Circumferential Shaving of the Cavity in Breast-Conserving Surgery: A Randomized Controlled Trial.

Circumferential Shaving of the Cavity in Breast-Conserving Surgery: A Randomized Controlled Trial. Ann Surg Oncol. 2019 Aug 19;: Authors: Chen K, Zhu L, Chen L, Li Q, Li S, Qiu N, Yang Y, Su F, Song E Abstract BACKGROUND: This randomized controlled trial aimed to investigate the effects of circumferential shaving on reducing the intraoperative margin positivity rate (MPR) during breast-conserving surgery (BCS). METHODS: Eligible breast cancer patients were randomly assigned into no-shave and shave groups. In the no-shave group, the cavity margins were collected for assessment after the tumor resection, whereas in the shave group, a circumferential shaving was performed before collecting the cavity margins. The primary outcome was the intraoperative MPR by frozen section analysis. RESULTS: A total of 181 patients, with a median age of 49 years, were randomized. Patient characteristics at baseline were well-balanced between the two groups. The intraoperative MPRs (12.1% vs. 7.8%, p = 0.38), postoperative MPRs (16.5% vs. 7.8%, p = 0.073), intraoperative re-excision rates (26.4% vs. 23.3%, p = 0.64), second operation rates (4.4% vs. 1.1%, p = 0.34), and successful BCS rate (93.4% vs. 94.4%, p = 0.94) were all similar between the no-shave and the shave groups. The volume of the shaved tissues was significantly increased in patients with larger breast volume (p 
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research

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AbstractBackgroundGrowing evidence suggests that the tumor immune microenvironment influences breast cancer development and prognosis. Density of tumor-infiltrating lymphocytes (TILs) within invasive breast cancer is correlated with response to therapy, especially in triple-negative disease. The clinical relevance and outcomes of TILs within ductal carcinoma in situ (DCIS) are less understood.MethodsOur institutional database of 668 patients with pure DCIS from 2010 to 2018 was queried. TILs were evaluated by International TILs Working Group guidelines. Percentage of TILs was assessed from the densest focus (hotspot) in on...
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsWith mature follow-up, our rates of local recurrence following breast-conserving therapy for DCIS remain very low (1.5% at 10  years). The incidence of CBC was higher than the LR incidence. Predisposing factors for the development of CBC are worthy of investigation.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Breast conserving surgery (BCS) followed by radiation therapy (RT) is the primary management for many women with early-stage, invasive breast cancer and ductal carcinoma in situ (DCIS) [1 –4]. Most women achieve good to excellent cosmesis after BCS and RT but some experience cosmetic failure, defined as fair or poor cosmetic outcomes [5–17]. However, comparisons of cosmetic outcomes across international jurisdictions using contemporary surgical and RT techniques for DCIS are lack ing.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
SummaryThis short review summarizes the most important facts presented at the San Antonio Breast Cancer Symposium 2018 concerning local therapy of breast cancer, including breast and lymph node surgery as well as radiotherapy. Despite the increasing use of neoadjuvant chemotherapy (nCHT) and consequently higher response and pathologic complete response (pCR) rates in the past years, breast-conserving surgery (BCS) has not increased. This is not only due to positive genetic testing, but it is mostly based on patients ’ preference. On the other hand, quality of life seems to be better in young patients undergoing BCS r...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 5 July 2019Source: Academic RadiologyAuthor(s): Diana L. Lam, Jacob Smith, Savannah C. Partridge, Adrienne Kim, Sara H. Javid, Daniel S. Hippe, Constance D. Lehman, Janie M. Lee, Habib RahbarRationale and ObjectivesUse of preoperative breast MRI (pMRI) to evaluate ductal carcinoma in situ (DCIS) extent is controversial due to limited data on its impact on surgical management. We sought to evaluate the effect of pMRI on surgical management of women with core needle biopsy (CNB)-diagnosed pure DCIS at a multidisciplinary academic institution.Materials and MethodsThis retrospective study inc...
Source: Academic Radiology - Category: Radiology Source Type: research
CONCLUSIONS: Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors. PMID: 31264148 [PubMed - as supplied by publisher]
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: Clin Transl Oncol Source Type: research
CONCLUSIONS: Among the patients with invasive carcinoma or DCIS within less than 1 mm from the resection margin, adjuvant RT with higher dose > 66Gy EQD2 might improve local control. Further prospective studies are warranted to validate the benefit and risk of a high dose boost after BCS in patients with a positive resection margin. PMID: 31265973 [PubMed - as supplied by publisher]
Source: Breast - Category: Cancer & Oncology Authors: Tags: Breast Source Type: research
Publication date: Available online 12 June 2019Source: European Journal of RadiologyAuthor(s): Min Sun Bae, Blanca Bernard-Davila, Janice S. Sung, Elizabeth A. MorrisAbstractPurposeTo determine preoperative magnetic resonance imaging (MRI) features associated with positive or close margins in patients with breast cancer who underwent breast-conserving surgery (BCS).Materials and methodsA retrospective review identified 249 patients with invasive ductal carcinoma (IDC) who underwent preoperative MRI and BCS as a primary procedure between 2008 and 2010. The MR images were reviewed for descriptions of findings with no new int...
Source: European Journal of Radiology - Category: Radiology Source Type: research
ConclusionsJapanese women classified with a negative margin by the polygon method show a very low risk of IBTR and account for approximately half of CBC cases. In this subset of DCIS patients, additional RT is not beneficial.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
oup Abstract BACKGROUND: One-fifth of patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) have invasive breast cancer (IBC) on definitive histology. Sentinel lymph node dissection (SLND) is performed in almost half of women having surgery for DCIS in Sweden. The aim of the present study was to try to minimize unnecessary SLND by injecting superparamagnetic iron oxide (SPIO) nanoparticles at the time of primary breast surgery, enabling SLND to be performed later, if IBC is found in the primary specimen. METHODS: Women with DCIS at high risk for the presence of invasion undergoing breast c...
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
More News: Breast Cancer | Breast Carcinoma | Breast Conservation Surgery | Cancer | Cancer & Oncology | Carcinoma | Carcinoma in Situ | DCIS (Ductal Carcinoma in Situ) | Ductal Carcinoma