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Surgical Oncology

Surgery

Surgery and Radiotherapy for Breast Cancer: A Look at the Studies
In December of 2005, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) published the combined results of 78 clinical trials evaluating radiation therapy and surgery in breast cancer patients.The group has published updates of this data every 5 years, and this publication represents 15 years of follow-up. The paper is jam-packed with

Preparing for Breast Surgery: Helpful Facts
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Preparing for Surgery: Breast Biopsy
About Breast Biopsy This "Helpful Facts" sheet is designed to give you basic information on breast biopsy. More detailed information can be provided by your doctor or nurse. If you have other questions or would like additional information, please talk to your doctor or nurse. What is a breast biopsy? A biopsy is a surgical procedure that

Effect of Nancy Reagan's Mastectomy on Choice of Surgery for Breast Cancer by US Women
Reviewers: John Han-Chih Chang, MD and Kenneth Blank, MD Source: Journal of the American Medical Association 1998; Volume 279: pages 762 - 766.BackgroundCancer treatment can take on various forms. It can include surgery, radiation therapy or chemotherapy. Recommendations on what is required to treat the certain cancer is influenced by extent of

Chemotherapy Before Surgery for Breast Cancer
Dear OncoLink "Ask The Experts," My mother has been diagnosed with stage 3-breast cancer. They are telling her that they want her to do chemotherapy before the surgery to remove her breast. Can you please explain to me why they would be doing this? Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of

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Surgical

Outcomes Among African-Americans and Caucasians in Colon Cancer Adjuvant therapy Trials: Findings From the National Surgical Adjuvant Breast and Bowel Project
Reviewers: Li Liu, MD Source: Journal of the National Cancer Institute, 91(22): 1933-1940, November 1999IntroductionSome retrospective studies have reported poorer outcomes from colon cancer among African-Americans compared to Caucasian Americans. The cause of this disparity may be multifactorial, including diagnosis at later disease stage,

Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17
Authors: Fisher B, Dignam J, Wolmark N, Mamounas E, Costantino J, Poller W, Fisher ER, Wickerham DL, Deutsch M, Margolese R, Dimitrov N, Kavanah M. Source: J Clin Oncol. 1998 Feb; 16(2): 441-52 Background Intraductal carcinoma-in-situ of the breast, commonly referred to as DCIS, is a pathologic diagnosis that is occurring with increasing

Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomized controlled trial
Reviewers: John Han-Chih Chang, MD Source: Lancet 1999 Jun 12; Volume 353: pages 1993 - 2000BackgroundWe have shown previously that lumpectomy with radiation therapy was more effective than lumpectomy alone for the treatment of ductal carcinoma in situ (DCIS). We did a double-blind randomized controlled trial to find out whether lumpectomy,

Lumpectomy and Radiation Therapy for the Treatment of Intraductal Breast Cancer: Findings from National Surgical Adjuvant Breast and Bowel Project B-17
Reviewers: John Han-Chih Chang, MD and Kenneth Blank, MD Source: Journal of Clinical Oncology 1998; volume 16 (number 2): pages 441 - 452BackgroundWith the use of screening studies such as mammograms and ultrasounds along with self breast exams, there has been a trend towards an increased incidence of finding breast cancers that are not invasive

Surgical Drains After Breast Reconstructive Surgery
Dear OncoLink "Ask The Experts," Tell me about the surgical drains after breast reconstructive surgery. Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:Jackson Pratt (JP) drains are placed under the skin during surgery to remove a collection of blood and other

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Lumpectomy

BRCA1/BRCA2 Germline Mutations in Locally Recurrent Breast Cancer Patients After Lumpectomy and Radiation Therapy: Implications for Breast-Conserving Management in Patients With BRCA1/BRCA2 Mutation
Reviewers: Li Liu, MD Source: Journal of Clinical Oncology, Volume 17, No 10:3017-3024, October 1999.BackgroundFor women with early stage breast cancer, lumpectomy followed by radiation therapy (LRT) has been an acceptable standard of care. Much effort has been made to identify a subgroup of patients who are at higher risk for ipsilateral breast

Second Malignancies after Treatment of Early-Stage Breast Cancer: Lumpectomy and Radiation Therapy Versus Mastectomy
Reviewers: Li Liu, M.D Source: Journal of Clinical Oncology, Volume 18 (12), 2406-2412 (June) 2000Précis: Radiation for breast cancer is not associated with greater risk of second malignancy.IntroductionAlmost all types of cancer can be caused by exposure to ionizing radiation with exception of chronic lymphocytic leukemia. Recent studies

Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17
Authors: Fisher B, Dignam J, Wolmark N, Mamounas E, Costantino J, Poller W, Fisher ER, Wickerham DL, Deutsch M, Margolese R, Dimitrov N, Kavanah M. Source: J Clin Oncol. 1998 Feb; 16(2): 441-52 Background Intraductal carcinoma-in-situ of the breast, commonly referred to as DCIS, is a pathologic diagnosis that is occurring with increasing

Lumpectomy and Radiation Therapy for the Treatment of Intraductal Breast Cancer: Findings from National Surgical Adjuvant Breast and Bowel Project B-17
Reviewers: John Han-Chih Chang, MD and Kenneth Blank, MD Source: Journal of Clinical Oncology 1998; volume 16 (number 2): pages 441 - 452BackgroundWith the use of screening studies such as mammograms and ultrasounds along with self breast exams, there has been a trend towards an increased incidence of finding breast cancers that are not invasive

Breast reconstruction after lumpectomy and radiation treatment
Dear OncoLink "Ask the Experts," It has been a year since I received 25 radiation treatments for Stage II Breast Cancer. Though I had a lumpectomy, I would like to reconstruct the breast to make it look more symmetrical. The plastic surgeon feels that a standard breast lift should fix the problem, but I would like to use a submuscular

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Biopsy

Preparing for Surgery: Breast Biopsy
About Breast Biopsy This "Helpful Facts" sheet is designed to give you basic information on breast biopsy. More detailed information can be provided by your doctor or nurse. If you have other questions or would like additional information, please talk to your doctor or nurse. What is a breast biopsy? A biopsy is a surgical procedure that

Morbidity following Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection for Patients with Breast Carcinoma
Reviewers: Li Liu, MD Source: Cancer, Volume 88:608-614, (February) 2000Précis: Sentinel lymph nodes biopsy is associated with negligible morbidityIntroductionThe histologic status of axillary lymph nodes, one of the most important prognostic indicators in patients with breast cancer, directly affects clinical management. However, over

Accuracy of Sentinel Lymph Node Biopsy in Patients with Large Primary Breast Tumors
Reviewers: Li Liu, MD Source: Cancer, Volume 88:2540-2545, (June) 2000Précis: Sentinel lymph nodes biopsy in patients with 2-5 cm. breast cancers appears accurateIntroductionThe sentinel lymph node (SLN) is the first lymph node to drain the primary tumor. In theory, if the SLN does not contain metastatic cancer, the remainder of the nodal

Sentinel Lymph Node Biopsy with Metastasis: Can Axillary Dissection Be Avoided in Some Patients with Breast Cancer?
Reviewers: John Han-Chih Chang, MD Source: Journal of Clinical Oncology; 1999, Volume 17: Pages 1720 26Background/Discussion/CritiqueThe sentinel lymph node (SLN) is the "first lymph node in a nodal basin to drain the primary tumor." In theory, a malignancy spreads to axillary lymph nodes (ALN's) and progresses in an orderly fashion

Breast Needle Biopsy
Dear OncoLink "Ask the Experts," My mother underwent a needle biopsy on her breast today. Her doctor told her last week when he scheduled the biopsy that he was sure it was cancerous and started planning her surgery. Today he did the biopsy, told her it would be 3 or 4 days before results are in but he has scheduled her for a mastectomy

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Lymph Node Dissection

A High Number of Tumor Free Axillary Lymph Nodes from Patients with Lymph Node Negative Breast Carcinoma is Associated with Poor Outcome
Reviewers: Li Liu, MD Source: Cancer, Volume 88:108-113, (January) 2000Précis: Total number of lymph nodes predicts outcome of node-negative breast cancerIntroductionThe histologic status of axillary lymph nodes is one of the most important prognostic indicators in patients with breast cancer. However, for patients with negative axillary

Accuracy of Sentinel Lymph Node Biopsy in Patients with Large Primary Breast Tumors
Reviewers: Li Liu, MD Source: Cancer, Volume 88:2540-2545, (June) 2000Précis: Sentinel lymph nodes biopsy in patients with 2-5 cm. breast cancers appears accurateIntroductionThe sentinel lymph node (SLN) is the first lymph node to drain the primary tumor. In theory, if the SLN does not contain metastatic cancer, the remainder of the nodal

Occult Metastases in the Sentinel Lymph Nodes of Patients with Early Stage Breast Carcinoma
Reviewers: Li Liu, MD Source: Cancer, 86:990-996, October 1999.BackgroundThe presence of nodal metastases and the number of lymph nodes with metastases are among the most important predictors of the outcome for patients with breast cancer. Approximately 20% to 40% of patients with breast cancer and clinically undetectable lymph nodes have

Prediction of Axillary Lymph Node Involvement of Women with Invasive Breast Carcinoma
Reviewers: John Han-Chih Chang, MD Source: Cancer 1998; Volume 83 (Number 5): pages 948 - 955BackgroundAxillary lymph nodes (ALN) are the most commonly involved siteof disease in breast cancer that has spread outside the primary lesion. Clinical examination is a relatively poor predictor of ALN status inbreast cancer. Because the prognostic

Lymphatic Mapping And Sentinel Lymph Node Sampling In Breast Cancer: A Meta-Analysis
Presenter: T. KimPresenter's Affiliation: Albany Medical CenterType of Session: ScientificBackground Sentinel lymph node sampling (SLNS) in breast cancer has become a common practice There is a lack of randomized clinical trials comparing SLNS to standard axillary lymph node dissection in the staging of breast cancer. This trial was designed to

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Mastectomy

Long-Term Results of a Randomized Trial Comparing Breast-Conserving Therapy With Mastectomy: European Organization for Research and Treatment of Cancer 10801 Trial
Reviewers: Li Liu, MD Source: Journal of the National Cancer Institute, Volume 92(14):1143-1150, (July) 2000Précis: Survival is similar after mastectomy, breast-conserving therapy for stage II tumorsIntroductionIt has been well established that either radical mastectomy or breast-conserving therapy results in the same long-term survival

Second Malignancies after Treatment of Early-Stage Breast Cancer: Lumpectomy and Radiation Therapy Versus Mastectomy
Reviewers: Li Liu, M.D Source: Journal of Clinical Oncology, Volume 18 (12), 2406-2412 (June) 2000Précis: Radiation for breast cancer is not associated with greater risk of second malignancy.IntroductionAlmost all types of cancer can be caused by exposure to ionizing radiation with exception of chronic lymphocytic leukemia. Recent studies

Prognostic Value of p53 for Local Failure in Mastectomy-Treated Breast Cancer Patients
Reviewers: Li Liu, MD Source: Journal of Clinical Oncology, Vol. 18, No 9, 1906-1913, (May) 2000IntroductionRandomized clinical trials have established that radiation therapy improves the local regional control and survival in selected breast cancer patients treated with mastectomy. However, only about 50% of patients will benefit from

Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy Plus Irradiation for the Treatment of Invasive Breast Cancer
Authors: Bernard Fisher, M.D., Stewart Anderson, Ph.D., John Bryant, Ph.D., et al. Source: N Engl J Med 2002, 347:1233-1241 Background The National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-04 showed that over 25 years of follow-up there was no significant difference in survival between women treated with a radical

Efficacy of Bilateral Prophylactic Mastectomy in Women with a Family History of Breast Cancer
Reviewers: Kenneth Blank, MD Source: The New England Journal of Medicine, January 14, 1999, Volume 340, Number 2BackgroundThe treatment of breast cancer has changed dramatically over the past two decades. Advances have included the recognition that breast conserving surgery when combined with radiotherapy offers similar survival compared to