Segmental Mastectomy

2020 ◽  
Author(s):  
Keyword(s):  
Segmental Mastectomy

Management of Breast Cancer During Pregnancy Using a Standardized Protocol

1999 ◽  
Vol 17 (3) ◽  
pp. 855-855 ◽  
Author(s):  
David L. Berry ◽  
Richard L. Theriault ◽  
Frankie A. Holmes ◽  
Valerie M. Parisi ◽  
Daniel J. Booser ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Combination Chemotherapy ◽  
Radical Mastectomy ◽  
First Trimester ◽  
Therapeutic Interventions ◽  
Outpatient Chemotherapy ◽  
Gestational Age At Delivery ◽  
Segmental Mastectomy ◽  
First Trimester Of Pregnancy

PURPOSE: No standardized therapeutic interventions have been reported for patients diagnosed with breast cancer during pregnancy. Of the potential interventions, none have been prospectively evaluated for treatment efficacy in the mother or safety for the fetus. We present our experience with the use of combination chemotherapy for breast cancer during pregnancy. PATIENTS AND METHODS: During the past 8 years, 24 pregnant patients with primary or recurrent cancer of the breast were managed by outpatient chemotherapy, surgery, or surgery plus radiation therapy, as clinically indicated. The chemotherapy included fluorouracil (1,000 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2), administered every 3 to 4 weeks after the first trimester of pregnancy. Care was provided by medical oncologists, breast surgeons, and perinatal obstetricians. RESULTS: Modified radical mastectomy was performed in 18 of the 22 patients, and two patients were treated with segmental mastectomy with postpartum radiation therapy. This group included patients in all trimesters of pregnancy. The patients received a median of four cycles of combination chemotherapy during pregnancy. No antepartum complications temporally attributable to systemic therapy were noted. The mean gestational age at delivery was 38 weeks. Apgar scores, birthweights, and immediate postpartum health were reported to be normal for all of the children. CONCLUSION: Breast cancer can be treated with chemotherapy during the second and third trimesters of pregnancy with minimal complications of labor and delivery.

Value of adjuvant radiation therapy in breast cancer patients with one to three positive lymph nodes undergoing a modified radical mastectomy and systemic therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 507-507 ◽  
Author(s):  
S. Dawood ◽  
A. M. Gonzalez-Angulo ◽  
W. Woodward ◽  
F. Meric-Bernstam ◽  
K. Hunt ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Lymph Nodes ◽  
Systemic Therapy ◽  
Distant Recurrence ◽  
Axillary Lymph Nodes ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Adjuvant Radiation Therapy ◽  
Increased Risk ◽  
Segmental Mastectomy

507 Background: Whether adjuvant radiation therapy should be utilized for patients (pts) with early stage breast cancer with up to 3 positive axillary lymph nodes treated with mastectomy and systemic therapy is controversial. This retrospective study was performed to determine if adjuvant radiation therapy had an impact on survival for this cohort of pts. Methods: 4240 pts with T1–2N0–1 breast cancers, diagnosed between 1980–2007, who underwent either mastectomy without adjuvant radiation therapy or segmental mastectomy with adjuvant radiation therapy were identified. All pts received systemic treatment. Women with >3 positive axillary lymph nodes were excluded. Overall (OS) and distant disease free survival (DDFS) were estimated using the Kaplan-Meir product method. Cox proportional hazards were used to determine associations between OS/DDFS and type of surgery after controlling for pt and disease characteristics. Results: 1336 (18.8%) had T1N0 disease, 1114 (26.27%) had T2N0 disease, 989 (23.33%) had T1N1 disease and 801 (18.89%) had T2N1 disease. Median follow-up was 54 months.5- year DDFS among women who underwent mastectomy and segmental mastectomy was 81% (95% 78%-83%) and 86% (95% CI 84%-87%), respectively (p < 0.0001). In the Cox analysis, pts who had mastectomy without radiation had a significantly increased risk of distant recurrence (HR= 1.39, 95% CI 1.14–1.70, p= 0.0013) than pts treated with segmental mastectomy and radiation. When looking at subgroups, no significant difference in DDFS was observed between the two groups in pts with lymph node negative disease. However, for pts with 1–3 positive lymph nodes, pts treated with mastectomy without radiation had significantly increased risk of distant recurrence compared to pts treated with segmental mastectomy with radiation (HR=1.614, 95% CI 1.198–2.177, p= 0.002). This difference was most pronounce in the subset of patients with T2N1 disease (HR= 1.794, 95% CI 1.220–2.637, p=0.003). Similar trends were observed for OS. Conclusions: This study provides provocative evidence for benefit of radiation therapy among pts with 1–3 positive axillary lymph nodes who are treated with surgery and systemic therapy. No significant financial relationships to disclose.

Clinicopathologic factors associated with involved margins following breast conserving surgery for invasive lobular carcinoma (ILC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11528-e11528
Author(s):  
E. J. Silberfein ◽  
K. K. Hunt ◽  
K. Broglio ◽  
J. Shen ◽  
A. Sahin ◽  
...  
Keyword(s):  
Excisional Biopsy ◽  
Breast Conserving Surgery ◽  
Total Mastectomy ◽  
Radiographic Appearance ◽  
Positive Margins ◽  
Factors Associated ◽  
Initial Surgery ◽  
Clinicopathologic Factors ◽  
Segmental Mastectomy ◽  
Biopsy Method

e11528 Background: ILC is characterized by a diffusely infiltrative growth pattern making it difficult to accurately assess disease extent prior to surgical resection. This has resulted in difficulty obtaining negative margins at the time of breast conserving surgery. We evaluated patients undergoing surgery for ILC to determine if there were specific clinicopathologic factors influencing the ability to obtain negative margins. Methods: We identified 211 patients with ILC treated between 1994 and 2004. Clinical data including radiographic appearance, biopsy method, initial surgical procedure (segmental vs. total mastectomy), and use of neoadjuvant chemotherapy were noted. Pathologic data included margin status (negative (>2mm), close (0–2mm), or positive), multifocality, multicentricity, ILC subtype, grade, associated LCIS or DCIS, hormone receptor status and HER2 status. Factors associated with close or positive margins were determined using univariate and multivariate analyses. Subset analysis was performed on patients whose initial surgery was segmental mastectomy. Results: 110 (52%) patients underwent total mastectomy and 101 (48%) underwent segmental mastectomy as their initial procedure. For patients undergoing segmental mastectomy, 50 (50%) had positive or close margins requiring re-excision. Patients with close or positive margins were more likely to have distortion on ultrasound (vs. mass, p=.05), to have undergone an excisional biopsy (vs. core or FNA, p=.008), and to have associated DCIS (p=.02). On multivariate analysis, only biopsy method retained significance (p = .006). Having an excisional biopsy for diagnosis was also associated with need for multiple surgeries (p < .0001). Breast conserving surgery was ultimately successful in 86 patients (85%). Conclusions: The majority of patients with ILC can undergo successful breast conserving surgery. Patients with distortion rather than a mass on imaging and those with DCIS are more likely to have close or positive margins. Diagnosis by excisional biopsy makes subsequent imaging less reliable and results in the need for multiple surgeries to ensure adequate excision. No significant financial relationships to disclose.

Ultrasound-Guided Segmental Mastectomy and Excisional Biopsy Using Hydrogel-Encapsulated Clip Localization as an Alternative to Wire Localization

2016 ◽  
Vol 23 (10) ◽  
pp. 3284-3289 ◽  
Author(s):  
Lori F. Gentile ◽  
Amber Himmler ◽  
Christiana M. Shaw ◽  
Amber Bouton ◽  
Elizabeth Vorhis ◽  
...  
Keyword(s):  
Excisional Biopsy ◽  
Wire Localization ◽  
Ultrasound Guided ◽  
Segmental Mastectomy
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