Correlation of tumor size on preoperative breast MRI and pathologic tumor size in Asian patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11546-e11546
Author(s):  
S. Lee ◽  
S. Kim ◽  
H. Kang ◽  
E. Lee ◽  
E. Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Mri ◽  
Positive Margin ◽  
Breast Cancer Surgery ◽  
Asian Patients ◽  
Positive Margin Rate ◽  
Preoperative Breast Mri ◽  
Intraoperative Conversion ◽  
The Impact

e11546 Background: As many Asian patients want breast conserving therapy (BCT), use of magnetic resonance imaging (MRI) increase in preoperative diagnosis for breast cancer. But the impact of MRI on these patients has not been unclear. Methods: From January 2008 to July 2008, 423 patients underwent breast cancer surgery in National Cancer Center, Korea. We enrolled 357 patients consecutively in this retrospective study; 290 patients (non-MRI group) with preoperative mammography (MMG) and ultrasonography (US) vs. 66 patients (MRI group) with additional MRI to MMG, US and excluded 67 patients (42 patients with preoperative chemotherapy, 8 patients with ipsilateral recurrence, 17 patients whose MRI showed no residual lesion after excisional biopsy). We examined MRI effect on mastectomy rate, intraoperative conversion from BCT to mastectomy, positive margin rate in frozen specimen in both group. In MRI group, we evaluated the correlation between tumor size on US, MRI and pathologic tumor size. Results: Mean age of this study was 48.89 years (Non-MRI group: 50.70 years vs. MRI group: 46.33 years, p=0.001). The rate of mastectomy wasn’t different in both groups (Non-MRI group: 13.7% vs. MRI group: 19.4%, p=0.252). Intraoperative conversion to mastectomy was performed frequently in MRI group. (Non-MRI group: 1.7% vs. MRI group: 7.5%, p=0.023). But positive margin rate in frozen specimen was similar in both groups (Non-MRI group: 23.2% vs. MRI group: 34.0%, p=0.111). In MRI group, mean tumor size on MRI, US was 3.07cm, 1.98cm respectively. Mean pathologic tumor size was 2.67cm. The tumor size on MRI correlated strongly with the pathologic tumor size. The correlation coefficient was 0.732 (p=0.0001). But the tumor size on US didn’t correlate with the pathologic tumor size (p=0.066). In twenty nine patients whose MMG showed suspicious microcalcification, tumor size on MRI also correlated strongly with pathologic tumor size. The correlation coefficient was 0.693 (p=0.0001). But US didn’t show the correlation with the pathologic tumor size in these patients. Conclusions: Preoperative breast MRI didn’t give the impact on breast cancer surgery in Asian patients and could overestimate the size of tumor. But it could strongly correlate with the pathologic tumor size in Asian patients. No significant financial relationships to disclose.

The impact of breast MRI workup on tumor size assessment and surgical planning in patients with early breast cancer

2018 ◽  
Vol 24 (6) ◽  
pp. 927-933 ◽  
Author(s):  
Catalin-Florin Pop ◽  
Claudia Stanciu-Pop ◽  
Stylianos Drisis ◽  
Magali Radermeker ◽  
Carine Vandemerckt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Tumor Size ◽  
Surgical Planning ◽  
Breast Mri ◽  
The Impact

Discordance Between Pathologic and Radiologic Tumor Size on Breast MRI May Contribute to Increased Re-excision Rates

2011 ◽  
Vol 77 (10) ◽  
pp. 1361-1363 ◽  
Author(s):  
Lindi H. Vanderwalde ◽  
Catherine M. Dang ◽  
Catherine Bresee ◽  
Edward H. Phillips
Keyword(s):  
Tumor Size ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Breast Cancers ◽  
Breast Center ◽  
Significant Difference ◽  
Preoperative Breast Mri ◽  
The Impact

Preoperative breast MRI does not decrease re-excision rates in patients who undergo lumpectomy. We evaluated concordance of tumor size on MRI and pathologic size in patients who underwent re-excision of margins after lumpectomy. A retrospective review of patients at the Cedars-Sinai Breast Center who received breast MRI was performed. We found that MRI was performed before lumpectomy in 136 patients. Mean age was 55.2 years (standard deviation ± 12.6). Re-excision occurred in 34 per cent (n = 46). Of those undergoing re-excision, 35 per cent (16/46) were re-excised for ductal carcinoma in situ (DCIS) at the lumpectomy margin. There was no significant difference between radiologic and pathologic size of the tumor (1.94 vs 2.12 cm; P = 0.159). In those who underwent re-excision, the radiologic size was underestimated compared with the pathologic size (2.01 vs 2.66 cm; P = 0.032). Patients with pure DCIS lesions (n = 9) also had smaller radiologic tumor size compared with pathologic (0.64 vs 2.88 cm; P = 0.039), and this difference trended toward significance in those who underwent re-excision (0.55 vs 3.50 cm; P = 0.059). Discordance between tumor size on MRI and pathologic size may contribute to re-excisions in patients who undergo lumpectomy. The limitations of breast MRI to evaluate the extent of DCIS surrounding many breast cancers, and the impact on re-excision rates, should be further evaluated.

Can Radiologic Tumor Size Following Neoadjuvant Therapy Reliably Guide Tissue Resection in Breast Conserving Surgery in Patients with Invasive Breast Cancer?

2020 ◽  
Vol 86 (10) ◽  
pp. 1248-1253
Author(s):  
Sarah Walcott-Sapp ◽  
Marissa K. Srour ◽  
Minna Lee ◽  
Michael Luu ◽  
Farin Amersi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Invasive Breast Cancer ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Breast Cancers ◽  
Positive Margin Rate

Optimum tissue resection volume for patients with invasive breast cancer undergoing breast conserving surgery following neoadjuvant therapy (NAT) is not known. We compared positive margin and in-breast tumor recurrence (IBTR) between 2 groups that were created based on radiologic tumor size (RTS (cm3)) at diagnosis, RTS post-NAT, and volume of tissue resected (VTL): Pre-NAT group, patients with VTL closer to RTS at diagnosis, and post-NAT group, patients with VTL closer to post-NAT RTS. 82 patients with 84 breast cancers treated with NAT between 2007 and 2017 who had pre- and post-NAT imaging were identified from a prospectively maintained database. RTS at diagnosis, RTS post-NAT, and VTL were determined. Clinical and treatment characteristics, IBTR, and disease-free survival (DFS) were compared between pre-NAT (n = 51) and post-NAT (n = 33) groups. Compared to post-NAT patients, pre-NAT patients had smaller RTS at presentation (9.2 vs. 33.5 cm3, P < .001) and post-NAT (1.2 vs. 8.2 cm3, P = .024). At median follow-up of 4 years, there were no differences between groups in pathologic tumor size, positive margin rate, adjuvant therapy, IBTR, or DFS. Resection volumes that matched RTS on post-NAT imaging were not associated with increased positive margins or IBTR. It may be appropriate to use post-NAT imaging to guide lumpectomy volume.

Does Breast Cancer Subtype Impact Margin Status in Patients Undergoing Partial Mastectomy?

2022 ◽  
pp. 000313482110697
Author(s):  
Ileana Horattas ◽  
Andrew Fenton ◽  
Joseph Gabra ◽  
Amanda Mendiola ◽  
Fanyong Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Positive Margin ◽  
Margin Status ◽  
Partial Mastectomy ◽  
Positive Margin Rate ◽  
Cancer Subtype ◽  
The Impact

Background Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy. Methods Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. Patients were classified as luminal if they were ER and/or PR positive; HER2 enriched if they were ER and PR negative but HER2 positive; and TN if they were negative for all 3 receptors. The impact of subtype on the margin status was evaluated at completion of standard PM, prior to randomization to CSM versus no CSM. Non-parametric statistical analyses were performed using SPSS Version 26. Results Molecular subtype was significantly correlated with race ( P = .011), palpability ( P = .007), and grade ( P < .001). Subtype did not correlate with Hispanic ethnicity ( P = .760) or lymphovascular invasion ( P = .756). In this cohort, the overall positive margin rate was 33.7%. This did not vary based on molecular subtype (positive margin rate 33.7% for patients with luminal tumors vs 36.4% for those with TN tumors, P = .425). Discussion Molecular subtype does not predict margin status. Therefore, molecular subtype should not, independent of other factors, influence surgical decision-making.

The impact of residual cancer removed during subsequent surgeries on the outcome of patients with localized breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11533-e11533
Author(s):  
N. B. Kouzminova ◽  
A. Aggarwal ◽  
S. Aggarwal ◽  
A. Y. Lin
Keyword(s):  
Breast Cancer ◽  
Positive Margin ◽  
Distant Recurrence ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Residual Cancer ◽  
Single Procedure ◽  
Second Surgery ◽  
Cox Proportional Hazard Regression ◽  
The Impact

e11533 Background: A close or positive margin after breast cancer surgery is an important risk factor for local recurrence. A significant percentage of breast cancer patients need additional surgeries to obtain clear margins. This study evaluated the impact of residual cancer (RC) found upon subsequent operations on the outcome of the patients with localized breast cancer. Methods: Under IRB approved protocol, we retrospectively analyzed data on 573 patients with stage I-IIIA breast cancer treated at our institution during 1994–2004. 202 patients had complete tumor removal at single procedure with clear margins, 319 patients had subsequent surgery due to initially compromised margins and 52 patients with compromised margins did not have second surgery. Cox Proportional Hazard regression test was performed to evaluate the effect of RC found on subsequent surgery on distant recurrence (DR) and disease specific survival (DSS). Results: Median follow-up was 5.4 years. Among 319 patients who underwent second surgery, 57.7% did not have any RC; 13.1% had in situ RC and 29.2% had invasive RC. 12.9% (74/573) patients had DR. The risk of DR was higher in patients with RC found upon second surgery compared to those who had single procedure breast cancer removal (22.6% vs. 9.9%; HR 2.4, 95% CI 1.3–4.4, p=0.006). Similarly, finding of RC was a significant predictor of DSS (80.6% vs.92.6%; HR 2.9, 95% CI 1.4–5.7, p=0.003). Multivariate analysis revealed that tumor size above 5 cm, lymph nodes involvement and grade III were significant predictors of DR and DSS along with invasive RC found during subsequent surgeries. Delay in adjuvant chemotherapy due to need for subsequent surgeries strongly correlated with earlier DR in patients with invasive RC found on subsequent operations (rS = - 0.55, p = 0.019, two-tailed). Conclusions: Invasive residual carcinoma found during subsequent surgery after initial compromised margin is an important prognostic factor for DR and DSS, even after clear margins are eventually achieved. No significant financial relationships to disclose.

scholarly journals Effect of physical activity levels on oncological breast surgery recovery: a prospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ifat Klein ◽  
Leonid Kalichman ◽  
Noy Chen ◽  
Sergio Susmallian
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Chronic Pain ◽  
Self Efficacy ◽  
Breast Cancer Surgery ◽  
Activity Levels ◽  
Axillary Web Syndrome ◽  
Function Range ◽  
A Prospective Study ◽  
The Impact

AbstractAfter breast cancer (BC) surgery, women may experience a physical decline. The effect of physical activity (PA) on the course of recovery after BC surgery has not yet been thoroughly examined. To analyze the impact of physical activity performed by women undergoing breast cancer surgery on measures of function, range of motion, and self-efficacy. A prospective study was carried out in 157 patients who underwent surgery for BC between October 2018 and April 2019, divided into four groups according to the intensity of PA with 6 months follow-up. 50 sedentary patients and 107 active patients were enrolled; the mean age was 52.6. Women who performed physical activity, moderate to vigorous, demonstrated lower function disabilities (QuickDASH 2.22) compared with inactivity or light physical activity (QuickDASH 7.0, p < 0.001), with better shoulder flexion (159.0° vs. 150.7°, p = 0.007) and abduction (159.5° vs. 152.2°, p = 0.008). Higher PA levels, displayed in higher self-efficacy reports (9.5 vs. 8.8, p = 0.002), and return to prior job status (0.005). The PA level does not influence pain at one, three and 6 months postoperatively (p = 0.278, p = 0.304 and p = 0.304 respectively). High PA levels increase the risk of axillary web syndrome (p = 0.041), although, it reduces the incidence of chronic pain (p = 0.007). Women who practice physical activity recover better from BC surgery than sedentary women. The higher the intensity and frequency of training, the better the results. Vigorous activity cause axillary web syndrome, despite, it has a beneficial effect on lowering the rate of chronic pain.

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