P035. Reaching a national consensus on the surgical management of multiple ipsilateral breast cancers (MIBCs): Perceptions by patients, healthy volunteers, surgeons and breast cancer associations

2015 ◽  
Vol 41 (6) ◽  
pp. S37
Author(s):  
Zoe Winters ◽  
Ramsey Cutress ◽  
Rosemary Greenwood ◽  
Jenny Ingram
Keyword(s):  
Breast Cancer ◽  
Healthy Volunteers ◽  
Surgical Management ◽  
Breast Cancers ◽  
Ipsilateral Breast ◽  
National Consensus

scholarly journals Surgical management of multiple ipsilateral breast cancers

2019 ◽  
Vol 15 (11) ◽  
pp. 1185-1191
Author(s):  
John R Benson ◽  
Ismail Jatoi ◽  
Masakazu Toi
Keyword(s):  
Surgical Management ◽  
Breast Cancers ◽  
Ipsilateral Breast

Experience with nipple-sparing mastectomy after prior whole-breast radiation.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 173-173
Author(s):  
Aimee Marlena Mackey ◽  
Bret Taback ◽  
Preya Ananthakrishnan ◽  
Sheldon M. Feldman
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Breast Cancers ◽  
Ipsilateral Breast ◽  
Immediate Reconstruction ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Good Cosmesis

173 Background: Nipple-sparing mastectomy (NSM) is being performed more frequently for risk reduction and breast cancer treatment. Prior whole breast irradiation (WBI) has been considered a contraindication to NSM. This study reviews our NSM experience following prior WBI. Methods: We reviewed our prospective mastectomy database from April 2007 to April 2012 for patients undergoing NSM. Ten patients out of a total 169 NSM were identified that underwent NSM following prior WBI. Data collected included incision type, follow-up, complications, cosmesis, and recurrence. Results: Of the ten NSM patients who received prior WBI, 6 had recurrent ipsilateral breast cancer at the lumpectomy site, 3 developed contralateral breast cancers and opted for bilateral NSM, and 1 patient opted for bilateral NSM after finding a BRCA mutation following BCT. Mean patient age was 53. Two patients had comorbities: 1 hyperlipidemia and 1 former smoker. Three of 10 (30%) developed complications, with 2 partial necrosis of nipple-areola complex (NAC) and 1 complete loss of the NAC (Table). No patient required return to the operating room (local resection in the office was performed for the complete NAC loss) and all patients had good final cosmesis. All patients underwent immediate reconstruction: 5 tissue expanders (TE), 2 DIEP and 3 TRAM flaps. Mean follow up is 23 months with no local recurrences to date. Conclusions: This study demonstrates that NSM with immediate reconstruction can be performed in selected patients with prior WBI with an acceptable rate of nipple preservation and good cosmesis. NAC preservation is the ultimate goal in patients undergoing NSM. Current studies are ongoing to identify risk factors that may be associated with nipple necrosis. [Table: see text]

scholarly journals Watchful Waiting: Well Behaved Breast Cancers Non-Surgical Management of Breast Cancer

2016 ◽  
Vol 01 (01) ◽  
Author(s):  
Willis Maurice ◽  
Robinson Angelica ◽  
Hermann Stephan ◽  
Sadruddin Sarfaraz
Keyword(s):  
Breast Cancer ◽  
Surgical Management ◽  
Watchful Waiting ◽  
Breast Cancers

Patient factors influencing choice for mastectomy.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 264-264 ◽  
Author(s):  
M. R. Hart ◽  
A. M. Steely ◽  
T. A. James ◽  
L. E. McCahill
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Management ◽  
Breast Conservation ◽  
Breast Conservation Therapy ◽  
Fear Of Recurrence ◽  
Breast Cancer Surgery ◽  
Breast Cancers ◽  
Eligibility Criteria ◽  
Factors Influencing

264 Background: The process of shared decision-making in the surgical management of breast cancer is complex. Many women eligible for breast conservation therapy (BCT) still choose total mastectomy (TM), and little is known about the factors responsible for their decision. We conducted a pilot, qualitative study in order to determine factors influencing the selection of TM over BCT, and to improve our understanding of patient’s concerns and priorities in their decision-making process for breast cancer surgery. Methods: Data were collected from a four-year, prospective Breast Cancer Surgical Quality Database. Study participants included female patients with invasive carcinoma who, despite being eligible for BCT, elected to undergo TM. Eligibility criteria included women with no contraindications to BCT, tumor size <2cm, and no evidence of extensive microcalcifications. Patients with tumor recurrence, multicentric disease, scleroderma, and lupus were excluded. Patients were contacted by phone and administered a survey designed to elicit the specific factors affecting their decision to undergo TM. Results: Out of 670 patients treated for IDC/ILC between 2003 and 2007, 12 met eligibility criteria and were subsequently interviewed. 10 patients identified fear of recurrence as the prevailing factor in their decision to undergo TM, and 5 patients identified availability of breast reconstruction as a moderate to strong influence in their decision to undergo TM. Time away from work and transportation during radiation therapy had minimal or no influence. Conclusions: Our results indicate that patients with small, invasive breast cancers who chose TM for their surgical treatment, despite being eligible for BCT, were primarily influenced by fear of recurrence. These decision factors persisted despite treatment at a multidisciplinary center, where patients are informed of equivalent survival and minimal difference in recurrence with appropriate BCT. These results highlight the need for further assessment of patient education and comprehension, as well as greater awareness of emotional factors which may influence a patient’s decision regarding the surgical management of her breast cancer.

scholarly journals Discordance between Primary Breast Cancer and Ipsilateral Breast Cancer Tumor Recurrence as a Function of Distance

2020 ◽  
Vol 9 (12) ◽  
pp. 4033
Author(s):  
Sebastian M. Jud ◽  
Reinhard Hatko ◽  
Julius Emons ◽  
Bianca Lauterbach ◽  
Carolin C. Hack ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Primary Tumor ◽  
Primary Breast Cancer ◽  
Tumor Recurrence ◽  
Relative Distance ◽  
Tumor Characteristics ◽  
Breast Cancers ◽  
Ipsilateral Breast ◽  
Cancer Tumor

Background: Risk factors for ipsilateral breast cancer tumor recurrence (IBTR) are well established and include grading, nodal status, and receptor status. Little is known about the influence of the local distance between the primary tumor and recurrences on changes in tumor characteristics and prognosis. Methods: In a retrospective setting, we analyzed primary breast cancers and their recurrences. Localizations of primary and recurrent breast cancer were recorded to calculate the relative distance in pixels. Analysis was performed regarding tumor characteristics, relative distance between both, and their impact on breast cancer prognosis. Results: In a cohort of 142 patients with ipsilateral recurrence, no statistically significant difference could be shown in the change in tumor characteristics depending on distance. Progesterone receptor (PR) and estrogene receptor (ER) status changed in 22.7% and 14.9% of cases, respectively. human epidermal growth factor receptor 2 (ERBB2, HER2) status changed in 18.3% of cases. Survival was in accordance with the literature, with luminal-A-like tumors as best and triple negative breast cancers (TNBC) as worst prognosis. With a threshold of 162 pixels, the survival was significantly better in the group with shorter distance. Conclusion: Change in tumor characteristics from primary breast cancer to recurrence occurs more often in PR than ER. In contrast to other work, in this dataset, recurrences with a larger distance to the primary tumor had a worse prognosis in univariate analysis. A Cox model might indicate the possibility that this influence is independent of other risk factors.

scholarly journals Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

2020 ◽  
Author(s):  
Giovanni Corso ◽  
Francesca Magnoni ◽  
Elena Provenzano ◽  
Antonia Girardi ◽  
Monica Iorfida ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Cancer Screening ◽  
Systemic Treatment ◽  
Molecular Characteristics ◽  
Breast Cancers ◽  
Imaging Findings ◽  
Ipsilateral Breast ◽  
Multicentric Breast Cancer

Multiple synchronous (multifocal or multicentric) ipsilateral breast cancers with heterogeneous histopathology are a rare clinical occurrence, however, their incidence is increasing due to the use of MRI for breast cancer screening and staging. Some studies have demonstrated poorer clinical outcomes for this pattern of breast cancer, but there is no evidence to guide clinical practice. In this multidisciplinary review, we reflect on pathology and molecular characteristics, imaging findings, surgical management including conservation and reconstructive options and approach to the axilla, and the role of chemotherapy and radiotherapy. Multidisciplinary discussions appear decisive in planning an appropriate surgical choice and defining the correct systemic treatment tailored to each clinical condition.

scholarly journals A Decade of Change: An Institutional Experience with Breast Surgery in 1995 and 2005

2008 ◽  
Vol 1 ◽  
pp. BCBCR.S587
Author(s):  
Amber A. Guth ◽  
Beth Ann Shanker ◽  
Daniel F. Roses ◽  
Deborah Axelrod ◽  
Baljit Singh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Management ◽  
Breast Imaging ◽  
Breast Surgery ◽  
Early Stage ◽  
Imaging Techniques ◽  
Screening Mammography ◽  
Breast Cancers ◽  
Cancer Awareness ◽  
Image Guided

Introduction With the adoption of routine screening mammography, breast cancers are being diagnosed at earlier stages, with DCIS now accouting for 22.5% of all newly diagnosed breast cancers. This has been attributed to both increased breast cancer awareness and improvements in breast imaging techniques. How have these changes, including the increased use of image-guided sampling techniques, influenced the clinical practice of breast surgery? Methods The institutional pathology database was queried for all breast surgeries, including breast reconstruction, performed in 1995 and 2005. Cosmetic procedures were excluded. The results were analysed utilizing the Chi-square test. Results Surgical indications changed during 10-year study period, with an increase in preoperatively diagnosed cancers undergoing definitive surgical management. ADH, and to a lesser extent, ALH, became indications for surgical excision. Fewer surgical biopsies were performed for indeterminate abnormalities on breast imaging, due to the introduction of stereotactic large core biopsy. While the rate of benign breast biopsies remained constant, there was a higher percentage of precancerous and DCIS cases in 2005. The overall rate of mastectomy decreased from 36.8% in 1995 to 14.5% in 2005. With the increase in sentinel node procedures, the rate of ALND dropped from 18.3% to 13.7%. Accompanying the increased recognition of early-stage cancers, the rate of positive ALND also decreased, from 43.3% to 25.0%. Conclusions While the rate of benign breast biopsies has remained constant over a recent 10-year period, fewer diagnostic surgical image-guided biopsies were performed in 2005. A greater percentage of patients with breast cancer or preinvasive disease have these diagnoses determined before surgery. More preinvasive and Stage 0 cancers are undergoing surgical management. Earlier stage invasive cancers are being detected, reflected by the lower incidence of axillary nodal metastases.

scholarly journals Surgical Management of Hereditary Breast Cancer

Genes ◽  
2021 ◽  
Vol 12 (9) ◽  
pp. 1371
Author(s):  
Elizabeth R. Berger ◽  
Mehra Golshan
Keyword(s):  
Breast Cancer ◽  
Surgical Management ◽  
Genetic Variant ◽  
Cancer Susceptibility ◽  
Breast Cancers ◽  
Cancer Treatments ◽  
Management Options ◽  
Cancer Susceptibility Genes ◽  
Brca 2 ◽  
Made In

The identification that breast cancer is hereditary was first described in the nineteenth century. With the identification of the BRCA1 and BRCA 2 breast/ovarian cancer susceptibility genes in the mid-1990s and the introduction of genetic testing, significant advancements have been made in tailoring surveillance, guiding decisions on medical or surgical risk reduction and cancer treatments for genetic variant carriers. This review discusses various medical and surgical management options for hereditary breast cancers.

Radiofrequency ablation for early-stage breast cancer: results from 5 years of follow-up in a prospective multicenter study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12098-e12098
Author(s):  
Takayuki Kinoshita ◽  
Naohito Yamamoto ◽  
Tomomi Fujisawa ◽  
Masato Takahashi ◽  
Kenjiro Aogi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Surgical Resection ◽  
Early Stage ◽  
Ablation Rate ◽  
Early Stage Breast Cancer ◽  
Maximum Diameter ◽  
Breast Cancers ◽  
Ipsilateral Breast

e12098 Background: Given the increasing number of early-stage breast cancers detected by screening mammography, we aim to establish RFA as a minimally invasive, cost-efficient, and cosmetically acceptable local treatment. In our Phase 1 study, localized tumors with a maximum diameter of 2 cm, preoperatively diagnosed by imaging and histopathology, were treated with RFA. A 90% complete ablation rate was confirmed histopathologically. Building on these results, we designed a Phase 2 clinical trial to investigate the efficacy of a non-surgical RFA procedure. Methods: From Nov. 2009 to Nov. 2012, 58 patients with early-stage breast cancer received non-surgical RFA therapy. Patients had localized solitary N0 tumors with a maximum diameter of 1 cm. They underwent RFA and sentinel lymph node biopsy under general anesthesia and adjuvant therapy and breast irradiation. Follow-up evaluation for residual tumor at 3, 6, and 12 months after RFA included clinical breast examination, diagnostic imagings (ultrasound, magnetic resonance, and mammography), and vacuum-assisted biopsy. Surgical resection was recommended for patients with suspected residual disease or incomplete ablation. The primary endpoint was the frequency of adverse events. Secondary endpoints included the complete ablation rate and ipsilateral breast relapse-free rate. The diagnostic performance of the follow-up examinations and cosmetic outcomes were evaluated for exploratory purposes. Results: The follow-up period ranged from 450 to 2552 days (median, 1832 days). The 57 patients completed the non-surgical RFA procedure and underwent diagnostic imaging and needle biopsy after 3 months. Seven patients with suspected incomplete ablation underwent surgical resection; incomplete ablation was confirmed in 5 (8.6%, 2 with invasive and 3 with non-invasive ductal carcinoma). During subsequent follow-up, 1 patient each was diagnosed with contralateral breast cancer and brain tumor. No ipsilateral breast tumor relapse or distant recurrence was documented. Cosmetic results were excellent in 94% of patients. Conclusions: RFA is a promising alternative to surgery for treating localized, early-stage breast cancers. Clinical trial information: UMIN000008675.

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