Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
World Journal of Surgery
Erschienen in: World Journal of Surgery 2/2016

01.02.2016 | Original Scientific Report

Optimising Breast Conservation Treatment for Multifocal and Multicentric Breast Cancer: A Worthwhile Endeavour?

verfasst von: Mona P. Tan, Nadya Y. Sitoh, Yih Yiow Sitoh

Erschienen in: World Journal of Surgery | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Breast conservation treatment (BCT) is an accepted treatment modality for early breast cancer. However, multifocal and multicentric breast cancer (MFMCBC) is a relative contraindication to BCT. This study was performed to compare BCT rates in MFMCBC and unifocal tumours and its outcomes.

Methods

A retrospective analysis was performed for patients with breast malignancies who underwent operative treatment between 2009 and 2011. Successful BCT was defined as the ability to obtain clear margins for all tumour foci through a single incision with acceptable resultant cosmesis.

Results

A total of 160 patients were analysed, of which 40 were MFMCBC. Thirty-four of the 40 patients with MFMCBC underwent BCT (85 %). After a mean follow-up period of 55 months, there were no local recurrences in patients with MFMCBC.

Conclusion

BCT was achieved in 85 % of the patients with MFMCBC in this cohort without evidence of poorer local control. Further investigation is needed to confirm this finding for its potential contribution to improved survival outcomes.
Literatur
1.
Halsted WS (1894) The results of operation for the cure of cancer of the breast performed at John Hopkins Hospital from June 1889 to January 1894. Ann Surg 20(5):497–555PubMedPubMedCentralCrossRef
2.
Veronesi U, Cascinelli N, Nariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232PubMedCrossRef
3.
Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomised trial comparing mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241PubMedCrossRef
4.
5.
McGuire KP, Santillan AA, Kaur P et al (2009) Are mastectomies on the rise? a 13-year trend analysis of the selection of mastectomy versus breast conservation therapy in 5965 patients. Ann Surg Oncol 16:2682–2690PubMedCrossRef
6.
Dragun AE, Huang B, Tucker TC, Spanos WJ (2012) Increasing mastectomy rates among all age groups for early stage breast cancer: a 10-year study of surgical choice. Breast J 18(4):318–325PubMedCrossRef
7.
McLaughlin SA (2013) Surgical management of the breast: breast conservation therapy and mastectomy. Surg Clin N Am 93:411–428PubMedCrossRef
8.
Spilsbury K, Semmens JB, Saunders CM, Holman CDJ (2005) Long-term survival outcomes following breast cancer surgery in Western Australia. ANZ J Surg 75:625–630PubMedCrossRef
9.
Martin MA, Meyricke R, O’Neill T, Roberts S (2007) Breast-conserving surgery versus mastectomy for survival from breast cancer: the Western Australian experience. Ann Surg Oncol 14:157–164PubMedCrossRef
10.
Schonberg MA, Marcantonio ER, Li D et al (2010) Breast cancer among the oldest old: tumour characteristics, treatment choices and survival. J Clin Oncol 28:2038–2045PubMedPubMedCentralCrossRef
11.
Keating NL, Landrum MB, Brooks JM et al (2011) Outcomes following local therapy for early-stage breast cancer in non-trial populations. Breast Cancer Res Treat 125:803–813PubMedPubMedCentralCrossRef
12.
Brooks JM, Chrischilles EA, Landrum MB et al (2012) Survival implications associated with variation in mastectomy rates for early-staged breast cancer. Int J Surg Oncol. doi:10.​1155/​2012/​127854
13.
Hwang ES, Lichtensztajn DY, Gomez SL et al (2013) Survival after lumpectomy and mastectomy for early stage invasive breast cancer: the effect of age and hormone receptor status. Cancer 119:1402–1411PubMedPubMedCentralCrossRef
14.
van Hezewijk M, Bastiaannet E, Putter H et al (2013) Effect of local therapy on locoregional recurrence in postmenopausal women with breast cancer in the tamoxifen exemestane adjuvant multinational (TEAM) trial. Radiother Oncol 108:190–196PubMedCrossRef
15.
Agarwal S, Pappas L, Neumayer L et al (2014) Effect of breast conservation therapy versus mastectomy on disease-specific survival for early-stage breast cancer. JAMA Surg 149:267–274PubMedCrossRef
16.
Schnitt SJ, Morrow M (2012) Should intraoperative frozen section evaluation of breast lumpectomy margins become routine practice? Am J Clin Pathol 138:635–638PubMedCrossRef
17.
Moran MS, Schnitt SJ, Gioliano AE et al (2014) Society of surgical oncology-american society for radiation oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. Ann Surg Oncol 21:704–716PubMedCrossRef
18.
Kaufmann M, Morrow M, von Minckwitz G et al (2010) Locoregional treatment of primary breast cancer: consensus recommendations from an international expert panel. Cancer 116:1184–1191PubMedCrossRef
19.
20.
21.
Wilson LD, Beinfield M, McKhamn CF, Haffty BG (1993) Conservative surgery and radiation in the treatment of synchronous ipsilateral breast cancers. Cancer 72:137–142PubMedCrossRef
22.
Bauman L, Barth RJ, Rosenkranz KM (2010) Breast conservation in women with multifocal-multicentric breast cancer: is it feasible? Ann Surg Oncol 17:S325–S329CrossRef
23.
Kapoor NM, Chung A, Huynh K, Giuliano AE (2012) Preliminary results: double lumpectomies for multicentric breast cancer. Am Surg 78:1345–1348PubMed
24.
Ustaalioglu BO, Bilici A, Kefeli U et al (2012) The importance of multifocal/multicentric tumour on the disease-free survival of breast cancer patients. Am J Clin Oncol 35:580–586PubMedCrossRef
25.
Wolters R, Wockel A, Janni W et al (2013) Comparing the outcome between multicentric and multifocal breast cancer: what is the impact on survival, and is there a role for guideline-adherent adjuvant therapy? a retrospective multicentre coort study of 8,935 patients. Breast Cancer Res Treat 142:579–590PubMedCrossRef
26.
Ataseven B, Lederer B, Blohmer JU et al (2014) Impact of multifocal and multicentric disease on surgery and locoregional. Distant and overall survival of 6.134 breast cancer patients treated with neoadjuvant chemotherapy. Ann Surg Oncol. doi:10.​1245/​s10434-014-4122-7 PubMed
27.
Patani N, Carpenter R (2010) Surgical and aesthetic considerations of conservational surgery for multifocal/multicentric breast cancer. Breast J 16:222–232PubMedCrossRef
28.
Holland R, Veling SHJ, Mravunac M, Mendriks JHCL (1985) Multifocality of Tis, T1-2 breast carcinomas: implications for clinical trials of breast-conserving surgery. Cancer 56:979–990PubMedCrossRef
29.
30.
Tan MP (2007) The boomerang incision for periareolar breast malignancies. Am J Surg 194:690–693PubMedCrossRef
31.
Massey EJD, Gouveia PF, Nos C et al (2013) A new level 1 oncoplastic technique for breast conserving surgery: rotation glandular flap. Breast 22(2):186–189PubMedCrossRef
32.
Fitoussi AD, Berry MG, Fama F et al (2010) Oncoplastic breast surgery for cancer: analysis of 540 cases. Plast Reconstr Surg 125:454–462PubMedCrossRef
33.
Wilkinson LS, Given-Wilson R, Hall T et al (2005) Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound. Clin Radiol 60:573–578PubMedCrossRef
34.
Sardanelli F, Giuseppetti GM, Panizza P et al (2004) Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard. AJR Am J Roentgenol 183:1149–1157PubMedCrossRef
35.
Houssami N, Turner R, Morrow M (2013) Preoperative magnetic resonance imaging in breast cancer. Ann Surg 257:249–255PubMedCrossRef
36.
37.
Qiao Q, Zhou G, Ling Y (1997) Breast volume measurement in young Chinese women and clinical applications. Aesthetic Plast Surg 21:362–368PubMedCrossRef
38.
Yau TK, Soong IS, Sze H et al (2009) Trends and patterns of breast conservation treatment in Hong Kong: 1994–2007. Int J Radiation Oncology Biol Phys 74:98–103CrossRef
39.
Kronowitz SJ, Kuerer HM, Buchholz TA, Valero V, Hunt KK (2008) A management algorithm and practical oncoplastic surgical techniques for repairing partial mastectomy defects. Plast Reconstr Surg 122:1631–1647PubMedCrossRef
40.
Zhou MR, Tang ZH, Li J et al (2013) Clinical and pathologic features of multifocal and multicentric breast cancer in Chinese women: a retrospective cohort study. J Breast Cancer 16(1):77–83PubMedPubMedCentralCrossRef
41.
Roughton MC, Shenaq D, Jaskowiak N, Park JE (2012) Optimizing delivery of breast conservation therapy. Ann Plast Surg 69:250–255PubMedCrossRef
42.
Clough KB, Ihrai T, Oden S et al (2012) Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant Atlas. Br J Surg 99:1389–1395PubMedCrossRef
43.
44.
Eaton BR, Losken A, Okwan-Duodu D et al (2014) Local recurrence patterns in breast cancer patients treated with oncoplastic reduction mammoplasty and radiotherapy. Ann Surg Oncol 21:93–99PubMedCrossRef
45.
Indelicato D, Grobmyer SR, Newlin H et al (2007) Association between operative closure type and acute infection, local recurrence, and disease surveillance in patients undergoing breast conserving therapy for early-stage breast cancer. Surgery 141:645–653PubMedCrossRef
46.
Eichler C, Kolsch M, Sauerwald A et al (2013) Lumpectomy versus Mastopexy– a post-surgery patient survey. Anticancer Res 33:731–736PubMed
47.
Fancellu A, Soro D, Castiglia P et al (2014) Usefulness of magnetic resonance in patients with invasive cancer eligible for breast conservation: a comparative study. Clin Breast Cancer 14(2):114–121.PubMedCrossRef
48.
Nijenhuis MV, Rutgers EJ (2013) Who should not undergo breast conservation? Breast 22:S110–S114PubMedCrossRef
49.
Mathe G (1998) Possible respect of patient quality of life—without reducing survival expectance—in breast cancer treatment. Biomed Pharmacother 52:97–100PubMedCrossRef
50.
Kurian AW, Lichtensztajn DY, Keegan THM et al (2014) Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998–2011. JAMA 312:902–914PubMedCrossRef
51.
Boughey JC, Hieken TJ, Jakub JW et al (2014) Impact of frozen section margin analysis on reoperation rates in women undergoing lumpectomy for breast cancer: evaluation of the NSQIP data. Surgery. doi:10.​1016/​j.​surg.​2014.​03.​025 PubMed
Metadaten
Titel
Optimising Breast Conservation Treatment for Multifocal and Multicentric Breast Cancer: A Worthwhile Endeavour?
verfasst von
Mona P. Tan
Nadya Y. Sitoh
Yih Yiow Sitoh
Publikationsdatum
01.02.2016
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 2/2016
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3336-6

Weitere Artikel der Ausgabe 2/2016

World Journal of Surgery 2/2016 Zur Ausgabe

Original Scientific Report

Ex Vivo Intra-arterial Methylene Blue Injection in Rectal Cancer Specimens Increases the Lymph-Node Harvest, Especially After Preoperative Radiation

Original Scientific Report

Liver Resection for De Novo Hepatocellular Carcinoma Complicated by Pyogenic Liver Abscess: A Clinical Challenge

Original Scientific Report

Neutrophil–Lymphocyte Ratio as a Prognostic Marker for Lung Adenocarcinoma After Complete Resection

Original Scientific Report

Evaluating the Incidence, Cause, and Risk Factors for Unplanned 30-Day Readmission and Emergency Department/General Practitioner Visit After Short-Stay Thyroidectomy

Original Scientific Report

Factors that Can Promote or Impede the Advancement of Women as Leaders in Surgery: Results from an International Survey

Scientific Review

A Systematic Review of Patient-reported Outcomes in Randomized Controlled Trials of Unplanned General Surgery

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.