scholarly journals True Local Recurrences or New Primary Tumors after Breast-Conserving Surgery and Radiation Therapy

2007 ◽  
Vol 57 (3) ◽  
pp. 221-224
Author(s):  
Jun Horiguchi ◽  
Yukio Koibuchi ◽  
Nana Rokutanda ◽  
Rin Nagaoka ◽  
Yuko Ishikawa ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Breast Conserving Surgery ◽  
Primary Tumors ◽  
Local Recurrences

Pathologic Evaluation of Surgical Margins and Local Recurrences after Breast-conserving Surgery without Irradiation

2000 ◽  
Vol 24 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Takao Kato ◽  
Tsunehito Kimura ◽  
Nobue Ishii ◽  
Akiho Fujii ◽  
Kazuko Yamamoto ◽  
...  
Keyword(s):  
Breast Conserving Surgery ◽  
Surgical Margins ◽  
Local Recurrences ◽  
Pathologic Evaluation

scholarly journals Ductal Carcinoma In Situ of the Breast

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Richard J. Lee ◽  
Laura A. Vallow ◽  
Sarah A. McLaughlin ◽  
Katherine S. Tzou ◽  
Stephanie L. Hines ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Treatment Options ◽  
Breast Conserving Surgery ◽  
Partial Breast Irradiation ◽  
Significant Shift

Ductal carcinoma in situ (DCIS) of the breast represents a complex, heterogeneous pathologic condition in which malignant epithelial cells are confined within the ducts of the breast without evidence of invasion. The increased use of screening mammography has led to a significant shift in the diagnosis of DCIS, accounting for approximately 27% of all newly diagnosed cases of breast cancer in 2011, with an overall increase in incidence. As the incidence of DCIS increases, the treatment options continue to evolve. Consistent pathologic evaluation is crucial in optimizing treatment recommendations. Surgical treatment options include breast-conserving surgery (BCS) and mastectomy. Postoperative radiation therapy in combination with breast-conserving surgery is considered the standard of care with demonstrated decrease in local recurrence with the addition of radiation therapy. The role of endocrine therapy is currently being evaluated. The optimization of diagnostic imaging, treatment with regard to pathological risk assessment, and the role of partial breast irradiation continue to evolve.

Genetic and immune divergence in pancreatic cancer lesions at the time of metastatic relapse compared to primary tumor.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4140-4140
Author(s):  
Bereket Gebregziabher ◽  
Derek A. Oldridge ◽  
Emma E. Furth ◽  
Michael D. Feldman ◽  
Andrew J. Rech ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Rna Sequencing ◽  
Primary Tumor ◽  
Metastatic Tumors ◽  
Kras Mutations ◽  
Primary Tumors ◽  
Metastatic Relapse ◽  
Resected Tumor ◽  
First Relapse

4140 Background: Relapse of pancreatic ductal adenocarcinoma (PDA) is common even after complete resection and adjuvant therapy. Compared to the resected tumor, the biological characteristics of metastatic tumors at the time of first relapse are poorly understood. Methods: Whole-exome sequencing (WES) (250x) and bulk RNA sequencing were performed on samples from 30 patients with PDA. Paired primary tumor samples were obtained after R0 or R1 resection, and metastatic tumor samples were obtained by biopsy at the time of first relapse. 74.1% of patients had received adjuvant chemotherapy and radiation therapy, 7.4% had received adjuvant chemotherapy only, and 3.7% had received adjuvant radiation therapy only. Most common metastatic sites were liver and lung. The cohort was 60% male with a median age at diagnosis of 64 years. The vast majority of patients had stage IIA or IIB disease at diagnosis. Median disease-free survival was 481 days. Analysis used Freebayes (somatic variant calling), Kallisto (transcript quantification), Danaher et al. (cell type deconvolution), and antigen.garnish (neoantigen prediction). Results: High-quality WES and/or RNA sequencing were available for 27/30 patients. Among these were 16 pairs of primary and metastatic samples for WES and 15 paired samples for RNA sequencing. Median tumor purity was 32% (primary) and 42% (metastatic). KRAS mutations were present in 43/48 evaluable samples, with conserved KRAS mutations in 14/16 primary-metastatic pairs. Tumors were otherwise highly variable, with 13/16 patients developing oncogenic mutations in metastatic tumors that were undetected in primary tumors (BRCA1 [3/16], AKT3 [3/16], TP53 [2/16], ROS1 [2/16]). Overall, primary and metastatic tumors had similar tumor mutation burden and neoantigen production rate. However, neoantigens were highly variable at the peptide and gene level, with conservation rates of 2.73% and 11.57%, respectively, across primary-metastatic pairs. PDA transcriptomic subtype also differed across primary-metastatic pairs in all cases. Furthermore, metastatic tumors contained lower immune suppressive signal by transcripts and deconvolution (CTLA4: p = 0.0012, FOXP3: p = 0.0026, PDCD11: p = 0.012, regulatory T cells: p = 0.012), while myeloid cells were higher (CD33: p = 0.0067). Conclusions: With the exception of KRAS, metastatic PDA tumors at relapse contain new oncogenes, distinct neoantigens, and lower immune-suppressive signal compared to primary PDA tumors. These data suggest a potential clinical utility for tumor biopsies at the time of first metastatic relapse and caution against clinical decisions for relapsed, metastatic patients based solely on sequencing of the originally resected tumor.

Stereotactic body radiation therapy for nonpulmonary primary tumors

2008 ◽  
Vol 8 (12) ◽  
pp. 1939-1951 ◽  
Author(s):  
Simon S Lo ◽  
Higinia R Cardenes ◽  
Bin S Teh ◽  
Achilles J Fakiris ◽  
Mark A Henderson ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Primary Tumors ◽  
Stereotactic Body Radiation
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