Successful Outcomes of Single‐Port Insufflation Endoscopic Breast‐Conserving Surgery for Breast Cancer

Abstract PurposeIn the surgical treatment of breast cancer, the goal of surgeons is to continuously create and improve minimally invasive surgical methods to increase the quality of life of the patient. Currently, routine breast-conserving surgery is performed using two obvious incisions. Here, we compare the clinical efficacy and aesthetic perspectives between a novel technique using one incision called single-port insufflation endoscopic breast-conserving surgery and conventional breast-conserving surgery in early stage breast cancer.MethodsA total of 180 patients with stage I or stage II breast cancer participated in this study. Single-port insufflation endoscopic breast-conserving surgery was performed on 63 patients, while conventional breast-conserving surgery was performed on 117 patients. The evaluation of the aesthetic outcome was carried out by the BREAST-Q scale. Logistic regression was conducted to assess the risk of local recurrence and metastasis.ResultsThere were significant differences between the two groups for chest well-being, psychological well-being, and adverse effects of radiation. The scores for satisfaction of breasts and sexual well-being showed no statistical differences between the two groups. There was no statistical significance in local recurrence or metastasis between the two groups. Single-port insufflation endoscopic breast-conserving surgery did not increase the risk of local recurrence or metastasis.ConclusionThe novel surgical technique, single-port insufflation endoscopic breast-conserving surgery, is a feasible and safe surgery and has advantages in terms of cosmetic outcome and psychological status.

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Method of detection of local recurrence in patients following breast conserving surgery and its utility for surveillance

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.611 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 611-611

Author(s):

B. Taback ◽

N. Hansen ◽

K. Conway ◽

A. Giuliano

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Ductal Carcinoma ◽

Early Stage ◽

Breast Conserving Surgery ◽

Conclusive Evidence ◽

Breast Cancer Patients ◽

Asymptomatic Patients

611 Background: It is estimated that approximately 10% of all breast cancer patients will develop local recurrence (LR) at 10 years. Routine surveillance for detection of early breast cancer recurrence is widely performed despite lack of conclusive evidence for an improvement in patient quality of life or potential for cure. A number of historical studies evaluating the effectiveness of routine screening for LR following treatment for early-stage breast cancer have suggested that the diagnosis of LR is more frequent during a routine visit and occurring in asymptomatic patients. However, differentiating the method of detection is not often elucidated. In this study we evaluated the manner in which patients presented with an isolated LR in clinical practice. Methods: Our routine patient follow-up consists of physical exam and mammogram every 6 mos for the first 2 years following breast conserving surgery (BCS) and yearly thereafter. We queried our prospectively collected breast cancer database (1632 patients from July 1986 - July 2004) for patients with an isolated LR following BCS (n=59 (3.6%); two patients had bilateral LRs). Medical records were not available for three patients. Results: At a median follow-up of 45 mos (range: 5–122 mos) there were 58 evaluable LRs: 15 DCIS, 31 infiltrating ductal carcinoma (IDC), 6 infiltrating lobular (ILC), 2 mixed IDC/ILC, 3 invasive cancers NOS and 1 unknown. Patient presentation was as follows: 25 were diagnosed by self-exam, 28 on screening mammogram, 2 were diagnosed by physician (includes one referral), and 3 unknown. Mammogram detected recurrences were more frequent among patients with DCIS whereas self-detected recurrences were more common in patients with IDC (79% vs 33% and 21% vs 67%, respectively; P<0.2). Mean tumor size was larger in self-presentation (2.1 cm; range: 0.8–4.5 cm) than in mammogram detected group (1.6 cm; range 0.4–6 cm). Conclusions: These findings demonstrate the value of mammography as compared to patient detected LRs. Whether a survival advantage exists remains uncertain. Nevertheless routine physician examination in this setting is highly insensitive and its further utility must be considered when devising cost-effective strategies for surveillance of breast cancer patients. No significant financial relationships to disclose.

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Interval Between Breast-Conserving Surgery and Start of Radiation Therapy in Early-Stage Breast Cancer is Not Predictive of Local Recurrence: A Single-Institution Experience

Clinical Breast Cancer ◽

10.1016/j.clbc.2011.03.004 ◽

2011 ◽

Vol 11 (2) ◽

pp. 114-120 ◽

Cited By ~ 10

Author(s):

Viviana Barbieri ◽

Pietro Sanpaolo ◽

Domenico Genovesi

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Local Recurrence ◽

Early Stage ◽

Breast Conserving Surgery ◽

Early Stage Breast Cancer ◽

Single Institution

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Well-Being, Depression, and Anxiety following Oncoplastic Breast Conserving Surgery versus Modified Radical Mastectomy Followed by Late Breast Reconstruction

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179320 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9320

Author(s):

Daciana Grujic ◽

Cătălina Giurgi-Oncu ◽

Cristina Oprean ◽

Zorin Crăiniceanu ◽

Ica Secoșan ◽

...

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Clinical Symptoms ◽

Clinical Care ◽

Statistical Significance ◽

Radical Mastectomy ◽

Well Being ◽

Breast Conserving Surgery ◽

Modified Radical Mastectomy ◽

Group I

Breast cancer requires complex clinical care. Well-being is an intricate concept, encompassing physical, functional, emotional, and social aspects. Background: This study aims to evaluate the relationship between the type of surgery our patients underwent and the timing of the reconstructive surgery with physical, emotional, social, and functional well-being. Furthermore, through our research we tried to identify potential mental health comorbidities in patients with breast cancer, clinical symptoms, and well-being in women with breast cancer, depending on the type of required surgery. Methods: The study included 69 women diagnosed with breast cancer, in stages I to III, divided in two groups: I—patients with oncoplastic breast-conserving surgery and contralateral correction surgery, for symmetry reasons; II—patients who underwent modified radical mastectomy and late breast reconstruction with contralateral symmetrisation. We evaluated socio-demographic aspects, alongside depression, anxiety, stress (DASS 21), and well-being (FACT-B). Data were statistically processed; statistical significance was set at p < 0.05. Results: Clinical elements of depression, anxiety, and stress were noted in both groups, without statistical significance (p > 0.05). Significant differences were found regarding psycho-emotional (p = 0.035) and functional well-being (p = 0.001), with higher scores for group I. The chi-square test indicated statistically significant differences (at p < 0.01) between the groups, regarding the frequency of scores on items B4 and B9 (FACT-B items, related to feminine aesthetics and desirability), with evidently higher scores in group I than in group II. Conclusions: The state of well-being, as well as the items related to femininity and sexuality had higher values in the group of women treated by oncoplastic conservative surgery compared to late reconstruction after modified radical mastectomy.

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Assessment of Suspected Breast Lesions in Early Stage Triple Negative Breast Cancer During Follow-up After Breast Conserving Surgery Using Multiparmetric MRI

10.21203/rs.3.rs-101187/v1 ◽

2020 ◽

Author(s):

Lamiss Mohamed abd el aziz sad ◽

Naglaa Lofty Dabees ◽

Dareen Abd El- Aziz Mohamed ◽

Amr Tageldin ◽

Samar Galal Younis

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Triple Negative Breast Cancer ◽

Predictive Value ◽

Triple Negative ◽

Early Stage ◽

Breast Conserving Surgery ◽

Post Contrast ◽

Dce Mri

Abstract Background: The local recurrence rate in triple negative breast cancer (TNBC) can be as high as 12%.The standard treatment for early-stage TNBC is breast conserving surgery (BCS), followed by postoperative radiotherapy with or without chemotherapy. However, detection of the local recurrence of the disease after radiotherapy is a major issue.Objective: The aim of this study was to investigate the role of dynamic and functional magnetic resonance imaging (MRI) during follow-up after BCS and radiotherapy with/without chemotherapy to differentiate between loco regional recurrence and postoperative fibrosis.Patients and methods: This prospective study was conducted at Oncology, Radiology, and Pathology Departments, Tanta University. It involved 50 patients with early-stage TNBC who were treated with BCS, followed by radiotherapy with/without chemotherapy. The suspected lesions were evaluated during the follow-up period by sonomammography. All patients were subjected to MRI, including conventional sequences, diffusion-weighted imaging (DWI), and dynamic post-contrast study. Results: Ten cases were confirmed as recurrent malignant lesions. After contrast administration, they all exhibited irregular T1 hypodense lesions of variable morphology with diffusion restriction and positive enhancement. Eight cases displayed a type III curve, while two showed a type II curve. Histopathological assessment was consistent with the MRI findings in all eight cases. The combination of the data produced by DWI-MRI and dynamic contrast enhanced (DCE)-MRI resulted in 100%sensitivity, 92.5% specificity, 90.9% positive predictive value, 100% negative predictive value, and 98% accuracy. Conclusion: Combination of DWI-MRI and DCE-MRI could have high diagnostic value for evaluating postoperative changes in patients with TNBC after BCS, followed by radiotherapy with/without chemotherapy.Trial Registrations: not trial to be registered

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Associated Factors and Survival Outcomes for Breast Conserving Surgery versus Mastectomy among New Zealand Women with Early-Stage Breast Cancer

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052738 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2738

Author(s):

Mohammad Shoaib Abrahimi ◽

Mark Elwood ◽

Ross Lawrenson ◽

Ian Campbell ◽

Sandar Tin Tin

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

New Zealand ◽

Early Stage ◽

Breast Conserving Surgery ◽

Early Stage Breast Cancer ◽

Clinical Factors ◽

Breast Cancer Specific Mortality ◽

Specific Mortality ◽

Cancer Specific Mortality

This study aimed to investigate type of loco-regional treatment received, associated treatment factors and mortality outcomes in New Zealand women with early-stage breast cancer who were eligible for breast conserving surgery (BCS). This is a retrospective analysis of prospectively collected data from the Auckland and Waikato Breast Cancer Registers and involves 6972 women who were diagnosed with early-stage primary breast cancer (I-IIIa) between 1 January 2000 and 31 July 2015, were eligible for BCS and had received one of four loco-regional treatments: breast conserving surgery (BCS), BCS followed by radiotherapy (BCS + RT), mastectomy (MTX) or MTX followed by radiotherapy (MTX + RT), as their primary cancer treatment. About 66.1% of women received BCS + RT, 8.4% received BCS only, 21.6% received MTX alone and 3.9% received MTX + RT. Logistic regression analysis was used to identify demographic and clinical factors associated with the receipt of the BCS + RT (standard treatment). Differences in the uptake of BCS + RT were present across patient demographic and clinical factors. BCS + RT was less likely amongst patients who were older (75+ years old), were of Asian ethnicity, resided in impoverished areas or areas within the Auckland region and were treated in a public healthcare facility. Additionally, BCS + RT was less likely among patients diagnosed symptomatically, diagnosed during 2000–2004, had an unknown tumour grade, negative/unknown oestrogen and progesterone receptor status or tumour sizes ≥ 20 mm, ≤50 mm and had nodal involvement. Competing risk regression analysis was undertaken to estimate the breast cancer-specific mortality associated with each of the four loco-regional treatments received. Over a median follow-up of 8.8 years, women who received MTX alone had a higher risk of breast cancer-specific mortality (adjusted hazard ratio: 1.38, 95% confidence interval (CI): 1.05–1.82) compared to women who received BCS + RT. MTX + RT and BCS alone did not have any statistically different risk of mortality when compared to BCS + RT. Further inquiry is needed as to any advantages BCS + RT may have over MTX alternatives.

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Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes: analysis of 1099 cases

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02214-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Yang Li ◽

Su Lu ◽

Yuhan Zhang ◽

Shuaibing Wang ◽

Hong Liu

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Molecular Subtypes ◽

Early Stage ◽

Young Patients ◽

Distant Metastases ◽

Early Stage Breast Cancer ◽

Regional Recurrence ◽

Her2 Status ◽

Over Time

Abstract Background The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusions The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.

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