After neoadjuvant chemotherapy, 24 patients with planned mastectomy underwent breast-conserving surgery and 48 continued with mastectomy. On the other hand, five patients with planned breast-conserving surgery underwent mastectomy after neoadjuvant chemotherapy as a result of disease progression or patients preference (Table 4). Among the 24 patients with successful conversion from mastectomy to breast-conserving surgery, 21 had tumour size of ,5 cm and 18 had stage II disease. Pre-chemotherapy disease staging (P=0.001) and tumour size (P=0.005) were important factors that determined successful conversion to breast-conserving treatment in univariate analysis (Table 5). The breast-conserving surgery to mastectomy ratio in patients with stage II disease was 32:14 patients, ie 2.3 to 1. On the contrary, 13 patients with stage III disease underwent breast-conserving surgery and 38 underwent mastectomy, ie a ratio of 1:3 for stage III disease. Among those who underwent breast-conserving surgery, 93% ...
After neoadjuvant chemotherapy, 24 patients with planned mastectomy underwent breast-conserving surgery and 48 continued with mastectomy. On the other hand, five patients with planned breast-conserving surgery underwent mastectomy after neoadjuvant chemotherapy as a result of disease progression or patients preference (Table 4). Among the 24 patients with successful conversion from mastectomy to breast-conserving surgery, 21 had tumour size of ,5 cm and 18 had stage II disease. Pre-chemotherapy disease staging (P=0.001) and tumour size (P=0.005) were important factors that determined successful conversion to breast-conserving treatment in univariate analysis (Table 5). The breast-conserving surgery to mastectomy ratio in patients with stage II disease was 32:14 patients, ie 2.3 to 1. On the contrary, 13 patients with stage III disease underwent breast-conserving surgery and 38 underwent mastectomy, ie a ratio of 1:3 for stage III disease. Among those who underwent breast-conserving surgery, 93% ...
The use of hypofractionated whole-breast irradiation (HF-WBI) for patients with early-stage breast cancer increased 17.4 percent from 2004 to 2011, and patients are more likely to receive HF-WBI compared to conventionally fractionated whole-breast irradiation (CF-WBI) when they are treated at an academic center or live ≥50 miles away from a cancer center, according to a study published in the December 1, 2014 issue of the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO). An analysis of randomized trials1 demonstrated that patients with early-stage breast cancer who are treated with breast-conserving surgery and adjuvant whole-breast irradiation have improved survival and a lower risk of tumor recurrence compared to patients who are not treated with radiation therapy. Patients are commonly treated with CF-WBI; however, several recent randomized trials2-5 have confirmed that ...
AND MATERIALS: From July 1986 to April 1993 the International Breast Cancer Study Group (IBCSG) Trial VI randomly assigned 1554 pre/perimenopausal node-positive breast cancer patients to receive cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) for either three consecutive courses on months 1-3, or six consecutive courses on months 1-6, both with or without reintroduction CMF. IBCSG Trial VII randomly assigned 1266 postmenopausal node-positive breast cancer patients to receive tamoxifen for 5 years, or tamoxifen for 5 years with three early cycles of CMF, both with or without three courses of delayed CMF. Both trials allowed a choice of mastectomy, or breast-conserving surgery plus radiation therapy, and both were stratified by type of surgery. Radiotherapy was delayed until the initial block of CMF was completed; 4 or 7 months after surgery for pre/perimenopausal patients, and 2 or 4 months after surgery for postmenopausal patients. Over both trials, 718 eligible patients elected to ...
Objective To evaluate the value of mammographic findings at predicting the presence of an extensive intraductal component (EIC), a major factor in determining breast conserving surgery Methods A prospective study of 348 consecutive mammograms in patients with stage Ⅰ or Ⅱ breast carcinoma, including infiltrating ductal carcinoma ( n =297), ductal carcinoma in situ (DCIS) associated with small invasive foci ( n =8), mucinous carcinoma ( n =21), and medullary carcinoma ( n =22), was performed to determine the predictive value of mammographic features in evaluating the presence or absence of an EIC Results (1) EIC+ cancers were significantly more likely to show the lesion with microcalcifications in comparing with EIC- cases (66 4% vs 20 4%, χ 2=75 29, P 0 001) In particular, the presence of microcalcifications alone was more common for EIC+ cancers than for EIC- cancers (21 1% vs 2 0%, χ 2=52 56, P 0 001) (2) 54 6% of patients in whom mammograms showed only a
Current standard of care for early stage breast cancer is mastectomy or breast conserving therapy with whole breast irradiation following lumpectomy. However, studies of breast cancer recurrence have demonstrated the majority of tumors to recur in or adjacent to the original tumor site. The question has thus been raised as to whether radiation to the whole breast is necessary or justified. Limiting radiation to the area of the original tumor may reduce acute and long-term skin and organ toxicities while making radiation therapy more convenient and less expensive. Several clinical trials are underway comparing partial breast irradiation (PBI) to whole breast irradiation. Numerous centers are offering partial breast irradiation outside of clinical trials as well, despite the lack of long-term safety and efficacy data on PBI.. Available PBI methods include brachytherapy, in which catheters or balloons are surgically inserted to deliver radiation therapy to the lumpectomy cavity, and conventional ...
Current standard of care for early stage breast cancer is mastectomy or breast conserving therapy with whole breast irradiation following lumpectomy. However, studies of breast cancer recurrence have demonstrated the majority of tumors to recur in or adjacent to the original tumor site. The question has thus been raised as to whether radiation to the whole breast is necessary or justified. Limiting radiation to the area of the original tumor may reduce acute and long-term skin and organ toxicities while making radiation therapy more convenient and less expensive. Several clinical trials are underway comparing partial breast irradiation (PBI) to whole breast irradiation. Numerous centers are offering partial breast irradiation outside of clinical trials as well, despite the lack of long-term safety and efficacy data on PBI.. Available PBI methods include brachytherapy, in which catheters or balloons are surgically inserted to deliver radiation therapy to the lumpectomy cavity, and conventional ...
... ? In fact, no matter what kind of diseases that patients is prefer to choose Conservation Treatments like oral medicines treatment and other treatments which can help t
Breast conservation therapy (BCT) is standard treatment for breast cancer, but few clinical trials have compared BCT with mastectomy.
Non-Invasive Brachytherapy Treatment Supplements Breast Conservation Therapy. BUFORD, Ga.--(BUSINESS WIRE)--Theragenics Corporation®, a medical device company serving the cancer treatment and surgical product markets, has reached an agreement with Advanced Radiation Therapy, LLC to distribute the AccuBoost® technology for the treatment of early stage breast cancer. The AccuBoost technology, developed by Advanced Radiation Therapy of Tyngsboro, MA, is used to provide a radiation "boost" following a lumpectomy. A radiation boost to the lumpectomy cavity margin as part of breast conservation therapy is the standard of care to minimize cancer recurrence. AccuBoost is also used as a non-invasive option for accelerated partial breast irradiation (APBI), a form of primary radiation therapy following lumpectomy. Under the agreement Theragenics is the exclusive third-party distributor of AccuBoost in the United States. AccuBoost, a real time mammography-guided radiation therapy, has been used to treat ...
Of the 449 patients who received neoadjuvant chemotherapy, 98 underwent breast-conserving surgery. The average diameter of the tumors was 5.3 cm, and 87.2% reached a size of up to 3 cm. Moreover, 86.7% were classified as clinical stage III, 74.5% had T3-T4 tumors, 80.5% had N1-N2 axilla, and 89.8% had invasive ductal carcinoma. A pathologic complete response was observed in 27.6% of the tumors, and 100.0% of samples had free margins. The 5-year actuarial overall survival rate was 81.2%, and the mean follow-up was 72.8 months. The rates of ipsilateral breast tumor recurrence and locoregional recurrence were 11.2% and 15.3%, respectively. Multifocal morphology response was the only factor related to ipsilateral breast tumor recurrence disease-free survival ...
breast irradiation group developed grade 3 late subcutaneous tissue toxicity (p=0·10). The cumulative incidence of any late side-effect of grade 2 or worse at 5 years was 27·0% (95% CI 23·0-30·9) in the whole-breast irradiation group versus 23·3% (19·9-26·8) in the APBI group (p=0·12). The cumulative incidence of grade 2-3 late skin toxicity at 5 years was 10·7% (95% CI 8·0-13·4) in the whole-breast irradiation group versus 6·9% (4·8-9·0) in the APBI group (difference -3·8%, 95% CI -7·2 to 0·4; p=0·020). The cumulative risk of grade 2-3 late subcutaneous tissue side-effects at 5 years was 9·7% (95% CI 7·1-12·3) in the whole-breast irradiation group versus 12·0% (9·4-14·7) in the APBI group (difference 2·4%; 95% CI -1·4 to 6·1; p=0·28). The cumulative incidence of grade 2-3 breast pain was 11·9% (95% CI 9·0-14·7) after whole-breast irradiation versus 8·4% (6·1-10·6) after APBI (difference -3·5%; 95% CI -7·1 to 0·1; p=0·074). At 5 years follow-up, according ...
Discusses lumpectomy and partial mastectomy, two types of breast-conserving surgery. Covers what is done and what to expect after surgery, including having radiation therapy. Also looks at risks. New Mexico, New Mexico
The operation is performed as an outpatient surgical procedure and administered under general or local anesthesia, depending on the location of the tumor.. Before the procedure, the location of your lump is detected through a biopsy. Often, a guide wire is placed in the breast to help ensure the precise location of the lump.. For those whose cancers are too large for a lumpectomy to be performed without causing significant changes in the appearance of the breast, neoadjuvant chemotherapy is sometimes used to shrink the cancer before lumpectomy.. During the procedure, your surgeon will make a small incision directly over the location of the tumor. The surgeon then removes the tumor and a small fraction of surrounding tissue and proceeds to suture the small incision. Incisions are often small enough to be hidden, and once healed, may even be difficult to see. The removed tissue is immediately examined to ensure it does not contain cancerous cells. Often, surgeons also remove lymph nodes located ...
Some patients with breast cancer develop local recurrence after breast-conservation surgery despite postoperative radiotherapy, whereas others remain free of local recurrence even in the absence of radiotherapy. As clinical parameters are insufficient for identifying these two groups of patients, we investigated whether gene expression profiling would add further information. We performed gene expression analysis (oligonucleotide arrays, 26,824 reporters) on 143 patients with lymph node-negative disease and tumor-free margins. A support vector machine was employed to build classifiers using leave-one-out cross-validation. Within the estrogen receptor-positive (ER+) subgroup, the gene expression profile clearly distinguished patients with local recurrence after radiotherapy (n = 20) from those without local recurrence (n = 80 with or without radiotherapy). The receiver operating characteristic (ROC) area was 0.91, and 5,237 of 26,824 reporters had a P value of less than 0.001 (false discovery rate = 0
Amanda Breakey, Mercer University College of Pharmacy According to the National Cancer Institute, radiation therapy following breast-conserving surgery greatly reduces the risk of local breast cancer recurrence and moderately reduces the risk of death from breast cancer.1 In a meta-analysis of multiple randomized phase III trials, the American Society for Radiation Oncology (ASTRO) stated that…
TY - JOUR. T1 - Survival benefit of postoperative radiotherapy for ductal carcinoma in situ after breast-conserving surgery. T2 - a Korean population-based cohort study. AU - Kim, Byoung Hyuck. AU - Ko, Byung Kyun. AU - Bae, Jeoung Won. AU - Nam, Seokjin. AU - Park, Min Ho. AU - Jeong, Joon. AU - Lee, Hyouk Jin. AU - Chang, Ji Hyun. AU - Kim, Suzy. AU - Hwang, Ki Tae. PY - 2019/11/1. Y1 - 2019/11/1. N2 - Purpose: It has been accepted that radiation therapy (RT) for ductal carcinoma in situ (DCIS) has no survival benefit despite increasing local control. However, a recent large database study reported a small but significant benefit. Using a Korean population-based large database, we examined the survival benefit of RT for DCIS after breast-conserving surgery (BCS) and analyzed which subgroup might derive benefit from it. Methods: Data from 6038 female DCIS patients who underwent BCS with or without RT between 1993 and 2012 were included in this study. We used propensity score analysis to control ...
Six modern, prospective, randomized trials have demonstrated that breast-conserving therapy (lumpectomy followed by radiation) offers survival rates equivalent to mastectomy (Table 61-1)1-7; however, when negative margins are not achieved or when radiation therapy is not pursued, breast conservation is associated with higher rates of local recurrence (Tables 61-1 and 61-2).1,2,8-14 Until recently, the impact of local recurrence on survival remained unclear. In 2005, the Early Breast Cancer Trialists Collaborative Group (EBCTCG) published the results of a large meta-analysis combining all individual patient data for 42,080 women who collectively took part in 78 treatment comparisons (more vs less surgery, more surgery vs radiotherapy, radiotherapy vs none) to determine the impact of local recurrence on survival. Specifically, among 10 breast-conservation trials included in the EBCTCG analysis (7311 women), postoperative radiation treatment (XRT) was associated with a statistically significant ...
True or False. A positive margin which is defined as ink on ductal carcinoma in situ (DCIS) is associated with an increase in ipsilateral breast tumor recurrence (IBTR), which is nullified by the use of whole-breast radiation therapy (WBRT). ...
This study aimed to compare the outcomes for patients who received whole and partial breast radiotherapy after undergoing breast conservation surgery. This study concluded that partial breast radiotherapy and lower dose radiotherapy had similar outcomes for patients when compared to whole breast radiotherapy. Relevant for : Treatment(s) now being considered-Breast reconstruction, Type(s) of breast cancer-Ductal carcinoma, Ongoing treatment(s)-Radiation, Current stage-Stage III, breast cancer, Research, Treatment
An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor). Also called breast-sparing surgery ...
1 Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.N Engl J Med. 2002;347:1233-1241.. 2 Lichter AS, Lippman ME, Jr Danforth DN, et al. Mastectomy versus breast-conserving therapy in the treatment of stage I and II carcinoma of the breast: a randomized trial at the National Cancer Institute. Journal of Clinical Oncology, Classic Papers and Current Comments. 1996;1:2-10.. 3 Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347;1227-1232.. 4 Edge SB, Niland JC, Bookman MA, et al. Emergence of sentinel node biopsy in breast cancer as standard-of care in academic comprehensive cancer centers. Journal of the National Cancer Institute. 2003;95:1514-1521.. 5 Veronesi U, Paganelli G, Viale G, et al. A randomized ...
Lets go back in time some 30 years and imagine, if you will, trying to explain this trial to a woman with breast cancer and persuade her to be randomized to have either a modified radical mastectomy (total mastectomy with axillary lymph node dissection), a lumpectomy plus axillary dissection, or a lumpectomy with axillary dissection plus radiation. Remember, when a patient signs up for a trial like this, she agrees to accept whatever treatment to which she is randomized. In this case, that would mean not knowing whether the operation would be a lumpectomy or removal of the entire breast. Truly, women today with breast cancer owe a huge debt of gratitude to these women who agreed to such an arrangement because this trial showed conclusively that lumpectomy plus radiation therapy produced equivalent survival rates as modified radical mastectomy. Moreover, just the thought experiment of thinking how you might persuade a woman with a relatively small cancer to agree to be randomized to such a trial ...
Our meta-analysis of 5-year data from published randomized trials of partial breast irradiation (PBI, alone or within a risk-adapted approach) vs. whole breast irradiation (WBI) for invasive breast cancer treated with lumpectomy, found no difference in breast cancer mortality (n=4489,difference 0.000%(95%CI -0.7 to +0.7),p=0.972). PBI was better than WBI for non-breast cancer mortality (n=4231,difference 1.1% (95%CI -2.1% to -0.2%),p=0.023), and total mortality (difference 1.3% (95%CI -2.5% - 0.0%),p=0.05), leading to a 25% relative risk reduction.". In the figure below, PBI means Partial Breast Irradiation i.e., radiation only to the area near the tumour rather than the whole breast (Whole Breast Irradiation WBI ...
Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
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Breast-conserving surgery for breast cancer has been developed to accomplish two major goals: the achievement of tumor-free resection margins and prevention of…
Principal Investigator:HIRANO Minoru, Project Period (FY):1990 - 1992, Research Category:Grant-in-Aid for General Scientific Research (B), Research Field:Otorhinolaryngology
7% vs. 1.5%, p < 0.001) patients compared with negative-margin patients; however, no differences in TR/MM Buparlisib concentration were noted. Univariate analysis of IBTR was performed for patients with negative and close/positive margins and is presented in Table 5. For close/positive margins, age was associated with a trend for IBTR (p = 0.07), whereas in the DCIS subset a trend was noted for age (p = 0.07), grade (p = 0.07), and hormonal therapy (p = 0.07).. For negative-margin patients, ER negativity (p < 0.001) and extensive intraductal component (p = 0.05) were significantly associated with IBTR. The results of this analysis confirm previous publications highlighting the efficacy of APBI using intracavitary brachytherapy in women who are appropriately selected. The first conclusion drawn from our analysis is that although no significant differences in IBTR were found between patients treated with APBI with negative vs. close or positive margins, a trend (p = 0.07) was noted when close and ...
Improvements in breast cancer treatments are making it possible for more women to conserve their breasts, reveals study presented at the ESMO 2012 Congress in Vienna, Austria.
A study has found no increase in overall survival but a reduction in breast cancer recurrence when additional radiation is given to the lymph nodes as well as the standard treatment of whole-breast irradiation after breast-conserving surgery.
Morrow, M., Van Zee, K., Solin, L., Houssami, N., Chavez-MacGregor, M., Harris, J., Horton, J., Hwang, S., Johnson, P., Marinovich, M., et al (2016). Society of Surgical Oncology-American Society for Radiation Oncology-American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation in Ductal Carcinoma In Situ. Annals of Surgical Oncology, 23(12), 3801-3810. [More Information] ...
Lumpectomy, also known as breast-conserving surgery, is the surgical removal of a cancerous lump (or tumor) in the breast, along with a small margin of
After a lumpectomy, a breast-sparing or breast-conserving operation, radiation usually is given to the breast to reduce the chance of the cancer returning.
Read about lumpectomy, the surgical procedure involving removing a suspected cancerous tumor or lump from a womans breast. Understand preparation, side effects, recovery times and radiation.
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Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0-64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences
Partial breast irradiation has become an increasingly popular mode of treatment after excisional biopsy to treat early stage invasive breast cancer. Its main advantage is that treatment can be delivered in five days rather than 30, as is standard for whole breast irradiation. Early reports suggest good to excellent cosmesis in the vast majority of subjects. Herein we report two cases of skin necrosis in women with Stage 1 breast cancer who smoked before and after partial breast irradiation.
BACKGROUND: The presence of tumor cells at the margins of breast lumpectomy specimens is associated with an increased risk of ipsilateral tumor recurrence. Twenty to 30 % of patients undergoing breast-conserving surgery require second procedures to achieve negative margins. This study evaluated the adjunctive use of the MarginProbe device (Dune Medical Devices Ltd, Caesarea, Israel) in providing real-time intraoperative assessment of lumpectomy margins. METHODS: This multicenter randomized trial enrolled patients with nonpalpable breast malignancies. The study evaluated MarginProbe use in addition to standard intraoperative methods for margin assessment. After specimen removal and inspection, patients were randomized to device or control arms. In the device arm, MarginProbe was used to examine the main lumpectomy specimens and direct additional excision of positive margins. Intraoperative imaging was used in both arms; no intraoperative pathology assessment was permitted. RESULTS: In total, 596 patients
There is a strong rationale for the use of accelerated partial-breast irradiation: The large majority of in-breast recurrences are at or near the primary site, limiting the radiation dose to the primary site has the potential to decrease side effects, and treatment can be delivered over a shorter period (typically about 1 week). Accelerated partial-breast irradiation can be performed by a variety of techniques, including external-beam (conformal or intensity-modulated) radiation therapy, interstitial multicatheter brachytherapy, intracavitary brachytherapy, or intraoperative radiation, typically at the time of resection of the primary tumor.. In the United States, external-beam radiotherapy is the most frequent technique for accelerated partial-breast irradiation. Most U.S. radiation oncologists are not skilled in the use of interstitial brachytherapy.. The 5-year results of the European GEC-ESTRO trial comparing accelerated partial-breast irradiation and whole-breast irradiation have been ...
Purpose: To assess the safety, feasibility, and efficacy of free-hand intraoperative multicatheter breast implant (FHIOMBI) and perioperative high-dose-rate brachytherapy (PHDRBT) in early breast cancer. Methods and Materials: Patients with early breast cancer candidates for breast conservative surgery (BCS) were prospectively enrolled. Patients suitable for accelerated partial breast irradiation (APBI) (low or intermediate risk according GEC-ESTRO criteria) received PHDRBT (3.4 Gy BID × 10 in 5 days). Patients not suitable for APBI (high risk patients according GEC-ESTRO criteria) received PHDRBT boost (3.4 Gy BID × 4 in 2 days) followed by whole breast irradiation. Results: From June 2007 to November 2014, 119 patients were treated and 122 FHIOMBI procedures were performed. Median duration of FHIOMBI was 25 minutes. A median of eight catheters (range, 4-14) were used. No severe intraoperative complications were observed. Severe early postoperative complications (bleeding) were documented in ...
Background. In recent years there has been a dramatic increase in the use of breast conservation therapy for patients with cancer. There are several factors associated with local recurrence but none are considered absolute contraindication for breast conserving therapy except multifocal carcinoma. This single-institution series investigates the effects of multiple factors on local relapse-free survival after breast-conserving therapy for women with invasive cancer. Methods. One-hundred and ninety-two patients (193 cancers) with invasive carcinoma underwent breast-conserving therapy (surgery, radiation therapy and chemotherapy if indicated) at University of Alabama at Birmingham Hospital from 1986 through 1995. The Kaplan-Meier method was used to calculate curves for local recurrence. The log rank statistic test was used for statistical comparison between curves. The Cox proportional hazards model was used for multivariate analysis. Significance was defined as p < 0.05. Results. Mean patient age ...
Breast-conserving surgery (BCS) is sometimes called a lumpectomy or a partial mastectomy. It may be done as part of a treatment plan for breast cancer. With BCS, only the part of the breast that has cancer is removed.
1 Recht A, Hayes DF, Everlein TJ, Sadowsky NL. In: Harris JR, Lippman ME, Morrow M, Hellman S, eds. Diseases of the Breast. Philadelphia: Lippincott-Raven Publishers; 1996:649-667.. 2 Doyle T, Schultz DJ, Peters C, et al. Long-term results of local recurrence after breast conservation treatment for invasive breast cancer. International Journal of Radiation Oncology, Biology and Physics. 2001;51:74-80.. 3 National Cancer Institute FactSheet. Herceptin® (Trastuzumab): Questions and Answers. Available at: http://www.cancer.gov/cancertopics/factsheet/therapy/herceptin. Accessed October 11, 2007.. 4 Hobday TJ, Perez EA. Molecularly targeted therapies for breast cancer. Cancer Control. 2005;73-81.. 5 Pegram MD, Slamon DJ. Combination therapy with trastuzumab (Herceptin) and cisplatin for chemoresistant metastatic breast cancer: Evidence for receptor-enhanced chemosensitivity. Seminars in Oncology. 1999;26:89-95.. 6 Gori S, Colozza M, Mosconi AM, et al. Phase II Study of weekly Paclitaxel and ...
Abstract Background In addition to breast imaging, ultrasound offers the potential for characterizing and distinguishing between benign and malignant breast tissues due to their different microstructures and material properties. The aim of this study was to determine if high-frequency ultrasound (20-80 MHz) can provide pathology sensitive measurements for the ex vivo detection of cancer in margins during breast conservation surgery. Methods Ultrasonic tests were performed on resected margins and other tissues obtained from 17 patients, resulting in 34 specimens that were classified into 15 pathology categories. Pulse-echo and through-transmission measurements were acquired from a total of 57 sites on the specimens using two single-element 50-MHz transducers. Ultrasonic attenuation and sound speed were obtained from time-domain waveforms. The waveforms were further processed with fast Fourier transforms to provide ultrasonic spectra and cepstra. The ultrasonic measurements and pathology types were
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Postoperative radiotherapy (RT) after the breast conservative surgery (BCT) or mastectomy, have been shown to reduce the rates of local recurrence and death in breast carcinomas (BC) [1-5]. It is the standard practice to offer patients adjuvant RT to whole breast or chest wall, with or without loco-regional RT (LRRT), depending on the stage of disease. The regional fields include the ipsilateral supraclavicular fossa (SCF). The Axilla (Ax) and internal mammary nodal region (IMN) RT is uncommon due to the toxicities associated with them [6-10].. Radiation pneumonitis (RP) and lung fibrosis are two known toxicities that arise from incidental irradiation of adjacent ipsilateral lung in BC. Other toxicities include breast fibrosis, cardiac toxicity, skin toxicity and lymphoedema of the ipsilateral upper limb. The risk of cardiac toxicity in tangential radiotherapy treatment of left breast or chest wall is well studied in literature [6-8]. However most studies were pre-conformal CT-based planning and ...
Materials And Methods: A total of 21 patients who were treated with conventional passive carbon-ion beam for pancreatic cancer underwent 4DCT imaging under free-breathing conditions. We defined two types of clinical target volume (CTV) for the initial and boost irradiations: CTV1 included the gross tumor volume (GTV) and peripheral organs, and CTV2 included the GTV only with an added uniform 2-mm margin. Planning target volumes 1 and 2 (PTV1 and PTV2) were calculated by adding the range variation considered internal margin defined by 4DCT to the respective CTVs. The initial prescribed dose (=45.6Gy (RBE); RBE-weighted absorbed dose) was given to PTV1, and the boost dose was increased up to 26.4Gy (RBE) and given to PTV2. Dose assessments were compared between irradiation techniques using the paired t-test ...
The resection must be complete and the procedure should be planned to achieve a tumor-free margin of a minimum of 5 mm to the sides. Reresection, however, is not necessary unless there is tumor in the resection margins ("ink not on tumor"). There is therefore no specific requirement for the width of the free resection margin. If it is uncertain whether the resection margins are free of tumor, a reoperation, reresection or mastectomy must be performed. If there is a need for multiple reresections, mastectomy should be considered as there is evidence for an association between repeated resections and local recurrence. For infiltrating cancer with no sign of metastasis to lymph nodes preoperatively, sentinel lymph node biopsy is performed (sentinel node diagnostics).. Several studies have shown that younger women treated with BCT have an enhanced risk of ipsilateral breast recurrence. Familiar and hereditary breast cancer appears more often in younger women. This enhances the difficulty of weighing ...
Expertise, Disease and Conditions: Breast Biopsy, Breast Cancer, Breast Cancer Prevention, Breast Conservation Surgery, Breast Disease, Breast Surgery, Breast Tissue Expander, Cancer Genetics, General Surgery, Genetics, Lumpectomy, Mastectomy, Nipple-Sparing Mastectomy, Surgical ...