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[PMID]:29391091
[Au] Autor:Vora H; Kim S; Amersi F; Giuliano A; Chung A
[Ad] Endereço:Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
[Ti] Título:Lobular Carcinoma : A 15-Year Single Institution Review.
[So] Source:Am Surg;83(10):1040-1044, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The optimal management of lobular carcinoma In Situ (LCIS) has largely been debated. This study evaluated practice patterns and outcomes in women diagnosed with LCIS at a single institution from 2000 to 2014. Patient characteristics, histology, method of diagnosis, and management were examined in relation to disease-free survival, and overall survival (OS). A total of 209 patients were identified. Surgical management in the majority of patients was excisional biopsy or local excision. Patients diagnosed with LCIS by core biopsy were less likely to have mastectomy as compared with other methods of initial diagnosis (P = 0.01). A total of 108 (90.8%) patients received chemoprevention (CP) counseling, and 47 (43.5%) used chemoprevention. Estimated five-year disease-free survival rate was 96.3 per cent (95% confidence interval (CI): 92.0-98.3%) and OS rate was 98.6 per cent (95% CI: 94.6-99.7%). Older age was associated with a higher risk of subsequent breast cancer (hazard ratio (HR): 1.04; 95% CI: 1.01-1.07; P = 0.01). Older age (HR: 1.06; 95% CI: 1.02-1.11; P = 0.004) and diagnosis in the earlier years of the study period (HR: 0.65; 95% CI: 0.48-0.89; P = 0.007) were significantly associated with worse OS in multivariate analysis. LCIS has a favorable prognosis and is most commonly managed conservatively.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/diagnóstico
Carcinoma de Mama in situ/terapia
Neoplasias da Mama/diagnóstico
Neoplasias da Mama/terapia
Carcinoma Lobular/diagnóstico
Carcinoma Lobular/terapia
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Antineoplásicos/uso terapêutico
Carcinoma de Mama in situ/mortalidade
Carcinoma de Mama in situ/patologia
Neoplasias da Mama/mortalidade
Neoplasias da Mama/patologia
Carcinoma Lobular/mortalidade
Carcinoma Lobular/patologia
Quimioprevenção
Terapia Combinada
Tratamento Conservador
Feminino
Seguimentos
Seres Humanos
Modelos Logísticos
Mastectomia
Meia-Idade
Prognóstico
Estudos Retrospectivos
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:28795842
[Au] Autor:Ambaye AB; Goodwin AJ; MacLennan SE; Naud S; Weaver DL
[Ad] Endereço:From the Departments of Pathology and Laboratory Medicine (Drs Ambaye, Goodwin, and Weaver) and Surgery (Dr MacLennan), University of Vermont Medical Center, Burlington; and the Department of Medical Biostatistics, University of Vermont, Burlington (Dr Naud).
[Ti] Título:Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic Tissue Sampling.
[So] Source:Arch Pathol Lab Med;141(11):1523-1528, 2017 Nov.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Breast reduction mammaplasty (RMP) for symptomatic macromastia or correction of asymmetry is performed in more than 100 000 patients per year in the United States. The reported incidence of significant pathologic findings (SPF), that is, carcinoma and atypical hyperplasia, ranges from 0.06% to 12.8%. No standard pathology assessment for RMP exists. OBJECTIVES: - To propose standard sampling for microscopic evaluation in RMP specimens, to evaluate the incidence of occult carcinoma and atypical hyperplasia, and to identify clinical risk factors for SPF in patients undergoing RMP. DESIGN: - All RMP specimens from 2006 to 2013 at a single institution were prospectively examined. After baseline gross and microscopic evaluations, each specimen was subjected to systematic additional sampling. The incidence of SPF was tabulated, and variables such as age, specimen weight, previous history of SPF, and results of preoperative mammogram were examined. Clinical follow-up review was also subsequently undertaken. RESULTS: - A total of 595 patients were evaluated. Significant pathologic findings were present in 9.8% (58 of 595) of patients. No cancer was identified in patients younger than 40 years; the rates of carcinoma were 2.4% (14 of 595) in all patients, 3.6% (14 of 392) in patients aged 40 years or older, and 4.3% (10 of 233) in patients aged 50 years or older. No carcinoma or atypical hyperplasia was identified on preoperative mammogram. Increased sampling was associated with a significantly greater frequency of SPF only in patients aged 40 years or older. CONCLUSIONS: - In patients younger than 35 years, gross-only evaluation is sufficient. However, increased sampling may be necessary in patients older than 40 years.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico
Mama/anormalidades
Mama/patologia
Detecção Precoce de Câncer/métodos
Hipertrofia/cirurgia
Mamoplastia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Mama/crescimento & desenvolvimento
Mama/cirurgia
Carcinoma de Mama in situ/complicações
Carcinoma de Mama in situ/diagnóstico
Carcinoma de Mama in situ/epidemiologia
Carcinoma de Mama in situ/patologia
Neoplasias da Mama/complicações
Neoplasias da Mama/epidemiologia
Neoplasias da Mama/patologia
Carcinoma Intraductal não Infiltrante/complicações
Carcinoma Intraductal não Infiltrante/diagnóstico
Carcinoma Intraductal não Infiltrante/epidemiologia
Carcinoma Intraductal não Infiltrante/patologia
Feminino
Seguimentos
Seres Humanos
Hiperplasia
Hipertrofia/complicações
Incidência
Meia-Idade
Guias de Prática Clínica como Assunto
Prevalência
Estudos Prospectivos
Fatores de Risco
Vermont/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0492-OA


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[PMID]:28702778
[Au] Autor:Polónia A; Oliveira G; Schmitt F
[Ad] Endereço:Department of Pathology, Ipatimup Diagnostics, Ipatimup-Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
[Ti] Título:Characterization of HER2 gene amplification heterogeneity in invasive and in situ breast cancer using bright-field in situ hybridization.
[So] Source:Virchows Arch;471(5):589-598, 2017 Nov.
[Is] ISSN:1432-2307
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The aims of this study were to evaluate and compare the HER2 gene amplification status in invasive and adjacent in situ breast carcinoma, using bright-field in situ hybridization, and to document the possible presence of HER2 genetic heterogeneity (HER2-GH) in both components. A cohort of 100 primary invasive carcinomas (IC) associated with carcinoma in situ (CIS) were evaluated for HER2 gene amplification by SISH according to the 2013 ASCO/CAP HER2 guideline. A second cohort of all the cases with HER2-GH since the introduction of the updated ASCO/CAP HER2 guideline was also characterized, and an evaluation of the HER2 gene amplification in the CIS component, if present, was also done. In the first cohort, the HER2 amplification in the IC was negative in 87% of the cases and positive in 13% of the cases, without the presence of HER2-GH. All the cases had an associated CIS with the same HER2 status as IC, with four cases of CIS presenting HER2-GH. In the CIS, we observed a significant relationship of HER2 gene amplification with high nuclear grade. In the four cases with HER2-GH in CIS, two cases presented HER2 gene amplification in the IC. The second cohort included 12 cases with HER2-GH in a total of 1243 IC cases (0.97%). Additionally, we identified two cases associated with non-amplified CIS. HER2-GH is a rare event in IC and can already be present in CIS, not being an important step in the acquisition of invasive features.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/genética
Neoplasias da Mama/genética
Carcinoma Intraductal não Infiltrante/genética
Hibridização In Situ/métodos
Receptor ErbB-2/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Carcinoma de Mama in situ/patologia
Neoplasias da Mama/patologia
Carcinoma Intraductal não Infiltrante/patologia
Feminino
Amplificação de Genes
Seres Humanos
Meia-Idade
Receptor ErbB-2/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1007/s00428-017-2189-9


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[PMID]:28646773
[Au] Autor:Xie ZM; Sun J; Hu ZY; Wu YP; Liu P; Tang J; Xiao XS; Wei WD; Wang X; Xie XM; Yang MT
[Ad] Endereço:Department of Breast Oncology, Sun Yat-Sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, 510060, PR China.
[Ti] Título:Survival outcomes of patients with lobular carcinoma in situ who underwent bilateral mastectomy or partial mastectomy.
[So] Source:Eur J Cancer;82:6-15, 2017 Sep.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To compare the survival outcomes between patients treated with bilateral mastectomy and partial mastectomy alone as the initial surgical management for primary lobular carcinoma in situ (LCIS). PATIENTS AND METHODS: Patients with histologically confirmed LCIS underwent partial mastectomy alone or bilateral mastectomy were identified by the SEER*Stat database (version 8.3.2) released in 2016. The primary outcome measure was all-cause mortality and the secondary outcome measure was breast cancer-specific mortality. RESULTS: Of the 5964 cases included in the analysis, 208 cases underwent bilateral mastectomy and 5756 cases underwent partial mastectomy alone. The 1-, 5- and 10-year estimated overall survival rates were 99.7%, 96.7% and 91.7%, respectively. Univariate and multivariate proportional hazards regression (Cox) analyses showed no significant difference between the risk of all-cause mortality in the bilateral mastectomy group compared with the partial mastectomy group (HR = 1.106, 95% confidence interval [CI] 0.350-3.500, P = 0.86). In propensity score-matched model, bilateral mastectomy still did not show benefit to overall mortality (HR = 2.248, 95% CI 0.451-11.200). Patients older than 60 years of age showed a higher risk of all-cause mortality (HR = 7.593, 95% CI 5.357-10.764, P < 0.0001). No risk factors, including surgery type, were identified for breast cancer-specific survival. CONCLUSIONS: Survival outcomes of patients with LCIS who underwent partial mastectomy without radiotherapy were not inferior to patients who underwent bilateral prophylactic mastectomy. Breast cancer-specific mortality in patients with LCIS was extremely low; aggressive prophylactic surgery like bilateral prophylactic mastectomy should not be advocated for most patients with LCIS.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/cirurgia
Neoplasias da Mama/cirurgia
Carcinoma Lobular/cirurgia
Mastectomia/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Mama in situ/mortalidade
Neoplasias da Mama/mortalidade
Carcinoma Lobular/mortalidade
Feminino
Seguimentos
Seres Humanos
Mastectomia/mortalidade
Meia-Idade
Análise de Regressão
Fatores de Risco
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE


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[PMID]:28586960
[Au] Autor:Rahimi A; Thomas K; Spangler A; Rao R; Leitch M; Wooldridge R; Rivers A; Seiler S; Albuquerque K; Stevenson S; Goudreau S; Garwood D; Haley B; Euhus D; Heinzerling J; Ding C; Gao A; Ahn C; Timmerman R
[Ad] Endereço:University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: asal.rahimi@utsouthwestern.edu.
[Ti] Título:Preliminary Results of a Phase 1 Dose-Escalation Trial for Early-Stage Breast Cancer Using 5-Fraction Stereotactic Body Radiation Therapy for Partial-Breast Irradiation.
[So] Source:Int J Radiat Oncol Biol Phys;98(1):196-205.e2, 2017 May 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the tolerability of a dose-escalated 5-fraction stereotactic body radiation therapy for partial-breast irradiation (S-PBI) in treating early-stage breast cancer after partial mastectomy; the primary objective was to escalate dose utilizing a robotic stereotactic radiation system treating the lumpectomy cavity without exceeding the maximum tolerated dose. METHODS AND MATERIALS: Eligible patients included those with ductal carcinoma in situ or invasive nonlobular epithelial histologies and stage 0, I, or II, with tumor size <3 cm. Patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Starting dose was 30 Gy in 5 fractions and was escalated by 2.5 Gy total for each cohort to 40 Gy. RESULTS: In all, 75 patients were enrolled, with a median age of 62 years. Median follow-up for 5 cohorts was 49.9, 42.5, 25.7, 20.3, and 13.5 months, respectively. Only 3 grade 3 toxicities were experienced. There was 1 dose-limiting toxicity in the overall cohort. Ten patients experienced palpable fat necrosis (4 of which were symptomatic). Physicians scored cosmesis as excellent or good in 95.9%, 100%, 96.7%, and 100% at baseline and 6, 12, and 24 months after S-PBI, whereas patients scored the same periods as 86.5%, 97.1%, 95.1%, and 95.3%, respectively. The disagreement rates between MDs and patients during those periods were 9.4%, 2.9%, 1.6%, and 4.7%, respectively. There have been no recurrences or distant metastases. CONCLUSION: Dose was escalated to the target dose of 40 Gy in 5 fractions, with the occurrence of only 1 dose-limiting toxicity. Patients felt cosmetic results improved within the first year after surgery and stereotactic body radiation therapy. Our results show minimal toxicity with excellent cosmesis; however, further follow-up is warranted in future studies. This study is the first to show the safety, tolerability, feasibility, and cosmesis results of a 5-fraction dose-escalated S-PBI treatment for early-stage breast cancer in the adjuvant setting.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/radioterapia
Neoplasias da Mama/radioterapia
Carcinoma Ductal de Mama/radioterapia
Tolerância a Radiação
Radiocirurgia/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Mama in situ/diagnóstico por imagem
Carcinoma de Mama in situ/patologia
Carcinoma de Mama in situ/cirurgia
Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/patologia
Neoplasias da Mama/cirurgia
Carcinoma Ductal de Mama/diagnóstico por imagem
Carcinoma Ductal de Mama/patologia
Carcinoma Ductal de Mama/cirurgia
Fracionamento de Dose
Estudos de Viabilidade
Feminino
Marcadores Fiduciais
Seres Humanos
Mastectomia Segmentar
Meia-Idade
Estudos Prospectivos
Radiocirurgia/efeitos adversos
Radioterapia Adjuvante/métodos
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE


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[PMID]:28541858
[Au] Autor:Jean-Louis CJ; Masdon J; Smith B; Battles O; Dale P
[Ti] Título:The Pathologic Finding of Combined Lobular Carcinoma and Invasive Lobular Cancer May Indicate more than Just a High-Risk Marker Role of Lobular Carcinoma .
[So] Source:Am Surg;83(5):482-485, 2017 May 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:For years, lobular carcinoma In Situ (LCIS) has been considered a high-risk marker for developing breast cancer. It is well known that ductal carcinoma In Situ is a precursor for the development of invasive ductal carcinoma, and ductal carcinoma In Situ is reported to be present in invasive ductal carcinoma in at least 40 per cent of cases. A similar relationship between LCIS and invasive lobular carcinoma (ILC) remains in question. This study evaluates the incidence of synchronous LCIS and ILC at our institution. This is a retrospective review of our tumor registry database of women diagnosed with LCIS or ILC from 2000 to 2014. Pathology reports were evaluated to determine the incidence of pure ILC and mixed ILC/LCIS. Those with both LCIS/ILC (mixed group) and those with pure ILC (pure group) were compared for age, surgical intervention, lymph node involvement, tumor size, nuclear grade, and margins between these two groups. A total of 182 women were identified with LCIS, ILC, or mixed LCIS and ILC. There were 76 subjects with pure ILC and 90 with mixed LCIS and ILC. The median and age range for each group were 63.6 (range: 40-97) for the mixed and 64.1 (range: 40-86) for pure groups. Tumor size was evaluated for each group and the median tumor size was 2.5 cm (range: 0.1-7.0cm) for the mixed group and 3.0 cm (range: 0.5-12.5 cm) for the pure group. Nodal involvement was present in 35.23 per cent of the mixed group and 46.3 per cent in the pure group. Surgical treatment for each group was similar, with mastectomy being the preferred surgical option over breast conservation therapy in the mixed and pure groups, 67.07 and 64.71 per cent, respectively. Presently, LCIS is considered a marker, or risk factor, for development of future breast cancer. This retrospective study does identify a strong relationship, 54 per cent, between LCIS and ILC at diagnosis. This high percentage of concurrent LCIS and ILC in surgical/pathological specimens supports the notion that LCIS may in fact have a precursory role in development of invasive lobular carcinoma of the breast. Additional studies to further investigate this relationship between LCIS and ILC, including genomic analysis, are presently underway.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/epidemiologia
Neoplasias da Mama/epidemiologia
Neoplasias da Mama/patologia
Carcinoma Lobular/epidemiologia
Neoplasias Primárias Múltiplas/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma de Mama in situ/patologia
Carcinoma de Mama in situ/terapia
Neoplasias da Mama/terapia
Carcinoma Lobular/patologia
Carcinoma Lobular/terapia
Feminino
Seres Humanos
Incidência
Mastectomia
Meia-Idade
Invasividade Neoplásica
Neoplasias Primárias Múltiplas/patologia
Neoplasias Primárias Múltiplas/terapia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE


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[PMID]:28475815
[Au] Autor:Park KU; Nathanson D
[Ad] Endereço:Department of Surgery, Henry Ford Hospital, Detroit, Michigan.
[Ti] Título:Translating the 2-dimensional mammogram into a 3-dimensional breast: Identifying factors that influence the movement of pre-operatively placed wire.
[So] Source:J Surg Oncol;116(2):208-212, 2017 Aug.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pre-operative measurements from the skin to a wire-localized breast lesion can differ from operating room measurements. This study was designed to measure the discrepancies and study factors that may contribute to wire movement. METHODS: Prospective data were collected on patients who underwent wire localization lumpectomy. Clip and hook location, breast size, density, and direction of wire placement were the main focus of the analysis. RESULTS: Wire movement was more likely with longer distance from skin to hook or clip, larger breast size (especially if "fatty"), longer time between wire placement and surgery start time, and medial wire placement in larger breast. Age, body mass index, presence of mass, malignant diagnosis, tumor grade, and clip distance to the chest wall were not associated with wire movement. A longer distance from skin to hook correlated with larger specimen volume. CONCLUSIONS: Translation of the lesion location from a 2-dimensional mammogram into 3-dimensional breasts is sometimes discrepant because of movement of the localizing wire. Breast size, distance of skin to clip or hook, and wire exit site in larger breasts have a significant impact on wire movement. This information may guide the surgeon's skin incision and extent of excision.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem
Mamografia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma de Mama in situ/diagnóstico por imagem
Carcinoma de Mama in situ/cirurgia
Neoplasias da Mama/cirurgia
Carcinoma Ductal de Mama/diagnóstico por imagem
Carcinoma Ductal de Mama/cirurgia
Carcinoma Lobular/diagnóstico por imagem
Carcinoma Lobular/cirurgia
Seres Humanos
Mastectomia Segmentar
Meia-Idade
Cuidados Pré-Operatórios
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170506
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24645


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[PMID]:28445590
[Au] Autor:Wallace AS; Tchatalbachev V; Nelson J; Wang Z; Dale P; Biedermann GB
[Ad] Endereço:University of Missouri School of Medicine, Columbia.
[Ti] Título:Long term radiographic findings of breast brachytherapy: Implications of surgical volume.
[So] Source:J Surg Oncol;116(2):203-207, 2017 Aug.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Little is known about long-term radiographic findings after treatment with accelerated partial breast irradiation (APBI). METHODS: Univariate and multivariate analysis of factors leading to formation and resolution of seroma were performed in patients treated with lumpectomy and APBI. RESULTS: Post-treatment images of 129 patients were reviewed by one radiologist. Median surgical excision volume was 108.9 cc (range 20.5-681.9). Primary mode of imaging was mammogram. Median time from end of RT to first and last surveillance image was 6 and 54 months, respectively. Median number of images was 7 (range 3-12). Seroma was identified in 98 (76%) patients, with median maximum diameter of 3.9 cm. Forty (41%) patients experienced resolution of seroma, at a median time of 29 months (range 6-74). On univariate analysis, surgical excision volume was associated with seroma formation, and tumor stage and margin re-excision were significant on univariate and multivariate analysis. No factors were associated with seroma resolution. CONCLUSION: Seroma formation after APBI resolves around 2.5 years for many patients, but persists for others possibly due to primary tumor and surgical excision volumes. With revised criteria on the definition of positive margins, smaller volumes may lead to decreased risk of seroma formation for future patients.
[Mh] Termos MeSH primário: Braquiterapia
Neoplasias da Mama/terapia
Mastectomia Segmentar
Seroma/diagnóstico por imagem
Seroma/etiologia
[Mh] Termos MeSH secundário: Braquiterapia/efeitos adversos
Carcinoma de Mama in situ/patologia
Carcinoma de Mama in situ/terapia
Neoplasias da Mama/patologia
Carcinoma Ductal de Mama/patologia
Carcinoma Ductal de Mama/terapia
Diagnóstico por Imagem/métodos
Feminino
Seres Humanos
Margens de Excisão
Meia-Idade
Análise Multivariada
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24646


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[PMID]:28401542
[Au] Autor:Dauplat J; Kwiatkowski F; Rouanet P; Delay E; Clough K; Verhaeghe JL; Raoust I; Houvenaeghel G; Lemasurier P; Thivat E; Pomel C; STIC-RMI working group
[Ad] Endereço:Centre Jean Perrin, Clermont Ferrand, France.
[Ti] Título:Quality of life after mastectomy with or without immediate breast reconstruction.
[So] Source:Br J Surg;104(9):1197-1206, 2017 Aug.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mastectomy with immediate breast reconstruction (IBR) is a surgical strategy in breast cancer when breast-conserving surgery is not an option. There is a lack of evidence showing an advantage of mastectomy plus IBR over mastectomy alone on health-related quality of life (QoL). METHODS: A large prospective multicentre survey, STIC-RMI (support of innovative and expensive techniques - immediate breast reconstruction), was undertaken to study the changes in QoL in patients treated by mastectomy with or without IBR. Patients were recruited between 2007 and 2009. European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 instruments were used to assess QoL before operation, and at 6 and 12 months after surgery. A propensity score was used to compare QoL between mastectomy alone and mastectomy plus IBR, with limited bias. RESULTS: A total of 595 patients were included from 22 French academic hospitals, of whom 407 (68·4 per cent) underwent IBR. One-year data were available for 71·1 per cent of patients. Factors associated with IBR were age, histological tumour type, palpable nodes and an attempt at breast-conserving surgery. At inclusion, QoL was significantly better in the IBR group (P < 0·001) and there was no significant change in either group during 1 year compared with baseline. Results for the QLQ-BR23 functional dimension varied according to propensity score quartiles; IBR had no influence in the lowest quartile. In the upper quartiles, QoL increased slightly over the year among patients who had IBR, whereas it decreased among those who had mastectomy alone (P = 0·037). Satisfaction with the cosmetic outcome strongly influenced QoL, especially in upper quartiles (P < 0·001). However, an unsatisfactory outcome after IBR was still considered a better condition than simple mastectomy. CONCLUSION: The QoL benefit provided by IBR depends on patients' life status at inclusion; young active women with an in situ tumour are more likely to preserve their QoL after IBR.
[Mh] Termos MeSH primário: Carcinoma de Mama in situ/cirurgia
Neoplasias da Mama/cirurgia
Carcinoma Ductal de Mama/cirurgia
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Assistência ao Convalescente
Idoso
Idoso de 80 Anos ou mais
Carcinoma de Mama in situ/psicologia
Neoplasias da Mama/psicologia
Estética
Feminino
Seres Humanos
Mamoplastia/métodos
Mamoplastia/psicologia
Mastectomia/métodos
Mastectomia/psicologia
Meia-Idade
Motivação
Satisfação do Paciente
Cuidados Pós-Operatórios
Pontuação de Propensão
Estudos Prospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10537


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[PMID]:28373294
[Au] Autor:Polónia A; Pinto R; Cameselle-Teijeiro JF; Schmitt FC; Paredes J
[Ad] Endereço:Epithelial Interactions in Cancer (EPIC), i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
[Ti] Título:Prognostic value of stromal tumour infiltrating lymphocytes and programmed cell death-ligand 1 expression in breast cancer.
[So] Source:J Clin Pathol;70(10):860-867, 2017 Oct.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: The present work aims to evaluate the presence of stromal tumour-infiltrating lymphocytes (TILs) and programmed cell death-ligand 1 (PDL1) expression in breast carcinomas and their correlation with available clinicopathological features. METHODS: Two independent series of invasive breast cancer (IBC), one including ductal carcinoma in situ (DCIS) pair-matched cases, were selected, and quantification of TILs was accomplished in each case. Immunohistochemistry was also performed to evaluate the expression of PDL1. RESULTS: In both cohorts evaluated, increased stromal TILs and PDL1 expression were present in about 10% of IBCs, being significantly associated with each other and both with grade 3 and triple-negative subtype. We observed a similar distribution of stromal TILs and PDL1 expression between DCIS and IBC. Finally, we observed that increased stromal TILs and PDL1 expression were significantly associated with cancer stem cell (CSC) markers, basal cell markers and vimentin expression. Interestingly, in IBC cases with vimentin expression, increased stromal TILs, as well as decreased PDL1 expression, disclosed a better clinical outcome, independently of the main classical BC prognostic factors. CONCLUSIONS: We have confirmed the association of stromal TILs and PDL1 expression with aggressive forms of BC and that both are already found in in situ stages. We also showed that stromal TILs and PDL1 expression are associated with clinical outcome in cases enriched for a mesenchymal immunophenotype. We describe for the first time a close relationship between CSC markers and PDL1 expression.
[Mh] Termos MeSH primário: Antígeno B7-H1/biossíntese
Carcinoma de Mama in situ/patologia
Neoplasias da Mama/patologia
Carcinoma Ductal de Mama/patologia
Linfócitos do Interstício Tumoral/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores Tumorais/análise
Carcinoma de Mama in situ/imunologia
Carcinoma de Mama in situ/mortalidade
Neoplasias da Mama/imunologia
Neoplasias da Mama/mortalidade
Carcinoma Ductal de Mama/imunologia
Carcinoma Ductal de Mama/mortalidade
Feminino
Seres Humanos
Imuno-Histoquímica
Estimativa de Kaplan-Meier
Meia-Idade
Células-Tronco Neoplásicas/patologia
Prognóstico
Modelos de Riscos Proporcionais
Análise Serial de Tecidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (B7-H1 Antigen); 0 (Biomarkers, Tumor); 0 (CD274 protein, human)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-203990



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