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Karamchandani MM, Jonczyk MM, De La Cruz Ku G, Gaffney KA, Wareham C, Nardello S, Persing SM, Homsy C, Chatterjee A. The adoption of oncoplastic surgery: Is there a learning curve? J Surg Oncol 2023. [PMID: 37092965 DOI: 10.1002/jso.27294] [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: 04/03/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Oncoplastic surgery (OPS) is a form of breast conservation surgery involving partial mastectomy followed by volume displacement or replacement surgery. As the field of OPS is growing, we sought to determine if there was a learning curve to this surgery. METHODS A retrospective chart review was conducted of all patients who underwent OPS over a 6-year period with a single surgeon formally trained in both Plastic Surgery and Breast Oncology. Cumulative summation analysis (CUSUM) was performed on mean operative time to generate the learning curve and learning curve phases. Outcomes were compared between phases to determine significance. RESULTS Mean operative time decreased significantly across the 6-year period, generating three distinct learning curve phases: Learner phase (cases 1-23), Competence phase (24-73), and Mastery phase (74 and greater). The overall positive margin rate was 10.9% and there was no significant difference in rates between phases (p = 0.49). Overall complication rates, reoperation rates, and locoregional recurrence remained the same across all phases (p = 0.16; p = 0.65; p = 0.41). The rate of partial nipple loss decreased between phases (p = 0.02). CONCLUSION As with many complex operations, there does appear to be a learning curve with OPS, as the operative time and the rates of partial nipple loss decreased over time.
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Affiliation(s)
| | - Michael M Jonczyk
- Department of Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
| | - Gabriel De La Cruz Ku
- Department of Surgery, UMass Memorial Medical Center, Worcester, Massachusetts, USA
- Universidad Cientifica del Sur, Lima, Peru
| | - Kerry A Gaffney
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | - Carly Wareham
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | - Salvatore Nardello
- Department of Surgery, Division of Surgical Oncology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Sarah M Persing
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Surgery, Division of Surgical Oncology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Christopher Homsy
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | - Abhishek Chatterjee
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Surgery, Division of Surgical Oncology, Tufts Medical Center, Boston, Massachusetts, USA
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Karamchandani MM, De La Cruz Ku G, Gaffney KA, Wareham C, Persing SM, Homsy C, Nardello S, Chatterjee A. Single Versus Dual Surgeon Approaches to Oncoplastic Surgery: A Comparison of Outcomes. J Surg Res 2023; 283:1064-1072. [PMID: 36914997 DOI: 10.1016/j.jss.2022.11.067] [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: 05/22/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Oncoplastic surgery (OPS) is traditionally performed using a dual surgeon (DS) approach that involves both a breast surgeon and a plastic surgeon. It is also performed using a single surgeon (SS) approach with a surgeon trained in both breast surgical oncology and plastic surgery. We sought to determine if outcomes differed between SS versus DS OPS approaches. METHODS A retrospective chart review was conducted of all OPS performed in a single health system over a 6-y period by either an SS or a DS approach. Primary outcomes were rates of positive margins and the overall complication rate; secondary outcomes were loco-regional recurrence, disease-free survival, and overall survival. RESULTS A total of 217 patients were identified; 117 were SS cases and 100 were DS cases. Baseline preoperative patient characteristics were similar between the two groups as there was no difference in mean Charlson Comorbidity Index scores (P = 0.07). There was no difference in tumor stage (P = 0.09) or nodal status (P = 0.31). Rates of positive margins were not significantly different (10.9% (SS) versus 9% (DS); P = 0.81), nor were rates of complications (11.1% (SS) versus 15% (DS); P = 0.42). Rates of locoregional recurrence were also not significantly different (1.7% (SS) versus 0% (DS); P = 0.5). Disease-free survival and overall survival were not significantly different at 1-y, 3-y, and 5-y time points (P = 0.20 and P = 0.23, respectively) although follow-up time was not sufficient for definitive analysis regarding survival. CONCLUSIONS Both SS and DS approaches to OPS have similar outcomes with regards to positive margin rates and surgical complication rates and are comparably safe.
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Affiliation(s)
| | - Gabriel De La Cruz Ku
- Department of Surgery, UMass Memorial Medical Center, Worcester, Massachusetts; Universidad Cientifica del Sur, Lima, Peru
| | - Kerry A Gaffney
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Carly Wareham
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Sarah M Persing
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, Massachusetts; Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Christopher Homsy
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Salvatore Nardello
- Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Abhishek Chatterjee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, Massachusetts; Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, Massachusetts.
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Ozcan LC, Donovan CA, Srour M, Chung A, Mirocha J, Frankel SD, Hakim P, Giuliano AE, Amersi F. Invasive Lobular Carcinoma-Correlation Between Imaging and Final Pathology: Is MRI Better? Am Surg 2022:31348221101600. [PMID: 35639048 DOI: 10.1177/00031348221101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Invasive lobular carcinoma (ILC) is associated with high re-excision rates following breast-conserving surgery (BCS). The correlation between lesion size on different imaging modalities and final tumor size has not been well characterized. METHODS A prospective database of patients with stage I-III breast cancer undergoing BCS between 2006 and 2016 was reviewed. Pearson correlation analysis was used to correlate tumor size on breast imaging to final pathology. RESULTS Of these, 111 patients with ILC were identified. Mean lesion size was 1.93 cm for MMG, 1.61 cm for US, and 2.51 cm for MRI. Mean tumor size on surgical excision was 2.64 cm. The correlation coefficient between pathology and the different imaging modalities were as follows: MMG .17, US 0.37, and MRI .58. Actual tumor size was underestimated by 1 cm in 27.1% of MMGs, 50% of USs, and in 13.3% of MRIs. 38 patients (34.2%) underwent re-excision. No differences in re-excision rates were noted in patients with and without MRI, 30.3% vs 40.0%, respectively (P = .31). CONCLUSION While MRI provides a better estimate of tumor size than MMG and US, the size of the tumor on imaging only weakly correlated with pathology. The use of MRI does not decrease re-excision rates.
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Affiliation(s)
- Lerna C Ozcan
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Cory A Donovan
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Marissa Srour
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alice Chung
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Mirocha
- Biostatistics Core, Research Institute and Samuel-Oschin Cancer Center, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Steven D Frankel
- Department of Breast Imaging, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul Hakim
- Department of Breast Imaging, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Armando E Giuliano
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Farin Amersi
- Division of Surgical Oncology, Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Garzotto F, Comoretto RI, Michieletto S, Franzoso G, Lo Mele M, Gregori D, Bonavina MG, Bozza F, Caumo F, Saibene T. Preoperative non-palpable breast lesion localization, innovative techniques and clinical outcomes in surgical practice: A systematic review and meta-analysis. Breast 2021; 58:93-105. [PMID: 33991806 PMCID: PMC8481910 DOI: 10.1016/j.breast.2021.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/31/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
Pre-operative localization of non-palpable breast lesions with non-wired non-ionizing (NWNI) techniques may improve clinical outcomes as reoperation rate, cosmetic outcome and contribute to organizational aspects improvement in breast-conserving surgery (BCS). However only limited literature is available and clinical studies involving these forefront devices are often small and non-randomized. Furthermore, there is a lack of consensus on free margins and cosmetic outcomes definitions. The objective of the present meta-analysis was to determine the crude clinical outcomes reported for the NWNI techniques on BCS. A literature search was performed of PubMed, Embase and Scopus databases up to February 2021 in order to select all prospective or retrospective clinical trials on pre-operative breast lesion localization done with NWNI devices. All studies were assessed following the PRISMA recommendations. Continuous outcomes were described in averages corrected for sample size, while binomial outcomes were described using the weighted average proportion. Twenty-seven studies with a total of 2103 procedures were identified. The technique is consolidated, showing for both reflectors' positioning and localization nearly the 100% rate of success. The re-excision and clear margins rates were 14% (95% CI, 11-17%) and 87% (80-92%), respectively. Overall, positive margins rates were 12% (8-17%). In studies that compared NWNI and wire localization techniques, positive margin rate is lower for the first techniques (12%, 6-22% vs 17%, 12-23%) and re-excision rate is slightly higher using the latter (13%, 9-19% vs 16%, 13-18%). Pre-operative NWNI techniques are effective in the localization of non-palpable breast lesions and are promising in obtaining clear (or negative) margins minimizing the need for re-excision and improving the cosmetic outcomes. Randomized trials are needed to confirm these findings.
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Affiliation(s)
- Francesco Garzotto
- Breast Radiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Rosanna Irene Comoretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Silvia Michieletto
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Marcello Lo Mele
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, 35121, Italy
| | - Dario Gregori
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | | | - Fernando Bozza
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Francesca Caumo
- Breast Radiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Tania Saibene
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
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Nowikiewicz T, Śrutek E, Głowacka-Mrotek I, Tarkowska M, Żyromska A, Zegarski W. Clinical outcomes of an intraoperative surgical margin assessment using the fresh frozen section method in patients with invasive breast cancer undergoing breast-conserving surgery - a single center analysis. Sci Rep 2019; 9:13441. [PMID: 31530867 PMCID: PMC6748937 DOI: 10.1038/s41598-019-49951-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/30/2019] [Indexed: 11/10/2022] Open
Abstract
Breast conserving treatment (BCT) is a safe standard therapeutic method in patients with early invasive breast cancer. However, it is associated with an increased risk of residual neoplastic tissues in surgical margins. The aim of this study was to assess the outcome of the use of the intraoperative pathologic analysis by the frozen section (FS) method for evaluation of the extent of the primary lumpectomy. The study concerns a retrospective analysis of a group of 1102 patients who underwent BCT between Jan 2015 and Dec 2016. The assessment focused on the frequency of the intraoperative pathologic analysis of the primary lumpectomy extent (fresh frozen section method). The influence of the BCT specimen analysis method on the free margins width, as well as the rate and the cause of reoperation were evaluated. The intraoperative lumpectomy evaluation was performed in 45.8% (505/1102) of patients (Group I), while in the remaining 54.2% of the cases it was decided to abandon this procedure (Group II). Although in 72 (14.3%) patients the intraoperative analysis gave negative results, the margins contained residual tumor tissue (vs. 16.9% in Group II). In Group I, conversion from the previously planned BCT to mastectomy was necessary in 5.9% (30/505) patients (vs. 9.7% in Group II). The duration of surgery was 48.9 ± 17.3 minutes (Group I) and 42.9 ± 13.6 minutes (Group II). In patients undergoing BCT, the use of the intraoperative pathologic analysis by the FS method resulted in a reduction of the total number of reoperations performed due to residual tumor found in the margins following the primary lumpectomy. However, it statistically significantly extended the duration of the surgery.
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Affiliation(s)
- Tomasz Nowikiewicz
- Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland. .,Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.
| | - Ewa Śrutek
- Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland
| | - Iwona Głowacka-Mrotek
- Department of Rehabilitation, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, M. Sklodowskiej-Curie 9, 85-001, Bydgoszcz, Poland
| | - Magdalena Tarkowska
- Department of Laser Therapy and Physiotherapy, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, M. Sklodowskiej-Curie 9, 85-001, Bydgoszcz, Poland
| | - Agnieszka Żyromska
- Chair and Clinic of Oncology and Brachytherapy, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.,Amethyst Radiotherapy Centre, Zgorzelec, Poland
| | - Wojciech Zegarski
- Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland
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Hellerhoff K, Birnbacher L, Sztrókay-Gaul A, Grandl S, Auweter S, Willner M, Marschner M, Mayr D, Reiser MF, Pfeiffer F, Herzen J. Assessment of intraductal carcinoma in situ (DCIS) using grating-based X-ray phase-contrast CT at conventional X-ray sources: An experimental ex-vivo study. PLoS One 2019; 14:e0210291. [PMID: 30625220 PMCID: PMC6326478 DOI: 10.1371/journal.pone.0210291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The extent of intraductal carcinoma in situ (DCIS) is commonly underestimated due to the discontinuous growth and lack of microcalcifications. Specimen radiography has been established to reduce the rate of re-excision. However, the predictive value for margin assessment with conventional specimen radiography for DCIS is low. In this study we assessed the potential of grating-based phase-contrast computed tomography (GBPC-CT) at conventional X-ray sources for specimen tomography of DCIS containing samples. MATERIALS AND METHODS GBPC-CT was performed on four ex-vivo breast specimens containing DCIS and invasive carcinoma of non-specific type. Phase-contrast and absorption-based datasets were manually matched with corresponding histological slices as the standard of reference. RESULTS Matching of CT images and histology was successful. GBPC-CT showed an improved soft tissue contrast compared to absorption-based images revealing more histological details in the same sections. Non-calcifying DCIS exceeding the invasive tumor could be correlated to areas of dilated bright ducts around the tumor. CONCLUSIONS GBPC-CT imaging at conventional X-ray sources offers improved depiction quality for the imaging of breast tissue samples compared to absorption-based imaging, allows the identification of diagnostically relevant tissue details, and provides full three-dimensional assessment of sample margins.
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MESH Headings
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Calcinosis/diagnostic imaging
- Calcinosis/pathology
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Female
- Humans
- In Vitro Techniques
- Mammography/methods
- Microscopy, Phase-Contrast/methods
- Prospective Studies
- Tomography, X-Ray Computed/methods
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Affiliation(s)
- Karin Hellerhoff
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
- Abteilung für Diagnostische Radiologie, Rotkreuzklinikum München, Munich, Germany
| | - Lorenz Birnbacher
- Chair of Biomedical Physics, Department of Physics & Munich School of BioEngineering, Technical University of Munich, Garching, Germany
- * E-mail:
| | - Anikó Sztrókay-Gaul
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
- Abteilung für Diagnostische Radiologie, Rotkreuzklinikum München, Munich, Germany
| | - Susanne Grandl
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
- Abteilung für Diagnostische Radiologie, Rotkreuzklinikum München, Munich, Germany
| | - Sigrid Auweter
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Marian Willner
- Chair of Biomedical Physics, Department of Physics & Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| | - Mathias Marschner
- Chair of Biomedical Physics, Department of Physics & Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| | - Doris Mayr
- Institute of Pathology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Maximilian F. Reiser
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Department of Physics & Munich School of BioEngineering, Technical University of Munich, Garching, Germany
- Institute of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julia Herzen
- Chair of Biomedical Physics, Department of Physics & Munich School of BioEngineering, Technical University of Munich, Garching, Germany
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7
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Hernanz F, González-Noriega M, Sánchez S, Paz L, Muñoz P, Hermana S. Oncoplastic breast conserving surgery with tailored needle-guided excision. Gland Surg 2018; 6:698-705. [PMID: 29302488 DOI: 10.21037/gs.2017.06.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Breast conserving surgery (BCS) administered with oncoplastic approach (OBCS), when it is required, is currently the gold standard for the treatment of early breast cancer. Wire-guided localization (WL) is the most popular technique used to help surgeon in breast cancer excision. Currently, a universal and undeniable goal is to minimize the rate of positive margins and re-excision operation after BCS improving cosmetic outcome and decreasing health care costs. This study is aimed to report our experience combining OBCS and tailored WL as surgical approach for early breast cancers. Methods We performed a retrospective study on 148 breast cancer patients who were treated with OBCS and tailored WL, which consists in individualization of the number and location of wires depending on patient particularities, in our Breast Unit from March 2013 to December 2015. A multivariate analysis was used to determine the association between clinic-pathologic variables, which can be known preoperatively, and margin status. Results The rate of affected margins was 13.5% and 10.8% patients underwent re-interventions for oncologic reasons. Multifocality was strongly associated with involved margins [odds ratio (OR) 4.67]. Conclusions OBCS together with tailored WL obtains an acceptable rate of positive margins and high rate of final BCS.
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Affiliation(s)
- Fernando Hernanz
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
| | - Mónica González-Noriega
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
| | - Sonia Sánchez
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
| | - Lucia Paz
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
| | - Pedro Muñoz
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
| | - Sandra Hermana
- Oncoplastic Breast Unit, Hospital Universitario Valdecilla, University of Cantabria, Santander, Spain
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8
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Reyna C, DeSnyder SM. Intraoperative Margin Assessment in Breast Cancer Management. Surg Oncol Clin N Am 2018; 27:155-165. [DOI: 10.1016/j.soc.2017.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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9
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Da Silva M, Porembka J, Mokdad AA, Seiler S, Huth J, Rivers A, Wooldridge R, Chu A, Brown E, Bao J, Farr D, Hansen M, Unzeitig-Barron A, Leitch M, Rao R. Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery. Breast J 2017; 24:161-166. [DOI: 10.1111/tbj.12854] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/27/2016] [Accepted: 12/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Monica Da Silva
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Jessica Porembka
- Department of Radiology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Ali A. Mokdad
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Stephen Seiler
- Department of Radiology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - James Huth
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Aeisha Rivers
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Rachel Wooldridge
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Amanda Chu
- Department of Radiology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Emily Brown
- Department of Radiology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Jean Bao
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Deborah Farr
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Meghan Hansen
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Alison Unzeitig-Barron
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Marilyn Leitch
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Roshni Rao
- Division of Surgical Oncology; Department of Surgery; University of Texas Southwestern Medical Center; Dallas TX USA
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10
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Management of Intraepithelial Disease. Breast Cancer 2017. [DOI: 10.1007/978-3-319-48848-6_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Toss MS, Pinder SE, Green AR, Thomas J, Morgan DAL, Robertson JFR, Ellis IO, Rakha EA. Breast conservation in ductal carcinomain situ(DCIS): what defines optimal margins? Histopathology 2016; 70:681-692. [DOI: 10.1111/his.13116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Michael S Toss
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Sarah E Pinder
- Department of Research Oncology; King's College London, Guy's Hospital; London UK
| | - Andrew R Green
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Jeremy Thomas
- Department of Pathology; Western General Hospital; Edinburgh UK
| | - David A L Morgan
- Department of Oncology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - John F R Robertson
- Division of Breast Surgery, Graduate Entry Medicine and Health School (GEMS); University of Nottingham, Royal Derby Hospital; Derby UK
| | - Ian O Ellis
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Emad A Rakha
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
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