scholarly journals Inequalities in breast-conserving surgery for female breast cancer in Świętokrzyskie Province, Poland

2021 ◽  
Author(s):  
Agnieszka Paszko ◽  
Dominik Maślach ◽  
Małgorzata Żendzian-Piotrowska ◽  
Michalina Krzyżak
Keyword(s):  
Breast Cancer ◽  
Rural Women ◽  
Rural Areas ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Female Breast Cancer ◽  
Breast Conservation Surgery ◽  
Disease Stage ◽  
Age Group ◽  
Breast Radiotherapy

Introduction: Breast cancer is the most common cancer among women in the world. Differences in the treatment of breast cancer may be observed by age, disease stage, place of residence and comorbid conditions. Aim: The aim of the study was to analyse the differences in the use of breast-conserving surgery among women in the Świętokrzyskie Province. Material and methods: The study included 483 female residents of Świętokrzyskie Province who were diagnosed with invasive breast cancer in 2013. Following indicators, recommended to evaluate the compliance with the best oncology practice, were calculated: a proportion of patients receiving post-operative breast radiotherapy after the breast-conserving surgery and a proportion of the breast-conservation surgery in pT1 cases. Results and discussion: The difference in the distribution of surgical procedures by age group (breast-conserving surgery vs. mastectomy) in pT1 cases was statistically significant (P = 0.006). The highest values of both indicators were observed in the age group recommended for breast cancer screening in Poland, while the lowest in women 70 years of age and older. Our study revealed a non-significantly higher proportion of patients receiving post-operative breast radiotherapy after breast conserving-surgery in urban than in rural women, amounting to 36.5% and 29.4%, respectively. Conclusions: Existing inequalities in the use of breast-conserving surgery indicate the need to consider the recommended breast cancer treatment to the highest possible proportion of patients residing in rural areas.

scholarly journals Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer

2010 ◽  
Vol 92 (7) ◽  
pp. 562-568 ◽  
Author(s):  
Siong-Seng Liau ◽  
Massimiliano Cariati ◽  
David Noble ◽  
Charles Wilson ◽  
Gordon C Wishart
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Breast Conservation Surgery ◽  
Breast Cancer Specific Survival ◽  
Breast Radiotherapy ◽  
Cancer Specific Survival ◽  
Conservation Surgery

INTRODUCTION The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a target radial margin of 5 mm for IBC, in combination with 40-Gy hypofractionated (15 fractions) breast radiotherapy, since 1999. PATIENTS AND METHODS An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy). RESULTS After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P < 0.0001). More importantly, patients with IBTR had a shorter breast cancer-specific survival than those who were IBTR-free (Log-rank, P < 0.0001). CONCLUSIONS Our treatment regimen, combining BCS with a 5-mm target margin and hypofractionated 40-Gy RT, results in an extremely low rate of IBTR, and compares favourably with the target IBTR rate of < 5% defined by the Association of Breast Surgeons (ABS) at BASO guidelines.

Ten-Year Multi-Institutional Results of Breast-Conserving Surgery and Radiotherapy in BRCA1/2-Associated Stage I/II Breast Cancer

2006 ◽  
Vol 24 (16) ◽  
pp. 2437-2443 ◽  
Author(s):  
Lori J. Pierce ◽  
Albert M. Levin ◽  
Timothy R. Rebbeck ◽  
Merav A. Ben-David ◽  
Eitan Friedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Breast Conservation Surgery ◽  
Breast Cancers ◽  
Mutation Status ◽  
High Risk Women ◽  
Mutation Carriers ◽  
Significant Difference

Purpose We compared the outcome of breast-conserving surgery and radiotherapy in BRCA1/2 mutation carriers with breast cancer versus that of matched sporadic controls. Methods A total of 160 BRCA1/2 mutation carriers with breast cancer were matched with 445 controls with sporadic breast cancer. Primary end points were rates of in-breast tumor recurrence (IBTR) and contralateral breast cancers (CBCs). Median follow-up was 7.9 years for mutation carriers and 6.7 years for controls. Results There was no significant difference in IBTR overall between carriers and controls; 10- and 15-year estimates were 12% and 24% for carriers and 9% and 17% for controls, respectively (hazard ratio [HR], 1.37; P = .19). Multivariate analyses for IBTR found BRCA1/2 mutation status to be an independent predictor of IBTR when carriers who had undergone oophorectomy were removed from analysis (HR, 1.99; P = .04); the incidence of IBTR in carriers who had undergone oophorectomy was not significantly different from that in sporadic controls (P = .37). CBCs were significantly greater in carriers versus controls, with 10- and 15-year estimates of 26% and 39% for carriers and 3% and 7% for controls, respectively (HR, 10.43; P < .0001). Tamoxifen use significantly reduced risk of CBCs in mutation carriers (HR, 0.31; P = .05). Conclusion IBTR risk at 10 years is similar in BRCA1/2 carriers treated with breast conservation surgery who undergo oophorectomy versus sporadic controls. As expected, CBCs are significantly increased in carriers. Although the incidence of CBCs was significantly reduced in mutation carriers who received tamoxifen, this rate remained significantly greater than in controls. Additional strategies are needed to reduce contralateral cancers in these high-risk women.

scholarly journals Emlőrák miatti szervmegtartó műtétek reszekciós széleinek vizsgálata. Multicentrikus retrospektív elemzés

2019 ◽  
Vol 160 (26) ◽  
pp. 1036-1044
Author(s):  
Bernadett Fakan ◽  
Eszter Baranyi ◽  
Réka Horváth ◽  
Endre Kálmán ◽  
Janina Kulka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Female Breast Cancer ◽  
Surgical Margins ◽  
Residual Cancer ◽  
Related Data ◽  
Boost Irradiation ◽  
Incomplete Removal ◽  
Boost Radiotherapy

Abstract: Introduction: Breast conserving surgery for breast cancer requires the analysis of surgical margins. If the tumor is not removed completely, additional treatments (reoperation, boost irradiation) are generally recommended. Aim: To analyze the information content of histopathology reports on surgical margins in consecutive cases of breast conservation for invasive female breast cancer, to evaluate the frequency of incompletely removed tumors and to estimate the rate of further treatments after incomplete removal. Method: Analysis of margin related data of consecutive histopathology reports from 8 Hungarian pathology units with locoregional treatment related data in case of unsafe margins. Results: 386 reports were analyzed after exclusions. 200 and 32 cases were identified as having unsafe margins according to the previous (<5 mm) and the new (0 mm) definition of unclear margin, respectively. Unsafe margins were more common with lobular carcinomas. Specimens with clear margins weighed more. Reoperations for unsafe margins were performed in 43/180 and 12/22 cases according to the previous and the new definitions, respectively. Only 75/137 patients without reoperation received boost irradiation of the tumor bed; information on boost radiotherapy was often missing. Residual cancer was identified in 15/43 reoperated patients, of whom 9 had >0 mm margin distance. Conclusions: Some pathology reports lack information on surgical margins. Unsafe margin rates decreased with the new definition. Residual cancer may be left behind in case of clear margins with no ink on tumor. Neither reoperation, nor boost radiotherapy is given to some patients with unclear surgical margins. Orv Hetil. 2019; 160(26): 1036–1044.

Periareolar zigzag incision in breast conserving surgery.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12093-e12093
Author(s):  
Beom Seok Ko ◽  
hee Jeong Kim ◽  
Jisun Kim ◽  
Sae Byul Lee ◽  
jong Won Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Axillary Dissection ◽  
Frozen Section ◽  
Bilateral Breast Cancer ◽  
Breast Conservation ◽  
Operation Time ◽  
Breast Conserving Surgery ◽  
Breast Conservation Surgery ◽  
Periareolar Incision ◽  
Surgical Field

e12093 Background: Breast conserving surgery (BCS) followed by radiation therapy is today standard therapy for early breast cancer. Avoiding scars on the breast is women’s desire. Numerous minimal approaches have evolved due to this concern. The periareolar incision is often used to remove relatively small tumors located near the nipple. But periareolar incision has a disadvantages include limited exposure of the surgical field. Periareolar zigzag incision has the advantage of not only good surgical field but also contributed to better surgical scars. The purpose of this study was to evaluate the usefulness of periaroar zigzag incision and oncological safety. Methods: We retrospectively reviewed breast cancer patients who performed breast conserving surgery with periareolar zigzag incision by one surgeon from January 2016 to December 2016. In this study, patients with bilateral breast cancer or other diseases who underwent cooperative surgery were excluded. Intraoperative frozen section margin was evaluated in all patients and additional resection was performed when positive margin was present. Final margin status was determined by examination of the permanent paraffin-embedded sections. Patients characteristics, tumor characteristics, operative time, size of specimen and the distance from the tumor to nipple were evaluated. Results: A total of 193 patients were reviewed. The median age of the patients was 50 years (range: 25-79 years), median tumor size was 1.7 cm (range: 0-8.8 cm), median tumor distance from the nipple was 3.0 cm (range: 0.5-8.0 cm) and median specimen sized was 5.0 cm (range: 2.0-15.0 cm). The median operation time was 70 minutes (range: 32-138 min) in patients without axillary dissection, and 91 minutes (range: 60-171 min) in patients who underwent axillary dissection. In 13 patients (6.7%), tumor was found in intraoperative frozen biopsy and re-excision was performed. There were no major complications associated with surgery. There were no reoperations due to bleeding or other reasons. Conclusions: In breast conservation surgery, the periareolar zigzag incision technique has good cosmetic effect and a enough operative field can be obtained, so it may be applied oncological safely even when relatively large tumors are removed.

Study of breast cancer surgeries at a tertiary hospital

2021 ◽  
Vol 18 (3) ◽  
pp. 93-97
Author(s):  
Pandit Shamarao Powar ◽  
Keyword(s):  
Breast Cancer ◽  
Rural Areas ◽  
Ductal Carcinoma ◽  
Hormone Replacement ◽  
Positive Family History ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Tertiary Hospital ◽  
Breast Conservation Surgery ◽  
Modified Radical Mastectomy

Background: Breast cancer is commonly treated by various combinations of surgery, chemotherapy, radiation therapy, hormone therapy and targeted therapy via a multimodality approach. Surgery is the mainstay of treatment of the early stages of breast cancer, and it ranges from lumpectomy to modified radical mastectomy. Surgery typically includes sentinel lymph nodes (LN) dissection for staging the extent of spread into the axilla. In present study we aimed to study surgeries done in patients with breast cancer at our tertiary hospital. Material and Methods: Present study was a prospective, observational study conducted in patients who underwent surgery for breast cancer, followed by histopathological report positive for breast malignancy. Results: Total 86 biopsy proven breast cancer patients underwent surgery during study period. All patients were females, with mean age 47.4 ± 10.7 years, from rural areas (74%), 9% had positive family history, 13% received Hormone Replacement Therapy/Oral Contraceptive Pills (for more than 5 years), 5% were smokers, 64% were premenopausal and 7% had history of breast biopsy. Modified radical mastectomy with axillary node dissection (69%) was most common surgery performed followed by breast conservation surgery (26%). Most patients were from stage II (64%) followed by stage I (15%). Infiltrating ductal carcinoma was most common histopathological variant (81%). Histopathologically most cancers were grade II (52%). Lymph nodal involvement (48%) and positive surgical margins (7%) were noted. Conclusion: Surgery is mainstay in treatment of breast cancer With introduction of BCS cosmetic and other concerns are tackled effectively.

scholarly journals Trends in Epidemiology and Management of Breast Cancer in Women Under 46 Years: Institutional Experience from a Tertiary Cancer Centre in Eastern India

2021 ◽  
Vol 8 (7) ◽  
pp. 278-285
Author(s):  
Sourav Kumar Ghosh ◽  
Sanskriti Poddar ◽  
Krishnangshu Bhanja Choudhury
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Staging System ◽  
Relevant Information ◽  
Breast Conservation Surgery ◽  
Age Group ◽  
Curative Intent ◽  
The Impact

Background: Breast cancer in younger women is a growing burden both in developed and Asian subcontinent. Despite studies showing varying results about the impact of age on treatment outcome and suboptimal survival, very few robust Indian studies have thrown light on this biologically different entity. Methods: Histologically / cytologically confirmed cases of non-sarcomatous, female ductal breast carcinoma patients of age group less than and equal to 45 years of all stages attending radiotherapy department of R.G Kar Medical College between January 2016-December 2018 were included in the study. Relevant information was obtained from patient`s files/case records. Database was locked on 31st March 2021.The baseline demographic profile, cancer subsites along with treatment provided were analysed using SPSS version 16 (IBM Inc, Armonk, New York, U.S.). Descriptive data are provided. Results: Total 272 patients were eligible for the study as per the inclusion criteria with median age of 39 years (22-45 years). Majority were urban married Hindu females. Majority were locally advanced and node positive high grade disease as per AJCC 7th staging system. Modified radical mastectomy was significantly higher than breast conservation surgery as the surgical modality (76 vs. 8.9%). 31.2%, 54.5% patients received neoadjuvant and adjuvant chemotherapy respectively.61% patients received curative intent radiotherapy either in conventional or hypofractionated schedule. Myelosuppression and oral mucositis were the major treatment related adverse events. Overall median PFS was 48 months. Conclusion: Breast cancer in younger age group is distinct in terms of disease biology. Effective screening and diagnostics modalities with focus on mass awareness amongst patients and health care workers are the cornerstone of improving outcome and survival. Keywords: breast cancer, young females, retrospective single institutional study.

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