scholarly journals Multifocal and multicentric breast cancer, is it time to think again?

2020 ◽  
Vol 102 (1) ◽  
pp. 62-66 ◽  
Author(s):  
YA Masannat ◽  
A Agrawal ◽  
L Maraqa ◽  
M Fuller ◽  
SK Down ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Disease Recurrence ◽  
Locoregional Control ◽  
Current Evidence ◽  
Multicentric Breast Cancer ◽  
Risk Of Disease ◽  
Short Narrative

Multifocal multicentric breast cancer has traditionally been considered a contraindication to breast conserving surgery because of concerns regarding locoregional control and risk of disease recurrence. However, the evidence supporting this practice is limited. Increasingly, many breast surgeons are advocating breast conservation in selected cases. This short narrative review summarises current evidence on the role of surgery in multifocal multicentric breast cancer and shows that when technically feasible the option of breast conservation is oncologically safe.

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 Impalpable Breast Cancer and Service Delivery During the COVID-19 Pandemic – the Role of Radiofrequency Tag localization

2021 ◽  
pp. 247-250
Author(s):  
Jonathan Strickland ◽  
Beatrix Elsberger ◽  
Gerald Lip ◽  
Mairi Fuller ◽  
Yazan Masannat
Keyword(s):  
Breast Cancer ◽  
Breast Lesion ◽  
Breast Surgery ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Breast Lesions ◽  
Tag Localization ◽  
The Uk ◽  
Lesion Localization

Background: Radiofrequency tags are used to localize breast lesions for surgery. During the Covid-19 pandemic, these offered the flexibility of inserting the Tags days or weeks before surgery. This made logistics of planning theatres lists easier, especially with most of the lists having been moved off site.Methods: In the 7 weeks following the first lockdown in the UK, we reviewed all planned admissions for breast surgery looking at the types of surgery offered, type of localization used and assessed which cases would not have been able to go ahead had radiofrequency tags not been available.Results: Out of 85 planned admission, 83 had surgery, 11 were for re-excision of margins and 72 for their first breast surgery excision (mastectomy or breast conservation). Out of the 54 that had breast conserving surgery, 40 needed localization, out of whom 27 had radiofrequency tags. Looking at theatre order list and location of surgery, 20 out of the 27 would not have had their surgery had radiofrequency tags not been available, which is 50% of the patients needing localization.Conclusion: Radiofrequency tags are new devices used for breast lesion localization that offer a much-needed flexibility especially as seen during the Covid-19 pandemic.

Preliminary Results: Double Lumpectomies for Multicentric Breast Carcinoma

2012 ◽  
Vol 78 (12) ◽  
pp. 1345-1348 ◽  
Author(s):  
Nimmi S. Kapoor ◽  
Alice Chung ◽  
Kelly Huynh ◽  
Armando E. Giuliano
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Second Malignancies ◽  
Small Series ◽  
Number Of Patients ◽  
Multicentric Breast Cancer

The standard operation for patients with multicentric breast cancer is total mastectomy. The safety of breast-conserving surgery (BCS) for these patients is unknown but interest in BCS has recently resurfaced as a result of the detection of occult second malignancies by breast magnetic resonance imaging (MRI). We report a small number of patients who chose to undergo “double lumpectomies,” defined as two separate segmental mastectomies for primary cancers in different quadrants of the same breast. Patients with multicentric breast cancer surgically managed with double lumpectomies at our institute were identified retrospectively. Clinicopathologic features are described and outcomes reported. Seven patients underwent double lumpectomies for multicentric carcinoma. Median age was 69 years (range, 61 to 80 years). In five patients, MRI identified ipsilateral second malignancies. All patients had two foci of invasive carcinoma, all tumors expressed estrogen receptor, and none showed HER-2 overexpression. Tumor sizes ranged from 0.7 to 2.9 cm. Six patients had histologically distinct tumors in the same breast: five had one invasive lobular carcinoma (ILC) and one invasive ductal carcinoma (IDC), and one had classic ILC in one quadrant and pleomorphic ILC in another. One patient had two foci of IDC in separate quadrants. All patients had sentinel lymph node biopsies and none had nodal metastasis. Median follow-up was 26 months (range, 18 to 85 months). No patient developed locoregional recurrence. This small series suggests that “double lumpectomy” may be considered for multicentric invasive breast carcinoma in carefully selected patients with favorable tumors who desire breast conservation.

scholarly journals The Emerging Role of Extracellular Vesicles in Endocrine Resistant Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1160
Author(s):  
Giusi La Camera ◽  
Luca Gelsomino ◽  
Amanda Caruso ◽  
Salvatore Panza ◽  
Ines Barone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Extracellular Vesicles ◽  
Molecular Mechanisms ◽  
Endocrine Resistance ◽  
Disease Recurrence ◽  
Estrogen Receptor Α ◽  
Research Area ◽  
Tumor Evolution

Breast cancer is the most common solid malignancy diagnosed in females worldwide, and approximately 70% of these tumors express estrogen receptor α (ERα), the main biomarker of endocrine therapy. Unfortunately, despite the use of long-term anti-hormone adjuvant treatment, which has significantly reduced patient mortality, resistance to the endocrine treatments often develops, leading to disease recurrence and limiting clinical benefits. Emerging evidence indicates that extracellular vesicles (EVs), nanosized particles that are released by all cell types and responsible for local and systemic intercellular communications, might represent a newly identified mechanism underlying endocrine resistance. Unraveling the role of EVs, released by transformed cells during the tumor evolution under endocrine therapy, is still an open question in the cancer research area and the molecular mechanisms involved should be better defined to discover alternative therapeutic approaches to overcome resistance. In this review, we will provide an overview of recent findings on the involvement of EVs in sustaining hormonal resistance in breast cancer and discuss opportunities for their potential use as biomarkers to monitor the therapeutic response and disease progression.

scholarly journals Immune Check-Point Inhibitors in Breast Cancer: Current Evidence and Future Directions

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Mosteiro M ◽  
◽  
Cejuela M ◽  
Pernas S ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Triple Negative ◽  
New Combination ◽  
Current Evidence ◽  
Check Point ◽  
Future Directions ◽  
Combination Strategies ◽  
Check Point Inhibitors

Check-point inhibitors have erupted as a treatment option for numerous kinds of neoplasms. Although there have been some achievements, the evidence supporting their use in breast cancer is scarce. Combinations with chemotherapy seem to provide better outcomes, and triple negative is the subtype most likely to benefit from them. New combination strategies are undergoing research to improve these results. Other approaches to determining biomarkers that identify which populations clearly benefit from these therapies are needed. Here, we review the clinical data of the role of immune check-point inhibitors in early and advanced breast cancer and present emerging strategies.

scholarly journals Extreme Oncoplasty: Breast Conservation in Patients with Large, Multifocal, and Multicentric Breast Cancer

2021 ◽  
Vol Volume 13 ◽  
pp. 353-359
Author(s):  
Francesca Savioli ◽  
Subodh Seth ◽  
Elizabeth Morrow ◽  
Julie Doughty ◽  
Sheila Stallard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Multicentric Breast Cancer

Axillary Metastasis with Occult Primary Breast Cancer

2017 ◽  
Author(s):  
Anne Kuritzky ◽  
Laila Khazai ◽  
Roberto Diaz ◽  
Christine Laronga
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Clinical Trial Data ◽  
Breast Conserving Surgery ◽  
Endocrine Treatment ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Cancer Breast

The identification of an axillary metastasis in the absence of a primary breast cancer can pose a diagnostic and therapeutic dilemma. The clinician should first use more sensitive imaging modalities, such as breast magnetic resonance imaging, to attempt to find the primary index lesion. If the primary cancer remains occult and the molecular markers are consistent with a breast origin, then the recommended treatment includes multimodality therapy including surgery, chemotherapy/endocrine treatment, and radiation. Historically, the modified radical mastectomy was the standard of practice. Recently, in the era of improved adjuvant therapies, breast-conserving surgery with irradiation is also being considered. Multiple retrospective reviews have shown no difference in survival or recurrence with these two surgical pathways. However, due to the rare nature of this clinical presentation, no multiinstitutional or prospective clinical trial data are available.  Key words: axillary lymph node dissection, axillary metastasis, breast cancer, breast conservation, local recurrence, occult primary tumor, radiotherapy 

Breast Cancer Surgery

2019 ◽  
pp. 144-156
Author(s):  
Peter A. van Dam ◽  
Cary Kaufman ◽  
Carlos Garcia-Etienne ◽  
Marie-Jeanne Vrancken Peeters ◽  
Robert Mansel
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Diseases ◽  
Breast Cancer Patients ◽  
Breast Conserving Treatment ◽  
Sentinel Node Concept

Abstract: The role of the surgeon managing breast diseases has been the subject of continuous evolution, moving from the cancer-extirpative surgeon to a deeply informed surgical leader, who interacts in a multidisciplinary setting also encompassing tasks for risk assessment, genetic counselling, and new diagnostic approaches. Surgical removal of the tumour remains the cornerstone in treating early stage breast cancer. During the last century, breast cancer surgery became less radical, breast-conserving treatment emerged, and the role of axillary lymphadenectomy changed from a therapeutic procedure into a staging procedure with prognostic implications. Later, the sentinel node concept reduced the need for complete axillary clearance in most cases. Nowadays, thanks to breast-conserving surgery, oncoplastic techniques, and reconstructive procedures, most breast cancer patients can overcome this disease without serious permanent physical mutilation. A multidisciplinary approach, benchmarking, and quality assurance have improved outcomes markedly.

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