scholarly journals R1 resection margin after organ-sparing/oncoplastic surgeries for breast cancer

2021 ◽  
Vol 17 (1) ◽  
pp. 12-19
Author(s):  
E.  A. Rasskazova ◽  
A.  D. Zikiryakhodzhaev ◽  
N.  N. Volchenko ◽  
Sh.  G. Khakimova
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Resection Margin ◽  
Invasive Cancer ◽  
Resection Margins ◽  
Histological Structure ◽  
R1 Resection ◽  
Repeated Surgery ◽  
Organ Sparing

The recurrence rate after organ-sparing surgeries for breast cancer depends on the resection margins: R1 status is associated with a higher risk of recurrence than R0.We analyzed a group of breast cancer patients with an R1 resection margin who underwent organ-sparing/oncoplastic surgeries. The R1 resection margin was detected in 62 out of 1279 patients who had organ-sparing/oncoplastic surgeries (4.9 % ± 0.6 %). In the group with invasive cancer and R1 resection margin, 80 % of patients were diagnosed with lobular carcinoma, whereas 14.8 % of patients had invasive cancer with no specific signs.We divided the group of repeated surgeries according to their histological structure at the resection margin: 28 patients were found to have carcinoma in situ, while 13 patients had invasive cancer.Among patients with carcinoma in situ, the resection margin after repeated surgery had no signs of malignancy in 14 women (50 %), while 10 (35.7 %) and 4 (14.3 %) women were diagnosed with carcinoma in situ and invasive cancer, respectively.In case of invasive cancer, 4 patients (30.8 %) had no signs of malignancy in their resection margins, while 1 (7.7 %) and 8 (61.5 %) patients were found to have carcinoma in situ and invasive cancer, respectivelyFollow-up of patients with an R1 resection margin after repeated surgery or radiotherapy revealed no cases of local recurrence between 3 and 65 months.

scholarly journals Study of Estrogen Receptor and Progesterone Receptor Expression in Breast Ductal Carcinoma In Situ by Immunohistochemical Staining in ER/PgR-Negative Invasive Breast Cancer

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Andrei Dobrescu ◽  
Monique Chang ◽  
Vatsala Kirtani ◽  
George K. Turi ◽  
Randa Hennawy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Receptor Expression ◽  
Invasive Cancer ◽  
Positive Staining ◽  
Receptor Status

Background. To our knowledge, the hormone receptor status of noncontiguous ductal carcinoma in situ (DCIS) occurring concurrently in ER/PgR-negative invasive cancer has not been studied. The current study was undertaken to investigate the ER/PgR receptor status of DCIS of the breast in patients with ER/PgR-negative invasive breast cancer. Methods. We reviewed the immunohistochemical (IHC) staining for ER and PgR of 187 consecutive cases of ER/PgR-negative invasive breast cancers, collected from 1995 to 2002. To meet the criteria for the study, we evaluated ER/PgR expression of DCIS cancer outside of the invasive breast cancer. Results. A total of 37 cases of DCIS meeting the above criteria were identified. Of these, 16 cases (43.2%) showed positive staining for ER, PgR, or both. Conclusions. In our study of ER/PgR-negative invasive breast cancer we found that in 8% of cases noncontiguous ER/PR-positive DCIS was present. In light of this finding, it may be important for pathologists to evaluate the ER/PgR status of DCIS occurring in the presence of ER/PgR-negative invasive cancer, as this subgroup could be considered for chemoprevention.

Advantages of intraoperative digital specimen radiography (IDSR) in breast surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12613-e12613
Author(s):  
Lyudmila Zhukova ◽  
Nikita Maksimov ◽  
Gurami Kvetenadze ◽  
Evgeniy Shivilov ◽  
Khalil Arslanov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Breast Conserving Surgery ◽  
Resection Margins ◽  
Positive Margins ◽  
Results Of Treatment ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

e12613 Background: Breast cancer is in first place among malignant diseases in women in Russia. We can provide, in most cases, breast-conserving surgery (BCS), due to progress in early diagnosis. Evaluation of positive margins is still one of the most important objectives in breast-conserving surgery. Objectives: To assess the benefits of IDSR in BCS of patients with “carcinoma in situ”. Methods: The results of treatment of 55 patients with breast cancer “carcinoma in situ” in our clinic were evaluated in two comparable groups. Group A included 28 patients, who were operated on from January 2019 to June 2019 and had breast-conserving surgery without IDSR. Group B included 27 patients, who were operated on from June 2019 to January 2020 and had breast-conserving surgery with the evaluation of margins by IDSR. Results: In a planned histological examination positive margins were detected in group A in 4 cases (14%) and required reoperation. In group B all margins were clear. After IDSR, 6 (22%) patients out of 27 in this group showed microcalcifications in the resection margins or at a distance of less than 1 mm and required intraoperative additional excision to obtain clean margins. Conclusions: IDSR reduces the frequency of reoperation due to increased detection of positive margins, allows to correct scope and duration of surgery because of impact on the time of the surgical decision-making process.

scholarly journals Breast Specimen Processing and Reporting With an Emphasis on Margin Evaluation: A College of American Pathologists Survey of 866 Laboratories

2018 ◽  
Vol 142 (4) ◽  
pp. 496-506 ◽  
Author(s):  
Anthony J. Guidi ◽  
Joseph A. Tworek ◽  
Daniel D. Mais ◽  
Rhona J. Souers ◽  
Barbara J. Blond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Margin Status ◽  
Invasive Cancer ◽  
Guideline Compliance ◽  
Specimen Processing ◽  
American Society

Context.— The College of American Pathologists (CAP) developed protocols for reporting pathologic characteristics of breast cancer specimens, including margin status. The Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published treatment guidelines regarding margins in patients with invasive cancer; and SSO, ASTRO, and the American Society of Clinical Oncology (ASCO) recently published guidelines for patients with ductal carcinoma in situ. Objective.— To assess current practices among pathologists with regard to the processing/reporting of breast specimens, assess compliance with CAP cancer protocols, and assess alignment with SSO/ASTRO and SSO/ASTRO/ASCO guidelines. Design.— A survey concerning breast specimen processing/reporting was distributed to pathologists enrolled in the CAP Performance Improvement Program in Surgical Pathology. Results.— Ninety-four percent (716 of 764 respondents) and 91% (699 of 769 respondents) define positive margins as “tumor on ink” for invasive cancer and ductal carcinoma in situ, respectively, in compliance with CAP cancer protocols and with SSO/ASTRO and SSO/ASTRO/ASCO guidelines. Of 791 respondents who provided details regarding methods for margin evaluation, 608 (77%) exclusively examine perpendicular margins, facilitating guideline compliance. However, 183 of 791 respondents (23%) examine en face margins in at least a subset of specimens, which may preclude guideline compliance in some cases. When separate cavity (shave) margins are examined, while 517 of 586 respondents (88%) ink these specimens, 69 of 586 (12%) do not, and this may also preclude guideline compliance in some cases. Conclusions.— A substantial proportion of survey participants report margin status for breast cancer specimens in a manner consistent with CAP cancer protocols, and in alignment with SSO/ASTRO and SSO/ASTRO/ASCO guidelines. However, there are opportunities for some laboratories to modify procedures in order to facilitate more complete adherence to guidelines.

scholarly journals Cumulative Risk Distribution for Interval Invasive Second Breast Cancers After Negative Surveillance Mammography

2018 ◽  
Vol 36 (20) ◽  
pp. 2070-2077 ◽  
Author(s):  
Janie M. Lee ◽  
Linn Abraham ◽  
Diana L. Lam ◽  
Diana S.M. Buist ◽  
Karla Kerlikowske ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Risk ◽  
Primary Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Interval Cancer ◽  
Invasive Cancer ◽  
Breast Cancers ◽  
Surveillance Mammography

Purpose The aim of the current study was to characterize the risk of interval invasive second breast cancers within 5 years of primary breast cancer treatment. Methods We examined 65,084 surveillance mammograms from 18,366 women with a primary breast cancer diagnosis of unilateral ductal carcinoma in situ or stage I to III invasive breast carcinoma performed from 1996 to 2012 in the Breast Cancer Surveillance Consortium. Interval invasive breast cancer was defined as ipsilateral or contralateral cancer diagnosed within 1 year after a negative surveillance mammogram. Discrete-time survival models—adjusted for all covariates—were used to estimate the probability of interval invasive cancer, given the risk factors for each surveillance round, and aggregated across rounds to estimate the 5-year cumulative probability of interval invasive cancer. Results We observed 474 surveillance-detected cancers—334 invasive and 140 ductal carcinoma in situ—and 186 interval invasive cancers which yielded a cancer detection rate of 7.3 per 1,000 examinations (95% CI, 6.6 to 8.0) and an interval invasive cancer rate of 2.9 per 1,000 examinations (95% CI, 2.5 to 3.3). Median cumulative 5-year interval cancer risk was 1.4% (interquartile range, 0.8% to 2.3%; 10th to 90th percentile range, 0.5% to 3.7%), and 15% of women had ≥ 3% 5-year interval invasive cancer risk. Cumulative 5-year interval cancer risk was highest for women with estrogen receptor– and progesterone receptor–negative primary breast cancer (2.6%; 95% CI, 1.7% to 3.5%), interval cancer presentation at primary diagnosis (2.2%; 95% CI, 1.5% to 2.9%), and breast conservation without radiation (1.8%; 95% CI, 1.1% to 2.4%). Conclusion Risk of interval invasive second breast cancer varies across women and is influenced by characteristics that can be measured at initial diagnosis, treatment, and imaging. Risk prediction models that evaluate the risk of cancers not detected by surveillance mammography should be developed to inform discussions of tailored surveillance.

scholarly journals EPIDEMIOLOGY, RISK FACTORS AND PATHOMORPHOLOGICAL FEATURES OF MAMMARY TUMORS IN CATS

THE BULLETIN ◽  
2020 ◽  
Vol 6 (388) ◽  
pp. 78-84
Author(s):  
Dyulger Georgy Petrovich, ◽  
◽  
Dyulger Petr Georgiyevich, ◽  
Alikhanov Oralbek, ◽  
Sedletskaya Evgenia Sergeevna, ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Carcinoma In Situ ◽  
Mammary Cancer ◽  
Malignant Tumors ◽  
Mammary Tumors ◽  
Biological Behavior ◽  
Histological Structure ◽  
Ovarian Status

Mammary tumors (MT) are the 3rd most common neoplasm in cats. The incidence rate is significantly influenced by gender, age, breed, ovarian status, and the use of progestin-based contraceptives. MTs are a group of neoplasms that is heterogeneous in terms of tissue belonging, histological structure, and biological behavior. Malignant tumors are most frequent and compile from 80% to 96% of all tumors and tumor-like mammary lesions. Mammary cancer (MC) prevails, accounting for 91.4% of all cases of malignant tumors. Invasive breast cancer is much more common than carcinoma in situ. Among histological types of breast cancer, cribriform, solid, and tubulopapillary carcinomas predominate; mucous, tubular, and papillary carcinomas are less common.

Surgical Treatment of Minimal Breast Cancer

1979 ◽  
Vol 65 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Bruno Salvadori ◽  
Marco Greco ◽  
Alberto R. Conti
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Carcinoma In Situ ◽  
Lobular Carcinoma ◽  
Invasive Cancer ◽  
Intraductal Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Lobular Carcinoma In Situ

The surgical approach to minimal breast cancer is still under discussion. In fact by the term « minimal » three lesions are meant, namely « lobular carcinoma in situ », « intraductal carcinoma » and invasive « microcarcinoma ». It is really difficult to indicate appropriate treatment for these tumors, also because the series reported in the literature are few and represented by a small number of cases. The present paper is a critical review of the literature on the subject. According to the most recent view lobular carcinoma in situ and intraductal carcinoma demand for radical surgery (total mastectomy) due to the high percentage of multicentricity and bilaterality of these lesions. More particularly with regard to lobular carcinoma in situ recent reports claim for a « wait and see » policy which is gaining favour, on the ground that the risk of developing invasive cancer in women with lobular carcinoma in situ is not so high and that the period of time between diagnosis of the lobular carcinoma and the development of the invasive cancer is usually very long. On the other side, for intraductal carcinoma, axillary dissection seems to be pleonastic due to the low percentage of secondary deposits in axillary lymph-nodes (1-3 %) in women operated on for intraductal carcinoma. Invasive microcarcinomas, less than 5 mm in diameter, should be considered as T1N0 tumors; actually there is no reason to treat them by a more conservative surgery than is done for T1N0 cancers, as they present the same involvement of the axillary lymph-nodes. In a small series of 38 microcarcinoma observed at the Milan Cancer Institut N+ cases were 27 %.

Residual Ductal Carcinoma In Situ in Patients With Complete Eradication of Invasive Breast Cancer After Neoadjuvant Chemotherapy Does Not Adversely Affect Patient Outcome

2007 ◽  
Vol 25 (19) ◽  
pp. 2650-2655 ◽  
Author(s):  
Chafika Mazouni ◽  
Florentia Peintinger ◽  
Shu Wan-Kau ◽  
Fabrice Andre ◽  
Ana M. Gonzalez-Angulo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Invasive Cancer ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Complete Eradication

Purpose To determine whether residual ductal carcinoma in situ (DCIS) after completion of preoperative chemotherapy affects the outcome of patients with histologically defined complete eradication of invasive cancer. Patients and Methods Retrospective analysis of a database including 2,302 breast cancer patients treated with neoadjuvant chemotherapy at The University of Texas M.D. Anderson Cancer Center between 1980 and 2004 was performed. The overall survival (OS), disease-free survival (DFS), and local recurrence-free survival were compared for patients with no residual invasive or in situ cancer (pathologic complete response [pCR]) and patients with no residual invasive cancer but persistent in situ disease (pCR+DCIS). Results The mean follow-up time was 250 months. Of the 2,302 treated patients, 78 (3.4%) had pCR, 199 (8.6%) had pCR+DCIS, and 2,025 (88%) had residual invasive cancer. For patients with pCR and pCR+DCIS, the 5-year DFS rates (87.1% in both groups) and 10-year DFS rates (81.3% v 81.7%, respectively) were similar; the 5-year OS rates (91.9% v 92.5%, respectively) and 10-year OS rates (91.8% v 92.5%, respectively) were also similar and significantly better than the rate of patients with residual invasive cancer (74.4%; P < .001). The 5-year locoregional recurrence-free survival rates were also not different between patients with pCR (92.8%; 95% CI, 86.1% to 96.4%) and patients with pCR+DCIS (90.9%; 95% CI, 77.3% to 96.5%; P = .63). Conclusion Residual DCIS in patients who experience complete eradication of the invasive cancer in the breast and lymph nodes does not adversely affect survival or local recurrence rate. Inclusion of patients with residual DCIS in the definition of pCR is justified when this outcome is used as an early surrogate for long-term survival.

scholarly journals Ductal Carcinoma In Situ Progression in Dog Model of Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 418 ◽  
Author(s):  
Sulma Mohammed ◽  
Sagar Utturkar ◽  
Maxwell Lee ◽  
Howard Yang ◽  
Zhibin Cui ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Canine Model ◽  
Invasive Cancer ◽  
Ductal Hyperplasia

The mechanisms that drive ductal carcinoma in situ (DCIS) progression to invasive cancer are not clear. Studying DCIS progression in humans is challenging and not ethical, thus necessitating the characterization of an animal model that faithfully resembles human disease. We have characterized a canine model of spontaneous mammary DCIS and invasive cancer that shares histologic, molecular, and diagnostic imaging characteristics with DCIS and invasive cancer in women. The purpose of the study was to identify markers and altered signaling pathways that lead to invasive cancer and shed light on early molecular events in breast cancer progression and development. Transcriptomic studies along the continuum of cancer progression in the mammary gland from healthy, through atypical ductal hyperplasia (ADH), DCIS, and invasive carcinoma were performed using the canine model. Gene expression profiles of preinvasive DCIS lesions closely resemble those of invasive carcinoma. However, certain genes, such as SFRP2, FZD2, STK31, and LALBA, were over-expressed in DCIS compared to invasive cancer. The over-representation of myoepithelial markers, epithelial-mesenchymal transition (EMT), canonical Wnt signaling components, and other pathways induced by Wnt family members distinguishes DCIS from invasive. The information gained may help in stratifying DCIS as well as identify actionable targets for primary and tertiary prevention or targeted therapy.

scholarly journals Concurrent Bowen’s Disease of the Nipple and Breast Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 1410-1414
Author(s):  
Kei Yamaguchi ◽  
Ryoichi Matsunuma ◽  
Toko Kumeta ◽  
Sae Imada ◽  
Ryosuke Hayami ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Squamous Cell Carcinoma ◽  
Carcinoma In Situ ◽  
Histopathological Examination ◽  
Careful Examination ◽  
Bowen’S Disease ◽  
Ipsilateral Breast ◽  
Surgical Specimen ◽  
Bowen's Disease

Bowen’s disease is a squamous cell carcinoma in situ that commonly develops on the trunk, arms, or legs and has not spread beyond the top layer of skin. It seldom develops on the nipple. We report a patient who presented with Bowen’s disease of the nipple and had a concurrent breast cancer identified in the ipsilateral breast after careful examination. Histopathological examination of the surgical specimen after mastectomy confirmed the diagnoses.

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