scholarly journals Nodal Status Assessment in Breast Cancer: Strategies of Clinical Grounds and Quality of Life Implications

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Orsaria ◽  
Dimitrios Varvaras ◽  
Gianluca Vanni ◽  
Giampiero Pagnani ◽  
Jacopo Scaggiante ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Functional Model ◽  
Surgical Oncology ◽  
Nodal Status ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Noninvasive Methods ◽  
Oncological Safety ◽  
Drainage Patterns ◽  
Status Assessment

Even in the era of gene-expression profiling, the nodal status still remains the primary prognostic discriminant in breast cancer patients. The exclusion of node involvement using noninvasive methods could reduce the rate of axillary surgery, thereby preventing from suffering complications. However, lymphatic mapping with sentinel node biopsy (SNB) is one of the most interesting recent developments in surgical oncology. Optimization of procedure could be implemented by dual mapping injection site skills, resection of all hot or blue nodes through tracer combination, and improvement in atypical drainage patterns mapping. This anatomical analysis suggests safety measures in patients with high probability of node metastasis through a renewed interest in surgical management. The perspective of a guided axillary sampling (GAS) could represent a potential development of recent anatomical and functional acquisitions, offering a dynamic technique shared according to clinical and anatomical disease parameters. Furthermore, the surgical staging procedures may adopt a conservative approach through the evaluation of upper arm lymphatics, thus defining a functional model aimed at the reduction of short- and long-term adverse events. Quality results in breast cancer surgery need to generate oncological safety devoid of complications through renewed clinical experience.

scholarly journals Is Mastectomy Oncologically Safer than Breast-Conserving Treatment in Early Breast Cancer

Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 385-390 ◽  
Author(s):  
Fabian Riedel ◽  
André Hennigs ◽  
Sarah Hug ◽  
Benedikt Schaefgen ◽  
Christof Sohn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Surgery ◽  
Breast Conservation ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Aesthetic Outcome ◽  
Breast Conserving Treatment ◽  
Routine Treatment ◽  
Oncological Safety ◽  
The Individual

Aim: To describe and discuss the evidence for oncological safety of different procedures in oncological breast surgery, i.e. breast-conserving treatment versus mastectomy. Methods: Literature review and discussion. Results: Oncological safety in breast cancer surgery has many dimensions. Breast-conserving treatment has been established as the standard surgical procedure for primary breast cancer and fits to the preferences of most breast cancer patients concerning oncological safety and aesthetic outcome. Conclusions: Breast-conserving treatment is safe. Nonetheless, the preferences of the individual patients in their consideration of breast conservation versus mastectomy should be integrated into routine treatment decisions.

scholarly journals Magnetic Seed (Magseed) Localisation in Breast Cancer Surgery: A Multicentre Clinical Trial

Breast Care ◽  
2020 ◽  
pp. 1-6
Author(s):  
Jan Žatecký ◽  
Otakar Kubala ◽  
Oldřich Coufal ◽  
Markéta Kepičová ◽  
Adéla Faridová ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Surgical Oncology ◽  
Breast Tumour ◽  
Axillary Node ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Magnetic Marker ◽  
Magnetic Seeds

<b><i>Introduction:</i></b> The aim of this study was to evaluate the accuracy and reliability of the Magseed magnetic marker in breast cancer surgery. <b><i>Methods:</i></b> Thirty-nine patients with 41 implanted Magseeds undergoing surgical treatment in 3 surgical oncology departments were included in the retrospective trial to study pilot use of the Magseed magnetic marker in the Czech Republic for localisation of breast tumours or pathological axillary nodes in breast cancer patients. <b><i>Results:</i></b> Thirty-four breast cancer and 7 pathological lymph node localisations were performed by Magseed implantation. No placement failures, or perioperative detection failures of Magseeds were observed (0/41, 0.0%), but one case of Magseed migration was present (1/41, 2.4%). All magnetic seeds were successfully retrieved (41/41, 100.0%). Negative margins were achieved in 29 of 34 (85.3%) breast tumour localisations by Magseed. <b><i>Conclusion:</i></b> Magseed is a reliable marker for breast tumour and pathological axillary node localisation in breast cancer patients. Magseed is comparable to conventional localisation methods in terms of oncosurgical radicality and safety.

scholarly journals Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Retrospective Studies ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

Systematic review: The oncological safety of adipose fat transfer after breast cancer surgery

The Breast ◽  
2017 ◽  
Vol 31 ◽  
pp. 128-136 ◽  
Author(s):  
Karl Waked ◽  
Julien Colle ◽  
Maarten Doornaert ◽  
Veronique Cocquyt ◽  
Phillip Blondeel
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Fat Transfer ◽  
Oncological Safety

scholarly journals Contrast-Enhanced Ultrasound for Precise Sentinel Lymph Node Biopsy in Women with Early Breast Cancer: A Preliminary Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2104
Author(s):  
Yangyang Zhu ◽  
Xiao Fan ◽  
Dan Yang ◽  
Tiantian Dong ◽  
Yingying Jia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
Lymphatic Drainage ◽  
Lymph Node Biopsy ◽  
Contrast Enhanced Ultrasound ◽  
Breast Cancer Patients ◽  
Drainage Patterns ◽  
Node Biopsy ◽  
Contrast Enhanced

Background: Sentinel lymph node biopsy (SLNB), as a common method for axillary staging of early breast cancer, has gradually attracted people’s attention to the false-negative rate and postoperative complications. The aim of the study is to investigate the clinical value of preoperative contrast-enhanced ultrasound (CEUS) for intraoperative SLNB in early breast cancer patients. Methods: A total of 201 patients scheduled for SLNB from September 2018 to April 2021 were collected consecutively. Preoperative CEUS was used to identify sentinel lymph nodes (SLN) and lymphatic drainage in breast cancer patients. Results: The SLN identification rate of CEUS was 93.0% (187/201) and four lymphatic drainage patterns were found: single LC to single SLN (70.0%), multiple LCs to single SLN (8.0%), single LC to multiple SLNs (10.2%), and multiple LCs to multiple SLNs (11.8%). The Sen, Spe, PPV, NPV, AUC of CEUS, US and CEUS + US in diagnosis of SLNs were 82.7%, 80.4%, 73.8%, 87.4%, 0.815; 70.7%, 77.7%, 68.0%, 79.8%, 0.742; and 86.7%, 77.7%, 72.2%, 89.7%, 0.822, respectively. There was no statistically significant difference between the diagnostic performance of CEUS and CEUS + US (p = 0.630). Conclusions: CEUS can be used to preoperatively assess the lymphatic drainage patterns and the status of the SLNs in early breast cancer to assist precision intraoperative SLNB.

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.

Adequate locoregional treatment for early breast cancer may prevent secondary dissemination.

1995 ◽  
Vol 13 (12) ◽  
pp. 2869-2878 ◽  
Author(s):  
R Arriagada ◽  
L E Rutqvist ◽  
A Mattsson ◽  
A Kramar ◽  
S Rotstein
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Distant Metastasis ◽  
Preoperative Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients

PURPOSE To analyze different events that determine event-free survival (EFS) in a randomized trial on adjuvant radiotherapy in early breast cancer patients with more than 15 years of follow-up evaluation. PATIENTS AND METHODS The trial included 960 patients with a unilateral, operable breast cancer. Surgery consisted of a modified radical mastectomy. The trial compared three arms, as follows: preoperative radiotherapy, postoperative radiotherapy, and no adjuvant treatment. Events were analyzed by a competing-risk approach. A proportional hazards multiple regression model was used to analyze the effects of radiotherapy on the risk of distant metastasis. Similar analyses were performed separately for node-negative [N(-)] and node-positive [N(+)] patients in the two groups that did not include preoperative radiotherapy. RESULTS Radiotherapy produced a fivefold decrease of the risk of local recurrence (P < .0001). In N(+) patients, postoperative radiotherapy decreased the risk of distant dissemination (relative risk, 0.63). When local recurrence was introduced in the model as a time-dependent covariate, this factor was predictive of distant dissemination (P < .0001) and nullified the effect of postoperative radiotherapy. This finding suggests that the decrease of distant metastases was related to the prevention of local recurrence. A similar effect was found in models that used overall survival as an end point. CONCLUSION This study shows that postmastectomy radiotherapy in N(+) breast cancer patients may decrease the distant metastasis rate by preventing local recurrences and thus avoiding secondary dissemination.

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