scholarly journals Predictive power of the intraoperative evaluation of retroareolar margin in mammary adenectomies for the treatment of early-stage breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Rebeca Neves Heinzen ◽  
Alfredo Carlos Simões Dornellas de Barros ◽  
Filomena Marino Carvalho ◽  
Fernando Nalesso Aguiar ◽  
Alfredo Luiz Jacomo
Keyword(s):  
Breast Cancer ◽  
Predictive Power ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Resonance Imaging ◽  
Intraoperative Evaluation ◽  
Areola Complex ◽  
Magnetic Resonance Imaging Mri ◽  
Paraffin Method

Introduction: Mammary adenectomy (MA) has been increasingly adopted to treat early-stage breast cancer (BC) for its cosmetic benefits and oncologic safety. In order to ensure the local control of the disease, the amount of remaining glandular tissue should be the least possible, and surgical margins must be free. Objective: To evaluate the predictive power of the intraoperative evaluation of retroareolar margin (IERM) compared to the gold-standard represented by the definitive analysis of sections embedded in paraffin. Method: This is a retrospective cohort study conducted with patients from the Clínica Professor Alfredo Barros, based on 224 individuals submitted to surgery with the MA technique (178 infiltrating carcinomas and 46 ductal carcinomas in situ). In all patients, the distance tumor-nipple-areola complex (NAC) was ≥2.0 cm, according to magnetic resonance imaging (MRI). A 0.5 cm thick flap was used in the region below the NAC. IERM was performed through cytopathological and histopathological examinations. IERM findings were compared to those of the definitive paraffin examination to calculate the parameters of predictive power. Results: In 5 cases (2.2%), IERM was positive, and NAC was immediately removed. The parameters of IERM predictive power can be seen below: Sensitivity 100%, Specificity 100%, Positive predictive value 100%, Positive negative value 97,3%, Accuracy 98,2%. Conclusion: IERM is highly accurate, has full specificity, and the NAC can be managed intraoperatively according to its result.

scholarly journals Is it necessary to remove intrapapillary ducts in therapeutic mammary adenectomies for breast cancer?

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Rebeca Neves Heinzen ◽  
Alfredo Carlos Simões Dornellas de Barros ◽  
Filomena Marino Carvalho ◽  
Cristiane da Costa Brandeia Abrahao Nimir ◽  
Alfredo Luiz Jacomo
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Glandular Tissue ◽  
Resonance Imaging ◽  
Areola Complex ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri

Introduction: The nipple-areola complex (NAC) has glandular tissue in intrapapillary ducts (IPDs). When the NAC is preserved during mammary adenectomies (MA) for the treatment of breast cancer (BC), this glandular tissue, which is a potential focus of tumor residues, remains. Objective: To estimate the frequency of neoplastic development in IPDs among BC patients treated with MA. Method: After the MA and with evidence of free retroareolar margin through intraoperative examination, the nipple was inverted, and its central portion, where mammary ducts are located, removed. A pointed-tip scalpel was used, preserving a tissue rim of 1.0 to 2.0 mm. The analysis involved 219 cases submitted to this type of surgery in the Clínica Professor Alfredo Barros. In all patients, the distance tumor-NAC was ≥2.0 cm, according to magnetic resonance imaging (MRI). The intrapapillary tissue removed was sent for microscopic examination of sections embedded in paraffin. Results: We found 4 cases of ductal carcinoma in situ (none infiltrating) in IPDs (1.19%). Considering only the 217 cases with free retroareolar margin in the definitive examination, the number of patients with ductal carcinoma in situ in IPDs decreased to 2 (0.9%). Conclusion: IPDs are rarely involved in selected cases of MA (distance tumor-NAC≥2.0 cm on MRI and free retroareolar margin). Ideally, they should be removed, especially when the intent is avoiding radiotherapy.

scholarly journals Use of Autoantibodies to Detect the Onset of Breast Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jérôme Lacombe ◽  
Alain Mangé ◽  
Jérôme Solassol
Keyword(s):  
Breast Cancer ◽  
Early Diagnosis ◽  
Early Stage ◽  
Tumor Development ◽  
Breast Cancer Diagnosis ◽  
Breast Disease ◽  
Screening Mammography ◽  
Early Stage Breast Cancer ◽  
Highly Sensitive Detection

The widespread use of screening mammography has resulted in increased detection of early-stage breast disease, particularly forin situcarcinoma and early-stage breast cancer. However, the majority of women with abnormalities noted on screening mammograms are not diagnosed with cancer because of several factors, including radiologist assessment, patient age, breast density, malpractice concerns, and quality control procedures. Although magnetic resonance imaging is a highly sensitive detection tool that has become standard for women at very high risk of developing breast cancer, it lacks sufficient specificity and costeffectiveness for use as a general screening tool. Therefore, there is an important need to improve screening and diagnosis of early-invasive and noninvasive tumors, that is,in situcarcinoma. The great potential for molecular tools to improve breast cancer outcomes based on early diagnosis has driven the search for diagnostic biomarkers. Identification of tumor-specific markers capable of eliciting an immune response in the early stages of tumor development seems to provide an effective approach for early diagnosis. The aim of this review is to describe several autoantibodies identified during breast cancer diagnosis. We will focus on these molecules highlighted in the past two years and discuss the potential future use of autoantibodies as biomarkers of early-stage breast cancer.

scholarly journals Role of Preoperative Magnetic Resonance Imaging in the Surgical Management of Early-Stage Breast Cancer

2014 ◽  
Vol 21 (11) ◽  
pp. 3473-3480 ◽  
Author(s):  
Sheenu Chandwani ◽  
Prethibha A. George ◽  
Michelle Azu ◽  
Elisa V. Bandera ◽  
Christine B. Ambrosone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Management ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Preoperative Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Preoperative Magnetic Resonance

scholarly journals Surgical attitudes toward preoperative breast magnetic resonance imaging in women with early-stage breast cancer

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
S. D. Mukherjee ◽  
N. Hodgson ◽  
P. J. Lovrics ◽  
K. Dhamanaskar ◽  
S. Chambers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Early Stage ◽  
Breast Mri ◽  
Early Stage Breast Cancer ◽  
Published Data ◽  
Resonance Imaging ◽  
Breast Magnetic Resonance

Background Preoperative breast magnetic resonance imaging (mri) is commonly requested by surgeons in the initial workup of women with breast cancer; however, its use is controversial. We performed a survey of breast cancer surgeons across Canada to investigate current knowledge about, attitudes to, and self-reported use of preoperative breast mri in a publicly funded health care system in light of the limited evidence to support it.Methods All identified general surgeons in Canada were mailed a survey instrument designed to probe current practice and knowledge of published trials.Results Of 403 responding surgeons, 233 (58%) indicated that they performed breast cancer surgery. Of those 233, 218 (94%) had access to breast mri and completed the entire survey. Overall, 54.6% of responding surgeons felt that breast mri was useful in surgical planning, and more than half (58.3%) indicated that their frequency of use was likely to increase over the next 5 years. Surgeons found preoperative mri most useful in detecting mammographically occult disease (71.5% of respondents) and in planning for breast-conserving surgery (57.3%). The main limitations reported were timely access to mri (51%) and false positives (36.7%). Responses suggest a knowledge gap in awareness of published trials in breast mri.Conclusions Our study found that, in early-stage breast cancer, self-reported use of mri by breast cancer surgeons in Canada varied widely. Reported indications did not align with published data, and significant gaps in self-reported knowledge of the data were evident. Our results would support the development and dissemination of guidelines to optimize use of mri.

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