Does Tumor Marking Before Neoadjuvant Chemotherapy Helps Achieve Better Outcomes in Patients Undergoing Breast Conservative Surgery? A Systematic Review

Jha, Chandan Kumar; Johri, Goonj; Singh, Prashant Kumar; Yadav, Sanjay Kumar; Sinha, Upasna

doi:10.1007/s13193-021-01393-7

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…In a recent systematic review of pre-NAST tumor marking techniques, the authors use margin status as the primary outcome mesure in assessing the advantage of tumor marking [21]. Patients with pCR are even excluded from analyzes of margin status, in order to obtain the "adjusted unsatisfactory margin", since "patients with pCR cannot have an unsatisfactory margin".…”

Section: Discussionmentioning

confidence: 99%

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Non-Invasive Three-Dimensional Breast Tumor Positioning Before Neoadjuvant Systemic Therapy as Promissing Alternative to the Invasive Tumor Marking – Technique Description and Feasibility

Bjelica,

Colakovic,

Opric

et al. 2024

Preprint

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Background: Surgical excision of the lodge of the tumor that has completely clinically regressed after neoadjuvant systemic therapy (NAST) is a necessary part of the treatment of early breast cancer. However, it is significantly hampered by the lack of a spatial landmark concerning the location of the pre-existing tumor in the breast. Standard surgical techniques of targeted excision of the pre-existing tumor bed generally rely on invasive insertion of various markers into or around the tumor before starting NAST. Invasive marking techniques are burdened by the disadvantages of technical complexity, invasiveness of procedures, and insufficient precision. Methods: In this paper authors present an original technique of non-invasive determining of the tumor position in the breast in three dimensions before starting NAST, with intention to overcome the disadvantages of invasive tumor marking. Tumor positioning is performed by ultrasound measurements – detailed description of the technique is given in the main text. The feasibility and precision of the technique was tested by the histological parameters of the adequacy and rationality of excision of the tumor bed, after complete clinical regression of the tumor after NAST, on a pilot series of patients. Results: A pilot series of 33 patients underwent a non-invasive breast tumor positioning technique before starting NAST. Twelve patients with complete clinical regression after NAST have been operated using a non-invasive tumor positioning technique, so far. In all cases, histological signs of tumor regression were verified in the specimen of the excised tumor bed. The ratio of the resected specimen volume to the volume of the tumor before NAST was on average 0,91, which is in favor of the rationality of excision and a good aesthetic effect. Conclusion: The initial results of a pilot series of treated patients imply that a non-invasive three-dimensional tumor positioning technique is feasible, with a satisfactory level of oncological safety and aesthetic effects of surgery. Performing a randomised clinical trial comparing this technique with standard techniques of invasive tumor marking is justified.

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Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis reviewing published studies on different tumor marking techniques prior to NAST concludes: "There is limited evidence that tumor marking before neoadjuvant chemotherapy improves the rate of unsatisfactory margins or survival outcomes in a patient undergoing BCS after NAST" [21].…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Three-Dimensional Breast Tumor Positioning Before Neoadjuvant Systemic Therapy as Promissing Alternative to the Invasive Tumor Marking – Technique Description and Feasibility

Bjelica,

Colakovic,

Opric

et al. 2024

Preprint

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“…There is some evidence that tumor marking before neoadjuvant chemotherapy improves the rate of satisfactory margins in patients undergoing BCS after NAT [149]. To reduce the need for re-excision in the case of BCS after NAT, MarginProbe, associated with a lower re-excision rate, was tested [150].…”

Section: Margin Acceptability In the Case Of Neoadjuvant Treatmentmentioning

confidence: 99%

Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery

Bertozzi¹,

Londero²,

Nanez³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Objective: Breast-conserving surgery (BCS) experienced a significant surge during the last decades due to the increase of early breast cancer detection. Central to the discussion is margin adequacy which represents one of the most significant predictive factors for local relapse. This paper aims to shed light on the problem of margins in breast surgery. Mechanism: We performed a systematic narrative review of the literature by conducting a search using Medline/PubMed, Scopus, and Embase. The following keywords were considered: "breast-conserving surgery" AND "margins"/"margin". Findings in Brief: In the case of invasive breast cancer, "no ink on tumor" can be considered an adequate margin, while for ductal carcinoma in situ (DCIS), a distance of 2 mm from tumor should be obtained. Many novel tools have been developed based both on the latest radiological imaging techniques and on the tissue expression of certain markers, with the aim of precise navigation of tumor excision and intraoperative evaluation of cavity excision margins. Oncoplastic surgery can be considered oncologically safe while improving the cosmetic outcome and patients' quality of life. The appropriate use of adjuvant treatments in the context of a multidisciplinary and personalized management of breast cancer is the only means to omit a second intervention in some carefully selected cases. Conclusions: Debate still exists concerning the definition of adequate clear margin following BCS for DCIS. Further studies are required to better assess multimodal treatment approaches in this condition.

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Does Tumor Marking Before Neoadjuvant Chemotherapy Helps Achieve Better Outcomes in Patients Undergoing Breast Conservative Surgery? A Systematic Review

Cited by 2 publications

References 31 publications

Non-Invasive Three-Dimensional Breast Tumor Positioning Before Neoadjuvant Systemic Therapy as Promissing Alternative to the Invasive Tumor Marking – Technique Description and Feasibility

Non-Invasive Three-Dimensional Breast Tumor Positioning Before Neoadjuvant Systemic Therapy as Promissing Alternative to the Invasive Tumor Marking – Technique Description and Feasibility

Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery

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