Recent Advances in the Surgical Treatment of Early Breast Cancer: An update (original) (raw)
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Feasibility of Percutaneous Excision Followed by Ablation for Local Control in Breast Cancer
Annals of Surgical Oncology, 2011
Objectives-Percutaneous ablation of breast cancer has shown promise as a treatment alternative to open lumpectomy. We hypothesized that percutaneous removal of breast cancer followed by percutaneous ablation to sterilize and widen the margins would not only provide fresh naïve tissue for tumor marker and research investigation but better achieve negative margins post ablation.
Minimally Invasive Treatment of Breast Cancer
2015
The development of diagnostic methods and screening leads to early detection of breast cancer, which is why aspirations are moving towards more conservative local treatment methods. New, non invasive and minimally invasive methods, should att ain same local control, with less cosmetic defects, side eff ects and complications compared to standard surgery. Five methods are being researched in clinical trials: cryoablation, radiofrequency ablation, laser ablation, microwave ablation and ablation by focused high intensity ultrasound waves. Although some results are promising, these methods need further technical development and prospective comparison with today’s golden standard oncoplastic breast surgery.
The Medical journal of Malaysia, 1993
Over the past 50 years, a variety of surgical procedures have been advocated for the treatment of operable breast cancer, ranging from local excision to supraradical mastectomy. Today, the surgical treatment of breast cancer remains highly contentious. We review the historical development of breast cancer surgery and analyse the available evidence supporting conservative procedures. We also express our opinions on the treatment of early breast cancer and illustrate the changing patterns of surgery with our experience at National University Hospital.
Minimally invasive therapy for the treatment of breast tumours
2002
Minimally invasive therapy has been explored as a potential means of treating breast tumours with minimal disruption to adjacent soft tissues. The purpose of this is to facilitate improved cosmesis and to offer treatment to women who are unfit for surgery. A number of treatment modalities including thermal therapies (intersitital laser photocoagulation, radiofrequency, focused ultrasound and cryotherapy), percutaneous excision and interstitial radiotherapy are being developed. The experience to date of each of these modalities is described and reviewed. Currently there are too few data to indicate the efficacy of these treatments although the preliminary data are encouraging. The need for large-scale studies examining the role of MIT in relationship to the overall management of breast cancer (including chemotherapy, radiotherapy, and the management of the axilla) and outcome is discussed.
Current Surgical Innovations in the Treatment of Breast Cancer
Exon Publications eBooks, 2022
Surgery is an essential component in the management of treatable breast cancer. With the use of standardized staging and data collection, evidencebased management of breast cancer has evolved to limit treatments to what is necessary but sufficient to allow tissue preservation and control of treatmentspecific morbidity. As more tumors are discovered by pretreatment imaging and are not identifiable on physical exam, intraoperative tumor localization techniques have become increasingly sophisticated and reliable. Techniques for localization of "sentinel" nodes has become increasingly accurate and technically less complicated. Surgical treatment may occur after pretreatment with systemic agents (neoadjuvant) or a part of reconstruction (oncoplastic resection). Postsurgical morbidity has become an increasing focus of concern as more patients survive breast cancer with modern therapy. Cosmetic deformity is a significant cause of distress in many patients and attributed to causing delay in seeking treatment and contributing to postoperative depression. Reconstruction with
Minimal Invasive Ablative Techniques in the Treatment of Breast Cancer: a Systematic Review
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group, 2016
Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer. A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016. Studies were considered eligible for inclusion if they evaluated the role of ablative techniques in the treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the inclusion criteria were excluded. We identified 63 studies including 1608 patients whose breast tumours were treated with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or microwave ablation. Fifty studies reported on the number of patients with complete ablation as found on histopathology and ...
World Journal of Clinical Oncology, 2013
Breast-conservation surgery (BCS) is established as a safe surgical treatment for most patients with early breast cancer. Recently, advances in oncoplastic techniques are capable of preserving the breast form and quality of life. Although most BCS defects can be managed with primary closure, the aesthetic outcome may be unpredictable. Among technical options, therapeutic reduction mammaplasty (TRM) remains a useful procedure since the BCS defect can be repaired and the preoperative appearance can be improved, resulting in more proportional breasts. As a consequence of rich breast tissue vascularization, the greater part of reduction techniques have based their planning on preserving the pedicle of the nipple-areola complex after tumor removal. Reliable circulation and improvement of a conical shape to the breast are commonly described in TRM reconstructions. With an immediate approach, the surgical process is smooth since both procedures can be carried out in one operative setting. Additionally, it permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reduces the incidence of margin involvement. Regardless of the fact that there is no consensus concerning the best TRM technique, the criteria is determined by the surgeon's experience, the extent/location of glandular tissue resection and the size of the defect in relation to the size of the remaining breast. The main advantages of the technique utilized should include reproducibility, low interference with the oncological treatment and long-term results. The success of the procedure depends on patient selection, coordinated planning and careful intra-operative management.
Modern Approaches to the Surgical Management of Malignant Breast Disease
Clinics in Plastic Surgery, 2018
A variety of surgical approaches exist for the management of breast cancer. Options include breast-conserving surgery, including oncoplastic techniques, as well as mastectomy with a standard, skin-and nipple-sparing approach with reconstruction. Adjuvant therapies such as radiation and systemic treatment (chemotherapy, endocrine therapy) are used in conjunction with surgical management for most patients, dependent on their disease stage and prognostic features.
Breast conservation in the treatment of early breast cancer a 20-year follow-up
Cancer, 1984
Two hundred sixty-three patients with unilateral primary breast cancer, treated by local excision of the primary tumor and radical radiation therapy between 1954 and 1969, were followed up for a minimum of 10 years and a maximum of 20 years. The treatment plan delivered 4500 rad in fractions of orthovoltage irradiation to five fields: tangential breast fields, axilla with posterior axillary field, parasternal and supraclavicular, with a subsequent boost of lo00 rad to the primary tumor site, axilla, and supraclavicular fossa. Patients were clinically staged using the TNM zyxwvu (UICC) system; 115 patients had tumors less than 2 cm in diameter and a clinically negative axilla (TlNONla), 96 had tumors 2 to 5 cm in diameter with a clinically negative axilla (TtNONla), and 52 had tumors less than 5 cm in diameter and clinical axillary lymph node metastases (TlT2Nl b). The actuarial relapse-free survival of patients with T1 NONla tumors was 72% at 5 years, 59% at 10 years, and 47% at both 15 and 20 years. The relapse-free survival of patients with T2NONla tumors was not statistically different zyxwv (P > 0.05). A significantly worse survival was observed in patients with clinical axillary lymph node metastases (TlT2Nlb), with a survival of 37% at 5 years, 29% at 10 years, 23% at 15 years, and 22% at 20 years, when compared with patients with clinically negative lymph nodes (P < 0.01). Locoregional relapse occurred in 22%, at 10 years, of those patients with T1 or T2NONla tumors and 52% of the patients with TlT2Nl b tumors. The pattern of locoregional relapses indicated that approximately 50% occur at least 5 years after treatment; this contrasts with the pattern of early locoregional relapse after mastectomy. The commonest sites of relapse were in the breast in 19% and axilla in 6% of patients with TI or T2NONla tumors. There was no attenuation of the radiation dose administered at the site of a subsequent relapse. Surgery for radiation failure produced a 42% crude relapse-free survival at 5 years after salvage mastectomy in those patients originally treated for TI or TlNONla tumors. The results of this study suggest that a significant proportion of patients relapse locally over a prolonged period after breast conservation. The evolution of new radiation techniques may provide better locoregional control and early salvage surgery may result in improved long-term survival.