Prospective study of non-infiltrating carcinoma of the breast

Ashikari, Roy; Huvos, Andrew G.; Snyder, Ruth E.

doi:10.1002/1097-0142(197702)39:2<435::aid-cncr2820390211>3.0.co;2-w

Cited by 92 publications

(14 citation statements)

References 7 publications

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“…Second, the removal of occult invasive disease at foci in other breast quadrants. This is estimated as occurring in 6-21% of breasts after excision of DCIS (Brown et al, 1976;Lagios et al, 1982;Rosen et al, 1979). Finally, mastectomy should prevent local recurrence or invasive disease arising from residual DCIS after local excision.…”

Section: Resultsmentioning

confidence: 99%

“…Theoretical arguments in favour of this approach include eradication of multicentric foci of DCIS, eradication of occult invasive foci in other breast quadrants and prevention of local recurrence from residual DCIS. Success following mastectomy for DCIS is demonstrated by local recurrence rates at 5 years of between 0 and 9.2% (Ashikari et al, 1971(Ashikari et al, , 1977Sunshine et al, 1985;Farrow, 1970;Westbrook & Gallager, 1975) and survival rates of 95% at 10 years (Sunshine et al, 1985).…”

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confidence: 99%

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Duct carcinoma in situ: predictors of local recurrence and progression in patients treated by surgery alone

Price

Sinnett²,

Gusterson³

et al. 1990

Br J Cancer

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Summary Between 1972 and 1982, 60 patients with histologically proven duct carcinoma in situ (DCIS) without evidence of invasive disease were treated by surgery alone. Treatment was not randomised and was total mastectomy (19), subcutaneous mastectomy (6) or local excision (35). Follow-up was by clinical examination and mammography with a median follow-up of 9 years (range 4-16 years). Twenty-six patients (43%) have recurred locally. The estimated proportion recurrence free at 7 years is 59% (95% CI 46-72%). Local recurrence on the chest wall occurred in one patient having total mastectomy and in the chest wall or nipple in three patients having subcutaneous mastectomy. Twenty-two patients recurred locally in the breast after conservative surgery. The 7-year recurrence-free rates were 94%, 44% and 45% respectively in the three groups. Of those patients who recurred locally 14/26 (54%) did so with invasive disease. Of the 34 who did not develop local recurrence, two developed metastases. The only factor which correlated with local recurrence and invasive local recurrence on multivariate analysis was conservative surgery (hazard ratio 4.71 (1.59-14.0),

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Duct carcinoma in situ: predictors of local recurrence and progression in patients treated by surgery alone

Price

Sinnett²,

Gusterson³

et al. 1990

Br J Cancer

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“…The only situation where axillary lymphadenectomy is not currently indicated is the presence of breast ductal carcinoma in situ, although it has a risk of axillary metastases from 0.9 to 3.8%, according to several authors 17,18 . Another subgroup with low potential of axillary metastases is microinvasive carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Frequency and factors associated with injury to the axillary vein in women that underwent axillary lymphadenectomy during breast cancer surgical treatment

Corrêa¹,

Hubie²,

Ribeiro³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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Objetivo: Avaliar quais variáveis se apresentam como fatores de risco associados à lesão da veia axilar durante a linfadenectomia no tratamento cirúrgico de pacientes portadoras de câncer de mama. Métodos: Estudo retrospectivo realizado por meio da análise de prontuário eletrônico de 1.007 pacientes submetidas a esvaziamento axilar no Hospital Erasto Gaertner, no período de janeiro de 2010 a dezembro de 2014. Foram avaliados, por meio de um questionário padrão, os seguintes possíveis fatores de risco: idade, índice de massa corpórea (IMC), presença de metástase axilar palpável no exame clínico, linfonodo sentinela pré-linfadenectomia, presença de metástase axilar no transoperatório, tamanho da metástase e se estava aderida aos vasos axilares, presença de invasão do músculo peitoral, ressecção do músculo peitoral menor, incisão axilar separada da incisão mamária, radioterapia prévia, quimioterapia neoadjuvante e estadiamento pré e pós-operatório. Para cada paciente que apresentou lesão de veia axilar foi realizado pareamento com dois controles homogêneos (idade, IMC, estadiamento pré-operatório, proposta cirúrgica e tratamento neoadjuvante). Resultados: Treze pacientes apresentaram lesão da veia axilar. Na avaliação transoperatória, em sua grande maioria, RESUMO ABSTRACTObjective: To evaluate which variables are considered risk factors associated with injury to the axillary vein during lymphadenectomy in the surgical treatment of breast cancer patients. Methods: Retrospective study performed through the electronic record analysis of 1,007 patients who underwent axillary lymph node dissection at Hospital Erasto Gaertner, from January 2010 to December 2014. We assessed the following risk factors using a standard questionnaire: age, body mass index (BMI), presence of palpable axillary metastasis in the clinical examination, sentinel lymph node pre-lymphadenectomy, presence of axillary metastasis in the perioperative period, size of metastasis and if it was adhered to axillary vessels, presence of pectoralis muscle invasion, resection of the pectoralis minor muscle, axillary incision separated from breast incision, prior radiotherapy, neoadjuvant chemotherapy, and pre and postoperative staging. For each patient who presented injury to the axillary vein, we paired them with two homogeneous controls (age, BMI, preoperative staging, surgical proposal, and neoadjuvant treatment). Results: Thirteen patients had injury to the axillary vein. In the perioperative evaluation, in most of them, the axilla was positive in the injury group (10 cases = 76.9%) and control group (12 cases = 46.1%), and it was adhered to axillary vessels in 10 cases in the injury group (76.9%) and 7 in the control group (26.9%). Conclusion: In this study, the presence of axillary metastasis in the perioperative evaluation, as well as that adhered to the axillary vessels, is associated with an increased risk of injury to the axillary vein during lymphadenectomy.

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“…[17][18][19] However, mastectomy has been viewed by some clinicians as a prophylactic treatment because it is used to prevent the development of an invasive breast cancer. With the increasing use of breast-conserving treatment for patients with invasive breast carcinoma, the routine use of mastectomy for patients with DCIS has been questioned, particularly for small, lowgrade lesions.…”

Section: Options For Treatmentmentioning

confidence: 99%