Safe Negative Margin Width in Breast Conservative Therapy: Results from a Population with a High Percentage of Negative Prognostic Factors

Bhatti, Abu Bakar Hafeez; Khan, Amina; Muzaffar, Narjis; Siddiqui, Neelam; Syed, Aamir Ali; Shah, Mazhar Ali; Aamir, Awais; Jamshed, Arif

doi:10.1007/s00268-014-2651-7

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…The explanation for this observation is multifactorial, including careful evaluation of the margins, use of more personalized and accurate radiotherapy in the tumor bed, and more patients receiving systemic therapy. [6][7][8] The use of new combinations of systemic adjuvant therapies and the use of trastuzumab may have resulted in an additional improvement in local control, especially in young patients. 9 In a population-based study, Voogd et al 10 evaluated the risk trends for local recurrence and the impact of local or distance recurrence on disease-free survival in patients with primary breast cancer aged <40 years.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of local recurrence of breast conservation surgery at the Ceará Institute of Cancer

Magalhães¹,

Cavalcante²,

Lima³

et al. 2019

Mastology

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O câncer de mama é o tumor maligno que mais acomete mulheres em todo o mundo, excetuando-se os casos de pele não melanoma. No Brasil, estimavam-se mais de 56.000 casos para 2016. A mortalidade esperada ainda é alta devido ao diagnóstico tardio. Na atualidade, a cirurgia conservadora é o padrão-ouro. Objetivo: Avaliar a recidiva locorregional da cirurgia conservadora praticada no Instituto do Câncer do Ceará, no período entre 2002 a 2012. Método: Estudo transversal e descritivo, utilizando dados secundários obtidos nos prontuários médicos de pacientes com câncer de mama operadas no Instituto do Câncer do Ceará. Resultados: A população em estudo foi de 360 pacientes. O carcinoma ductal invasivo foi o tipo mais comum (72,8%), seguido do carcinoma ductal in situ (16,4%) e do carcinoma lobular invasivo (4,7%). Os outros tipos histológicos representam 6,4% (cribiforme, 0,5%; medular, 0,6%; microinvasor, 0,3%; mucinosos, 1,1%; papilífero, 3,1%; e tubular, 0,8%). Na amostra, 25 pacientes tiveram algum tipo de recidiva: 13/360 (3,6%), local ou locorregional; e 12/360 (3,3%), recidiva a distância. Conclusão: Da análise dos dados, podemos concluir que a cirurgia conservadora praticada no Instituto do Câncer do Ceará tem dados de recorrência compatíveis com a literatura internacional.

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Section: Discussionmentioning

confidence: 99%

Evaluation of local recurrence of breast conservation surgery at the Ceará Institute of Cancer

Magalhães¹,

Cavalcante²,

Lima³

et al. 2019

Mastology

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“…Factors that influence local recurrence include patient age, tumor stage, tumor grade, lymphovascular invasion, molecular subtype, and positive surgical margins. 6 , 33 – 37 Positive surgical margin has been demonstrated to be the most important and preventable factor associated with recurrence of operable breast cancers. 6 , 35 , 37 Methods that show promise for minimizing the rate of positive margin involvement 10 include margin index, nomograms, intraoperative ultrasound-guided resection, wire-guided localization, radioactive seed localization, standardize cavity shaving, frozen section analysis, and MRI.…”

Section: Discussionmentioning

confidence: 99%

Does Breast Magnetic Resonance Imaging Combined With Conventional Imaging Modalities Decrease the Rates of Surgical Margin Involvement and Reoperation?

et al. 2016

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The objective of this study was to assess whether preoperative breast magnetic resonance imaging (MRI) combined with conventional breast imaging techniques decreases the rates of margin involvement and reexcision.Data on patients who underwent surgery for primary operable breast cancer were obtained from the Changhua Christian Hospital (CCH) breast cancer database. The rate of surgical margin involvement and the rate of reoperation were compared between patients who underwent conventional breast imaging modalities (Group A: mammography and sonography) and those who received breast MRI in addition to conventional imaging (Group B: mammography, sonography, and MRI).A total of 1468 patients were enrolled in this study. Among the 733 patients in Group A, 377 (51.4%) received breast-conserving surgery (BCS) and 356 (48.6%) received mastectomy. Among the 735 patients in Group B, 348 (47.3%) received BCS and 387 (52.7%) received mastectomy. There were no significant differences in operative method between patients who received conventional imaging alone and those that received MRI and conventional imaging (P = 0.13). The rate of detection of pathological multifocal/multicentric breast cancer was markedly higher in patients who received preoperative MRI than in those who underwent conventional imaging alone (14.3% vs 8.6%, P < 0.01). The overall rate of surgical margin involvement was significantly lower in patients who received MRI (5.0%) than in those who received conventional imaging alone (9.0%) (P < 0.01). However, a significant reduction in rate of surgical margin positivity was only observed in patients who received BCS (Group A, 14.6%; Group B, 6.6%, P < 0.01). The overall BCS reoperation rates were 11.7% in the conventional imaging group and 3.2% in the combined MRI group (P < 0.01). There were no significant differences in rate of residual cancer in specimens obtained during reoperation between the 2 preoperative imaging groups (Group A, 50%; Group B, 81.8%, P = 0.09). In multivariate analysis, multifocal/multicentric breast cancer (odds ratio = 2.38, P = 0.02) and without MRI use (odds ratio = 2.35, P < 0.01) were the major predisposing factors to margin involvement in patients received BCS.Preoperative breast MRI combined with conventional breast imaging results in a lower rate of surgical margin involvement and reoperations in patients who receive BCS.

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“…As seen, tissue spatial heterogeneity results in mis-alignments on the order of 1.0–1.5 mm in some regions. This may be significant, and for example exceeds the tolerance level in resection margins for routine breast cancer procedures 41, 42 . Therefore, the previous implementation of our approach 18 could lead to false positives (potentially resulting in unnecessary resection of healthy tissue) or false negatives (potentially resulting in cancer recurrence due to incomplete removal of viable cancer cells).…”

Section: Resultsmentioning

confidence: 99%

Optimized Mass Spectrometry Analysis Workflow with Polarimetric Guidance for ex vivo and in situ Sampling of Biological Tissues

Woolman

Gribble

Bluemke

et al. 2017

Sci Rep

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Spatially Targeted Mass Spectrometry (MS) analysis using survey scans with an imaging modality often requires consecutive tissue slices, because of the tissue damage during survey scan or due to incompatible sample preparation requirements between the survey modality and MS. We report two spatially targeted MS analysis workflows based on polarized light imaging guidance that use the same tissue sample for survey and targeted analysis. The first workflow is applicable for thin-slice analysis, and uses transmission-polarimetry-guided Desorption ElectroSpray Ionization Mass Spectrometry (DESI-MS), and confirmatory H&E histopathology analysis on the same slice; this is validated using quantitative digital pathology methods. The second workflow explores a polarimetry-guided MS platform for thick tissue assessment by developing reflection-mode polarimetric imaging coupled with a hand-held Picosecond InfraRed Laser (PIRL) MS ablation probe that requires minimal tissue removal to produce detectable signal. Tissue differentiation within 5–10 s of sampling with the hand-held probe is shown using multivariate statistical methods of the MS profiles. Both workflows were tasked with differentiating necrotic cancer sites from viable cancers using a breast tumour model, and their performance was evaluated. The use of the same tissue surface addresses mismatches in guidance due to intrinsic changes in tissue morphology over consecutive sections.

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Safe Negative Margin Width in Breast Conservative Therapy: Results from a Population with a High Percentage of Negative Prognostic Factors

Abstract: A negative margin width of 2 mm might represent an adequate negative margin width in the Pakistani population undergoing breast conservative therapy.

Cited by 8 publications

References 34 publications

Evaluation of local recurrence of breast conservation surgery at the Ceará Institute of Cancer

Evaluation of local recurrence of breast conservation surgery at the Ceará Institute of Cancer

Does Breast Magnetic Resonance Imaging Combined With Conventional Imaging Modalities Decrease the Rates of Surgical Margin Involvement and Reoperation?

Optimized Mass Spectrometry Analysis Workflow with Polarimetric Guidance for ex vivo and in situ Sampling of Biological Tissues

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