Reducing the Number of Unnecessary Percutaneous Biopsies: The Role of Second Opinion by Expert Breast Center Radiologists

Pistolese, Chiara Adriana; Lamacchia, Feliciana; Tosti, Daniela; Anemona, Lucia; Ricci, Francesca; Censi, Michela; Materazzo, Marco; Vanni, Gianluca; Collura, Alberto; Giuliano, Francesca Di; Perretta, Tommaso; Buonomo, Oreste Claudio

doi:10.21873/anticanres.14027

Cited by 14 publications

(13 citation statements)

References 40 publications

(49 reference statements)

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“…Data from surgical specimen were included in the study, when not available due to the short surgical period data from preoperative biopsy as core needle biopsy (CNB) or vacuum assisted biopsy (VAB) were utilized [ 11 , 12 ]. Tumour maximum diameter was collected and reported in cm.…”

Section: Methodsmentioning

confidence: 99%

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

et al. 2020

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Introduction COVID-19 is a declared worldwide pandemic. In our country, due to shortage of hospitals and beds in intensive care unit, oncological and breast cancer (BC) resources are temporarily shifted to COVID-19 patients. In addition, risk of cross-infections should be considered in these frail patients. To accomplish more surgical procedures and to reduce the length of hospital stay (LOS), fast track awake BC surgery should be implemented. The aim of the study is to estimate the effects of surgical shift in our facility during the early COVID-19 outbreak. Materials and methods From 30th January 2020 to 30th of March 2020, 86 consecutive patients were retrospectively enrolled and divided into pre-COVID-19-BC and COVID-19-BC. Clinical parameters and anamnestic data were collected and analyzed. Surgical procedures, relative complications and type of anaesthesia were reported. The effect on surgical time (ST), operative room time (ORT) and length of stay (LOS) were described and examined. Results No statistical difference was found in complications rate, clinical data and surgical procedures ( p > 0.05). Awake breast conservative surgery (BCS) was the most frequent procedure in COVID-19-BC ( p = 0.006). A statistically significant decrease in ORT and LOS was reported in COVID-19-BC ( p = 0.040 and p = 0.0015 respectively), while comparable time resulted for ST ( p = 0.976). Mean ORT and LOS reduction were 20.79 min and 0.57 hospital bed days. Conclusion In the “COVID-19 era”, fast track awake breast surgery provides a reduction of ORT, LOS and potentially surgical treatment for a wider number of oncological patients.

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Section: Methodsmentioning

confidence: 99%

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

et al. 2020

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“…admitted to percutaneous procedure [as core needle biopsy/vacuum assisted biopsy (CNB/VAB)] for new SBL were selected for this analysis. The main inclusion criterion for retrospective enrolment was a complete previous imaging evaluation of the breast as well as new SBL classified as BI-RADS ≥4, according to breast imaging reports and data system lexicon (BI-RADS) (12), after revaluation by our Breast Expert Radiologists (13). Moreover, when indicated, our patients went through an 8-gauge Vacuum assisted biopsy to reduce the need for further treatment in case of benign lesions (14)(15)(16).…”

Section: Suspicious Breast Lesion Study Group (N=82) a Total Of 82 Pmentioning

confidence: 99%

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

Vanni

Materazzo

Pellicciaro

et al. 2020

In Vivo

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Background/Aim: Coronavirus-19 (COVID-19) pandemic outbreak is currently having a huge impact on medical resource allocation. Breast Cancer (BC) patients are concerned both with BC treatment and COVID-19. This study aimed to estimate the impact of anxiety among patients, caused by the spreading of COVID-19. Patients and Methods: Between the 16th of January and the 20th of March 2020, we retrospectively enrolled 160 patients. Eighty-two patients with a suspected breast lesion (SBL) were divided into two groups: PRE-COVID-19-SBL and POST-COVID-19-SBL. Seventy-eight BC patients were divided into PRE-COVID-19-BC and POST-COVID-19-BC. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure Refusal (PR) and Surgical Refusal (SR) were also recorded with their reason. Results: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). Both POST-COVID-19-SBL and POST-COVID-19-BC groups showed higher rates of PR and SR (p=0.0208, p=0.0065 respectively). Infection risk represented primary reason for refusal among POST-COVID-19 patients. Conclusion: COVID-19-related anxiety could affect patients' decisionmaking process. Since December 2019, the novel coronavirus (SARS-COV-2) has emerged as a highly contagious human pathogen. On March 20, 2020 more than 234000 cases were confirmed worldwide , with more than 9800 registered deaths (1). Following the initial outbreak in the Chinese Hubei Province on March 11, WHO has labelled the latest coronavirus disease COVID-19 (caused by SARS-COV-2) as a pandemic. The reported fatality rate is 4.2% globally (1, 2). Human to human transmission occurs through direct contact or air droplets (2) placing health care providers at a high risk due to the close proximity to potentially infected patients (3). Preliminary data of nationwide analysis in China demonstrated cancer as a risk factor for developing severe complications/disease course among COVID-19 patients (4, 5). Although further studies are required in order to accurately estimate the risk (6, 7) among patients who underwent chemotherapy or surgery in the months prior to the outbreak, the risk of developing severe conditions seems considerably higher compared to the general population (6). Breast Cancer (BC) is the most common neoplasm worldwide representing the primary cause of death due to neoplasms in Italy (5). A report published in 2017 stated that more than 50% of BC patients were older than 60 years (8). Therefore, due to the higher risk of adverse events in older patients, underlined in the preliminary data (9), it is essential to evaluate the risk of COVID-19 infection among these frail BC patients (10). Furthermore, during the COVID-19 outbreak, hospital resources are reallocated from elective and semi-elective procedures to meet the needs of COVID-19 patients in critical conditions (11). The subsequent scarcity of resources could potentially delay diagnostic evaluations and treatment of BC ...

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“…To avoid any detrimental effect on the clinical outcome, we routinely offer a preoperative psychological evaluation for any breast cancer patient. In addition to reduced patient mortality, treatment in a centralized tertiary facility reduces the number of unnecessary interventions (35), reduces the hospitalization of patients (36-38), and provides a lower rate of complications during reconstruction surgery (1) or innovative approach to reduce the impact of surgery (36, 39). In our opinion, tertiary breast cancer facility could produce a higher medical standard for patients and could provide a better medical treatment for breast pathology.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Early Breast Cancer Recurrence Mimicking BIA-ALCL in a Patient With Multiple Breast Procedures

et al. 2021

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Breast reconstruction plays a fundamental role in the therapeutic process of breast cancer treatment and breast implants represents the leading breast reconstruction strategy. Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), locoregional recurrence in the skin flap, and skin flap necrosis are well-known complications following mastectomy and immediate breast reconstruction (IBR). We report a case of locoregional cancer recurrence in the mastectomy flap mimicking BIA-ALCL, in a patient who underwent 6 breast procedures in four facilities across 15 years including immediate breast reconstruction with macrotextured breast implants. Despite the rate and onset of the disease, clinicians should be aware of BIA-ALCL. Due to the risk of false negative results of fine needle aspiration, clinical suspicion of BIA-ALCL should drive clinicians' choices, aside from cytological results. In the present case, surgical capsulectomy of the abnormal periprosthesic tissue revealed locoregional recurrence.

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Reducing the Number of Unnecessary Percutaneous Biopsies: The Role of Second Opinion by Expert Breast Center Radiologists

Cited by 14 publications

References 40 publications

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

Case Report: Early Breast Cancer Recurrence Mimicking BIA-ALCL in a Patient With Multiple Breast Procedures

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