Mastectomy Research Today is a free monthly online journal that collates and summarizes the latest research about Mastectomy, including details on breast cancer, prosthesis, recovery, surgery, complications.

Young age is not associated with increased local recurrence for DCIS treated by breast-conserving surgery and radiation.

Turaka A, Freedman GM, Li T, Anderson PR, Swaby R, Nicolaou N, Goldstein L, Sigurdson ER, Bleicher RJ

Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.

BACKGROUND: We report local recurrence (LR) after breast-conserving surgery and radiation (BCS + RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged <or=40 years compared with older women. METHODS: The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical, and adjuvant treatments were analyzed for an effect on LR. RESULTS: Median age was 56.5 years with 24 patients aged <or=40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged <or=40. Tamoxifen was used in 22%, but only one patient aged <or=40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4-11%) at 10 years and 8% (5-14%) at 15 years. There was no difference in LR by age (P = 0.76). CONCLUSIONS: The long-term risk of LR after BCS + RT for DCIS is low, even in patients <or=40 years. This may be due to patient selection for small size, high utilization of re-excision, and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.

Published 18 June 2009 in J Surg Oncol, 100(1): 25-31.
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Articles on Mastectomy published 5 June 2009:

The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer.   Am J Surg, 197(6): 740-6.

BACKGROUND: The study's aim was to identify technical factors that are predictive of negative margins after breast-conserving surgery (BCS). METHODS: This was a retrospective, cohort study of patients who underwent BCS for early-stage cancer from 2000 to 2002. Pathological and specific surgical factors were compared with margin status. Univariate and multivariate regression analyses were performed. RESULTS: Four hundred eighty-nine cases were reviewed. The positive margin rate after the initial ... [Abstract] [Full-text]

Articles on Mastectomy published 1 June 2009:

Nipple-sparing mastectomy.   Plast Reconstr Surg, 123(6): 1665-73.

BACKGROUND: The debate over nipple-sparing mastectomy continues to evolve. Over the past several years, it has become more widely accepted, especially in the setting of prophylactic mastectomy, but its role in the treatment of breast cancer has only recently been reexamined. METHODS: Two indications for the procedure are discussed: prophylactic, for the high-risk patient; and the more controversial topic, therapeutic nipple-sparing mastectomy, for the patient with breast cancer. A review of the ... [Abstract] [Full-text]

The dynamic tumor bed: volumetric changes in the lumpectomy cavity during breast-conserving therapy.   Int J Radiat Oncol Biol Phys, 74(3): 695-701.

PURPOSE: To characterize the magnitude of volume change in the postoperative tumor bed before and during radiotherapy, and to identify any factors associated with large volumetric change. METHODS AND MATERIALS: Thirty-six consecutive patients with early-stage or preinvasive breast cancer underwent breast-conserving therapy at our institution between June 2006 and October 2007. Computed tomography (CT) scans of the breast were obtained shortly after surgery, before the start of radiotherapy (RT) ... [Abstract] [Full-text]

Articles on Mastectomy published 29 May 2009:

Radiotherapy and adjuvant trastuzumab in operable breast cancer: tolerability and adverse event data from the NCCTG Phase III Trial N9831.   J Clin Oncol, 27(16): 2638-44.

PURPOSE: To assess whether trastuzumab (H) with radiotherapy (RT) increases adverse events (AEs) after breast-conserving surgery or mastectomy. PATIENTS AND METHODS: Patients with early-stage resected human epidermal growth factor receptor 2 (HER-2) -positive breast cancer (BC) were randomly assigned to doxorubicin (A) and cyclophosphamide (C), followed by weekly paclitaxel (T; AC-T-H or AC-TH-H). RT criteria (with or without nodal RT) were postlumpectomy breast or (optional) postmastectomy ... [Abstract] [Full-text]

Articles on Mastectomy published 25 May 2009:

Unavoidable mastectomy for ipsilateral breast tumour recurrence after conservative surgery: patient outcome.   Ann Oncol, 20(6): 1008-12.

BACKGROUND: In the case of ipsilateral breast tumour recurrence (IBTR) after breast-conserving surgery (BCS), a second conservative surgical approach maybe considered in some motivated patients whereas in others mastectomy is unavoidable. PATIENTS AND METHODS: From 1997 to 2004, 282 patients presented at the European Institute of Oncology with an operable invasive IBTR after BCS. One hundred and sixty-one (57%) underwent a second conservative surgery, whereas 121 patients (43%) were given a ... [Abstract] [Full-text]

Articles on Mastectomy published 19 May 2009:

Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five national surgical adjuvant breast and bowel project protocols of node-negative breast cancer.   J Clin Oncol, 27(15): 2466-73.

PURPOSE: Locoregional failure (LRF) after breast-conserving therapy (BCT) is associated with increased risk of distant disease and death. The magnitude of this risk has not been adequately characterized in patients with lymph node-negative disease. PATIENTS AND METHODS: Our study population included 3,799 women randomly assigned to five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative disease (ie, B-13, B-14, B-19, B-20, and B-23) who underwent lumpectomy and whole ... [Abstract] [Full-text]

Articles on Mastectomy published 11 May 2009:

Quality of life after breast cancer surgery: What have we learned and where should we go next?   J Surg Oncol, 99(7): 447-55.

Treatment options for women with newly diagnosed breast cancer include breast conservation therapy and mastectomy with or without reconstruction, which provide equivalent cancer outcomes in properly selected patients. Although multiple studies have evaluated breast surgery quality-of-life outcomes, the data are inconsistent. This factor is important to consider when counseling patients and defining surgical quality measures. [Abstract] [Full-text]

Articles on Mastectomy published 5 May 2009:

Diagnostic breast magnetic resonance imaging and contralateral prophylactic mastectomy.   Ann Surg Oncol, 16(6): 1597-605.

BACKGROUND: Preoperative use of breast magnetic resonance imaging (MRI) in women with breast cancer may increase rates of mastectomy. This study investigated relationships between breast MRI and therapeutic and contralateral prophylactic mastectomy (CPM) in women with breast cancer. METHODS: A total of 3606 women diagnosed with stage 0-III breast cancer from 1998 through 2000 (n = 1743; early period) or from 2003 through 2005 (n = 1863; late period) were retrospectively identified. Patient ... [Abstract] [Full-text]

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