Conservative surgery and radiation therapy for macroscopically multiple ipsilateral invasive breast cancers

Cho, L. Chinsoo; Senzer, Neil; Peters, G.

doi:10.1016/s0002-9610(02)00864-4

Cited by 45 publications

(43 citation statements)

References 20 publications

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“…The 24 studies had retrospective observational designs, comprising 17 comparative studies20, 21, 22, 23 27, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43 and seven case series28 44, 45, 46, 47, 48, 49 ( Table 1; Table S1, supporting information). The studies included a total of 3537 women with MIBC undergoing BCS: 2677 with tumours defined as MF, 292 as MC, and 568 not defined as either MF or MC, but reported as MIBC.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies20 21, 27 28, 32 34, 35, 36, 37 40, 41, 42 44, 46, 47, 48, 49 were from single centres, four33 38, 39 45 involved two centres, and there were three multicentre studies22 23, 43 comprising a regional cancer registry (British Columbia Cancer Agency)43, a German regional study group (BRENDA Study Group: Breast Cancer Care under Evidence‐based Guidelines)23 and a substudy within three multicentre RCTs of neoadjuvant chemotherapy (German Breast Group (Gepar) trials)22 ( Table 1; Table S1, supporting information).…”

Section: Resultsmentioning

confidence: 99%

“…35–169) in comparative studies and 22 (14–43) in case series. Diagnostic methods for evaluating MIBC were recorded in six of the seven case series44, 45, 46, 47, 48, 49 and nine27 32, 33 35, 36, 37, 38, 39, 40 of the 17 comparative studies. In these 15 studies, 258 of 592 patients (43·6 per cent) were diagnosed by postoperative pathology and 294 (49·7 per cent) before surgery: clinical examination (129, 21·8 per cent), radiology (103, 17·4 per cent) or undefined methods (62, 10·5 per cent).…”

Section: Resultsmentioning

confidence: 99%

“…Another six studies21 28, 39 44, 46 47 used the feasibility of BCS to define eligibility. The remaining studies included: macroscopically separate tumours33 35, 45, synchronous ipsilateral breast cancers on gross pathological review over and above microscopy38, patients with DCIS undergoing BCS41 and recruitment within the Gepar trials22.…”

Section: Resultsmentioning

confidence: 99%

“…Definitions of MF or MC tumours were described in 2120, 21, 22, 23 27, 28 32, 34 35, 37 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 of 24 studies. Eleven studies assessed MIBC as a single group33 36, 37, 38, 39, 40 42, 43, 44, 45 47, and 1320, 21, 22, 23 27, 28 32, 34 35, 41 46, 48 49 evaluated BCS in MF and MC cancers separately ( Table 1; Table S3, supporting information).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Systematic review of the impact of breast‐conserving surgery on cancer outcomes of multiple ipsilateral breast cancers

Winters¹,

Horsnell

Elvers

et al. 2018

BJS Open

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BackgroundThe clinical effectiveness of treating ipsilateral multifocal (MF) and multicentric (MC) breast cancers using breast‐conserving surgery (BCS) compared with the standard of mastectomy is uncertain. Inconsistencies relate to definitions, incidence, staging and intertumoral heterogeneity. The primary aim of this systematic review was to compare clinical outcomes after BCS versus mastectomy for MF and MC cancers, collectively defined as multiple ipsilateral breast cancers (MIBC).MethodsComprehensive electronic searches were undertaken to identify complete papers published in English between May 1988 and July 2015, primarily comparing clinical outcomes of BCS and mastectomy for MIBC. All study designs were included, and studies were appraised critically using the Newcastle–Ottawa Scale. The characteristics and results of identified studies were summarized.ResultsTwenty‐four retrospective studies were included in the review: 17 comparative studies and seven case series. They included 3537 women with MIBC undergoing BCS; breast cancers were defined as MF in 2677 women, MC in 292, and reported as MIBC in 568. Six studies evaluated MIBC treated by BCS or mastectomy, with locoregional recurrence (LRR) rates of 2–23 per cent after BCS at median follow‐up of 59·5 (i.q.r. 56–81) months. BCS and mastectomy showed apparently equivalent rates of LRR (risk ratio 0·94, 95 per cent c.i. 0·65 to 1·36). Thirteen studies compared BCS in women with MIBC versus those with unifocal cancers, reporting LRR rates of 2–40 per cent after BCS at a median follow‐up of 64 (i.q.r. 57–73) months. One high‐quality study reported 10‐year actuarial LRR rates of 5·5 per cent for BCS in 300 women versus 6·5 per cent for mastectomy among 887 women.ConclusionThe available studies were mainly of moderate quality, historical and underpowered, with limited follow‐up and biased case selection favouring BCS rather than mastectomy for low‐risk patients. The evidence was inconclusive, weakening support for the St Gallen consensus and supporting a future randomized trial.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review of the impact of breast‐conserving surgery on cancer outcomes of multiple ipsilateral breast cancers

Winters¹,

Horsnell

Elvers

et al. 2018

BJS Open

View full text Add to dashboard Cite

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Breast cancer—The catalyst of contemporary trials design

Al‐Hilli

Weiss

Armani

et al. 2021

Journal of Surgical Oncology

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Surgical trials in breast cancer have catalyzed contemporary trial design for solid organ cancers and are a prime example of surgeons taking the lead in clinical trial design. Surgeons have lead trials that have improved patient outcomes and quality of life without sacrificing oncologic safety. We have evolved from radical mastectomy to breast conservation and sentinel node biopsy. Contemporary trial design in breast cancer now focus on personalizing care based on tumor genomics

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