Breast Cancer Incidence by Stage Before and After Change in Screening Guidelines

Guo, Fangjian; Kuo, Yong Fang; Berenson, Abbey B.

doi:10.1016/j.amepre.2018.08.018

Cited by 16 publications

(16 citation statements)

References 39 publications

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“…Breast cancer is the second most prevalent cancer and the second leading cause of cancer death among women worldwide, with a slight but stable increase in its incidence in the most recent decade [1]. At our center, breast cancer patients account for approximately onethird of all patients requiring curative radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Lin

et al. 2020

Radiat Oncol

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Background: Hypofractionated whole-breast irradiation is a standard adjuvant therapy for early-stage breast cancer. This study evaluates the plan quality and efficacy of an in-house-developed automated radiotherapy treatment planning algorithm for hypofractionated whole-breast radiotherapy. Methods: A cohort of 99 node-negative left-sided breast cancer patients completed hypofractionated whole-breast irradiation with six-field IMRT for 42.56 Gy in 16 daily fractions from year 2016 to 2018 at a tertiary center were replanned with an in-house-developed algorithm. The automated plan-generating C#-based program is developed in a Varian ESAPI research mode. The dose-volume histogram (DVH) and other dosimetric parameters of the automated and manual plans were directly compared. Results: The average time for generating an autoplan was 5 to 6 min, while the manual planning time ranged from 1 to 1.5 h. There was only a small difference in both the gantry angles and the collimator angles between the autoplans and the manual plans (ranging from 2.2 to 5.3 degrees). Autoplans and manual plans performed similarly well in hotspot volume and PTV coverage, with the autoplans performing slightly better in the ipsilateral-lungsparing dose parameters but were inferior in contralateral-breast-sparing. The autoplan dosimetric quality did not vary with different breast sizes, but for manual plans, there was worse ipsilateral-lung-sparing (V 4Gy ) in larger or medium-sized breasts than in smaller breasts. Autoplans were generally superior than manual plans in CI (1.24 ± 0.06 vs. 1.30 ± 0.09, p < 0.01) and MU (1010 ± 46 vs. 1205 ± 187, p < 0.01). Conclusions:Our study presents a well-designed standardized fully automated planning algorithm for optimized whole-breast radiotherapy treatment plan generation. A large cohort of 99 patients were re-planned and retrospectively analyzed. The automated plans demonstrated similar or even better dosimetric quality and efficacy in comparison with the manual plans. Our result suggested that the autoplanning algorithm has great clinical applicability potential.

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Section: Introductionmentioning

confidence: 99%

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Lin

et al. 2020

Radiat Oncol

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“…Primary angiosarcoma of the breast (PAS) and radiation-associated angiosarcoma of the breast (RAAS) are rare sarcomas that affect the inner lining of blood vessels in the breast with incidences of 0.05% and 0.02%, respectively [1][2][3]. Moreover, given the aggressive nature of these sarcomas, locoregional recurrence rates (53% for PAS and 46% for RAAS) and distant metastasis (34% for PAS and 13% for RAAS) remain high, leading to poor median overall survival (OS) rates at 16 months for PAS and 12 months for RAAS following either surgery or chemotherapy alone [2,[4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Kronenfeld

Crystal

Ryon

et al. 2021

Cancers

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Background: The optimal management of primary angiosarcoma (PAS) and radiation-associated angiosarcoma (RAAS) of the breast remains undefined. Available data show persistently poor survival outcomes following treatment with surgery or chemotherapy alone. The objective of this study was to evaluate long-term outcomes in patients treated with multimodality therapy. Methods: Patients diagnosed with stage I–III PAS or RAAS of the breast were identified from our local tumor registry (2010–2020). Patient demographics, tumor characteristics, and treatment were collected. Primary outcomes were local recurrence (LR), distant recurrence (DR), and median overall survival (OS). A secondary outcome was pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC). Mann–Whitney U, chi-squared, or Fisher exact tests were used to analyze data. Kaplan–Meier curves compared OS for PAS and RAAS. Results: Twenty-two patients met inclusion criteria, including 11 (50%) with RAAS and 11 (50%) with PAS. Compared to PAS patients, RAAS patients were older and had more comorbidities. For RAAS patients, median time from radiation to diagnosis was 6 years (IQR: 5–11). RAAS patients were more likely to have a pCR to NAC (40% vs. 20%, p = 0.72). RAAS patients had a higher LR rate (43% vs. 38%, p = 0.83), and PAS patients were more likely to develop a DR (38% vs. 0%, p = 0.07). Median OS was 81 months in PAS patients and 90 months in RAAS patients (p = 1.00). Discussion: Long-term survival can be achieved in patients with PAS and RAAS who undergo multimodality treatment. NAC can result in pCR. The long-term clinical implications of pCR warrant further investigation.

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“…Breast cancer is the most common malignancy in women, with over 250,000 annual diagnoses in the United States. 1 Postmastectomy breast reconstruction has established itself as a critical component in the treatment algorithm of breast cancer patients, as evidenced by an almost 40% increase in the number of breast reconstructions performed in the United States over the past 20 years. 2 The main contributor to this growth has been implant-based reconstruction, which accounts for 80% of all breast reconstructions.…”

Section: Introductionmentioning

confidence: 99%

Advances in Tissue Expander Technology Enable Early Targeted Intervention in Prepectoral Breast Reconstruction

Liu

Henn

Shrefren

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Seroma and infection are among the most common complications after staged prepectoral implant-based reconstruction. Advances in tissue expander technology permit seroma aspiration via an integrated drain port, thus, holding promise for improving clinical outcomes. Methods: A prospectively maintained database of patients who had undergone immediate prepectoral breast reconstruction using the Sientra AlloX2 tissue expander was used to determine the rate of postoperative seroma formation, its volume and microbiological spectrum, as well as postoperative complications. Results: 49 patients (mean age: 49 years, mean body mass index: 24.5 kg/m 2 ) underwent 79 prepectoral breast reconstructions. Seroma was clinically suspected in 26 reconstructions (32.9%) and was easily aspirated in all cases via the integrated drain port. Importantly, periprosthetic fluid was successfully aspirated in 45 reconstructions (57%) without any clinical evidence for seroma, with aspirated cumulative fluid volumes exceeding 10 cm 3 in 12 reconstructions. Bacterial cultures from aspirated fluid were positive in six patients (12.2%), of whom two developed clinical signs of infection, at which point targeted antibiotic treatment was initiated. Conclusions: Our study demonstrates that routine office-based aspiration of periprosthetic fluid via the integrated drain port of the AlloX2 tissue expander not only permits successful aspiration of periprosthetic fluid but also allows aspirated fluid to be sent for culture, thus, providing a lead-time advantage for initiation of targeted antibiotic therapy in cases of postoperative surgical site infection. Furthermore, our observations indicate that positive bacterial cultures in the absence of clinical signs of infection do not mandate antibiotic therapy.

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Breast Cancer Incidence by Stage Before and After Change in Screening Guidelines

Cited by 16 publications

References 39 publications

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Advances in Tissue Expander Technology Enable Early Targeted Intervention in Prepectoral Breast Reconstruction

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