The Adoption of Oncoplastic Surgery Using Breast Reduction or Mastopexy Techniques in an Academic Breast Cancer Center Program Can Increase Breast Conservation Rates

2020 ◽  
Vol 85 (S1) ◽  
pp. S12-S16
Author(s):  
Yurie Sekigami ◽  
Ritam Chowdhury ◽  
Sydney Char ◽  
Jacob Radparvar ◽  
Lilian Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reduction ◽  
Breast Conservation ◽  
Oncoplastic Surgery ◽  
Cancer Center ◽  
Center Program

Clinical Management Factors Contribute to the Decision for Contralateral Prophylactic Mastectomy

2011 ◽  
Vol 29 (16) ◽  
pp. 2158-2164 ◽  
Author(s):  
Tari A. King ◽  
Rita Sakr ◽  
Sujata Patil ◽  
Inga Gurevich ◽  
Michelle Stempel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Breast Conservation ◽  
Contralateral Prophylactic Mastectomy ◽  
Cancer Center ◽  
Unilateral Breast Cancer ◽  
Brca Mutations ◽  
Immediate Reconstruction ◽  
Magnetic Resonance Imaging Mri ◽  
Index Cancer

Purpose To determine whether increasing rates of contralateral prophylactic mastectomy (CPM) are due to recognition of risk factors for contralateral breast cancer (CBC) or treatment factors related to the index lesion. Methods From 1997 to 2005, 2,965 patients with stage 0 to III primary unilateral breast cancer underwent mastectomy at Memorial Sloan-Kettering Cancer Center. Patients who did and did not undergo CPM within 1 year of treatment for their index cancer were compared to identify independent predictors of CPM. Results The rate of CPM was 13.8% (n = 407), increasing from 6.7% in 1997 to 24.2% in 2005 (P < .0001). Patients with BRCA mutations or prior mantle radiation (n = 52) accounted for 13% of those having CPM. The rate of CPM by surgeon varied from 1% to 26%. Multivariate logistic regression adjusting for surgeon-identified white race (odds ratio [OR] = 3.3), immediate reconstruction (OR = 3.3), family history of breast cancer (OR = 2.9), magnetic resonance imaging (MRI) at diagnosis (OR = 2.8), age younger than 50 years (OR = 2.2), noninvasive histology (OR = 1.8), and prior attempt at breast conversation (OR = 1.7) to be independent predictors of CPM. Conclusion These data suggest that increasing use of CPM is not associated with increased recognition of patients at high risk for CBC. Treatment factors, such as immediate reconstruction, preoperative MRI, and unsuccessful attempts at breast conservation, are associated with increased rates of CPM. Efforts to optimize breast conservation, minimize unnecessary tests, and improve patient education about the low risk of CBC may help to curb this trend.

Locoregional Control of Clinically Diagnosed Multifocal or Multicentric Breast Cancer After Neoadjuvant Chemotherapy and Locoregional Therapy

2006 ◽  
Vol 24 (31) ◽  
pp. 4971-4975 ◽  
Author(s):  
Julia L. Oh ◽  
Mark J. Dryden ◽  
Wendy A. Woodward ◽  
Tse-Kuan Yu ◽  
Welela Tereffe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Breast Conservation ◽  
Disease Free Survival ◽  
Locoregional Control ◽  
Locoregional Therapy ◽  
Cancer Center ◽  
Free Survival ◽  
Disease Free

Purpose The purpose was to assess whether patients with clinical multifocal or multicentric (MFMC) breast cancer determined by mammogram, ultrasound, or physical examination have inferior outcome compared with patients with clinical unicentric lesions. Patients and Methods We retrospectively analyzed 706 consecutive patients with stages I-III breast cancer treated at the M.D. Anderson Cancer Center (Houston, TX) from 1976 to 2003 who received neoadjuvant anthracycline-based chemotherapy followed by breast conservation therapy (BCT), mastectomy alone, or mastectomy plus postmastectomy radiation therapy. Results The mean follow-up was 66 months. At presentation, 97 of 706 patients had clinically MFMC disease (13.7%). The 5-year rate of locoregional failure was 10% for unicentric disease compared with 7% for MFMC disease (P = .78). Subset analyses of patients by treatment groups confirmed no statistical difference in locoregional control regardless of the type of locoregional treatment. Among patients with multifocal disease treated with BCT, there were no in-breast recurrences and one supraclavicular recurrence. Five-year disease-free survival and overall survival was equivalent between patients with MFMC and unicentric breast cancers. Conclusion Patients with clinical MFMC breast cancer at the time of diagnosis treated with neoadjuvant chemotherapy followed by locoregional therapy have similar 5-year rates of locoregional control, disease-free survival, and overall survival as those with unicentric disease. Clinically detected MFMC disease did not predict for inferior outcome.

scholarly journals A PICTORIAL REVIEW OF ONCOPLASTIC & RECONSTRUCTIVE BREAST SURGERY

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Muhammad Asad Parvaiz ◽  
Nicola Roche ◽  
Jennifer Rusby ◽  
Steven Goh ◽  
Tapan Sircar
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Breast Conservation ◽  
Oncoplastic Surgery ◽  
Complete Excision ◽  
Oncological Safety ◽  
Conservation Treatment ◽  
Pictorial Review ◽  
Breast Conservation Treatment ◽  
Broad Concept

Oncoplastic surgery (OPS) of the breast has revolutionised the surgical practice in the past few years worldwide and has become an integral part of the breast cancer surgical treatment. OPS blends the principals of good local oncological control with plastic surgery techniques for immediate breast reshaping to provide best cosmetic results as well as oncological safety. It helps in extending the boundaries of breast-conservation treatment to include a group of patients who would otherwise require mastectomy to achieve complete excision of the tumour. OPS is a broad concept that can be used for several different combinations of oncological breast-conserving surgery and reconstructive surgery in the form of breast re-shaping/re-modelling. Careful patient selection and pre-operative planning are key components for the success of any OPS operation for breast cancer. Thorough surgical planning is mandatory including clinical assessment and breast measurements with reference to tumour/breast volume ratios. Mastectomy and total breast reconstruction are an option for patients that cannot have breast conservation. In this article, we provide a pictorial review of various oncoplastic and reconstructive breast operations, explaining the indications, essential principles, concepts and techniques of various surgical procedures.Key words: Breast cancer, oncoplastic surgery, breast reconstruction

scholarly journals Microcalcification-Associated Breast Cancer: Presentation, Successful First Excision, Long-Term Recurrence and Survival Rate

Breast Care ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. 380-385 ◽  
Author(s):  
Marga B. Rominger ◽  
Carolin Steinmetz ◽  
Ronny Westerman ◽  
Annette Ramaswamy ◽  
Ute-Susann Albert
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Breast Imaging ◽  
Breast Conservation ◽  
Breast Conserving Therapy ◽  
Cancer Center ◽  
Breast Cancers ◽  
Term Survival

Introduction: In this study we evaluated mammographic, histological and immunohistochemical findings for microcalcification-associated breast cancer with regards to breast-conserving therapy, recurrence and survival rate. Patients and Methods: We retrospectively analyzed 99 consecutive, non-palpable and microcalcification-associated breast cancers (94 women) that were treated surgically between January 2002 and December 2003 at a national academic breast cancer center. Calcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Descriptors, surgical outcome and histological findings were assessed. Recurrences and survival rates were evaluated based on medical records, standardized patient questionnaires and/or contacting the physician. Results: 42 of the 99 lesions (42.4%) were invasive carcinomas, 57 (57.6%) were pure ductal carcinoma in situ (DCIS). 6 out of 99 (6.1%) lesions were triple negative, and 29 (29.3%) were HER2/neu positive. Successful first excision rate was 76/99 lesions (76.8%). Breast conservation was achieved in 73.7% (73/99). 10 women showed local recurrences without negatively impacting survival. The recurrences included round/punctate, amorphous, fine pleomorphic, and fine linear or fine-linear branching descriptors. The breast cancer-specific long-term survival rate was 91/94 (96.8%) for a mean follow-up of 81.4 months. The 3 patients who died due to breast carcinoma showed fine pleomorphic calcifications, and had nodal-positive invasive carcinoma at diagnosis. Conclusion: Microcalcification-associated breast cancers are frequently treated with breast-conserving therapy. Continuous clinical and mammographic follow-up is recommended for all descriptors.

Outcomes of 47 patients with human immunodeficiency virus infection treated for breast cancer: A 20-year experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1071-1071 ◽  
Author(s):  
Roberto Enrique Ochoa ◽  
Christos Kyriakopoulos ◽  
Judith Hurley
Keyword(s):  
Breast Cancer ◽  
Human Immunodeficiency Virus ◽  
Breast Conservation ◽  
Stage Iv ◽  
Radical Mastectomy ◽  
Infectious Complications ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Immunodeficiency Virus ◽  
Er Positive

1071 Background: Patients (pts) with Human Immunodeficiency Virus (HIV) are living longer and non-AIDS defining malignancies have been increasingly reported in these patients. Methods: Retrospective review identified 47 pts with breast cancer (BC) and HIV who were seen at the University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital between January 1999 and June 2011. Results: Pt characteristics: 46 female, 1 male, mean age 46 years (range 31-65). Race: African American 79%, Caucasian 21%. Ethnic: Hispanics 14%, non-Hispanics 86%. Premenopausal 68% postmenopausal 32%. Tumor characteristics: Stage: Tis 4%, Stage I: 6 % , Stage II: 38%, Stage III: 38%, Stage IV: 9%. ER positive (50%) her-2 positive (15%), Triple negative (21%). HIV characteristics: 36 pts with HIV before or concurrent with the diagnosis of BC. 6 pts diagnosed with HIV within 1 year of BC diagnosis. HIV dx date unavailable in 5 pts. 27% had AIDS. CD4 counts (in cells/µL)were: > 500 (23%); 201-500 (37%), 51 – 200 (20%) < 50 (20%). 15 pts were diagnosed with BC in preHAART era. Of those dx with BC after 1996, 60% were on HAART. BC treatment: 43 pts had localized disease. 32 underwent modified radical mastectomy, 8 breast conservation and 3 pts refused surgery. 26 pts received curative or palliative chemotherapy. Complications of BC treatment: serious side effects were reported in 11 (42%) including neutropenic fever/sepsis (10 pts), ARDS (1 pt). Zoster infection was reported in 12% of the pts. 3 patients developed rapidly progressive and fatal AIDS within 6 months of completion of chemotherapy. Survival: See Table. Conclusions: BC in patients with HIV infection spans the spectrum of BC presentations. Hormonal therapy, surgery and radiation therapy were well tolerated. Infectious complications were common in patients treated with chemotherapy and routine use of growth factors and prophylactic acyclovir should be considered. [Table: see text]

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