Skip to main content
Erschienen in: Annals of Surgical Oncology 5/2013

01.05.2013 | Breast Oncology

Other Primary Malignancies in Breast Cancer Patients Treated with Breast Conserving Surgery and Radiation Therapy

verfasst von: Min Yi, MD, PhD, Janice N. Cormier, MD, MPH, Yan Xing, MD, PhD, Sharon Hermes Giordano, MD, Christy Chai, MD, Funda Meric-Bernstam, MD, Georges Vlastos, MD, Henry M. Kuerer, MD, PhD, Nadeem Q. Mirza, MD, MPH, Thomas A. Buchholz, MD, Kelly K. Hunt, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Our purpose was to examine the incidence and impact on survival of other primary malignancies (OPM) outside of the breast in breast cancer patients and to identify risk factors associated with OPM.

Methods

Patients with stage 0–III breast cancer treated with breast conserving therapy at our center from 1979 to 2007 were included. Risk factors were compared between patients with/without OPM. Logistic regression was used to identify factors that were associated with OPM. Standardized incidence ratios (SIRs) were calculated.

Results

Among 4,198 patients in this study, 276 (6.6 %) developed an OPM after breast cancer treatment. Patients with OPM were older and had a higher proportion of stage 0/I disease and contralateral breast cancer compared with those without OPM. In a multivariate analysis, older patients, those with contralateral breast cancer, and those who did not receive chemotherapy or hormone therapy were more likely to develop OPM after breast cancer. Patients without OPM had better overall survival. The SIR for all OPM sites combined after a first primary breast cancer was 2.91 (95 % confidence interval: 2.57–3.24). Significantly elevated risks were seen for numerous cancer sites, with SIRs ranging from 1.84 for lung cancer to 5.69 for ovarian cancer.

Conclusions

Our study shows that breast cancer patients have an increased risk of developing OPM over the general population. The use of systemic therapy was not associated with increased risk of OPM. In addition to screening for a contralateral breast cancer and recurrences, breast cancer survivors should undergo screening for other malignancies.
Literatur
1.
Zurück zum Zitat Colditz GA, Baer HJ, Tamimi RM. Breast cancer. In: Schottenfeld D, Fraumeni JFJ, eds. Cancer Epidemiology and Prevention. New York: Oxford University Press; 2006. Colditz GA, Baer HJ, Tamimi RM. Breast cancer. In: Schottenfeld D, Fraumeni JFJ, eds. Cancer Epidemiology and Prevention. New York: Oxford University Press; 2006.
2.
Zurück zum Zitat Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef
3.
Zurück zum Zitat Montague ED. Conservation surgery and radiation therapy in the treatment of operable breast cancer. Cancer. 1984;53:700–4.PubMedCrossRef Montague ED. Conservation surgery and radiation therapy in the treatment of operable breast cancer. Cancer. 1984;53:700–4.PubMedCrossRef
4.
Zurück zum Zitat Rayter Z, Gazet JC, Ford HT, Easton DF, Coombes RC. Comparison of conservative surgery and radiotherapy with mastectomy in the treatment of early breast cancer. Eur J Surg Oncol. 1990;16:486–92.PubMed Rayter Z, Gazet JC, Ford HT, Easton DF, Coombes RC. Comparison of conservative surgery and radiotherapy with mastectomy in the treatment of early breast cancer. Eur J Surg Oncol. 1990;16:486–92.PubMed
5.
Zurück zum Zitat Cancer Facts and Figures 2011. Atlanta: American Cancer Society; 2011. Cancer Facts and Figures 2011. Atlanta: American Cancer Society; 2011.
6.
Zurück zum Zitat Brown LM, Chen BE, Pfeiffer RM, Schairer C, Hall P, Storm H, et al. Risk of second non-hematological malignancies among 376,825 breast cancer survivors. Breast Cancer Res Treat. 2007;106:439–51.PubMedCrossRef Brown LM, Chen BE, Pfeiffer RM, Schairer C, Hall P, Storm H, et al. Risk of second non-hematological malignancies among 376,825 breast cancer survivors. Breast Cancer Res Treat. 2007;106:439–51.PubMedCrossRef
7.
Zurück zum Zitat Mellemkjaer L, Friis S, Olsen JH, Scelo G, Hemminki K, Tracey E, et al. Risk of second cancer among women with breast cancer. Int J Cancer. 2006;118:2285–92.PubMedCrossRef Mellemkjaer L, Friis S, Olsen JH, Scelo G, Hemminki K, Tracey E, et al. Risk of second cancer among women with breast cancer. Int J Cancer. 2006;118:2285–92.PubMedCrossRef
8.
Zurück zum Zitat Bernstein L, Deapen D, Cerhan JR, Schwartz SM, Liff J, McGann-Maloney E, et al. Tamoxifen therapy for breast cancer and endometrial cancer risk. J Natl Cancer Inst. 1999;91:1654–62.PubMedCrossRef Bernstein L, Deapen D, Cerhan JR, Schwartz SM, Liff J, McGann-Maloney E, et al. Tamoxifen therapy for breast cancer and endometrial cancer risk. J Natl Cancer Inst. 1999;91:1654–62.PubMedCrossRef
9.
Zurück zum Zitat Brady MS, Garfein CF, Petrek JA, Brennan MF. Post-treatment sarcoma in breast cancer patients. Ann Surg Oncol. 1994;1:66–72.PubMedCrossRef Brady MS, Garfein CF, Petrek JA, Brennan MF. Post-treatment sarcoma in breast cancer patients. Ann Surg Oncol. 1994;1:66–72.PubMedCrossRef
10.
Zurück zum Zitat Curtis RE, Boice JD, Jr, Shriner DA, Hankey BF, Fraumeni JF, Jr. Second cancers after adjuvant tamoxifen therapy for breast cancer. J Natl Cancer Inst. 1996;88:832–4.PubMedCrossRef Curtis RE, Boice JD, Jr, Shriner DA, Hankey BF, Fraumeni JF, Jr. Second cancers after adjuvant tamoxifen therapy for breast cancer. J Natl Cancer Inst. 1996;88:832–4.PubMedCrossRef
11.
Zurück zum Zitat Del Mastro L, Garrone O, Guenzi M, Cafiero F, Nicolo G, Rosso R, et al. Angiosarcoma of the residual breast after conservative surgery and radiotherapy for primary carcinoma. Ann Oncol. 1994;5:163–5.PubMed Del Mastro L, Garrone O, Guenzi M, Cafiero F, Nicolo G, Rosso R, et al. Angiosarcoma of the residual breast after conservative surgery and radiotherapy for primary carcinoma. Ann Oncol. 1994;5:163–5.PubMed
12.
Zurück zum Zitat Ibrahim NK. Leukemogenic effect of chemotherapy in patients with breast carcinoma: is it a real concern? Cancer. 2004;101:1479–81.PubMedCrossRef Ibrahim NK. Leukemogenic effect of chemotherapy in patients with breast carcinoma: is it a real concern? Cancer. 2004;101:1479–81.PubMedCrossRef
13.
Zurück zum Zitat Inskip PD, Stovall M, Flannery JT. Lung cancer risk and radiation dose among women treated for breast cancer. J Natl Cancer Inst. 1994;86:983–8.PubMedCrossRef Inskip PD, Stovall M, Flannery JT. Lung cancer risk and radiation dose among women treated for breast cancer. J Natl Cancer Inst. 1994;86:983–8.PubMedCrossRef
14.
Zurück zum Zitat Levi F, Randimbison L, Te VC, La Vecchia C. Cancer risk after radiotherapy for breast cancer. Br J Cancer. 2006;95:390–2.PubMedCrossRef Levi F, Randimbison L, Te VC, La Vecchia C. Cancer risk after radiotherapy for breast cancer. Br J Cancer. 2006;95:390–2.PubMedCrossRef
15.
Zurück zum Zitat Matesich SM, Shapiro CL. Second cancers after breast cancer treatment. Semin Oncol. 2003;30:740–8.PubMedCrossRef Matesich SM, Shapiro CL. Second cancers after breast cancer treatment. Semin Oncol. 2003;30:740–8.PubMedCrossRef
16.
Zurück zum Zitat Peters MH, Sonpal IM, Batra MK. Breast cancer in women following mantle irradiation for Hodgkin’s disease. Am Surg. 1995;61:763–6.PubMed Peters MH, Sonpal IM, Batra MK. Breast cancer in women following mantle irradiation for Hodgkin’s disease. Am Surg. 1995;61:763–6.PubMed
17.
Zurück zum Zitat Rubino C, de Vathaire F, Diallo I, Shamsaldin A, Le MG. Increased risk of second cancers following breast cancer: role of the initial treatment. Breast Cancer Res Treat. 2000;61:183–95.PubMedCrossRef Rubino C, de Vathaire F, Diallo I, Shamsaldin A, Le MG. Increased risk of second cancers following breast cancer: role of the initial treatment. Breast Cancer Res Treat. 2000;61:183–95.PubMedCrossRef
18.
Zurück zum Zitat Rubino C, de Vathaire F, Shamsaldin A, Labbe M, Le MG. Radiation dose, chemotherapy, hormonal treatment and risk of second cancer after breast cancer treatment. Br J Cancer. 2003;89:840–6.PubMedCrossRef Rubino C, de Vathaire F, Shamsaldin A, Labbe M, Le MG. Radiation dose, chemotherapy, hormonal treatment and risk of second cancer after breast cancer treatment. Br J Cancer. 2003;89:840–6.PubMedCrossRef
19.
Zurück zum Zitat Swerdlow AJ, Jones ME. Tamoxifen treatment for breast cancer and risk of endometrial cancer: a case-control study. J Natl Cancer Inst. 2005;97:375–84.PubMedCrossRef Swerdlow AJ, Jones ME. Tamoxifen treatment for breast cancer and risk of endometrial cancer: a case-control study. J Natl Cancer Inst. 2005;97:375–84.PubMedCrossRef
20.
Zurück zum Zitat Taghian A, de Vathaire F, Terrier P, Le M, Auquier A, Mouriesse H, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991;21:361–7.PubMedCrossRef Taghian A, de Vathaire F, Terrier P, Le M, Auquier A, Mouriesse H, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991;21:361–7.PubMedCrossRef
21.
Zurück zum Zitat Travis LB, Hill DA, Dores GM, Gospodarowicz M, van Leeuwen FE, Holowaty E, et al. Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA. 2003;290:465–75.PubMedCrossRef Travis LB, Hill DA, Dores GM, Gospodarowicz M, van Leeuwen FE, Holowaty E, et al. Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA. 2003;290:465–75.PubMedCrossRef
22.
Zurück zum Zitat Obedian E, Fischer DB, Haffty BG. Second malignancies after treatment of early-stage breast cancer: lumpectomy and radiation therapy versus mastectomy. J Clin Oncol. 2000;18:2406–12.PubMed Obedian E, Fischer DB, Haffty BG. Second malignancies after treatment of early-stage breast cancer: lumpectomy and radiation therapy versus mastectomy. J Clin Oncol. 2000;18:2406–12.PubMed
23.
Zurück zum Zitat Hunt K, Singletary SE, Smith TL, Ross MI, Strom EA, McNeese MD, et al. Conservation surgery and radiation: The MD Anderson Cancer Center experience. In: The breast: comprehensive management of benign and malignant diseases. Philadelphia: W.B. Saunders; 1998. p. 1179–82. Hunt K, Singletary SE, Smith TL, Ross MI, Strom EA, McNeese MD, et al. Conservation surgery and radiation: The MD Anderson Cancer Center experience. In: The breast: comprehensive management of benign and malignant diseases. Philadelphia: W.B. Saunders; 1998. p. 1179–82.
24.
Zurück zum Zitat Buzdar AU HG, Kau SW. Breast Cancer Adjuvant Therapy at the MD Anderson Cancer Center: Results of Four Prospective Studies. Philadelphia: J.B. Lippincott; 1993. Buzdar AU HG, Kau SW. Breast Cancer Adjuvant Therapy at the MD Anderson Cancer Center: Results of Four Prospective Studies. Philadelphia: J.B. Lippincott; 1993.
25.
Zurück zum Zitat NAACCR. Section III: Average Annual Age-adjusted NAACCR Combined Cancer Incidence Rates for the United States 2002–2006. NAACCR. Section III: Average Annual Age-adjusted NAACCR Combined Cancer Incidence Rates for the United States 2002–2006.
26.
Zurück zum Zitat Galper S, Gelman R, Recht A, Silver B, Kohli A, Wong JS, et al. Second nonbreast malignancies after conservative surgery and radiation therapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2002;52:406–14.PubMedCrossRef Galper S, Gelman R, Recht A, Silver B, Kohli A, Wong JS, et al. Second nonbreast malignancies after conservative surgery and radiation therapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2002;52:406–14.PubMedCrossRef
27.
Zurück zum Zitat Sanchez L, Lana A, Hidalgo A, Rodríguez JM, Del Valle Mdel O, Cueto A, et al. Risk factors for second primary tumours in breast cancer survivors. Eur J Cancer Prev. 2008;17:406–13.PubMedCrossRef Sanchez L, Lana A, Hidalgo A, Rodríguez JM, Del Valle Mdel O, Cueto A, et al. Risk factors for second primary tumours in breast cancer survivors. Eur J Cancer Prev. 2008;17:406–13.PubMedCrossRef
28.
Zurück zum Zitat Fowble B, Hanlon A, Freedman G, Nicolaou N, Anderson P. Second cancers after conservative surgery and radiation for stages I–II breast cancer: identifying a subset of women at increased risk. Int J Radiat Oncol Biol Phys. 2001;51:679–90.PubMedCrossRef Fowble B, Hanlon A, Freedman G, Nicolaou N, Anderson P. Second cancers after conservative surgery and radiation for stages I–II breast cancer: identifying a subset of women at increased risk. Int J Radiat Oncol Biol Phys. 2001;51:679–90.PubMedCrossRef
29.
Zurück zum Zitat Herring MK, Buzdar AU, Smith TL, Hortobagyi GN, Blumenschein GR. Second neoplasms after adjuvant chemotherapy for operable breast cancer. Am J Clin Oncol. 1986;9:269–75.PubMedCrossRef Herring MK, Buzdar AU, Smith TL, Hortobagyi GN, Blumenschein GR. Second neoplasms after adjuvant chemotherapy for operable breast cancer. Am J Clin Oncol. 1986;9:269–75.PubMedCrossRef
30.
Zurück zum Zitat Rubagotti A, Perrotta A, Casella C, Boccardo F. Risk of new primaries after chemotherapy and/or tamoxifen treatment for early breast cancer. Ann Oncol. 1996;7:239–44.PubMedCrossRef Rubagotti A, Perrotta A, Casella C, Boccardo F. Risk of new primaries after chemotherapy and/or tamoxifen treatment for early breast cancer. Ann Oncol. 1996;7:239–44.PubMedCrossRef
31.
Zurück zum Zitat Rutqvist LE, Johansson H, Signomklao T, Johansson U, Fornander T, Wilking N. Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. Stockholm Breast Cancer Study Group. J Natl Cancer Inst. 1995;87:645–51.PubMedCrossRef Rutqvist LE, Johansson H, Signomklao T, Johansson U, Fornander T, Wilking N. Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. Stockholm Breast Cancer Study Group. J Natl Cancer Inst. 1995;87:645–51.PubMedCrossRef
32.
Zurück zum Zitat Katase K, Sugiyama Y, Hasumi K, Yoshimoto M, Kasumi F. The incidence of subsequent endometrial carcinoma with tamoxifen use in patients with primary breast carcinoma. Cancer. 1998;82:1698–703.PubMedCrossRef Katase K, Sugiyama Y, Hasumi K, Yoshimoto M, Kasumi F. The incidence of subsequent endometrial carcinoma with tamoxifen use in patients with primary breast carcinoma. Cancer. 1998;82:1698–703.PubMedCrossRef
33.
Zurück zum Zitat Fornander T, Rutqvist LE, Cedermark B, Glas U, Mattsson A, Silfverswärd C, et al. Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Lancet. 1989;1:117–20.PubMedCrossRef Fornander T, Rutqvist LE, Cedermark B, Glas U, Mattsson A, Silfverswärd C, et al. Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Lancet. 1989;1:117–20.PubMedCrossRef
34.
Zurück zum Zitat Matsuyama Y, Tominaga T, Nomura Y, Koyama H, Kimura M, Sano M, et al. Second cancers after adjuvant tamoxifen therapy for breast cancer in Japan. Ann Oncol. 2000;11:1537–43.PubMedCrossRef Matsuyama Y, Tominaga T, Nomura Y, Koyama H, Kimura M, Sano M, et al. Second cancers after adjuvant tamoxifen therapy for breast cancer in Japan. Ann Oncol. 2000;11:1537–43.PubMedCrossRef
35.
Zurück zum Zitat Newcomb PA, Solomon C, White E. Tamoxifen and risk of large bowel cancer in women with breast cancer. Breast Cancer Res Treat. 1999;53:271–7.PubMedCrossRef Newcomb PA, Solomon C, White E. Tamoxifen and risk of large bowel cancer in women with breast cancer. Breast Cancer Res Treat. 1999;53:271–7.PubMedCrossRef
36.
Zurück zum Zitat Peters-Engl C, Frank W, Danmayr E, Friedl HP, Leodolter S, Medl M. Association between endometrial cancer and tamoxifen treatment of breast cancer. Breast Cancer Res Treat. 1999;54:255–60.PubMedCrossRef Peters-Engl C, Frank W, Danmayr E, Friedl HP, Leodolter S, Medl M. Association between endometrial cancer and tamoxifen treatment of breast cancer. Breast Cancer Res Treat. 1999;54:255–60.PubMedCrossRef
37.
Zurück zum Zitat Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet. 2000;355:1757–70. Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet. 2000;355:1757–70.
38.
Zurück zum Zitat Curtis RE, Boice JD, Jr., Stovall M, Bernstein L, Greenberg RS, Flannery JT, et al. Risk of leukemia after chemotherapy and radiation treatment for breast cancer. N Engl J Med. 1992;326:1745–51.PubMedCrossRef Curtis RE, Boice JD, Jr., Stovall M, Bernstein L, Greenberg RS, Flannery JT, et al. Risk of leukemia after chemotherapy and radiation treatment for breast cancer. N Engl J Med. 1992;326:1745–51.PubMedCrossRef
39.
Zurück zum Zitat Doherty MA, Rodger A, Langlands AO, Kerr GR. Multiple primary tumours in patients treated with radiotherapy for breast cancer. Radiother Oncol. 1993;26:125–31.PubMedCrossRef Doherty MA, Rodger A, Langlands AO, Kerr GR. Multiple primary tumours in patients treated with radiotherapy for breast cancer. Radiother Oncol. 1993;26:125–31.PubMedCrossRef
40.
Zurück zum Zitat Fisher B, Rockette H, Fisher ER, Wickerham DL, Redmond C, Brown A. Leukemia in breast cancer patients following adjuvant chemotherapy or postoperative radiation: the NSABP experience. J Clin Oncol. 1985;3:1640–58.PubMed Fisher B, Rockette H, Fisher ER, Wickerham DL, Redmond C, Brown A. Leukemia in breast cancer patients following adjuvant chemotherapy or postoperative radiation: the NSABP experience. J Clin Oncol. 1985;3:1640–58.PubMed
41.
Zurück zum Zitat Jacobson JA, Danforth DN, Cowan KH, d’Angelo T, Steinberg SM, Pierce L, et al. Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med. 1995;332:907–11. Jacobson JA, Danforth DN, Cowan KH, d’Angelo T, Steinberg SM, Pierce L, et al. Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med. 1995;332:907–11.
42.
Zurück zum Zitat Neugut AI, Robinson E, Lee WC, Murray T, Karwoski K, Kutcher GJ. Lung cancer after radiation therapy for breast cancer. Cancer. 1993;71:3054–7.PubMedCrossRef Neugut AI, Robinson E, Lee WC, Murray T, Karwoski K, Kutcher GJ. Lung cancer after radiation therapy for breast cancer. Cancer. 1993;71:3054–7.PubMedCrossRef
43.
Zurück zum Zitat Arriagada R, Le MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. J Clin Oncol. 1996;14:1558–64.PubMed Arriagada R, Le MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. J Clin Oncol. 1996;14:1558–64.PubMed
44.
Zurück zum Zitat Roychoudhuri R, Evans H, Robinson D, Moller H. Radiation-induced malignancies following radiotherapy for breast cancer. Br J Cancer. 2004;91:868–72.PubMed Roychoudhuri R, Evans H, Robinson D, Moller H. Radiation-induced malignancies following radiotherapy for breast cancer. Br J Cancer. 2004;91:868–72.PubMed
45.
Zurück zum Zitat Deutsch M, Land SR, Begovic M, Wieand HS, Wolmark N, Fisher B. The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy. Results of National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trials B-04 and B-06. Cancer. 2003;98:1362–8.PubMedCrossRef Deutsch M, Land SR, Begovic M, Wieand HS, Wolmark N, Fisher B. The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy. Results of National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trials B-04 and B-06. Cancer. 2003;98:1362–8.PubMedCrossRef
46.
Zurück zum Zitat Zablotska LB, Neugut AI. Lung carcinoma after radiation therapy in women treated with lumpectomy or mastectomy for primary breast carcinoma. Cancer. 2003;97:1404–11.PubMedCrossRef Zablotska LB, Neugut AI. Lung carcinoma after radiation therapy in women treated with lumpectomy or mastectomy for primary breast carcinoma. Cancer. 2003;97:1404–11.PubMedCrossRef
47.
Zurück zum Zitat Best T, Li D, Skol AD, Kirchhoff T, Jackson SA, Yasui Y, et al. Variants at 6q21 implicate PRDM1 in the etiology of therapy-induced second malignancies after Hodgkin’s lymphoma. Nat Med. 2011;17:941–3.PubMedCrossRef Best T, Li D, Skol AD, Kirchhoff T, Jackson SA, Yasui Y, et al. Variants at 6q21 implicate PRDM1 in the etiology of therapy-induced second malignancies after Hodgkin’s lymphoma. Nat Med. 2011;17:941–3.PubMedCrossRef
Metadaten
Titel
Other Primary Malignancies in Breast Cancer Patients Treated with Breast Conserving Surgery and Radiation Therapy
verfasst von
Min Yi, MD, PhD
Janice N. Cormier, MD, MPH
Yan Xing, MD, PhD
Sharon Hermes Giordano, MD
Christy Chai, MD
Funda Meric-Bernstam, MD
Georges Vlastos, MD
Henry M. Kuerer, MD, PhD
Nadeem Q. Mirza, MD, MPH
Thomas A. Buchholz, MD
Kelly K. Hunt, MD
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 5/2013
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2774-8

Weitere Artikel der Ausgabe 5/2013

Annals of Surgical Oncology 5/2013 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

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

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

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

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.