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Leiloglou M, Kedrzycki MS, Elson DS, Leff DR. ASO Author Reflections: Towards Fluorescence Guided Tumor Identification for Precision Breast Conserving Surgery. Ann Surg Oncol 2022; 29:564-565. [PMID: 34406539 PMCID: PMC9675703 DOI: 10.1245/s10434-021-10626-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Maria Leiloglou
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London, UK. .,Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Martha S Kedrzycki
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Daniel S Elson
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Daniel R Leff
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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2
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Kedrzycki MS, Leiloglou M, Chalau V, Chiarini N, Thiruchelvam PTR, Hadjiminas DJ, Hogben KR, Rashid F, Ramakrishnan R, Darzi AW, Elson DS, Leff DR. The Impact of Temporal Variation in Indocyanine Green Administration on Tumor Identification During Fluorescence Guided Breast Surgery. Ann Surg Oncol 2021; 28:5617-5625. [PMID: 34347221 PMCID: PMC8418597 DOI: 10.1245/s10434-021-10503-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/07/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND On average, 21% of women in the USA treated with Breast Conserving Surgery (BCS) undergo a second operation because of close positive margins. Tumor identification with fluorescence imaging could improve positive margin rates through demarcating location, size, and invasiveness of tumors. We investigated the technique's diagnostic accuracy in detecting tumors during BCS using intravenous indocyanine green (ICG) and a custom-built fluorescence camera system. METHODS In this single-center prospective clinical study, 40 recruited BCS patients were sub-categorized into two cohorts. In the first 'enhanced permeability and retention' (EPR) cohort, 0.25 mg/kg ICG was injected ~ 25 min prior to tumor excision, and in the second 'angiography' cohort, ~ 5 min prior to tumor excision. Subsequently, an in-house imaging system was used to image the tumor in situ prior to resection, ex vivo following resection, the resection bed, and during grossing in the histopathology laboratory to compare the technique's diagnostic accuracy between the cohorts. RESULTS The two cohorts were matched in patient and tumor characteristics. The majority of patients had invasive ductal carcinoma with concomitant ductal carcinoma in situ. Tumor-to-background ratio (TBR) in the angiography cohort was superior to the EPR cohort (TBR = 3.18 ± 1.74 vs 2.10 ± 0.92 respectively, p = 0.023). Tumor detection reached sensitivity and specificity scores of 0.82 and 0.93 for the angiography cohort and 0.66 and 0.90 for the EPR cohort, respectively (p = 0.1051 and p = 0.9099). DISCUSSION ICG administration timing during the angiography phase compared with the EPR phase improved TBR and diagnostic accuracy. Future work will focus on image pattern analysis and adaptation of the camera system to targeting fluorophores specific to breast cancer.
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Affiliation(s)
- Martha S Kedrzycki
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Maria Leiloglou
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK. .,Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Vadzim Chalau
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nicolas Chiarini
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paul T R Thiruchelvam
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Dimitri J Hadjiminas
- Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Katy R Hogben
- Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Faiza Rashid
- Department of Histopathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Rathi Ramakrishnan
- Department of Histopathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Ara W Darzi
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Daniel S Elson
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Daniel R Leff
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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3
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Balasundaram G, Krafft C, Zhang R, Dev K, Bi R, Moothanchery M, Popp J, Olivo M. Biophotonic technologies for assessment of breast tumor surgical margins-A review. JOURNAL OF BIOPHOTONICS 2021; 14:e202000280. [PMID: 32951321 DOI: 10.1002/jbio.202000280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Breast conserving surgery (BCS) offering similar surgical outcomes as mastectomy while retaining breast cosmesis is becoming increasingly popular for the management of early stage breast cancers. However, its association with reoperation rates of 20% to 40% following incomplete tumor removal warrants the need for a fast and accurate intraoperative surgical margin assessment tool that offers cellular, structural and molecular information of the whole specimen surface to a clinically relevant depth. Biophotonic technologies are evolving to qualify as such an intraoperative tool for clinical assessment of breast cancer surgical margins at the microscopic and macroscopic scale. Herein, we review the current research in the application of biophotonic technologies such as photoacoustic imaging, Raman spectroscopy, multimodal multiphoton imaging, diffuse optical imaging and fluorescence imaging using medically approved dyes for breast cancer detection and/or tumor subtype differentiation toward intraoperative assessment of surgical margins in BCS specimens, and possible challenges in their route to clinical translation.
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Affiliation(s)
- Ghayathri Balasundaram
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | | | - Ruochong Zhang
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Kapil Dev
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Renzhe Bi
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Mohesh Moothanchery
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jürgen Popp
- Leibniz Institute of Photonic Technology, Jena, Germany
- Institute of Physical Chemistry and Abbe Center of Photonics, University Jena, Jena, Germany
| | - Malini Olivo
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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4
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Kosik I, Brackstone M, Kornecki A, Chamson-Reig A, Wong P, Carson JJ. Lipid-weighted intraoperative photoacoustic tomography of breast tumors: Volumetric comparison to preoperative MRI. PHOTOACOUSTICS 2020; 18:100165. [PMID: 32426228 PMCID: PMC7226881 DOI: 10.1016/j.pacs.2020.100165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/07/2020] [Accepted: 01/29/2020] [Indexed: 06/01/2023]
Abstract
With a lifetime risk of 1 in 8, breast cancer continues to be a major concern for women and their physicians. The optimal treatment of the disease depends on the stage of the cancer at diagnosis, which is typically assessed using medical imaging. However, currently employed imaging systems for breast tumor measurement rarely agree perfectly. Our group developed an Intraoperative Photoacoustic Screening (iPAS) soft tissue scanner featuring high bulk tissue sensitivity, a clinically compatible scan-time of 6 min, imaging depths greater than 2 cm and the capability to visualize whole breast tumors based on their lipid, rather than hemoglobin, profile. Here, we report on the first clinical experience with breast cancer patients by comparing tumor-measurement using iPAS, preoperative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and gold-standard pathology. Tumor size was measured volumetrically for iPAS and DCE-MRI, and separately using maximum diameters for pathology, DCE-MRI and iPAS. Comparisons were performed using Pearson's correlation coefficients, and the non-parametric Wilcoxon signed-rank test. Twelve consecutive patients were included in the study, contingent on pathologically documented invasive carcinoma. iPAS volumetric tumor size was positively correlated to DCE-MRI (Pearson's r = 0.78, p = 0.003) and not significantly different (Wilcoxon, p = 0.97). In comparison to pathology, tumor diameters given by iPAS were positively correlated (Pearson's r = 0.87, p = 0.0002) and significantly different (Wilcoxon, p = 0.0015). The results indicated that volumetric-measurement of invasive breast tumors with iPAS is similar to that of DCE-MRI. On the other hand, tumor diameter measurements were less reliable. Beyond enhancing surgical specimen examination, an extension of this technology to diagnostic imaging promises a new perspective on tumor assessment, potentially improving our current understanding and treatment of breast cancer.
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Affiliation(s)
- Ivan Kosik
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Muriel Brackstone
- Department of Oncology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Anat Kornecki
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | | | - Philip Wong
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Jeffrey J.L. Carson
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Physics and Astronomy, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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5
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Curcumin and Its Derivatives as Potential Therapeutic Agents in Prostate, Colon and Breast Cancers. Molecules 2019; 24:molecules24234386. [PMID: 31801262 PMCID: PMC6930580 DOI: 10.3390/molecules24234386] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/27/2019] [Accepted: 10/03/2019] [Indexed: 02/06/2023] Open
Abstract
Cancer is a life-threatening disease and is the second leading cause of death around the world. The increasing threats of drug-resistant cancers indicate that there is an urgent need for the improvement or development of more effective anticancer agents. Curcumin, a phenolic compound originally derived from turmeric plant (Curcuma longa L. (Zingiberaceae family)) widely known as a spice and a coloring agent for food have been reported to possess notable anticancer activity by inhibiting the proliferation and metastasis, and enhancing cell cycle arrest or apoptosis in various cancer cells. In spite of all these benefits, the therapeutic application of curcumin in clinical medicine and its bioavailability are still limited due to its poor absorption and rapid metabolism. Structural modification of curcumin through the synthesis of curcumin-based derivatives is a potential approach to overcome the above limitations. Curcumin derivatives can overcome the disadvantages of curcumin while enhancing the overall efficacy and hindering drug resistance. This article reports a review of published curcumin derivatives and their enhanced anticancer activities.
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6
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Davoine E, Dion L, Nyangoh Timoh K, Beraud E, Tas P, Tavenard A, Laviolle B, Perrin C, Foucher F, Levêque J, Lavoué V. Predictive factors associated with involved margins in breast cancer treated with neoadjuvant chemotherapy followed by breast-conserving therapy. J Gynecol Obstet Hum Reprod 2019; 48:467-472. [DOI: 10.1016/j.jogoh.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
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7
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Kosik I, Brackstone M, Kornecki A, Chamson-Reig A, Wong P, Araghi MH, Carson JJL. Intraoperative photoacoustic screening of breast cancer: a new perspective on malignancy visualization and surgical guidance. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-12. [PMID: 31111698 PMCID: PMC6993064 DOI: 10.1117/1.jbo.24.5.056002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 04/23/2019] [Indexed: 05/07/2023]
Abstract
High re-excision rates in breast-conserving surgery call for a new intraoperative approach to the lumpectomy margin evaluation problem. The unique intraoperative imaging system, presented here, demonstrated the capability of photoacoustic tomography (PAT) to deliver optical sensitivity and specificity, along with over 2-cm imaging depth, in a clinical setting. The system enabled the evaluation of tumor extent, shape, morphology, and position within lumpectomy specimens measuring up to 11 cm in diameter. The investigation included all major breast cancer-related lesions, such as invasive ductal carcinoma (IDC), multifocal IDC, ductal carcinoma in situ and combinations of these variants. Coregistration with established ultrasound (US) technology, as well as comparison to specimen radiography, validated the performance of PAT, which appeared to facilitate better tumor visualization. Contrary to expected PA contrast mechanisms, PAT images of hemoglobin distribution correlated poorly with US-determined tumor location, while hypointense regions in lipid-weighted PAT images were in better agreement with US.
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MESH Headings
- Aged
- Aged, 80 and over
- Algorithms
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Diagnosis, Computer-Assisted/methods
- Female
- Hemoglobins/analysis
- Humans
- Image Processing, Computer-Assisted
- Lipids/chemistry
- Margins of Excision
- Mastectomy, Segmental/methods
- Middle Aged
- Monitoring, Intraoperative
- Phantoms, Imaging
- Photoacoustic Techniques/methods
- Ultrasonography/methods
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Affiliation(s)
- Ivan Kosik
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
- Address all correspondence to Ivan Kosik, E-mail:
| | - Muriel Brackstone
- Schulich School of Medicine and Dentistry, Department of Oncology, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Surgery, London, Ontario, Canada
| | - Anat Kornecki
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medical Imaging, London, Ontario, Canada
| | | | - Philip Wong
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
| | | | - Jeffrey J. L. Carson
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medical Biophysics, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Surgery, London, Ontario, Canada
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8
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Tomeh MA, Hadianamrei R, Zhao X. A Review of Curcumin and Its Derivatives as Anticancer Agents. Int J Mol Sci 2019; 20:E1033. [PMID: 30818786 PMCID: PMC6429287 DOI: 10.3390/ijms20051033] [Citation(s) in RCA: 461] [Impact Index Per Article: 92.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 02/16/2019] [Accepted: 02/21/2019] [Indexed: 12/30/2022] Open
Abstract
Cancer is the second leading cause of death in the world and one of the major public health problems. Despite the great advances in cancer therapy, the incidence and mortality rates of cancer remain high. Therefore, the quest for more efficient and less toxic cancer treatment strategies is still at the forefront of current research. Curcumin, the active ingredient of the Curcuma longa plant, has received great attention over the past two decades as an antioxidant, anti-inflammatory, and anticancer agent. In this review, a summary of the medicinal chemistry and pharmacology of curcumin and its derivatives in regard to anticancer activity, their main mechanisms of action, and cellular targets has been provided based on the literature data from the experimental and clinical evaluation of curcumin in cancer cell lines, animal models, and human subjects. In addition, the recent advances in the drug delivery systems for curcumin delivery to cancer cells have been highlighted.
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Affiliation(s)
- Mhd Anas Tomeh
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK.
| | - Roja Hadianamrei
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK.
| | - Xiubo Zhao
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK.
- School of Pharmaceutical Engineering and Life Science, Changzhou University, Changzhou 213164, China.
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9
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Utilization of iron (III)-doped nanoshells for in vivo marking of nonpalpable tumors using a VX2 rabbit model. Am J Surg 2016; 212:1140-1146. [PMID: 27776757 DOI: 10.1016/j.amjsurg.2016.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 09/09/2016] [Accepted: 09/10/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND We aimed to evaluate the potential for ultrasound (US) visible biodegradable nanoshells (NS) as an alternative to wire-guided localization for nonpalpable tumors in vivo. METHODS VX2 tumor was injected in bilateral thighs of 22 New Zealand rabbits and after 5 to 10 days, 1 tumor was marked with a wire as a control and the contralateral tumor was injected with 1 mL of 500 nm gas-filled silica NS under Doppler US. Tumors were excised after 24 hours. Chi-square was used for significance, P = .05. RESULTS One rabbit was excluded on postoperative day 1 due to equipment failure, no ill effects were observed from the NS. The NS were used to localize and resect 100% of marked tissue, 4/21 wires were displaced (P < .05). CONCLUSIONS We have shown that preoperatively injected US visible silica NS can be successfully used to mark nonpalpable tumors in vivo more consistently than WL.
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10
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Escribà JM, Esteban L, Gálvez J, Pla MJ, Melià A, Gil-Gil M, Clèries R, Pareja L, Sanz X, Bustins M, Borrás JM, Ribes J. Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study. Clin Transl Oncol 2016; 19:448-456. [PMID: 27624712 DOI: 10.1007/s12094-016-1546-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/27/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics. METHODS Women with invasive incident breast cancer identified from the Patient's Hospital Discharge Database [174.0-174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery. RESULTS Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months' follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women. CONCLUSIONS Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months' follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies.
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Affiliation(s)
- J M Escribà
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain.
- Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain.
| | - L Esteban
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - J Gálvez
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M J Pla
- Breast Cancer Functional Unit, Catalan Institute of Oncology, L' Hospitalet de Llobregat, Barcelona, Spain
| | - A Melià
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Gil-Gil
- Breast Cancer Functional Unit, Catalan Institute of Oncology, L' Hospitalet de Llobregat, Barcelona, Spain
| | - R Clèries
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain
| | - L Pareja
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - X Sanz
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Bustins
- Divisió d'Anàlisi de la Demanda i l'Activitat, Department of Health, Generalitat de Catalunya, Catalan Health Service, Barcelona, Spain
| | - J M Borrás
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain
| | - J Ribes
- Catalan Cancer Registry, Cancer Planning Directorate, Av. Gran Vía 199-203, L' Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L' Hospitalet de Llobregat, Barcelona, Spain
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11
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De La Cruz L, Blankenship SA, Chatterjee A, Geha R, Nocera N, Czerniecki BJ, Tchou J, Fisher CS. Outcomes After Oncoplastic Breast-Conserving Surgery in Breast Cancer Patients: A Systematic Literature Review. Ann Surg Oncol 2016; 23:3247-58. [DOI: 10.1245/s10434-016-5313-1] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Indexed: 11/18/2022]
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12
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Moschetta M, Telegrafo M, Introna T, Coi L, Rella L, Ranieri V, Cirili A, Stabile Ianora AA, Angelelli G. Role of specimen US for predicting resection margin status in breast conserving therapy. G Chir 2016; 36:201-4. [PMID: 26712255 DOI: 10.11138/gchir/2015.36.5.201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess the diagnostic accuracy of specimen ultrasound (US) for predicting resection margin status in women undergoing breast conserving therapy for US-detected cancer, having the histological findings as the reference standard. PATIENTS AND METHODS A total of 132 consecutive patients (age range, 34-87 years; mean, 51 years) underwent breast-conserving surgery for US-detected invasive breast cancer. All surgical specimens underwent US examination. The presence of lesion within the specimen and its distance from the specimen margins were assessed considering a threshold distance between the lesion and specimen margins of 10 mm. US findings were then compared with the pathological ones and specimen US. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) for predicting histological margin status were evaluated, having the histological findings as the reference standard. RESULTS The histological examination detected invasive ductal carcinoma in 96/132 (73%) cases, invasive lobular carcinoma in 32/132 (24%), mucinous carcinoma in 4/132 (3%). The pathological margin analysis revealed 96/132 (73%) negative margins and 36 (27%) close/positive margins. US examination detected all 132 breast lesions within the surgical specimens. 110 (83%) negative margins and 22 (17%) positive margins were found on US. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 44%, 94%, 80%, 73% and 82%, respectively, were found for specimen US. CONCLUSIONS Specimen US represents a time and cost saving imaging tool for evaluating the presence of US detected-breast lesion within surgical specimen and for predicting the histological margin status.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/surgery
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/epidemiology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/surgery
- Female
- Humans
- Italy/epidemiology
- Mastectomy, Segmental/methods
- Middle Aged
- Predictive Value of Tests
- Sensitivity and Specificity
- Treatment Outcome
- Ultrasonography
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13
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Navigated Breast Tumor Excision Using Electromagnetically Tracked Ultrasound and Surgical Instruments. IEEE Trans Biomed Eng 2016; 63:600-6. [DOI: 10.1109/tbme.2015.2466591] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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14
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A Comparative Retrospective Analysis of Complications After Oncoplastic Breast Reduction and Breast Reduction for Benign Macromastia. Ann Plast Surg 2015; 75:370-5. [DOI: 10.1097/sap.0000000000000159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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South FA, Chaney EJ, Marjanovic M, Adie SG, Boppart SA. Differentiation of ex vivo human breast tissue using polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2014; 5:3417-26. [PMID: 25360360 PMCID: PMC4206312 DOI: 10.1364/boe.5.003417] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/23/2014] [Accepted: 08/27/2014] [Indexed: 05/03/2023]
Abstract
Successful treatment of breast cancer typically requires surgical removal of the tumor. Optical coherence tomography (OCT) has been previously developed for real-time imaging of the surgical margin. However, it can be difficult to distinguish between normal stromal tissue and cancer tissue based on scattering intensity and structure alone. Polarization-sensitive optical coherence tomography (PS-OCT) is sensitive to form birefringence of biological tissue. We report on the development of a high-speed PS-OCT system and imaging of ex vivo human breast tissue, showing enhanced contrast between healthy and cancerous tissues based upon collagen content confirmed with corresponding histology. These results demonstrate the feasibility of using PS-OCT to supplement structural OCT as a possible method for intraoperative tumor margin evaluation.
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Affiliation(s)
- Fredrick A. South
- Beckman Institute for Advanced Science and Technology, 405 N Mathews Avenue, Urbana, IL 61801, USA
- Department of Electrical and Computer Engineering, 306 N Wright Street, Urbana, IL 61801, USA
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, 405 N Mathews Avenue, Urbana, IL 61801, USA
| | - Marina Marjanovic
- Beckman Institute for Advanced Science and Technology, 405 N Mathews Avenue, Urbana, IL 61801, USA
| | - Steven G. Adie
- Beckman Institute for Advanced Science and Technology, 405 N Mathews Avenue, Urbana, IL 61801, USA
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, 405 N Mathews Avenue, Urbana, IL 61801, USA
- Department of Electrical and Computer Engineering, 306 N Wright Street, Urbana, IL 61801, USA
- Department of Bioengineering, 1304 W Springfield Avenue, Urbana, IL 61801, USA
- Department of Internal Medicine, 506 S Mathews Avenue, Urbana, IL 61801, USA
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