scholarly journals Effect of Formalin Fixation on Surgical Margins in Breast Cancer Surgical Specimen

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Masooma Zaidi ◽  
Shaista Khan ◽  
Najiha Bilal Farooqi ◽  
Kashif Abbas ◽  
Romana Idrees
Keyword(s):  
Breast Cancer ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Formalin Fixation ◽  
University Hospital ◽  
Postoperative Treatment ◽  
Cancer Type ◽  
Surgical Specimen ◽  
Free Margin ◽  
The Mean

Margin analysis in breast surgery is an important predictor of local recurrence and can have vital impact on the postoperative treatment planning.Objective. The aim was to assess the mean reduction in the closest tumor-free surgical margin in millimeters of breast cancer specimens following formalin fixation.Materials and Methods. We conducted a cross-sectional study at the Aga Khan University Hospital from March 30, 2010 to January 20, 2011. One hundred consecutive breast tumour surgical specimens which had macroscopically visible tumour were included. The cancer type included both in situ and invasive cancers. Excluded were the patients who had previous surgery or systemic/radiation therapy. The closest tumor-free margin was recorded and compared with the margin after formalin fixation.Pvalue of <0.05 was considered significant.Results. The mean age of our 100 patients was 53 years with the majority of the patients having undergone mastectomy for predominantly invasive ductal carcinoma. Following formalin fixation, the mean reduction of the closest tumor-free margin was noted as 2.14 mm which was found statistically significant.Conclusion. Considerable shrinkage of tumor-free surgical margins of breast cancer specimen was noted after formalin fixation. This inference can have implications on the postoperative management plan.

scholarly journals Prognostic Value of Metabolic Activity of the Psoas Muscle Evaluated By Preoperative 18 F- FDG PET-CT in Breast Cancer: A Retrospective Cross-Sectional Study

2021 ◽  
Author(s):  
Keunyoung Kim ◽  
In-Ju Kim ◽  
Kyoungjune Pak ◽  
Taewoo Kang ◽  
Young Mi Seol ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Activity ◽  
Cox Regression ◽  
Surrogate Marker ◽  
Psoas Muscle ◽  
University Hospital ◽  
Cox Regression Analysis ◽  
Standardized Uptake Values ◽  
The Mean ◽  
Receptor Negativity

Abstract Background: This study aimed to evaluate the potential of metabolic activity of the psoas muscle measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography to predict treatment outcomes in patients with resectable breast cancer.Methods: The medical records of 288 patients who had undergone surgical resection for stages I–III invasive ductal carcinoma of the breast between January 2014 and December 2014 in Pusan National University Hospital were reviewed. The standardized uptake values (SUVs) of the bilateral psoas muscle were normalized using the mean SUV of the liver. SUVRmax was calculated as the ratio of the maximum SUV of the average bilateral psoas muscle to the mean SUV of the liver. SUVRmean was calculated as the ratio of the averaged bilateral psoas muscle to the mean SUV of the liver.Results: Univariate analyses identified a higher T stage, higher N stage, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor 2 positivity, triple-negative breast cancer, mastectomy (rather than breast-conserving surgery), SUVRmean > 0.464, and SUVRmax > 0.565 as significant adverse factors for progression-free survival (PFS). Multivariate Cox regression analysis revealed that N3 stage (hazard ratio [HR] = 5.347, P = 0.031) was an independent factor for recurrence. An SUVRmax > 0.565 (HR = 4.987, P = 0.050) seemed to have a correlation with shorter PFS.Conclusions: A higher SUVRmax of the psoas muscle, which could be a surrogate marker of insulin resistance, showed strong potential as an independent prognostic factor for recurrence in patients with resectable breast cancer.

scholarly journals Analysis of the Most Viewed First 50 Videos on YouTube about Breast Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Isil Yurdaisik
Keyword(s):  
Breast Cancer ◽  
Healthcare Professionals ◽  
The Internet ◽  
Accurate Information ◽  
Cancer Type ◽  
Common Cancer ◽  
Health Related ◽  
The Mean ◽  
Common Cancer Type

Objective. Breast cancer is the most common cancer type among women worldwide. Today, health consumers search the Internet to gain health information about many diseases including breast cancer. YouTube™ is the second most commonly used website on the Internet. However, the quality and accuracy of health-related YouTube™ videos are controversial. The objective of this study was to investigate the quality and accuracy of breast cancer-related videos on YouTube™. Material and Methods. “Breast cancer” keyword was entered into YouTube™ search bar, and after excluding advertisement, duplicate, and non-English videos, the first most viewed 50 videos were analyzed. Videos’ length, the number of views, comments, likes, and dislikes were recorded. DISCERN and JAMA scores and Video Power Index (VPI) values of the videos were calculated. All videos were evaluated by two independent radiologists experienced on breast cancer. The correlation between the two observers was also analyzed. Results. Of all videos, 14% were uploaded by physicians, 26% by health channels, 20% by patients, 10% by news channels, 2% by herbalists, 2% by blog channels, and 2% by nonprofit activism channels. The mean DISCERN score was calculated as 26.70±10.99 and the mean JAMA score as 2.23±0.97. The mean VPI value, which was calculated to determine the popularity of the videos, was found as 94.10±4.48. A strong statistically significant correlation was found between the two observers in terms of both DISCERN and JAMA scores. There was an excellent agreement between the two observers. Conclusion. The overall quality of the viewed videos was found as poor. Healthcare professionals should be encouraged to upload breast cancer-related videos with accurate information to promote patients for screening and direct them appropriately.

Optimizing Clinical Management of Surgical Margins in Breast-Conserving Therapy for Breast Cancer

2013 ◽  
pp. 66-71
Author(s):  
Stephen R. Grobmyer ◽  
Michael S. Cowher ◽  
Joseph P. Crowe
Keyword(s):  
Breast Cancer ◽  
Retrospective Studies ◽  
Tumor Biology ◽  
Surgical Margin ◽  
Breast Conserving Therapy ◽  
Surgical Margins ◽  
Margin Assessment ◽  
Margin Width ◽  
Definition Of ◽  
Made In

There has been, and continues to be, significant controversy over the definition of an “optimal” surgical margin in breast-conserving therapy (BCT). The historic basis of this controversy stems from the original trials documenting the safety of BCT and many conflicting retrospective studies that have sought to define the association between surgical margin width and outcomes over the last 20 years. It is important to understand that margin assessment is an inexact science, and current laboratory approaches to surgical-margin assessment represent only a sampling of the surgical margin. Currently available evidence suggests that decisions regarding surgical margins in BCT should be made in the context of what is known about the biology of breast cancer, as well the interactions of tumor biology, adjuvant treatment for breast cancer, and outcomes. Achieving consensus on management of surgical margins in BCT should be a clinical priority as it offers the opportunity to reduce the burden of breast cancer treatment on patients without compromising cancer-related outcomes.

Estimating the real cost of adjuvant (adj) trastuzumab (T) in patients (pts) with HER-2+ (H+) early stage breast cancer (ESBC): Potential impact of reduced use of expensive oncology drugs (EOD) in metastatic breast cancer (MBC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6534-6534
Author(s):  
R. O'Cearbhaill ◽  
E. Wilson ◽  
A. deFrein ◽  
Z. Qadir ◽  
D. McDonnell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Societal Cost ◽  
University Hospital ◽  
The Real ◽  
Real Cost ◽  
The Mean ◽  
The Cost

6534 Background: Pts with H+ early stage BC have an approximately 35% risk of developing MBC (BCIRG001). T has been reported to reduce this risk by 33–50%, but costs approximately €;30k per pt, a burden some health systems deem unsustainable. This risk reduction might however result in decreased utilization of EOD in MBC, lowering the societal cost of adjT. We attempted to estimate the cost per relapse prevented (Crp), and the real cost of adjT, allowing for potential savings in prevented cases of MBC. Methods: We conducted a retrospective analysis of the mean cost per pt of AdjT (1 year) and of EOD in MBC in St. Vincent's University Hospital. We devised an equation to calculate the Crp for adj T. Crp=[A-M(NRA/104)]/[NRA/104] where A = cost per pt for adjT, M = EOD cost per pt with MBC, N = % of pts relapsing after standard adj treatment, RA = % reduction in the risk of relapse after adjT (over standard adj). Results: H+ pts with MBC received T (average 34 cycles €;2,400 each) with a combination of the following drugs: docetaxel (x8 €;1,500), gemcitabine (x5 €;1,215), capecitabine (x8 €;400), vinorelbine ( x19 €;187). Only 2 pts received bevacizumab (Bev) (x15 €;3,000). In our unit the mean EOD cost per pt with MBC was €;108k. The cost per relapse prevented for a 33% and a 50% reduction in relapse rate would be €;152k and €;63k, respectively. Furthermore, assuming a 50% reduction in the rate of relapse (from 35 to 17.5%) the real cost of adjT per pt treated is not €;30k, but approximates €;11k (€;30k×100-{17.5x €;108k}). Conclusions: The reduced utilization of EOD in MBC likely has a very beneficial impact on the societal cost of adjT. Confirmation of the efficacy of shorter adjT (e.g. FinnHer) would produce further benefit. The increasing use of novel EOD in MBC e.g. Bev would make adjT even more cost-effective. No significant financial relationships to disclose.

A ten-year epidemiology of cancers managed at the hematology and oncology unit of a Haitian tertiary hospital from 2006 to 2015.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13061-e13061
Author(s):  
Flawendjee Djaweelentz Jacques ◽  
Joseph Bernard ◽  
Elsie Metellus Chalumeau
Keyword(s):  
Breast Cancer ◽  
Tertiary Hospital ◽  
Common Type ◽  
University Hospital ◽  
Cancer Type ◽  
State University ◽  
Gastrointestinal Cancers ◽  
Histologic Diagnosis ◽  
Lung Cancers ◽  
Oncology Unit

e13061 Background: The recent epidemiology of cancers in Haiti is poorly known, since there is no national cancer registry. The data from GLOBOCAN 2012 are estimations that do not reflect the real cancer epidemiology in countries such as Haiti. The aim of this study was to determine the ten-year epidemiology of cancer cases managed at a Haitian tertiary hospital. Methods: A retrospective study based on the chart review of cancer cases aged 18 years old or more with histologic diagnosis was conducted at the Hematology and Oncology Unit of the State University Hospital of Haiti (HUEH) from 2006 to 2015. Variables such as age, gender, year of diagnosis and cancer type were collected. Results: Eight hundred seventy-five cancer cases out of 1191 (73.47%) were selected for this study. The mean age of the study population is 51 years-old [18 – 91] and there were 13.6% males and 86.4% females. Breast cancer is the most common type (70.74% [95% CI, 67.58% - 73.71%]) followed by gastrointestinal cancers (5.6% [95% CI, 4.21% - 7.39%]), leukemias/multiple myeloma (4.69% [95% CI, 3.43% - 6.36%]), skin cancers (4.57% [95% CI, 3.32% - 6.23%]), gynecological cancers (4% [95% CI, 2.84% - 5.58%]), lymphomas (3.77% [95% CI, 2.65% - 5.31%]), sarcomas (3.31% [95% CI, 2.27% - 4.78%]) and ear, nose and throat (ENT) cancers (1.14% [95% CI, 0.58% - 2.16%]). Breast cancer is the most common type among women (80.6%) and the gastrointestinal cancers the most diagnosed among men (21.9%). Conclusions: Breast cancer is by far the most prevalent cancer in this retrospective cohort. Gynecological and lung cancers are underestimated and urology cancers not represented in this sample possibly because they are not systematically referred to the unit.This study can hopefully lead to more advocacy for all patients to be evaluated at the Hematology and Oncology Unit for a better management.

scholarly journals Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Juliana Rodrigues Tovar ◽  
Eliana Zandonade ◽  
Maria Helena Costa Amorim
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Early Stage ◽  
Surgical Margin ◽  
Conservative Surgery ◽  
Local Recurrences ◽  
Unified Health System ◽  
Her 2 ◽  
Clinical Profiles ◽  
The Mean

Conservative surgery is considered the procedure of choice for women who are affected by early stage tumours. The local recurrence of cancer as a consequence of breast tissue conservation is a growing concern. This study aimed to describe the sociodemographic and clinical profiles of women who had local recurrences of breast cancer after conservative surgery and to examine the associations between sociodemographic and clinical variables and the incidence of tumour recurrence in these women. The retrospective cohort included 880 women who were diagnosed with breast cancer and underwent conservative surgery between January 2000 and December 2010. Recurrences occurred in 60 patients, and the mean age of the women at diagnosis was 48.8 years. Predictive factors for local recurrence were young age (<39 years) (P=0.028andOR=10.93), surgical margin involvement (P=0.001andOR=3.66), and Her-2 overexpression (P=0.045andOR=1.94). The establishment of sociodemographic and clinical characteristics might help to select optimum treatments, which is a crucial challenge for public health in Brazil, especially with regard to reductions of surgery and hospitalisation expenditures in the Unified Health System (Sistema Único de Saúde—SUS).

scholarly journals Clinical efficacy of intraoperative ultrasound for margin assessment in breast conserving surgery

2020 ◽  
Author(s):  
Jeeyeon Lee ◽  
Ho Yong Park ◽  
Wan Wook Kim ◽  
Chan Sub Park ◽  
Yungeun Ji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Resection Margin ◽  
Frozen Section ◽  
Intraoperative Ultrasound ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Assessment ◽  
Clinicopathologic Characteristics ◽  
Tumor Margin ◽  
The Mean

Abstract Background: Surgical margin negativity is highly related to local recurrence of breast cancer. The authors performed this study to evaluate if specimen mammography or ultrasonography can replace the frozen section procedure for surgical margins. Methods: One-hundred fifty five patients with breast cancer were included in this study. After the surgery, the frozen biopsies were assessed in more than three different directions, and all specimens were analyzed with mammography and ultrasonography. The clinicopathologic characteristics of the patients were assessed, and closest tumor margin–resection margin distance (TM–RM distance) to the tumor was compared among specimen mammography, ultrasonography, and pathology. Results: On comparing initial cases of positive and negative margins, the mean closest TM–RM distance in specimen ultrasonography and final pathologic reports was statistically different between both groups (DCIS: p < 0.001, p = 0.006; IDC: p = 0.042, p = 0.022). Conclusion: When the closest TM–RM distance is less than 1.8 mm in specimen ultrasonography, the frozen section cannot be waived because of high risk of margin positivity. However, if the closest TM–RM distance is >4 mm in specimen ultrasonography, the frozen section can be omitted carefully because of the very low risk of margin positivity.

scholarly journals Effect of LigaSure™, Monopolar Cautery, and Bipolar Cautery on Surgical Margins in Breast-Conserving Surgery

Breast Care ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 194-199 ◽  
Author(s):  
Ahmet Türkan ◽  
Gökhan Akkurt ◽  
Metin Yalaza ◽  
Gürkan Değirmencioğlu ◽  
Mehmet Tolga Kafadar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Thermal Damage ◽  
False Negative ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Surgical Margins ◽  
Bipolar Cautery ◽  
Tissue Sections ◽  
Significant Difference ◽  
Lumpectomy Specimen

Background: We compared the differences in thermal damage at the surgical margin between monopolar cautery, bipolar cautery, and LigaSure™ in breast cancer lumpectomy specimens and assessed the effect of these techniques on the evaluation of the surgical margins. Methods: 30 patients scheduled for breast-conserving surgery for breast cancer were included in this study. During lumpectomy, each of the superior, inferior, lateral, and medial borders of the tumour was excised using one of the following: a scalpel, monopolar cautery, bipolar cautery, and LigaSure technology. The surgical margins of frozen and paraffin-embedded tissue sections of the lumpectomy specimen were evaluated. Thermal damage was defined as the maximum depth of thermal damage (in mm) from the surgical margin, and the level was categorized as none, low (≤1 mm), or high (>1 mm). Results: There was no statistically significant difference between monopolar cautery, bipolar cautery, and LigaSure in terms of thermal damage. There was no thermal damage at the surgical margin in tissues dissected by scalpel. Conclusion: Thermal damage due to the excision method may cause false-negative and false-positive results in the surgical margin evaluation of lumpectomy specimens. More research is needed on the effects of different energy modalities on surgical margin evaluation in breast-conserving surgery.

scholarly journals Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision

2021 ◽  
pp. e2021046
Author(s):  
Julia Fougelberg ◽  
Hampus Ek ◽  
Magdalena Claeson ◽  
John Paoli
Keyword(s):  
Head And Neck ◽  
Surgical Margin ◽  
Upper Extremities ◽  
Surgical Margins ◽  
University Hospital ◽  
International Consensus ◽  
Experienced Surgeon ◽  
Incomplete Excision ◽  
Neck Area ◽  
Strict Definition

Background: One common treatment for Bowen’s disease (BD) is surgical excision, but there is no international consensus on the appropriate surgical margins. Objectives: This study examined what factors affect the rate of incomplete excision of BD. Methods: Clinicopathological data potentially linked to surgical outcome (complete or incomplete excision) were retrospectively collected from medical and histopathological records on all surgically excised BD lesions diagnosed at Sahlgrenska University Hospital in Gothenburg, Sweden during 2014-2015. Data were analyzed with two definitions of incomplete excision: less strict (ie, BD present at the surgical margin) and strict (ie, dysplasia present at the surgical margin). Results: In total, 463 BD lesions among 408 patients were included. With the less strict definition, 3 factors were associated with significantly higher rates of incomplete excision: surgical margins <3 mm, a less experienced surgeon, and use of punch biopsy excision. The same factors plus a tumor location on the head and neck area or upper extremities were associated with significantly higher rates of incomplete excision using the strict definition. After adjustment for confounders, less experience was independently associated with incomplete excision using the less strict definition, whereas less experience and location on the head and neck area or upper extremities were independently associated with incomplete excision using the strict definition. Surgeon specialty was not associated with incomplete excision regardless of the definition. Conclusions: When removing BD surgically, an elliptical excision with surgical margins ≥3 mm carried out by an experienced surgeon should be recommended. Surgical margins may need to be adjusted depending on body site.

scholarly journals Assessment of breast cancer surgical margins with multimodal optical microscopy: A feasibility clinical study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245334
Author(s):  
Mark T. Scimone ◽  
Savitri Krishnamurthy ◽  
Gopi Maguluri ◽  
Dorin Preda ◽  
Jesung Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Resolution ◽  
Optical Imaging ◽  
Predictive Value ◽  
Surgical Margin ◽  
Positive Margin ◽  
Breast Cancer Surgery ◽  
Preliminary Evaluation ◽  
Surgical Specimen ◽  
Positive Margins

Providing surgical margin information during breast cancer surgery is crucial for the success of the procedure. The margin is defined as the distance from the tumor to the cut surface of the resection specimen. The consensus among surgeons and radiation oncologists is that there should be no tumor left within 1 to maximum 2 mm from the surface of the surgical specimen. If a positive margin remains, there is substantial risk for tumor recurrence, which may also result in potentially reduced cosmesis and eventual need for mastectomy. In this paper we report a novel multimodal optical imaging instrument based on combined high-resolution confocal microscopy-optical coherence tomography imaging for assessing the presence of potential positive margins on surgical specimens. Since rapid specimen analysis is critical during surgery, this instrument also includes a fluorescence imaging channel to enable rapid identification of the areas of the specimen that have potential positive margins. This is possible by specimen incubation with a cancer specific agent prior to imaging. In this study we used a quenched contrast agent, which is activated by cancer specific enzymes, such as urokinase plasminogen activators (uPA). Using this agent or a similar one, one may limit the use of high-resolution optical imaging to only fluorescence-highlighted areas for visualizing tissue morphology at the sub-cellular scale and confirming or ruling out cancer presence. Preliminary evaluation of this technology was performed on 20 surgical specimens and testing of the optical imaging findings was performed against histopathology. The combination of the three imaging modes allowed for high correlation between optical image analysis and histological ground-truth. The initial results are encouraging, showing instrument capability to assess margins on clinical specimens with a positive predictive value of 1.0 and a negative predictive value of 0.83.

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