Fat necrosis of the breast in the accelerated partial breast irradiation era: the need for a universal grading system

Russo, Andrea; Taghian, Alphonse G.

doi:10.1007/s10549-013-2611-1

Cited by 16 publications

(8 citation statements)

References 40 publications

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“…In non-IBC, HER2-enriched and triple-negative tumors have increased breast cancer-specific mortality in comparison with the other subtypes [ 7 , 8 ]. For IBC, a recent analysis of the American National Cancer Database showed that HR-positive disease was not associated with an advantageous prognosis, and HER2-enriched status was not correlated with unfavorable overall survival (OS).…”

Section: Introductionmentioning

confidence: 99%

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Uden

Maaren

Bult³

et al. 2019

Breast Cancer Res Treat

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Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2−. Patient-, tumor-and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan-Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7%), HR−/HER2− (N = 258, 24.3%), HR−/HER2+ (N = 180,17.0%), and HR+/HER2+ (N = 170,16.0%). In total, 679 patients (85.0%) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43%, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1%), HR+/HER2+ (80.4 vs. 52.6%), HR−/HER2+ (76.4 vs. 29.7%), HR−/HER2− (47.6 vs. 27.8%). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).

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Section: Introductionmentioning

confidence: 99%

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Uden

Maaren

Bult³

et al. 2019

Breast Cancer Res Treat

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“…Fat necrosis can negatively affect the quality of life of the patients because of poor cosmetic result and pain. Unfortunately, fat necrosis cannot be efficiently evaluated because there are no standard systems for grading [33]. Breast surgeons need to explain the severity and of frequency fat necrosis to the patients.…”

Section: Introductionmentioning

confidence: 99%

Fat necrosis in the Breast: A systematic review of clinical

et al. 2019

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Breast fat necrosis (FN) originates from aseptic fat saponification, which is a typical lipid cyst or a spiculated lesion called mammographic presentation which mimics malignancy. In order to avoid biopsy, it would be necessary to identify the spectrum of fat necrosis appearances. A systematic research was conducted in October 2018 by using PubMed, MEDLINE, Embase, Google Scholar databases and Google to search for science literature published after 2004. Therefore, the aim of this systematic review, it is that the FN can provide radiologists, surgeons, and oncologists with better insight and help them manage the condition efficiently.

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“…Another advantage of ADM is that it is composed of cells that are resistant to radiation and have already been applied irradiation. Radiation therapy is also a risk factor of fat necrosis [18].…”

Section: Discussionmentioning

confidence: 99%

Volume replacement with diced acellular dermal matrix in oncoplastic breast-conserving surgery: a prospective single-center experience

et al. 2020

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Background: Several studies have reported the use of acellular dermal matrix in breast reconstruction. However, the primary role of acellular dermal matrix in these studies was to support the implant; there are no reports on the use of acellular dermal matrix exclusively as volume replacement. Thus, we aimed to evaluate the safety and effectiveness of filling of the defect with acellular dermal matrix in oncoplastic breast-conserving surgery. Methods: We prospectively recruited 120 adult breast cancer patients who were scheduled to undergo oncoplastic breast-conserving surgery with acellular dermal matrix filling from 2017 to 2018. Intraoperatively, diced human acellular dermal matrix measuring 3-5 mm was used on each side to fill in the excisional defect immediately. After 6 months, satisfaction of the patients and surgeons with overall and cosmetic outcomes was evaluated with a survey using a 10-point scale. Postoperative complications were assessed at 2 weeks and 6 months postoperatively. Results: Of the 117 patients who were evaluated for their satisfaction, 94.0% were strongly satisfied with the cosmetic outcomes and 90.4% were strongly satisfied overall. Patient overall satisfaction scores were higher than surgeon satisfaction scores (p < 0.001). Of the 117 patients who underwent evaluation of complications 6 months postoperatively, six (5.1%) had hematoma and seven (6.0%) had seroma. The overall reoperation rate due to complications was 8.5%. Only two patients needed acellular dermal matrix removal due to hematoma and inflammation. Conclusion: Oncoplastic breast-conserving surgery with acellular dermal matrix filling of defects can be performed safely with high cosmetic satisfaction.

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Fat necrosis of the breast in the accelerated partial breast irradiation era: the need for a universal grading system

Cited by 16 publications

References 40 publications

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Fat necrosis in the Breast: A systematic review of clinical

Volume replacement with diced acellular dermal matrix in oncoplastic breast-conserving surgery: a prospective single-center experience

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