Treatment Trends in Early-Stage Invasive Lobular Carcinoma

Singletary, S. Eva; Patel-Parekh, Lina; Bland, Kirby I.

doi:10.1097/01.sla.0000171306.74366.22

Cited by 74 publications

(60 citation statements)

References 35 publications

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“…These results, coupled with the observations of others that local control rates do not differ between patients with IDC and ILC, 25,27,28 do not provide a justification for the routine use of MRI in the breast cancer patient newly diagnosed with ILC. We believe that the routine incorporation of MRI into surgical treatment planning awaits the demonstration in a prospective randomized trial of a decrease in the rate of local recurrence after BCT or a reduction in the number of surgical procedures needed to complete local therapy.…”

Section: Percent Change In Managementsupporting

confidence: 54%

Selecting patients for breast‐conserving therapy

Morrow

Keeney

Scholtens

et al. 2006

Cancer

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Objective Urgent evaluation and treatment of transient ischemic attack (TIA) patients in a dedicated TIA clinic may reduce the 90‐day stroke risk by 80%. ABCD2 (Age, Blood pressure, Clinical features, Duration, Diabetes) score and magnetic resonance imaging abnormalities help to identify patients at high risk of stroke. Our aim was to determine whether the use of transcranial Doppler (TCD) examination on arrival at the TIA clinic yields additional information that facilitates the identification of patients at high risk of stroke recurrence. Methods Between January 2003 and December 2007, 1,881 patients were admitted to SOS‐TIA clinic (a TIA clinic with around‐the‐clock access). Clinical and vascular assessment included TCD performed by a neurologist immediately after admission. Stroke prevention measures were initiated on arrival, in accordance with guidelines. All patients were followed for 1 year after presentation to the SOS‐TIA clinic. Results A total of 1,823 TCD examinations were performed within 4 hours of admission. Intracranial narrowing or occlusion was found in 8.8% of patients, and was independently associated with age, hypertension, and diabetes. After 1‐year follow‐up on best preventive therapy, the incidence of recurrent vascular events (intracranial revascularization for TIA recurrence, stroke, myocardial infarction, and vascular death combined) was 7.0% in patients with intracranial narrowing or occlusion and 2.4% in those without (log‐rank, p = 0.007). The hazard ratio of combined outcome for the presence of intracranial narrowing or occlusion was 2.29 (95% confidence interval [CI], 1.15‐4.56; p = 0.02) in multivariate analysis including age, gender, hypertension, and diabetes, and was 2.50 (95%CI, 1.24–5.05; p = 0.01) in multivariate analysis including ABCD2 score ≥4. Interpretation Immediate TCD examination on arrival at the TIA clinic is feasible and could help to identify patients at high risk of vascular events recurrence. This study supports a systematic intracranial vascular examination in the initial management of TIA. ANN NEUROL 2010;68:9–17

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Section: Percent Change In Managementsupporting

confidence: 54%

Selecting patients for breast‐conserving therapy

Morrow

Keeney

Scholtens

et al. 2006

Cancer

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“…In cases where CTCs infiltrate the bone marrow, they are able to persist for years without doing any harm and become disseminated tumor cells (DTCs) (11)(12)(13)(14)(15)(16). The occurrence of CTCs and DTCs is often an indicator of an unfavorable prognosis for patients (10,17), and therefore are included in international tumor staging systems (18,19).…”

Section: Introductionmentioning

confidence: 99%

Quantitative PCR marker genes for endometrial adenocarcinoma

Kölbl

Victor

Birk

et al. 2016

Molecular Medicine Reports

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Abstract. Endometrial adenocarcinoma is a common malignancy in women worldwide, with formation of remote metastasis occurring following oncological treatment. Circulating tumor cells (CTCs) are regarded to be the origin of haematogenous metastasis formation. The present study aimed to identify suitable marker genes using a quantitative polymerase chain reaction (qPCR) approach to detect CTCs from blood samples of patients with endometrial carcinoma. Therefore, RNA was isolated from endometrial adenocarcinoma cell lines and from healthy endometrial tissue and reverse transcribed to cDNA, which was then used in qPCR on a number of marker genes. Cytokeratin 19 and claudin 4 were identified as suitable marker genes for CTCs in endometrial adenocarcinoma, due to their high expression in the majority of the cell lines investigated. The expression values of the genes examined varied widely between the different cell lines, which is similar to the variation in the patient samples. Therefore, the necessity for a set of genes for CTC detection and not one single marker gene is demonstrated. qPCR is a fast, cost-efficient and easy to perform technique, which may be used in the detection of CTCs. Investigation of the occurrence of CTCs in cancer patients would aid in the prevention of metastasis and thereby refine treatment.

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“…Within the past 20 years, there has been a rapidly increasing tendency towards minimally invasive methods in the field of breast surgery as in other surgical interventions (8). In a randomized study, no significant differences in terms of recurrence were seen in the 10-year and 20-year follow-ups of cases who underwent BCS and mastectomy (9).…”

Section: Discussionmentioning

confidence: 99%

The adaptation process of a teaching and research hospital to changing trends in modern breast surgery

Ünsal

Dural

Çelik

et al. 2015

UCD

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Objective: Minimally invasive surgery is increasingly gaining importance in breast surgery parallel to other surgical branches. Sentinel lymph node biopsy (SLNB) is a method that has radically changed the approach to breast surgery in the last decade of the 20 th century. In this study, we aimed to evaluate the adaptation process to these alterations in breast surgery at our clinic. Material and Methods:Patients who underwent surgery with a diagnosis of breast cancer in our clinic between April 2010 and November 2013 were retrospectively evaluated in terms of demographic characteristics, the number of operations and type of surgical methods applied according to years, SLNB performance rate, and results of frozen section and histopathological analysis. The first year of SLNB practice was accepted as part of the learning curve, and 24 patients who were operated during that period underwent routine axillary dissection. Results:The median age of 198 patients who were included in the study was 55 years (25-89). It was detected that the number of cases who underwent surgery for breast cancer increased in years, that the SLNB application rate increased from 37% to 66% between 2010 and 2013 (p=0.01), and SLNB staining rates increased from 70% to 94% (p=0.03). When only results from the last four years were evaluated, the mean staining rate in patients with SLNB (n=105) was 88% (n=92), with positive histopathology in 32% of these cases (n=30). Despite a decreasing trend over the years, a metastatic axillary lymph node was detected in paraffin block evaluation in spite of negative frozen section examination of SLNB in five cases, and 5 patients (5%) out of 97 patients who underwent breast conserving surgery required re-excision. The histopathological diagnosis was invasive ductal carcinoma in 84% (n=167) of patients. Conclusion:It was observed that during the four-year period of adaptation, the application rate of breast conserving surgery and SLNB reached accepted standards, and that both the technical problems encountered in SLNB and the requirement for re-excision after breast conserving surgery significantly decreased with increasing case volume and experience.

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Treatment Trends in Early-Stage Invasive Lobular Carcinoma

Abstract: Less invasive treatment options are becoming widely used for invasive lobular carcinoma, yielding outcomes equivalent to those seen with more aggressive treatment.

Cited by 74 publications

References 35 publications

Selecting patients for breast‐conserving therapy

Selecting patients for breast‐conserving therapy

Quantitative PCR marker genes for endometrial adenocarcinoma

The adaptation process of a teaching and research hospital to changing trends in modern breast surgery

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