving therapy, gaps in treatment exist

EurekAlert! - Medicine and Health — Fri, 09 Oct 2009 04:00:00 +0100

(Weber Shandwick Worldwide) 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. For example, women in the Northeast and Pacific West are significantly more likely to receive BCS than those in the South and parts of the Midwest. (Source: EurekAlert! - Medicine and Health)

Technique May Spare Biopsies in Early Breast Cancer

OncologySTAT Latest News — Wed, 07 Oct 2009 14:05:34 +0100

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Managing a small recurrence in the previously irradiated breast. Is there a second chance for breast conservation?

Oncology (Williston Park, N.Y.) — Thu, 01 Oct 2009 00:00:00 +0100

In this report, we review the controversial subject of a second chance at breast conservation for women with a prior history of breast irradiation. PMID: 19947343 [PubMed - in process] (Source: Oncology (Williston Park, N.Y.))

Bacteriologic features of surgical site infections following breast surgery

American Journal of Surgery — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: Gram-negative SSIs constituted half of the SSIs in this breast surgery cohort. Of all breast isolates, 17.5% were resistant to cefazolin. On the basis of these findings, antibiotic prophylaxis regimens alternative to cefazolin should be considered. (Source: American Journal of Surgery)

Prediction of Local Recurrence, Distant Metastases, and Death After Breast-Conserving Therapy in Early-Stage Invasive Breast Cancer Using a Five-Biomarker Panel [Breast Cancer]

Journal of Clinical Oncology — Mon, 28 Sep 2009 23:00:00 +0100

Conclusion The 5-year and 10-year survival rates varied according to molecular subtype. Although this approach provides additional information to predict time to IBTR, LRR, DDFS, and death from breast cancer, its predictive power is less than that of traditional pathologic indices. This information may be useful in discussing outcomes and planning management with patients after BCT. (Source: Journal of Clinical Oncology)

Determinants of wound infections for breast procedures: Assessment of the risk of wound infection posed by an invasive procedure for subsequent operation

International Journal of Surgery — Sun, 27 Sep 2009 00:00:00 +0100

We examined whether there is any higher risk of wound infection in patients undergo a reoperation after an initial operation or excision/incision biopsy.Methods and Results: A retrospective review of medical charts of patients with breast operations between January 1990 and July 2008 was carried out. The overall incidence of wound infection was 18.2% (231/1267). The rate of wound infection was (32%) when reoperation was done after previous modified radical mastectomy, 18.9% and 16.8% when the previous operations were lumpectomy/segmenectomy with axillary dissection and simple mastectomy without axillary dissection, respectively and (10.8%) when reoperation was performed after previous biopsy. Reoperation involving axillary dissection was associated with significantly higher rates of wound ...

Axillary Recurrence Rate Following Negative Sentinel Node Biopsy for Invasive Breast Cancer: Long-Term Follow-Up

Annals of Surgical Oncology — Thu, 24 Sep 2009 14:35:03 +0100

Conclusion These data confirm that SLN biopsy is an effective and safe alternative to ALND for detection of nodal metastases in patients with invasive breast cancer and should be used as the standard tool for nodal staging. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0704-1Authors John V. Kiluk, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USAQuan P. Ly, University of Nebraska Medical Center Omaha NE USATammi Meade, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USADaniel Ramos, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa FL USADouglas S. Reintgen, Lakeland Regional Cancer Center Lakeland FL USASophie Dessureault, H. Lee Moffitt Cancer Center and Research Institute (MCC) Tampa ...

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Re the article: “Impact of the boost dose of 10Gy versus 26Gy in patients with early stage breast cancer after a microscopically incomplete lumpectomy: 10-year results of the randomised EORTC boost trial. On behalf of the EORTC Radiation Oncology and Breast Cancer Groups. Radiother Oncol 2009;90:80–5”

Radiotherapy and Oncology — Mon, 14 Sep 2009 00:00:00 +0100

Dr. Poortmans and his colleagues need to be complimented for conducting and reporting the EORTC 22881-10882 ‘‘boost” trial . This trial addresses a very relevant issue for the breast radiation oncologists. It investigates the relevance of a boost dose to the primary tumour site after lumpectomy and whole breast irradiation. Intuitively it can be stated that higher doses should lead to significantly better local control rates. In this context, the results of the trial are provocative indeed. (Source: Radiotherapy and Oncology)

The Toolbox of Self-Deception, Part III

Psychology Today Work Center — Sat, 12 Sep 2009 17:27:57 +0100

Below, the third of three parts on the ubiquitous nature of self-deception in daily life; click here for Part I and here for Part II. When you stop to think about it (and that's what we psychologists are trained to do), we enlist an impressive array of cognitive tactics and behavioral gambits in the daily effort to feel good about ourselves. We carry around a veritable toolbox of self-deception, including well more individual tools than I can catalog here. What follows is but a sampling of the more common strategies we employ in the daily pursuit of positive self-regard... 5. Downward Social ComparisonSo, associating ourselves with successful and accomplished others is always the way to go, right? Not so fast. What if those others are thriving in the very areas where we're ...

Re the article: "Impact of the boost dose of 10Gy versus 26Gy in patients with early stage breast cancer after a microscopically incomplete lumpectomy: 10-year results of the randomised EORTC boost trial. On behalf of the EORTC Radiation Oncology and Breast Cancer Groups. Radiother Oncol 2009;90:80-5"

Wed, 09 Sep 2009 23:00:00 +0100

Authors: Munshi A PMID: 19748145 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Accelerated hypofractionated radiotherapy schedules in breast cancer: a review of the current literature.

Reviews on Recent Clinical Trials — Tue, 01 Sep 2009 00:00:00 +0100

Authors: Kalogeridi MA, Kelekis N, Kouvaris J, Platoni K, Kyrias G, Pectasides D, Kouloulias V Lumpectomy followed by breast irradiation is an alternative to mastectomy for patients with early-stage breast cancer. The purpose of radiation treatment following lumpectomy is to minimize the risk of recurrent cancer in the treated breast with as little toxicity as possible so that good cosmesis and function are maintained. Conventional fractionation schedules for postlumpectomy radiotherapy give 50 Gy in 2 Gy daily fractions, often with an additional boost to the tumor bed, resulting in treatment being given over 5-7 weeks. Delivering postoperative radiotherapy in a shorter period of time, provided it is as effective as longer treatment regiments, could result in greater convenience for pa...

Outcome of multiple-wire localization for larger breast cancers: do multiple wires translate into additional imaging, biopsies, and recurrences?

American Journal of Surgery — Mon, 31 Aug 2009 23:00:00 +0100

Conclusions: We found no increased risk of early local recurrence, metastasis, or additional imaging or biopsies in patients requiring multiple-wire localization for lumpectomy. Breast conservation should be considered a safe option even for patients with mammographically extensive lesions. (Source: American Journal of Surgery)

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Breast Cancer Radiation Guidelines Called Positive Step

Cancercompass News: Breast Cancer — Fri, 14 Aug 2009 05:00:00 +0100

The new medical consensus statement on accelerated partial breast irradiation is an important step toward defining patient selection criteria and highlights the importance of targeting radiation, said two of the nation's leading APBI physicians. The consensus statement, from the American Society for Radiation Oncology (ASTRO) outlines patient selection criteria and best practices for the use of APBI, a simpler, much shorter course of radiation treatment following lumpectomy surgery for breast cancer. It was published in the July 15, 2009, issue of the International Journal of Radiation Oncology*Biology*Physics, the organization's official journal. "Patient selection for APBI is a critical component of the treatment decision-making pro... (Source: Cancercompass News: Breast Cancer)

Arm Exercises Help With Lymphedema

About.com Breast Cancer — Tue, 11 Aug 2009 23:00:00 +0100

Pole Walking Illustration © Pam Stephan When my lymph nodes were sampled during my lumpectomy, my left arm could not process the lymphatic fluid as well. My surgeon sent me home... (Source: About.com Breast Cancer)

Breast cancer surgery: an historical narrative. Part III. From the sunset of the 19th to the dawn of the 21st century

European Journal of Cancer Care — Thu, 06 Aug 2009 23:00:00 +0100

The 20th century is marked by significant advances regarding the management of breast cancer. A clear trend towards less aggressive surgical operation was constantly noted. Modified radical mastectomy gradually replaced radical mastectomy during the second half of the 20th century, while during the last two decades breast-conservation therapy became the treatment of choice for the treatment of breast cancer. This type of therapy includes segmental mastectomy (either quadrantectomy or lumpectomy) with axillary lymph node dissection, followed by postoperative irradiation. Other significant advances during the 20th century include the introduction of systemic therapy (chemotherapy, hormonal therapy) and radiation therapy. Better patient follow-up, statistical analysis, development of staging ...

Is this mildly pruritic eruption a bacterial infection—or something else?

Consultant Live — Wed, 05 Aug 2009 11:30:01 +0100

This pruritic rash developed in a 43-year-old woman who had undergone a lumpectomy and lymph node dissection for breast cancer. She completed radiation therapy and chemotherapy 3 weeks ago. The rash has been present for 5 days. Levofloxacin was started 1 day ago. (Source: Consultant Live)

Breast Cancer Radiation Guidelines Called Positive Step - ASTRO Document Stresses Importance Of Minimizing Radiation To Healthy Tissue

Cancercompass News: Breast Cancer — Tue, 04 Aug 2009 05:00:00 +0100

PHOENIX -- The new medical consensus statement on accelerated partial breast irradiation is an important step toward defining patient selection criteria and highlights the importance of targeting radiation, said two of the nation's leading APBI physicians. The consensus statement, from the American Society for Radiation Oncology (ASTRO) outlines patient selection criteria and best practices for the use of APBI, a simpler, much shorter course of radiation treatment following lumpectomy surgery for breast cancer. It was published in the July 15, 2009, issue of the International Journal of Radiation Oncology*Biology*Physics, the organization's official journal. "Patient selection for APBI is a critical component of the tr... (Source: Cancercompass News: Breast Cancer)

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Early-stage BRCA2-linked breast cancer diagnosed in the first trimester of pregnancy associated with a hypercoagulable state.

Oncology (Williston Park, N.Y.) — Fri, 31 Jul 2009 23:00:00 +0100

Authors: Diamond JR, Finlayson CA, Thienelt C, Kabos P, Hardesty L, Barbour L, Klein CE, Rabinovitch R, Elias A, Borges VF This patient was found to have a BRCA2 gene mutation. She underwent lumpectomy and axillary lymph node dissection without any evidence of lymph node metastasis. Systemic chemotherapy with doxorubicin and cyclophosphamide for four cycles was administered beginning in the second trimester. She was treated with prophylactic LMWH until delivery and then for 6 weeks postpartum. She delivered a healthy baby boy and, after a period of breast-feeding, underwent bilateral mastectomy with immediate reconstruction. She remains well and is expecting her second child. Prophylactic oophorectomy is planned after completion of this pregnancy. PMID: 19777765 [PubMed - in proces...

Accelerated whole-breast irradiation does more with less after lumpectomy

Cancer Network — Tue, 28 Jul 2009 12:00:00 +0100

Shortening the course of whole-breast irradiation aft er lumpectomy from five weeks to three can improve convenience and cut costs without sacrifi cing results, according to research from McMaster University in Hamilton, Ontario. (Source: Cancer Network)

A novel ultrasound-guided electrosurgical loop device for intra-operative excision of breast lesions; an improvement in surgical technique

American Journal of Surgery — Fri, 24 Jul 2009 11:45:52 +0100

Conclusions: These results demonstrate improved efficiency, a decrease in the volume of excision, smaller incision size, and very low need for reoperation secondary to involved margins using the Phantom device for real-time, ultrasound-guided lumpectomy. (Source: American Journal of Surgery)

MRI Guidance for Accelerated Partial Breast Irradiation in Prone Position: Imaging Protocol Design and Evaluation

International Journal of Radiation Oncology * Biology * Physics — Thu, 23 Jul 2009 23:00:00 +0100

Conclusions: MRI guidance for accelerated partial breast irradiation with the patient in the prone position with adequate contrast, spatial fidelity, and resolution is possible. (Source: International Journal of Radiation Oncology * Biology * Physics)

Patient age and positive margins are predictive factors of residual tumor on mastectomy specimen after conservative treatment for breast cancer

The Breast — Wed, 22 Jul 2009 23:00:00 +0100

Conclusion: Young age of patients (under 45-years-old) and presence of positive margins on the operative specimen are independent risk factors of residual tumor after conservative treatment of breast cancer. (Source: The Breast)

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Patient age and positive margins are predictive factors of residual tumor on mastectomy specimen after conservative treatment for breast cancer.

Breast — Mon, 20 Jul 2009 23:00:00 +0100

CONCLUSION: Young age of patients (under 45-years-old) and presence of positive margins on the operative specimen are independent risk factors of residual tumor after conservative treatment of breast cancer. PMID: 19628389 [PubMed - as supplied by publisher] (Source: Breast)

Obtaining Adequate Surgical Margins in Breast-Conserving Therapy for Patients with Early-Stage Breast Cancer: Current Modalities and Future Directions

Annals of Surgical Oncology — Sat, 18 Jul 2009 19:53:22 +0100

Abstract Inadequate surgical margins represent a high risk for adverse clinical outcome in breast-conserving therapy (BCT) for early-stage breast cancer. The majority of studies report positive resection margins in 20% to 40% of the patients who underwent BCT. This may result in an increased local recurrence (LR) rate or additional surgery and, consequently, adverse affects on cosmesis, psychological distress, and health costs. In the literature, various risk factors are reported to be associated with positive margin status after lumpectomy, which may allow the surgeon to distinguish those patients with a higher a priori risk for re-excision. However, most risk factors are related to tumor biology and patient characteristics, which cannot be modified as such. Therefore, ef...

Mast vs Lump Qs 2 Decide

About.com Breast Cancer — Thu, 16 Jul 2009 23:00:00 +0100

Mastectomy vs Lumpectomy - it can be a very hard decision to make. Women with early-stage breast cancer may have options between mastectomy and lumpectomy. Here are 10 questions to help you decide which you want - mastectomy or lumpectomy. (Source: About.com Breast Cancer)

Georgia Center for Total Cancer Care (GCTCC) At Coliseum Medical Center Gets AccuBoost Novel New Breast Cancer Treatment

Medical News (via PRIMEZONE) — Thu, 16 Jul 2009 19:12:00 +0100

MACON, Ga., July 16, 2009 (GLOBE NEWSWIRE) -- Today Dr. Sean Cavanaugh, Chief Radiation Oncologist at GCTCC, began treating patients with AccuBoost. Mrs. Evelyn Turner of Macon, GA was the first local woman to benefit from this new technology. After diagnosis with early stage breast cancer, Mrs. Turner was referred for AccuBoost treatment by her surgeon Dr. Arnold Conforti after successful lumpectomy. (Source: Medical News (via PRIMEZONE))

Magnetic Resonance Imaging in the Planning of Initial Lumpectomy for Invasive Breast Carcinoma: Its Effect on Ipsilateral Breast Tumor Recurrence After Breast-Conservation Therapy

Annals of Surgical Oncology — Wed, 15 Jul 2009 17:20:49 +0100

Conclusion MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after BCS with RT in this cohort of patients. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0607-1Authors Nicholas Hwang, University of Toronto Department of Surgical Oncology, Princess Margaret Hospital Toronto ON CanadaDan E. Schiller, University of Alberta Department of Surgery Edmonton AB CanadaPavel Crystal, University of Toronto Department of Medical Imaging, Princess Margaret Hospital, Mount Sinai Hospital Toronto ON CanadaEllen Maki, University of Toronto Department of Statistics Toronto ON CanadaDavid R. McCready, University of Toronto Department of Surgical Oncology, Princess Margaret Hospital Tor...

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Mastectomy Or Lumpectomy - How to Decide?

About.com Breast Cancer — Sun, 05 Jul 2009 23:00:00 +0100

After my biopsy came back and I found out I did indeed have breast cancer, my surgeon said I could choose between a mastectomy and a lumpectomy. What -... (Source: About.com Breast Cancer)

Medical Madness: More Women Scared Into Double Mastectomy as Way to "Prevent" Cancer

NaturalNews.com — Fri, 26 Jun 2009 07:00:00 +0100

(NaturalNews) Increasing numbers of women are choosing to have both breasts removed in order to avoid breast cancer -- but doctors warn that many of these procedures may expose women to serious risk without providing the promised benefit.In general, two kinds of women use double mastectomy as a preemptive breast cancer treatment. One group consists of women who have been diagnosed with cancer in one breast and choose to have both breasts completely removed in order to avoid the risk of developing cancer in the healthy breast. This procedure is called contralateral prophylactic mastectomy. Another group, the so-called "pre-vivors," are women who have not received a cancer diagnosis at all but believe they have a high enough cancer risk to justify the measure.Performing mastectomies as proph...

Accelerated Partial Breast Irradiation: Caution and Concern From an ASTRO Task Force

International Journal of Radiation Oncology * Biology * Physics — Thu, 25 Jun 2009 08:18:12 +0100

Breast conservation therapy (BCT), consisting of resection of the primary breast cancer (lumpectomy, segmental mastectomy, wide local excision) followed by whole breast irradiation (WBI), is one of the great success stories of modern radiation oncology. This procedure has been demonstrated to be equivalent to more extensive surgery, i.e., the radical or modified radical mastectomy, in multiple Phase III trials involving thousands of patients, too well known to merit a repeat citation here. Virtually all studies have shown quite low long-term toxicity, even though most studies antedate the modern treatment era of three-dimensional planning, intensity-modulated radiotherapy, gated radiotherapy for left-sided breast cancers, and so forth. Indeed, when we consider treatment options for a varie...

Sonique Back in Surgery and Facing Chemo

About.com Breast Cancer — Sun, 21 Jun 2009 17:40:49 +0100

SoniquePhoto © Dave Hogan/Getty Images Sonique, the BRIT-award winning singer and DJ, is going back in the operating room for another lumpectomy. Her first operation for breast cancer was done... (Source: About.com Breast Cancer)

Accelerated Partial Breast Irradiation: What is Dosimetric Effect of Advanced Technology Approaches?

International Journal of Radiation Oncology * Biology * Physics — Thu, 18 Jun 2009 23:00:00 +0100

Purpose: The present treatment planning study compared whole breast radiotherapy (WBRT) to accelerated partial breast irradiation (APBI) for different external beam techniques and geometries (e.g., free breathing [FB] and deep inspiration breath hold [DIBH]).Methods and Materials: After approval by our institutional review board, a treatment planning study was performed of 10 patients with left-sided Stage 0-I breast cancer enrolled in a Phase I-II study of APBI using intensity-modulated radiotherapy (IMRT). After lumpectomy, patients underwent planning computed tomography scans during FB and using an active breathing control device at DIBH. For the FB geometry, standard WBRT and three-dimensional conformal radiotherapy (3D-CRT) APBI plans were created. For the DIBH geometry with active br...

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Association of Routine Pretreatment Magnetic Resonance Imaging with Time to Surgery, Mastectomy Rate, and Margin Status

Journal of the American College of Surgeons — Wed, 17 Jun 2009 23:00:00 +0100

Conclusions: Breast MRI use was not confined to any particular patient group. MRI use was not associated with improved margin status or BCT attempts, but was associated with a treatment delay and increased mastectomy rate. Without evidence of improved oncologic outcomes as a result, our study does not support the routine use of MRI to select patients or facilitate the performance of BCT. (Source: Journal of the American College of Surgeons)

Intra-operative touch preparation cytology following lumpectomy for breast cancer: A series of 400 procedures

The Breast — Wed, 10 Jun 2009 23:00:00 +0100

Conclusion: IOTPC is a reliable extemporaneous method for assessing surgical margins in conservative treatment for breast cancer and a useful tool for surgeons. (Source: The Breast)

The influence of the use of CT-planning on the irradiated boost volume in breast conserving treatment

Radiotherapy and Oncology — Tue, 09 Jun 2009 23:00:00 +0100

Abstract: Background and purpose: The purpose of this study was to investigate the effect of CT-based delineation and planning on the irradiated boost volume. For this specific purpose we used the data as derived from 2 prospective phase III randomised trials.Patients and methods: Data from 1331 patients (⩽50 years) were analyzed with a reported boost volume from a simulation-based treatment plan (EORTC boost vs no boost trial, n=922), and a CT-scan-based treatment plan (Young Boost Trial, n=409) group. Tumour diameter, irradiation technique (photons vs electrons), lumpectomy size, and age were used as covariates.Results: Median V95% in the conventional simulation-based treatment plans was 99 cc (range 9–628) for photons and was 98 cc (13–651) for electrons, whereas in the CT-planned...

SAVI Breast Cancer Radiation Device Expands Availability Of Brachytherapy, Studies Report

Cancercompass News: Breast Cancer — Mon, 08 Jun 2009 05:00:00 +0100

Breast cancer radiation with the SAVI applicator provides outstanding cosmetic and other clinical outcomes, according to two new studies, and is an ideal solution for breast conservation therapy patients with small breasts, small tumor beds and minimal distance between the lumpectomy cavity and skin surfaces. The studies, which were conducted at Moores Cancer Center at University of California, San Diego, will be presented from the podium at the American Brachytherapy Society s annual meeting, May 31-June 2, 2009, in Toronto. SAVI is implemented as part of breast conservation therapy, which encompasses surgery to remove the breast cancer and follow-up radiation delivered inside the breast in a procedure known as breast brachytherapy... (Source: Cancercompass News: Breast Cancer)

[Breast Cancer] Feasibility Trial of Partial Breast Irradiation With Concurrent Dose-Dense Doxorubicin and Cyclophosphamide in Early-Stage Breast Cancer

Journal of Clinical Oncology — Mon, 08 Jun 2009 04:00:00 +0100

Conclusion PBI with concurrent ddAC is feasible, and local/systemic toxicity is acceptable. Larger studies are warranted to assess long-term locoregional control and late toxicities. (Source: Journal of Clinical Oncology)

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Dynamic tumor bed volume in breast cancer patients after lumpectomy

MedWire News - Oncology — Mon, 08 Jun 2009 00:00:00 +0100

Patients who undergo breast-conserving surgery and radiotherapy continue to show changes in tumor bed volume after surgery and throughout radiation treatment, a study shows. (Source: MedWire News - Oncology)

Dynamic tumor bed volume in breast cancer patients after lumpectomy

MedWire News - Breast Cancer — Mon, 08 Jun 2009 00:00:00 +0100

Intra-operative touch preparation cytology following lumpectomy for breast cancer: A series of 400 procedures.

Breast — Sun, 07 Jun 2009 23:00:00 +0100

CONCLUSION: IOTPC is a reliable extemporaneous method for assessing surgical margins in conservative treatment for breast cancer and a useful tool for surgeons. PMID: 19515566 [PubMed - as supplied by publisher] (Source: Breast)

The influence of the use of CT-planning on the irradiated boost volume in breast conserving treatment.

Sun, 07 Jun 2009 23:00:00 +0100

CONCLUSIONS: The use of a CT-scan for delineation and treatment planning led to a significant increase of the irradiated boost volume by a factor of 1.5-1.8, compared to conventional simulator-based plans. PMID: 19515444 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Unusual Tumors of the Breast

Current Problems in Surgery — Fri, 05 Jun 2009 17:40:11 +0100

The days of routine radical, or even modified radical mastectomy, have been replaced in large part by the less morbid lumpectomy and reconstruction. It has been said that routine radiation only benefits 30% of patients, with 60% who would do well without it and 10% who would recur regardless of radiation therapy. Thus, recent trials have focused on determining what patients would be suited for surgical extirpation alone. In that regard, surgical pathology becomes extremely important and even for carcinomas of the usual type we catalog in extreme detail size, grade, nuclear grade, lymphovascular invasion, size, and grade of any in situ component, multifocality versus multicentricity, hormone receptors, Her-2-neu amplification, width of the margin, and nodal status. Probably 95% of breast tu...

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In vitro interaction between mouse breast cancer cells and mouse mesenchymal stem cells during adipocyte differentiation.

Journal of Tissue Engineering and Regenerative Medicine — Fri, 29 May 2009 04:00:00 +0100

Authors: Xu F, Gomillion C, Maxson S, Burg KJ Surgical treatment following breast cancer, i.e. lumpectomy and mastectomy, may not efficiently remove all cancerous cells. As such, when mesenchymal stem cells (MSCs) are incorporated into the breast reconstruction process, it is likely that those MSCs will encounter remnant cancerous cells after transplantation into the defect site. The potential interaction between breast cancer cells and MSCs remains unclear. We hypothesized that paracrine interactions might occur between cells and various proteinases, growth factors and other cytokine molecules in the local microenvironment. Conditioned media (CM) from two mouse mammary cancer cell lines (4T1 and 4T07) and one mouse mammary epithelial cell line (NMuMG) were studied in the experimental ...

In vitro interaction between mouse breast cancer cells and mouse mesenchymal stem cells during adipocyte differentiation

Journal of Tissue Engineering and Regenerative Medicine — Thu, 28 May 2009 23:00:00 +0100

Surgical treatment following breast cancer, i.e. lumpectomy and mastectomy, may not efficiently remove all cancerous cells. As such, when mesenchymal stem cells (MSCs) are incorporated into the breast reconstruction process, it is likely that those MSCs will encounter remnant cancerous cells after transplantation into the defect site. The potential interaction between breast cancer cells and MSCs remains unclear. We hypothesized that paracrine interactions might occur between cells and various proteinases, growth factors and other cytokine molecules in the local microenvironment. Conditioned media (CM) from two mouse mammary cancer cell lines (4T1 and 4T07) and one mouse mammary epithelial cell line (NMuMG) were studied in the experimental model. Post-confluent mouse MSCs (D1 cells) were d...

Autologous Fat Graft in Radiated Tissue Prior to Alloplastic Reconstruction of the Breast: Report of Two Cases

Aesthetic Plastic Surgery — Wed, 27 May 2009 05:51:09 +0100

Conclusion The preliminary results show that fat injection in irradiated tissue prior to breast alloplastic reconstruction may reduce the radiation-related complications on implants. Benefits from fat grafting are in keeping with the theoretical basis of this surgery. Larger studies are needed to confirm our observations. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00266-009-9367-3Authors Marzia Salgarello, University Hospital A. Gemelli Department of Plastic and Reconstructive Surgery, Catholic University of “Sacro Cuore” Largo A. Gemelli 8 00168 Rome ItalyGiuseppe Visconti, University Hospital A. Gemelli Catholic University of “Sacro Cuore” Largo A. Gemelli 8 00168 Rome ItalyEugenio Farallo, University Hospital A. Gemelli Department of Plast...

Breast-conserving therapy after previous irradiation for lymphoma

Breast Cancer Research and Treatment — Fri, 22 May 2009 05:48:29 +0100

Abstract There is an increased risk of breast cancer in patients who have undergone radiation treatment for lymphoma. While this usually precludes further radiotherapy (RT), we report five women who received irradiation for lymphoma and who subsequently received breast-conserving therapy between 1995 and 2007 for early-stage breast cancer. There was an overlap between the two treatment fields in all patients. RT for lymphoma ranged between 29.8 and 40 grays (Gy). The interval between lymphoma and the diagnosis of breast cancer was 11–24 years. All five patients had lumpectomy and received subsequent RT (45 Gy in four patients, 50 Gy in the other). All tolerated breast RT well, and toxicity was limited to grade 1 events. All five patients were alive at ...

Tumor Bed Delineation for Partial Breast and Breast Boost Radiotherapy Planned in the Prone Position: What Does MRI Add to X-ray CT Localization of Titanium Clips Placed in the Excision Cavity Wall?

International Journal of Radiation Oncology * Biology * Physics — Thu, 21 May 2009 23:00:00 +0100

Conclusions: Addition of MR to CT/clip data generated TB volumes that were discordant with those based on CT/clips alone. However, clinically satisfactory coverage of CTVMRCT by CTVCT-based tangential PBI fields provides support for CT/clip-based TB delineation remaining the method of choice for PBI/breast boost radiotherapy planned using tangential fields. (Source: International Journal of Radiation Oncology * Biology * Physics)

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Tumor reduction rate predicts early recurrence in patients with breast cancer failing to achieve complete response to primary chemotherapy.

Breast Cancer — Wed, 20 May 2009 23:00:00 +0100

CONCLUSIONS: The evaluation of tumor reduction rates on MRI was considered to be useful for predicting early outcome among breast cancer patients who cannot achieve pCR after PCT. PMID: 19459030 [PubMed - as supplied by publisher] (Source: Breast Cancer)

[Adenoid cystic carcinoma of the breast.]

Cancer Radiotherapie — Tue, 19 May 2009 23:00:00 +0100

Authors: Kallel R, Bahri Zouari I, Gouiaa N, Charfi S, Daoud E, Ayadi L, Makni S, Daoud J, Sellami Boudawara T Adenoid cystic carcinoma of the breast is a rare neoplasm, accounting for only 0.1% of all malignant breast tumours. It is more common in women in the sixth decade of their lives and often in the subareolar area. The clinical criteria is not specific and the radiographic examination showed a benign-appearing tumour. The preoperative diagnosis is possible with fine-needle aspiration cytology. The diagnosis is made by histological examination, presented a difficult differential diagnosis with cribriform carcinoma; so it is necessary to use histochemical or immunohistochemical techniques. The treatment is not well established. It consists of lumpectomy with radiation or mastectom...

[Breast Cancer] Prognosis After Ipsilateral Breast Tumor Recurrence and Locoregional Recurrences in Patients Treated by Breast-Conserving Therapy in Five National Surgical Adjuvant Breast and Bowel Project Protocols of Node-Negative Breast Cancer

Journal of Clinical Oncology — Mon, 18 May 2009 04:00:00 +0100

Conclusion Although LRF is uncommon in patients with node-negative breast cancer who are treated with lumpectomy, radiation, and adjuvant systemic therapy, those who do develop LRF have substantially worse OS and DDFI. (Source: Journal of Clinical Oncology)

Radiation recall reaction with docetaxel administration after accelerated partial breast irradiation with electronic brachytherapy

Brachytherapy — Sun, 17 May 2009 23:00:00 +0100

Conclusions: We present a case of an ulcerative radiation recall reaction in a patient receiving APBI with electronic brachytherapy followed by chemotherapy. Our analysis shows that the use of electronic brachytherapy resulted in the deposition of significantly higher equivalent dose at the skin compared with 192Ir. These findings suggest that standard guidelines (e.g., surface-to-skin distance) that apply to 192Ir-based balloon brachytherapy may not be applicable to electronic brachytherapy. (Source: Brachytherapy)

Dosimetric Parameters in Partial Breast Irradiation Through Brachytherapy

Medical Dosimetry — Sun, 17 May 2009 23:00:00 +0100

The objective of this work is to evaluate biological models and dose homogeneity in a new partial breast irradiation method, the MammoSite RTS. The study is based on 11 patients who received the therapy. For each patient, we determined the dose volume distribution delivered to the breast. Based on these data, we estimate some important biological parameters. Eleven patients with early-stage, invasive, ductal breast cancer were treated using MammoSite RTS brachytherapy, which delivers radiation through a balloon placed in the lumpectomy bed. The radiation was provided by an Iridium-192 source, and 340 cGy were delivered per fraction twice daily. We calculated some commonly used dosimetric parameters, and evaluated the biological parameters tumor control probability (TCP) and normal tissue c...

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Male breast cancer. Evolution of treatment and prognostic factors. Analysis of 489 cases

Critical Reviews in Oncology Hematology — Wed, 13 May 2009 00:00:00 +0100

Abstract: Background: Infiltrating MBC represents less than 1% of all male cancers. Our study details clinico-pathological features, treatments and prognostic factors in a large French cohort.Material and methods: Four hundred and eighty-nine patients were collected from 1990 to 2005. Median age was 66 years (34% over 70 years) and median follow-up 58 months.Results: According to TN classification, we found T1: 39%, T2: 41%, T3T4: 9%, Tx: 11% and N1N2: 27%. Lumpectomy (L) and mastectomy (M) were performed in 8.6% and 91.4% of the cases. Axillary dissection (AD), sentinel node biopsy or both were performed in 90%, 2% and 5% of the cases, respectively. Ninety-five percent of tumours were ductal carcinomas; 47% were pT1, 20% pT2 and 33% pT3–T4. Axillary nodal involvement was present in 52.8...

The Lateral Decubitus Breast Boost: Description, Rationale, and Efficacy

International Journal of Radiation Oncology * Biology * Physics — Fri, 24 Apr 2009 00:00:00 +0100

Conclusions: The lateral decubitus position allows for a decrease in the distance from the skin to the target volume depth, improving electron coverage of the tumor bed while reducing skin entrance dose. This is a well-tolerated regimen for a patient population with a high BMI or deep tumor location. (Source: International Journal of Radiation Oncology * Biology * Physics)

The Risk of Developing Arm Lymphedema Among Breast Cancer Survivors: A Meta-Analysis of Treatment Factors

Annals of Surgical Oncology — Tue, 14 Apr 2009 05:48:41 +0100

Conclusions Mastectomy, extent of axillary dissection, radiation therapy, and presence of positive nodes increased risk of developing arm lymphedema after breast cancer. These factors likely reflected lymph node removal, which most surgeons consider to be the largest risk factor for lymphedema. Future studies should consider examining sentinel node biopsy versus no dissection with a long follow-up time post surgery to see if there is a benefit of decreased lymphedema compared with no dissection. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0452-2Authors Rebecca J. Tsai, University of Iowa Department of Epidemiology, College of Public Health Iowa City IA USALeslie K. Dennis, University of Iowa Department of Epidemiology, College of Public...

Surgical gel used to stop bleeding could confuse mammograms

EurekAlert! - Cancer — Tue, 14 Apr 2009 04:00:00 +0100

(Loyola University Health System) A gel sometimes used during surgery to stop bleeding could cause misleading mammograms. Researchers reported seven cases in which a sealant called FloSeal, used during lumpectomies, mimicked malignant microcalcifications in follow up mammograms. Microcalcifications can be a sign of breast cancer. Researchers said they do not recommend FloSeal for lumpectomies. (Source: EurekAlert! - Cancer)

Seroma is an expected consequence and not a complication of MammoSite® brachytherapy

Brachytherapy — Wed, 01 Apr 2009 04:00:00 +0100

Purpose: Seroma has long been listed as a complication of MammoSite® brachytherapy. In our experience, clinical examination at 1 month following MammoSite® treatment reveals that 100% of our patients had a palpable seroma in the lumpectomy cavity. There is a lack of literature on the natural history and resolution of seroma. We therefore embarked on this study to evaluate the incidence, resolution, possible contributing factors and cosmesis associated with seroma formation after MammoSite® partial breast irradiation. (Source: Brachytherapy)

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What is the optimal insertion angle of MammoSite® balloon in partial breast brachytherapy? A dosimetric point of view

Brachytherapy — Wed, 01 Apr 2009 04:00:00 +0100

In this study, we investigated two possible insertion angles which may result in reduced skin dose while keeping desired PTV coverage. (Source: Brachytherapy)

The miniSAVI multicatheter accelerated partial breast irradiation applicator and its use in patients with small lumpectomy cavities and/or inadequate skin distance: Early clinical experience

Brachytherapy — Wed, 01 Apr 2009 04:00:00 +0100

Purpose: The purpose of this study was to determine whether the the use of the miniSAVI multicatheter allowed acceptable dosimetrical results in patients in whom the size of the lumpectomy cavity and its proximity to the skin precluded treatment and use of other available accelerated partial breast irradiation (APBI) applicators (MammoSite® or Contura™). (Source: Brachytherapy)

A comparison study of technique, limitations and clinical outcome of MammoSite® vs. SAVI for partial breast brachytherapy

Brachytherapy — Wed, 01 Apr 2009 04:00:00 +0100

Purpose: Clinical evaluation and comparative dosimetric assessment of the treatment plans of MammoSite® and SAVI devices used for partial breast brachytherapy. Methods and Materials: The treatment plans and clinical outcome of 21 MammoSite® cases and 5 SAVI cases were compared. The 26 cases were treated between November 2007 and November 2008 with median followup of 6 months. All cases were diagnosed with localized breast carcinoma with stage T1-2N0M0. None of the patients had positive lymph nodes. The maximum size of the primary breast lesion was 3.0cm. All cases had a treatment planning CAT scan and a 3D HDR treatment planning was done using the PLATO HDR software. The Treatment Target Volumes (PTVs) were made by adding 1cm to the original lumpectomy cavity. The balloon cavity was sub...

On the impacts of the uncertainty of tissue chemical composition on dose distribution for breast low-dose-rate brachytherapy

Brachytherapy — Wed, 01 Apr 2009 04:00:00 +0100

In this study, MC methods are used in order to evaluate the impact of the variability of the proportion of breast adipose on dose distributions for breast 103Pd brachytherapy. (Source: Brachytherapy)

Re: What do Recent Studies on Lumpectomy Cavity Volume Change Imply for Breast Clinical Target Volumes?

International Journal of Radiation Oncology * Biology * Physics — Fri, 27 Mar 2009 15:41:07 +0100

To the Editor: In their recent editorial, Kim et al. consider the question of optimal target volume definition for breast radiotherapy planning, an issue frequently encountered by radiation oncologists, but probably seldom given much thought. (Source: International Journal of Radiation Oncology * Biology * Physics)

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More Surgery for Stage 0 Than Stage 1

Breast Cancer Chronicles — Thu, 26 Mar 2009 03:41:01 +0100

A woman with stage-0 ductal carcinoma in situ (DCIS)—a non-invasive form of breast cancer—can end up needing a mastectomy, while her girlfriend, who has stage-1 invasive disease, gets to have just a lumpectomy and save her breast. This doesn't seem fair or logical, but it can happen. Why is this so?The answer is related to the size of the cancers. ... (Source: Breast Cancer Chronicles)

The survival impact of the choice of surgical procedure after ipsilateral breast cancer recurrence

American Journal of Surgery — Mon, 23 Mar 2009 00:00:00 +0100

The topic of treating local reappearance of breast cancer after a conservative approach is very controversial and we read with interest the article by Chen and Martinez, “The survival impact of the choice of surgical procedure after ipsilateral breast cancer recurrence.” The authors reported on 747 patients who experienced ipsilateral breast cancer recurrence (IBTR) after conservative surgery and radiotherapy identified using the Surveillance, Epidemiology, and End Results database. They compared 179 patients receiving lumpectomy (24%) with 568 women who underwent mastectomy, showing 5-year overall survival rates of 67% and 78%, respectively. Both univariate and multivariable analyses identified mastectomy as the treatment achieving a better overall survival, and they concluded that th...

Lumpectomy

About.com Breast Cancer — Mon, 16 Mar 2009 04:00:00 +0100

A lumpectomy, sometimes called a wide local excision (WLE), is a type of breast cancer surgery. This is a breast conserving surgery, that removes the least amount of tissue that is safely possible. Learn more about a lumpectomy for breast cancer here. (Source: About.com Breast Cancer)

Repeat Computed Tomography Simulation to Assess Lumpectomy Cavity Volume During Whole-Breast Irradiation

International Journal of Radiation Oncology * Biology * Physics — Mon, 16 Mar 2009 00:00:00 +0100

Conclusions: Patients who undergo lumpectomy almost always have a decrease in their LCV during whole-breast RT. There was a correlation between the initial LCV and decrease in volume on repeat CT simulation. Evaluating patients for this change can potentially lead to decreased doses of radiation to the remaining breast and other critical structures when delivering a small-field boost. Repeat CT simulation should be considered in patients with larger cavities or cavities near critical structures. (Source: International Journal of Radiation Oncology * Biology * Physics)