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Liu M, Zhou X, Gao L, Wang Z, Li L, Li Y, Sun Q. Considerable Long-Term Aesthetic Outcomes and Oncologic Safety of Breast-Conserving Surgery Via a Periareolar Incision: A Retrospective Study. Clin Breast Cancer 2023; 23:e549-e559.e4. [PMID: 37758558 DOI: 10.1016/j.clbc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/03/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND To investigate the application effect of periareolar incision breast-conserving surgery in patients with early breast cancer. METHODS From January 2017 to November 2021, a clinician in our research center performed a total of 533 breast-conserving surgery. After screening, we collected the information of 209 patients through telephone, online questionnaires, and outpatient follow-up. One hundred seventeen patients with early breast cancer underwent breast-conserving surgery under the periareolar incision, while 92 patients underwent surgery through the tumor surface incision. We compared the differences between the 2 groups in the length of stay, postoperative complications, adjuvant therapy, and other clinical indicators, as well as the subjective and objective evaluation of the long-term postoperative breast aesthetic outcome, local recurrence, distant metastasis, and survival. RESULTS With a mean follow-up of 3.9 years, patients in the periareolar incision group (PAIG) and tumor surface incision group (TSIG) had no significant differences in clinical indicators, local recurrence, distant metastasis, and survival. However, PAIG patients had better subjective satisfaction with postoperative breast appearance. In the evaluation of objective aesthetic outcomes, PAIG was significantly better than TSIG in texture and elasticity, symmetry, sunken degree of the operative side, skin color, surgical scar, and breast compliance difference. CONCLUSION By observing and comparing the clinical indicators, postoperative recurrence, and metastasis of the enrolled patients, this study found that periareolar incision surgery could achieve radical therapeutic effects similar to those achieved through tumor surface incision, and had advantages in improving postoperative aesthetic outcomes, which could provide certain references for clinical practice.
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Affiliation(s)
- Mohan Liu
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xingtong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Lu Gao
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Zihao Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Linrong Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China.
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China.
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2
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Wu CL, Liu JF, Liu Y, Wang YX, Fu KF, Yu XJ, Pu Q, Chen XX, Zhou LJ. Beclin1 inhibition enhances paclitaxel‑mediated cytotoxicity in breast cancer in vitro and in vivo. Int J Mol Med 2019; 43:1866-1878. [PMID: 30720049 DOI: 10.3892/ijmm.2019.4089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 01/30/2019] [Indexed: 11/05/2022] Open
Abstract
Beclin1, a key regulator of autophagy, has been demonstrated to be associated with cancer cell resistance to chemotherapy. Paclitaxel is a conventional chemotherapeutic drug used in the clinical treatment of breast cancer. However, the function and mechanism of Beclin1 in paclitaxel‑mediated cytotoxicity in breast cancer are not well defined. The present study demonstrated that paclitaxel suppressed cell viability and Beclin1 expression levels in BT‑474 breast cancer cells in a dose‑ and time‑dependent fashion. Compared with the control, the knockdown of Beclin1 significantly enhanced breast cancer cell death via the induction of caspase‑dependent apoptosis following paclitaxel treatment in vitro (P<0.05). In a BT‑474 xenograft model, paclitaxel achieved substantial inhibition of tumor growth in the Beclin1 knockdown group compared with the control group. Furthermore, analysis of the publicly available Gene Expression Omnibus datasets revealed a clinical correlation between Beclin1 levels and the response to paclitaxel therapy in patients with breast cancer. Collectively, the present results suggest that Beclin1 protects breast cancer cells from apoptotic death. Thus, the inhibition of Beclin1 may be a novel way to improve the effect of paclitaxel. Additionally, Beclin1 may function as a favorable prognostic biomarker for paclitaxel treatment in patients with breast cancer.
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Affiliation(s)
- Cheng-Lin Wu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Jian-Fei Liu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Yan Liu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Yu-Xiao Wang
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Kai-Fei Fu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Xiao-Jie Yu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Qian Pu
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Xiu-Xiu Chen
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
| | - Li-Jun Zhou
- Central Laboratory, Navy General Hospital, Beijing 100048, P.R. China
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Agrawal J, Mehta S, Goel A, Selvakumar VP, Kumar K, Pande PK. Reconstruction in Breast Conservation Therapy-Single Tertiary Care Institution Experience with 472 Patients. Indian J Surg Oncol 2018; 9:362-368. [PMID: 30287999 PMCID: PMC6154353 DOI: 10.1007/s13193-017-0663-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 04/24/2017] [Indexed: 11/25/2022] Open
Abstract
Breast conservation therapy (BCT) is now internationally accepted treatment for early breast cancer. Despite of high incidence of carcinoma breast in India, BCT rates are very low as compared to the west. In this article, we wish to share our experience of breast conservation with oncoplasty in Indian women. A retrospective analysis of case records of patients treated with oncoplastic breast conservation from January 2009 to June 2014 in a single surgical oncology unit in a tertiary cancer institute. Demographic patient data, stage of disease, location of primary tumour, use of neo-adjuvant chemotherapy if received, tumour size and breast size ratio, reconstruction method used, post-operative complications and aesthetic score of patients were analysed. Various methods of oncoplasty and partial breast reconstruction used are discussed. Four hundred and seventy-two patient records were found suitable for analysis. Most common stage of presentation was T2N0 in 189 patients (40%). Forty-one patients received neo-adjuvant chemotherapy (NACT). Tumour arising in upper outer quadrant was most common site, seen in 268 (56.7%). The most common method of reconstruction was volume displacement, done in 57.6% patients. Overall surgical complications included wound infection with or without dehiscence, seroma formation, partial flap necrosis and fat necrosis. Cosmesis was found to be excellent in 23.09% and good in 58.47% at 6-month follow-up. Breast conservation with oncoplasty is oncologically safe for early breast cancer treatment and has good cosmetic outcome with high patient satisfaction rates. Its practice should be encouraged in Indian set-up also.
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Affiliation(s)
- Juhi Agrawal
- Reconstructive Surgery, Department of Surgical Oncology, BLK Super Specialty Hospital, Pusa Road, Delhi, India
| | - Sandeep Mehta
- Reconstructive Surgery, Department of Surgical Oncology, BLK Super Specialty Hospital, Pusa Road, Delhi, India
| | - Ashish Goel
- Department of Surgical Oncology, Pusa Road, Delhi, Delhi 110005 India
| | | | - Kapil Kumar
- Department of Surgical Oncology, Pusa Road, Delhi, Delhi 110005 India
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4
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Tan MP, Silva E. Addressing the paradox of increasing mastectomy rates in an era of de-escalation of therapy: Communication strategies. Breast 2018; 38:136-143. [DOI: 10.1016/j.breast.2017.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 11/13/2017] [Accepted: 12/14/2017] [Indexed: 12/18/2022] Open
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5
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La Padula S, Billon R, Schonauer F, D'Andrea F, Noel W, Belkacémi Y, Bosc R, Hersant B, Meningaud JP. Skin-reducing oncoplasty: A new concept and classification in breast cancer surgery. ANN CHIR PLAST ESTH 2018; 63:285-293. [PMID: 29566954 DOI: 10.1016/j.anplas.2018.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 02/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Breast-conserving surgery and skin-sparing mastectomy are nowadays widely accepted as the standard of care in selected patients with early breast cancer. After an accurate review of the literature, it appeared that no ordered list of the numerous techniques described for conservative breast surgery has been established so far. The aim of this study was to develop a simple classification of the different skin incision patterns that may be used in breast surgery. METHODS A systematic review of the English literature was conducted using the PubMed database to identify all the articles reporting breast-conserving surgery and skin-sparring mastectomy techniques up to the 31st of December 2016. RESULTS Among the 1426 titles identified, 230 were selected for review. Based on the reviewed papers, the skin-reducing oncoplasty incision pattern (SROIP) classification was elaborated. CONCLUSIONS Breast cancer surgery should nowadays optimise aesthetic outcomes by improving the final breast shape, volume and scar location. This may be achieved using different procedures that we grouped together under the term skin-reducing oncoplasty (SRO). Depending on the breast cancer location, the SROIP classification helps in the choice of the best technique to be used.
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Affiliation(s)
- S La Padula
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - R Billon
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - F Schonauer
- Department of plastic, reconstructive and aesthetic surgery, university of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - F D'Andrea
- Department of plastic, reconstructive and aesthetic surgery, university of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - W Noel
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Y Belkacémi
- Radiation oncology department, GH Henri-Mondor Breast center, university Paris-East Créteil (UPEC), AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - R Bosc
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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6
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Tan MP. Refining Tumor Resection Techniques for Managing Inferior Pole Breast Malignancies. Ann Surg Oncol 2017; 24:590-591. [PMID: 29098457 DOI: 10.1245/s10434-017-6163-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Mona P Tan
- MammoCare The Breast Clinic & Surgery, Singapore, Singapore.
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Yoon JJ, Green WR, Kim S, Kearney T, Haffty BG, Eladoumikdachi F, Goyal S. Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review. Adv Radiat Oncol 2016; 1:205-215. [PMID: 28740889 PMCID: PMC5514175 DOI: 10.1016/j.adro.2016.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/15/2016] [Accepted: 09/14/2016] [Indexed: 12/15/2022] Open
Abstract
Breast-conserving therapy (BCT), or breast-conserving surgery with adjuvant radiation therapy, has become a standard treatment alternative to mastectomy for women with early-stage breast cancer after many long-term studies have reported comparable rates of overall survival and local control. Oncoplastic breast surgery in the setting of BCT consists of various techniques that allow for an excision with a wider margin and a simultaneous enhancement of cosmetic sequelae, making it an ideal breast cancer surgery. Because of the parenchymal rearrangement that is routinely involved in oncoplastic techniques, however, the targeted tissue can be relocated, thus posing a challenge to localize the tumor bed for radiation planning. The goals of this systematic review are to address the challenges, outcomes, and cosmesis of oncoplastic breast surgery in the setting of BCT.
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Affiliation(s)
| | | | - Sinae Kim
- Biometrics Division, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Thomas Kearney
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Bruce G Haffty
- Department of Radiation Oncology, New Brunswick, New Jersey
| | - Firas Eladoumikdachi
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Sharad Goyal
- Department of Radiation Oncology, New Brunswick, New Jersey
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8
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Rassu PC, Serventi A, Giaminardi E, Bocchio M, Tava P. An example of lumpectomy for lower inner quadrant breast cancer with 1(st) level oncoplastic reconstruction by glandular splitting. Gland Surg 2014; 2:170-2. [PMID: 25083479 DOI: 10.3978/j.issn.2227-684x.2013.07.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 07/19/2013] [Indexed: 11/14/2022]
Abstract
Oncoplastic techniques extend the scope for breast conserving surgery by combining an extensive local excision with a simultaneous reconstruction of the defect to avoid local deformity. If less than 20% of the breast volume is excised a level I procedure is adequate and can be performed by breast surgeon without specific training in plastic surgery. For breast cancer is possible to fill the defect of the lower inner lumpectomy by splitting the upper inner quadrant. The Authors describe a novel technique in giant breast.
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Affiliation(s)
- Pier Carlo Rassu
- General Surgery Department, Novi Ligure-Tortona, San Giacomo Hospital, Viale Edilio Raggio 12, 15067 Novi Ligure (Alessandria), Italy
| | - Alberto Serventi
- General Surgery Department, Novi Ligure-Tortona, San Giacomo Hospital, Viale Edilio Raggio 12, 15067 Novi Ligure (Alessandria), Italy
| | - Eliana Giaminardi
- General Surgery Department, Novi Ligure-Tortona, San Giacomo Hospital, Viale Edilio Raggio 12, 15067 Novi Ligure (Alessandria), Italy
| | - Maurizia Bocchio
- General Surgery Department, Novi Ligure-Tortona, San Giacomo Hospital, Viale Edilio Raggio 12, 15067 Novi Ligure (Alessandria), Italy
| | - Paolo Tava
- General Surgery Department, Novi Ligure-Tortona, San Giacomo Hospital, Viale Edilio Raggio 12, 15067 Novi Ligure (Alessandria), Italy
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9
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Tenofsky PL, Dowell P, Topalovski T, Helmer SD. Surgical, oncologic, and cosmetic differences between oncoplastic and nononcoplastic breast conserving surgery in breast cancer patients. Am J Surg 2013; 207:398-402; discussion 402. [PMID: 24581764 DOI: 10.1016/j.amjsurg.2013.09.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/16/2013] [Accepted: 09/18/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is a lack of information regarding the safety, complication rate, and cosmetic outcome of oncoplastic breast conserving surgery. The purpose of this study is to evaluate and compare oncoplastic and nononcoplastic procedures. METHODS A retrospective review was conducted of patients treated with oncoplastic or nononcoplastic lumpectomies. Immediate and long-term complication rates and cosmetic satisfaction were compared. RESULTS Of the 142 surgeries, 58 were oncoplastic lumpectomies (40.8%). Oncoplastic patients were younger than nononcoplastic patients (60.9 vs 65.2 years, P = .043). Immediate complications were similar with the exception of nonhealing wounds (oncoplastic = 8.6% vs nononcoplastic = 1.2%, P = .042). Cosmetic complaints were similar, but fat necrosis was more common in the oncoplastic group (25.9% vs 9.5%, P = .009). Time to radiation and number of future biopsies were similar between the groups. CONCLUSION Oncoplastic lumpectomy is a safe alternative to standard lumpectomy for selected breast cancer patients.
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Affiliation(s)
- Patty L Tenofsky
- Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA; Via Christi Clinic, 1947 Founders' Circle Drive, Wichita, KS 67206, USA.
| | - Phaedra Dowell
- Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA
| | - Terri Topalovski
- Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA
| | - Stephen D Helmer
- Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA; Department of Medical Education, Via Christi Hospitals Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA
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10
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Preoperative localization and surgical margins in conservative breast surgery. Int J Surg Oncol 2013; 2013:793819. [PMID: 23986868 PMCID: PMC3748755 DOI: 10.1155/2013/793819] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 06/06/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022] Open
Abstract
Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer. The adequacy of surgical margins (SM) is a crucial issue for adjusting the volume of excision and for avoiding local recurrences, although the precise definition of an adequate margins width remains controversial. Moreover, other factors such as the biological behaviour of the tumor and subsequent proper systemic therapies may influence the local recurrence rate (LRR). However, a successful BCS requires preoperative localization techniques or margin assessment techniques. Carbon marking, wire-guided, biopsy clips, radio-guided, ultrasound-guided, frozen section analysis, imprint cytology, and cavity shave margins are commonly used, but from the literature review, no single technique proved to be better among the various ones. Thus, an association of two or more methods could result in a decrease in rates of involved margins. Each institute should adopt its most congenial techniques, based on the senologic equipe experience, skills, and technologies.
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Reedijk M, Hodgson N, Gohla G, Boylan C, Goldsmith CH, Foster G, Cornacchi SD, McCready D, Lovrics PJ. A prospective study of tumor and technical factors associated with positive margins in breast-conservation therapy for nonpalpable malignancy. Am J Surg 2012; 204:263-8. [DOI: 10.1016/j.amjsurg.2012.03.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/05/2012] [Accepted: 03/05/2012] [Indexed: 11/29/2022]
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12
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Greenup RA, Camp MS, Taghian AG, Buckley J, Coopey SB, Gadd M, Hughes K, Specht M, Smith BL. Cost comparison of radiation treatment options after lumpectomy for breast cancer. Ann Surg Oncol 2012; 19:3275-81. [PMID: 22851048 DOI: 10.1245/s10434-012-2546-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Indexed: 12/24/2022]
Abstract
BACKGROUND Radiation therapy (RT) after lumpectomy for breast cancer can be delivered with several different regimens. We evaluated a cost-minimization strategy to select among RT options. METHODS An institutional review board (IRB)-approved retrospective review identified a sample of 100 women who underwent lumpectomy for invasive or in situ breast cancer during 2009. Post lumpectomy RT options included: no radiation in women ≥70 years [T1N0, estrogen receptor (ER)+] per Cancer and Leukemia Group B (CALGB) 9343 (no-RT), accelerated external-beam partial-breast irradiation (APBI), and Canadian fractionation (C-RT), as alternatives to standard whole-breast radiation therapy (WBRT). Eligibility for RT regimens was based on published criteria. RT costs were estimated using the 2011 US Medicare Physician Fee Schedule and average Current Procedural Terminology (CPT) codes billed per regimen at our institution. Costs were modeled in a 1,000-patient theoretical cohort. RESULTS Median patient age was 56.5 years (range 32-93 years). Tumor histology included invasive ductal cancer (78 %), ductal carcinoma in situ (DCIS) (15 %), invasive lobular cancer (6 %), and mixed histology (1 %). Median tumor size was 1 cm (range 0.2-5 cm). Estimated per-patient cost of radiation was US$5,341.81 for APBI, US$9,121.98 for C-RT, and US$13,358.37 for WBRT. When patients received the least expensive radiation regimen for which they were eligible, 14 % received no-RT, 44 % received APBI, 7 % received C-RT, and 35 % defaulted to WBRT. Using a cost-minimization strategy, estimated RT costs were US$7.67 million, versus US$13.36 million had all patients received WBRT, representing cost savings of US$5.69 million per 1,000 patients treated. CONCLUSIONS A cost-minimization strategy results in a 43 % reduction in estimated radiation costs among women undergoing breast conservation.
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Affiliation(s)
- Rachel A Greenup
- Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
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13
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Chen X, Yun J, Fei F, Yi J, Tian R, Li S, Gan X. Prognostic value of nuclear hepatoma-derived growth factor (HDGF) localization in patients with breast cancer. Pathol Res Pract 2012; 208:437-43. [PMID: 22682760 DOI: 10.1016/j.prp.2012.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 01/15/2012] [Accepted: 03/06/2012] [Indexed: 01/22/2023]
Abstract
Hepatoma-derived growth factor (HDGF) plays an important role in tumor progression. Highly expressed HDGF has been found to indicate poor prognosis in many cancers. However, no information is available regarding the prognostic value of nuclear or cytoplasmic HDGF staining level in breast cancer. In the present study, the nuclear or cytoplasmic HDGF staining level was investigated in 86 patients with primary breast cancer by immunohistochemistry; the relationship between nuclear or cytoplasmic HDGF staining level and clinicopathological parameters was examined by Two-tailed Mann-Whitney U-test or Krustal-Wallis. The prognostic value of nuclear or cytoplasmic HDGF staining level in disease-free survival and overall survival was analyzed by Kaplan-Meier methods and log-rank test. We found that the percentage of cases with strong nuclear HDGF staining level was significantly higher in the cases with high tumor grade, high stage, high proliferation index (Ki-67 index>20%), as well as in those with lymph node invasion and recurrence (p<0.05) compared to those without. No significant correlation was found between cytoplasmic HDGF expression and any clinicopathological variables. In addition, disease-free survival and overall survival were significantly lower in patients with high nuclear HDGF expression (level 2) than in those with low nuclear HDGF expression (level 0 and level 1). Further Cox multivariate analysis showed that high nuclear HDGF expression is an independent factor for indicating poor prognosis in breast cancer patients. No significant difference in disease-free survival rate and overall survival was found between different cytoplasmic HDGF staining levels. All these findings suggest that increased nuclear HDGF expression is involved in tumor progression and might be used as a new prognosticator for breast cancer.
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Affiliation(s)
- Xiaoyan Chen
- Department of Neurosurgery, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
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14
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Tan MP. Alternatives for optimizing outcomes in oncoplastic breast surgery. Ann Surg Oncol 2012; 19:2327-33. [PMID: 22395982 DOI: 10.1245/s10434-012-2261-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Breast conservation treatment (BCT) is an accepted option for the treatment of breast malignancies. However, as suboptimal surgical techniques result in poor cosmetic outcomes, a plethora of operative approaches to prevent potential deformity has emerged in contemporary literature. Many of these procedures, referred to as oncoplastic breast surgery (OBS), depend on complex mammoplasty-type procedures, often with contralateral symmetrisation, and the frequent use of volume replacement techniques with implants or autologous tissue flaps. However, there have been reports of moderately high rates of complications for these types of procedures. OBJECTIVE To propose surgical approaches that reduce tissue manipulation and lower complication rates without sacrificing local control and survival. METHODS A description of methods is presented, involving closely coordinated collaboration with members of the interdisciplinary team to enable accurate resection with minimal tissue loss for appropriate margins, allowing adequate retained tissue for acceptable cosmesis. RESULTS Using these techniques, more women with breast malignancies may undergo BCT without elaborate mammoplasty procedures or volume replacement operations with implants or autologous flaps. CONCLUSIONS The approaches described are alternatives to the conventional volume displacement techniques for optimising outcomes with OBS. They allow a greater proportion of women to undergo BCT with less tissue manipulation and lower complication rates.
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Affiliation(s)
- Mona P Tan
- Breast Surgical Oncology, MammoCare, The Breast Clinic and Surgery, Singapore, Singapore.
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15
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Alternative splicings on p53, BRCA1 and PTEN genes involved in breast cancer. Biochem Biophys Res Commun 2011; 413:395-9. [DOI: 10.1016/j.bbrc.2011.08.098] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 08/20/2011] [Indexed: 01/08/2023]
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