Breast cancer recurrence after lumpectomy & RT is treatable with localized RT without mastectomy
(NRG Oncology) Approximately 10% of breast cancer patients treated with lumpectomy (breast-conserving surgery [BCS]) and whole-breast radiation (WBI) will have a subsequent in-breast local recurrence of cancer (IBTR) when followed long term.
Publication date: Available online 5 December 2019Source: The LancetAuthor(s): Frank A Vicini, Reena S Cecchini, Julia R White, Douglas W Arthur, Thomas B Julian, Rachel A Rabinovitch, Robert R Kuske, Patricia A Ganz, David S Parda, Michael F Scheier, Kathryn A Winter, Soonmyung Paik, Henry M Kuerer, Laura A Vallow, Lori J Pierce, Eleftherios P Mamounas, Beryl McCormick, Joseph P Costantino, Harry D Bear, Isabelle GermainSummaryBackgroundWhole-breast irradiation after breast-conserving surgery for patients with early-stage breast cancer decreases ipsilateral breast-tumour recurrence (IBTR), yielding comparable results to m...
Conclusions and Relevance: For patients experiencing recurrence of breast cancer in the ipsilateral breast after lumpectomy and whole breast irradiation, a second breast conservation was achievable in 90%, with a low risk of re-recurrence of cancer in the ipsilateral breast using adjuvant partial breast reirradiation. This finding suggests that this treatment approach is an effective alternative to mastectomy. PMID: 31750868 [PubMed - as supplied by publisher]
AbstractBackground.The benefit of repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery is currently inconclusive.Materials and Methods.Patients with IBTR with definitive surgery were identified in the Surveillance, Epidemiology, and End Results registry between 1973 and 2013. The effect of different IBTR surgeries on overall and cancer‐specific mortality was assessed using risk‐adjusted Cox proportional hazard regression modeling and stratified propensity score‐matching analysis (PSMA).Results.Of the 5,098 patients with IBTR, 4,048 (79.4%) women underwent mastectomy and 1,0...
DiscussionTechniques and approaches are discussed in this article to enable a reduction in positive margin status, and therefore ROR. The rationale for achieving ROR of 10 –20% are explicated, as well as the impact this would have on BCT rates, which translates to better survival outcomes for women with breast cancer.
This report details our experience using accelerated partial breast irradiation (APBI) as a component of salvage breast conserving treatment.
ConclusionPLM plays an important role in the evaluation of patients undergoing breast conservation for breast cancer presenting with microcalcifications. Residual malignancy was detected on positive PLM in 6% of patients with negative margins.
Carcinosarcoma is a rare, aggressive type of breast cancer accounting for
ConclusionsThe extent of surgery is not associated with improved survival in women with LBA, and patients may consider breast-conservation surgery. Adjuvant therapies are not associated with improved survival, with the exception of possible role of adjuvant chemotherapy in large primary tumors (5 cm or greater). Further clinical studies are needed to determine the impact of these treatments on local control, progression-free survival, and patients’ quality of life. Until then, the findings of our analysis will form basis for the multi-disciplinary discussion of management of women with L BA.
Publication date: Available online 10 February 2019Source: European Journal of Surgical OncologyAuthor(s): Coco J.E.F. Walstra, Robert-Jan Schipper, Ingrid G.M. Poodt, Yvonne E. van Riet, Adri C. Voogd, Maurice J.C. van der Sangen, Grard A.P. NieuwenhuijzenAbstractThe standard of care for patients with an ipsilateral breast tumour recurrence (IBTR) after breast-conserving therapy (BCT) is a salvage mastectomy. However, there is growing interest in the feasibility of repeat BCT for these patients. This systematic review contains the latest insights on BCT options for patients with an IBTR after initial BCT.A PubMed literatu...
Conclusions: This study is consistent with previous research showing that breast-conserving surgery after neoadjuvant chemotherapy does not reduce breast cancer–specific survival. In fact, patients undergoing breast-conservation after neoadjuvant therapy appeared to have better survival than patients undergoing mastectomy without radiation.