Breast conservation surgery and radiation for a patient with synchronous primary breast cancers and BRCA1/BRCA2 positivity: is mastectomy required?

2011 ◽  
Vol 11 (1) ◽  
pp. 62-65
Author(s):  
Mark Trombetta ◽  
Katherine Kotinsley ◽  
Thomas B. Julian
Keyword(s):  
Breast Conservation ◽  
Genetic Mutation ◽  
Breast Conservation Surgery ◽  
Genetic Mutations ◽  
Breast Cancers ◽  
Brca1 And Brca2 ◽  
Breast Preservation ◽  
Conservation Surgery ◽  
Brca1 Brca2

AbstractThe role of breast conservation in patients expressing BRCA1 and BRCA2 genetic mutations is controversial. A patient who was found to have bilateral synchronous breast cancers and expressed a BRCA genetic mutation was recently evaluated. The patient had a strong desire for breast preservation. This case and a review of the pertinent literature are presented to discuss the role of breast conservation and radiation in patients with BRCA1 or BRCA2 genetic mutations.

scholarly journals Breast Conservation Surgery: State of the Art

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Jonathan White ◽  
Raj Achuthan ◽  
Philip Turton ◽  
Mark Lansdown
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Surgical Techniques ◽  
Breast Conservation Surgery ◽  
Breast Size ◽  
Conservation Surgery ◽  
Multicentric Breast Cancer ◽  
The Relationship ◽  
Endoscopic Breast Surgery

Breast conservation surgery is available to the vast majority of women with breast cancer. The combination of neoadjuvant therapies and oncoplastic surgical techniques allows even large tumours to be managed with a breast-conserving approach. The relationship between breast size and the volume of tissue to be excised determines the need for volume displacement or replacement. Such an approach can also be used in the management of carefully selected cases of multifocal or multicentric breast cancer. The role of novel techniques, such as endoscopic breast surgery and radiofrequency ablation, is yet to be precisely defined.

scholarly journals Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
W. Dooley ◽  
J. Bong ◽  
J. Parker
Keyword(s):  
Breast Cancer ◽  
Hazard Rate ◽  
Early Stage ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Entire Group ◽  
Breast Cancers ◽  
Extensive Disease ◽  
Complete Excision ◽  
Conservation Surgery

Objectives. The “Sick Lobe” hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units.Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision.Results. Breast conservation surgery for stage 0–2 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases). With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their “sick lobe.”Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series.

The Role of Margin Status and Reexcision in Local Recurrence Following Breast Conservation Surgery

2013 ◽  
Vol 20 (7) ◽  
pp. 2250-2255 ◽  
Author(s):  
Barbara J. Adams ◽  
Christine K. Zoon ◽  
Christina Stevenson ◽  
Padma Chitnavis ◽  
Luke Wolfe ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Breast Conservation ◽  
Margin Status ◽  
Breast Conservation Surgery ◽  
Conservation Surgery
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