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Kaidar-Person O, Faermann R, Polikar D, Cohen K, Bernstein-Molho R, Morrow M, Boersma LJ, Offersen BV, Poortmans P, Sklair-Levy M, Anaby D. A BRILLIANT-BRCA study: residual breast tissue after mastectomy and reconstruction. Breast Cancer Res Treat 2024:10.1007/s10549-024-07425-4. [PMID: 38980506 DOI: 10.1007/s10549-024-07425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 06/29/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Different types of mastectomies leave different amounts of residual breast tissue. The significance of the residual breast volume (RBV) is not clear. Therefore, we developed an MRI tool that allows to easily assess the RBV. In this study we evaluated factors associated with RBV after skin or nipple sparing mastectomy (SSM/NSM) in breast cancer BRCA pathogenic variant (PV) carriers who underwent both therapeutic and risk reducing SSM/NSM and its relation to breast cancer outcomes using an innovative MRI-based tool. METHODS Data of breast cancer BRCA PV who were treated between 2006 and 2020 were retrieved from of the oncogenetics unit databases. Only patients who underwent SSM/NSM and had a postoperative breast MRI available for analysis were included. Data collected included demographics, clinicopathological features, and outcomes. The MRI tool was developed by a breast cancer imaging laboratory. A logistic regression test and 95% confidence interval (CI) were used to assess the associated risk of increased RBV. A forward stepwise linear regression was used to correlate tumour-patient specific factors and RBV, and a Kaplan-Meier curve to show the probability of locoregional relapse. RESULTS A total of 84 patients undergoing 89 mastectomies were included. At a median follow-up of 98 months, 5 local, 2 regional, and 4 distant recurrences were observed. RBV was not significantly related with breast cancer outcomes (p value = NS). A higher body mass index (BMI) was associated with a higher RBV (p < 0.0001). A larger number of involved axillary nodes was associated with a smaller RBV (p = 0.025). The RBV on the risk-reducing mastectomy side was significantly higher compared to the breast cancer side (p value = 0.007). Local recurrences occurred in the vicinity of the primary tumour.
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Affiliation(s)
- Orit Kaidar-Person
- School of Medicine, Faculty of Medical & Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
- Breast Radiation Unit, The Jusidman Cancer Center, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
| | - Renata Faermann
- School of Medicine, Faculty of Medical & Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
- The Merav High-Risk Clinic - Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Dor Polikar
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Kfir Cohen
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Rinat Bernstein-Molho
- School of Medicine, Faculty of Medical & Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Breast Cancer Institute, The Jusidman Cancer Center, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Oncogenetics Unit, Institute of Genetics, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Liesbeth Jorinne Boersma
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Birgitte Vrou Offersen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk-Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium
| | - Miri Sklair-Levy
- School of Medicine, Faculty of Medical & Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
- The Merav High-Risk Clinic - Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Debbie Anaby
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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Littrup PJ, Duric N, Sak M, Li C, Roy O, Brem RF, Yamashita M. The Fat-glandular Interface and Breast Tumor Locations: Appearances on Ultrasound Tomography Are Supported by Quantitative Peritumoral Analyses. JOURNAL OF BREAST IMAGING 2021; 3:455-464. [PMID: 38424790 DOI: 10.1093/jbi/wbab032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To analyze the preferred tissue locations of common breast masses in relation to anatomic quadrants and the fat-glandular interface (FGI) using ultrasound tomography (UST). METHODS Ultrasound tomography scanning was performed in 206 consecutive women with 298 mammographically and/or sonographically visible, benign and malignant breast masses following written informed consent to participate in an 8-site multicenter, Institutional Review Board-approved cohort study. Mass locations were categorized by their anatomic breast quadrant and the FGI, which was defined by UST as the high-contrast circumferential junction of fat and fibroglandular tissue on coronal sound speed imaging. Quantitative UST mass comparisons were done for each tumor and peritumoral region using mean sound speed and percentage of fibroglandular tissue. Chi-squared and analysis of variance tests were used to assess differences. RESULTS Cancers were noted at the FGI in 95% (74/78) compared to 51% (98/194) of fibroadenomas and cysts combined (P < 0.001). No intra-quadrant differences between cancer and benign masses were noted for tumor location by anatomic quadrants (P = 0.66). Quantitative peritumoral sound speed properties showed that cancers were surrounded by lower mean sound speeds (1477 m/s) and percent fibroglandular tissue (47%), compared to fibroadenomas (1496 m/s; 65.3%) and cysts (1518 m/s; 84%) (P < 0.001; P < 0.001, respectively). CONCLUSION Breast cancers form adjacent to fat and UST localized the vast majority to the FGI, while cysts were most often completely surrounded by dense tissue. These observations were supported by quantitative peritumoral analyses of sound speed values for fat and fibroglandular tissue.
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Affiliation(s)
- Peter J Littrup
- Departments of Radiology and Oncology, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, Wayne State University, Detroit, Novi, MI, USA
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Nebojsa Duric
- Departments of Radiology and Oncology, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, Wayne State University, Detroit, Novi, MI, USA
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Mark Sak
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Cuiping Li
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Olivier Roy
- Delphinus Medical Technologies, Inc., Novi, MI, USA
| | - Rachel F Brem
- The George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Mary Yamashita
- University of Southern California; Norris Cancer Center and Hospital, Los Angeles, CA, USA
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Sisti A, Huayllani MT, Boczar D, Restrepo DJ, Spaulding AC, Emmanuel G, Bagaria SP, McLaughlin SA, Parker AS, Forte AJ. Breast cancer in women: a descriptive analysis of the national cancer database. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:332-341. [PMID: 32420970 PMCID: PMC7569667 DOI: 10.23750/abm.v91i2.8399] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 04/27/2019] [Indexed: 12/26/2022]
Abstract
Background and aim of the work: Breast cancer is the most common cancer in women in the United States. National Cancer Database (NCDB) is one of the largest tumor databases of the United States. This study aimed to evaluate the features of breast cancer in women from a large updated database. Methods: We describe and analyze the frequencies and percentages of the clinical and pathological features of women diagnosed with breast cancer registered in NCDB, in a period from 2004 to 2015. Results: A total of 2,423,875 women were diagnosed with breast cancer between 2004 and 2015. The nationally representative analysis demonstrated that the incidence of breast cancer among women increased over the years. Upper-outer quadrant was the most frequent primary tumor site, and the intraductal carcinoma was the most frequent histology. The prevalence of breast cancer increased with age. The most frequent grade at diagnosis was grade II. Broadly, invasive characteristics were noted more frequently in younger patients. Left and right breast were affected with almost the same frequency, with a slight predominance of the left breast. The most frequent surgical treatment was a partial mastectomy. Reconstruction with implant was the most frequent choice. Post-mastectomy radiation therapy was administered in the majority of patients. Conclusions: To the authors’ knowledge, the current study is the largest descriptive analysis to date on the clinical and pathological features of breast cancer in a population-based database. The increase in incidence over the years indicates an important need for etiologic research and innovative approaches to improve breast cancer prevention. (www.actabiomedica.it)
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Affiliation(s)
- Andrea Sisti
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
| | - Maria T Huayllani
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
| | - Daniel Boczar
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
| | - David J Restrepo
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
| | - Aaron C Spaulding
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida, USA.
| | | | | | | | - Alexander S Parker
- Office of Research Affairs, University of Florida, College of Medicine, Jacksonville, Florida, USA.
| | - Antonio J Forte
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida.
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Chen JH, Liao F, Zhang Y, Li Y, Chang CJ, Chou CP, Yang TL, Su MY. 3D MRI for Quantitative Analysis of Quadrant Percent Breast Density: Correlation with Quadrant Location of Breast Cancer. Acad Radiol 2017; 24:811-817. [PMID: 28131498 DOI: 10.1016/j.acra.2016.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVES Breast cancer occurs more frequently in the upper outer (UO) quadrant, but whether this higher cancer incidence is related to the greater amount of dense tissue is not known. Magnetic resonance imaging acquires three-dimensional volumetric images and is the most suitable among all breast imaging modalities for regional quantification of density. This study applied a magnetic resonance imaging-based method to measure quadrant percent density (QPD), and evaluated its association with the quadrant location of the developed breast cancer. MATERIALS AND METHODS A total of 126 cases with pathologically confirmed breast cancer were reviewed. Only women who had unilateral breast cancer located in a clear quadrant were selected for analysis. A total of 84 women, including 47 Asian women and 37 western women, were included. An established computer-aided method was used to segment the diseased breast and the contralateral normal breast, and to separate the dense and fatty tissues. Then, a breast was further separated into four quadrants using the nipple and the centroid as anatomic landmarks. The tumor was segmented using a computer-aided method to determine its quadrant location. The distribution of cancer quadrant location, the quadrant with the highest QPD, and the proportion of cancers occurring in the highest QPD were analyzed. RESULTS The highest incidence of cancer occurred in the UO quadrant (36 out of 84, 42.9%). The highest QPD was also noted most frequently in the UO quadrant (31 out of 84, 36.9%). When correlating the highest QPD with the quadrant location of breast cancer, only 17 women out of 84 (20.2%) had breast cancer occurring in the quadrant with the highest QPD. CONCLUSIONS The results showed that the development of breast cancer in a specific quadrant could not be explained by the density in that quadrant, and further studies are needed to find the biological reasons accounting for the higher breast cancer incidence in the UO quadrant.
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