Extent and Role of Margin Control for DCIS Managed by Breast-Conserving Surgery

2015 ◽  
pp. 67-83 ◽  
Author(s):  
Melissa Pilewskie ◽  
Monica Morrow
Keyword(s):  
Breast Conserving Surgery ◽  
Margin Control

scholarly journals Preoperative breast magnetic resonance imaging in patients with ductal carcinoma in situ: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)

2021 ◽  
Author(s):  
Carlos Canelo-Aybar ◽  
Alvaro Taype-Rondan ◽  
Jessica Hanae Zafra-Tanaka ◽  
David Rigau ◽  
Axel Graewingholt ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Surgical Outcomes ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Cochrane Library ◽  
Treatment Change ◽  
The Impact

Abstract Objective To evaluate the impact of preoperative MRI in the management of Ductal carcinoma in situ (DCIS). Methods We searched the PubMed, EMBASE and Cochrane Library databases to identify randomised clinical trials (RCTs) or cohort studies assessing the impact of preoperative breast MRI in surgical outcomes, treatment change or loco-regional recurrence. We provided pooled estimates for odds ratios (OR), relative risks (RR) and proportions and assessed the certainty of the evidence using the GRADE approach. Results We included 3 RCTs and 23 observational cohorts, corresponding to 20,415 patients. For initial breast-conserving surgery (BCS), the RCTs showed that MRI may result in little to no difference (RR 0.95, 95% CI 0.90 to 1.00) (low certainty); observational studies showed that MRI may have no difference in the odds of re-operation after BCS (OR 0.96; 95% CI 0.36 to 2.61) (low certainty); and uncertain evidence from RCTs suggests little to no difference with respect to total mastectomy rate (RR 0.91; 95% CI 0.65 to 1.27) (very low certainty). We also found that MRI may change the initial treatment plans in 17% (95% CI 12 to 24%) of cases, but with little to no effect on locoregional recurrence (aHR = 1.18; 95% CI 0.79 to 1.76) (very low certainty). Conclusion We found evidence of low to very low certainty which may suggest there is no improvement of surgical outcomes with pre-operative MRI assessment of women with DCIS lesions. There is a need for large rigorously conducted RCTs to evaluate the role of preoperative MRI in this population. Key Points • Evidence of low to very low certainty may suggest there is no improvement in surgical outcomes with pre-operative MRI. • There is a need for large rigorously conducted RCTs evaluating the role of preoperative MRI to improve treatment planning for DCIS.

Extending the role of breast-conserving surgery by immediate volume replacement

1997 ◽  
Vol 84 (7) ◽  
pp. 1028-1029
Author(s):  
M. Noguchi ◽  
U. Khan ◽  
A. E. Young ◽  
C. Healy ◽  
R. M. Rainsbury
Keyword(s):  
Breast Conserving Surgery ◽  
Volume Replacement

scholarly journals Ductal Carcinoma In Situ of the Breast

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Richard J. Lee ◽  
Laura A. Vallow ◽  
Sarah A. McLaughlin ◽  
Katherine S. Tzou ◽  
Stephanie L. Hines ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Treatment Options ◽  
Breast Conserving Surgery ◽  
Partial Breast Irradiation ◽  
Significant Shift

Ductal carcinoma in situ (DCIS) of the breast represents a complex, heterogeneous pathologic condition in which malignant epithelial cells are confined within the ducts of the breast without evidence of invasion. The increased use of screening mammography has led to a significant shift in the diagnosis of DCIS, accounting for approximately 27% of all newly diagnosed cases of breast cancer in 2011, with an overall increase in incidence. As the incidence of DCIS increases, the treatment options continue to evolve. Consistent pathologic evaluation is crucial in optimizing treatment recommendations. Surgical treatment options include breast-conserving surgery (BCS) and mastectomy. Postoperative radiation therapy in combination with breast-conserving surgery is considered the standard of care with demonstrated decrease in local recurrence with the addition of radiation therapy. The role of endocrine therapy is currently being evaluated. The optimization of diagnostic imaging, treatment with regard to pathological risk assessment, and the role of partial breast irradiation continue to evolve.

The Role of Intraoperative Flow Cytometry in Breast-Conserving Surgery

2021 ◽  
Author(s):  
George Vartholomatos ◽  
Haralambos Harissis ◽  
Georgios S. Markopoulos ◽  
George A. Alexiou
Keyword(s):  
Flow Cytometry ◽  
Breast Conserving Surgery

Breast Cancer Surgery

2019 ◽  
pp. 144-156
Author(s):  
Peter A. van Dam ◽  
Cary Kaufman ◽  
Carlos Garcia-Etienne ◽  
Marie-Jeanne Vrancken Peeters ◽  
Robert Mansel
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Diseases ◽  
Breast Cancer Patients ◽  
Breast Conserving Treatment ◽  
Sentinel Node Concept

Abstract: The role of the surgeon managing breast diseases has been the subject of continuous evolution, moving from the cancer-extirpative surgeon to a deeply informed surgical leader, who interacts in a multidisciplinary setting also encompassing tasks for risk assessment, genetic counselling, and new diagnostic approaches. Surgical removal of the tumour remains the cornerstone in treating early stage breast cancer. During the last century, breast cancer surgery became less radical, breast-conserving treatment emerged, and the role of axillary lymphadenectomy changed from a therapeutic procedure into a staging procedure with prognostic implications. Later, the sentinel node concept reduced the need for complete axillary clearance in most cases. Nowadays, thanks to breast-conserving surgery, oncoplastic techniques, and reconstructive procedures, most breast cancer patients can overcome this disease without serious permanent physical mutilation. A multidisciplinary approach, benchmarking, and quality assurance have improved outcomes markedly.

scholarly journals Multifocal and multicentric breast cancer, is it time to think again?

2020 ◽  
Vol 102 (1) ◽  
pp. 62-66 ◽  
Author(s):  
YA Masannat ◽  
A Agrawal ◽  
L Maraqa ◽  
M Fuller ◽  
SK Down ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Disease Recurrence ◽  
Locoregional Control ◽  
Current Evidence ◽  
Multicentric Breast Cancer ◽  
Risk Of Disease ◽  
Short Narrative

Multifocal multicentric breast cancer has traditionally been considered a contraindication to breast conserving surgery because of concerns regarding locoregional control and risk of disease recurrence. However, the evidence supporting this practice is limited. Increasingly, many breast surgeons are advocating breast conservation in selected cases. This short narrative review summarises current evidence on the role of surgery in multifocal multicentric breast cancer and shows that when technically feasible the option of breast conservation is oncologically safe.

The Role of Reexcision for Positive Margins in Optimizing Local Disease Control After Breast-Conserving Surgery for Cancer

2006 ◽  
Vol 12 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Dalal Aziz ◽  
Ellen Rawlinson ◽  
Steven A. Narod ◽  
Ping Sun ◽  
H. Lavina A. Lickley ◽  
...  
Keyword(s):  
Disease Control ◽  
Breast Conserving Surgery ◽  
Positive Margins ◽  
Local Disease ◽  
Local Disease Control

Role of re-excision for positive and close resection margins in patients treated with breast-conserving surgery

The Breast ◽  
2014 ◽  
Vol 23 (6) ◽  
pp. 870-875 ◽  
Author(s):  
N. Biglia ◽  
R. Ponzone ◽  
V.E. Bounous ◽  
L.L. Mariani ◽  
F. Maggiorotto ◽  
...  
Keyword(s):  
Breast Conserving Surgery ◽  
Resection Margins
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