Multidisciplinary Care for Patients With Breast Cancer

Shuster, Todd D.; Girshovich, Lyubov; Whitney, Timothy M.; Hughes, Kevin S.

doi:10.1016/s0039-6109(05)70199-7

Cited by 21 publications

(8 citation statements)

References 88 publications

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“…Especially in breast cancer and melanoma the involvement of regional lymph nodes is an excellent prognostic indicator. But about two thirds of the invasive cancers have no regional lymph node involvement and of those another third will recur (13,14). Studies evaluating the prognostic value of tumor-free sentinel lymph nodes are contradictory (15–17).…”

Section: Introductionmentioning

confidence: 99%

Induced lymphatic sinus hyperplasia in sentinel lymph nodes by VEGF-C as the earliest premetastatic indicator

Liersch

Hirakawa

Berdel

et al. 2012

International Journal of Oncology

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Research on tumor-induced lymphangiogenesis has predominantly focused on alterations and abnormal growth of peritumoral and intratumoral lymphatic vessels. However, recent evidence indicates that lymphangiogenesis of sentinel lymph nodes might also contribute to cancer progression. In clinical oncology, the sentinel lymph nodes play an important role in diagnosis, staging and management of disease. The prognostic value that may be placed in the analysis of various parameters in tumor-free lymph nodes is still under debate. We, therefore, chose to investigate genetically fluorescent MDA-MB-435/green fluorescent protein human cancer cells transfected to overexpress VEGF-C in a nude mouse model and investigated metastasis, lymph node lymphangiogenesis, lymph node angiogenesis and size of sentinel lymph nodes. The nature of MDA-MB-435, identified as a breast cancer cell line for several decades, has recently been reidentified as being from melanoma origin. Vascular endothelial growth factor-C overexpression induced early metastasis and significantly increased the lymphatic vessel area in sentinel lymph nodes even before the tumor metastasis. At early time-points, expansion of the lymphatic network was observed even though no difference of blood vessel area and lymph node size was detected. These results suggest that primary tumors -via secretion of VEGF-C- can induce hyperplasia of the sentinel lymph node lymphatic vessel network and thereby promote their further spread. In cases of tumor-free lymph nodes the increased lymphatic network of sentinel lymph nodes is a very early premetastatic sign and may provide a new prognostic indicator and target for aggressive diseases.

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Section: Introductionmentioning

confidence: 99%

Induced lymphatic sinus hyperplasia in sentinel lymph nodes by VEGF-C as the earliest premetastatic indicator

Liersch

Hirakawa

Berdel

et al. 2012

International Journal of Oncology

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“…The management decisions for breast cancer patients taken within the context of a MDT meeting involves collaboration between specialist teams and a consensus agreement being reached after consideration of available therapeutic options. This facilitates patient-centred, evidence-based treatment planning with good access to clinical trials (Shuster et al , 2000; Tripathy, 2003). This multidisciplinary approach to the management of patients with breast cancer is not unique to the United Kingdom and is widely utilised in other European countries, America, Australia and Asia (Chang et al , 2001; Zorbas et al , 2003; Saini et al , 2012).…”

mentioning

confidence: 99%

Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended?

et al. 2013

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Background:A multidisciplinary team (MDT) approach to breast cancer management is the gold standard. The aim is to evaluate MDT decision making in a modern breast unit.Methods:All referrals to the breast MDT where breast cancer was diagnosed from 1 July 2009 to 30 June 2011 were included. Multidisciplinary team decisions were compared with subsequent patient management and classified as concordant or discordant.Results:Over the study period, there were 3230 MDT decisions relating to 705 patients. Overall, 91.5% (2956 out of 3230) of decisions were concordant, 4.5% (146 out of 3230), were discordant and 4% (128 out of 3230) had no MDT decision. Of 146 discordant decisions, 26 (17.8%) were considered ‘unjustifiable' as there was no additional information available after the MDT to account for the change in management. The remaining 120 discordant MDT decisions were considered ‘justifiable', as management was altered due to patient choice (n=61), additional information available after MDT (n=54) or MDT error (n=5).Conclusion:The vast majority of MDT decisions are implemented. Management alteration was most often due to patient choice or additional information available after the MDT. A minority of management alterations were ‘unjustifiable' and the authors recommend that any patient whose treatment is subsequently changed should have MDT rediscussion prior to treatment.

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“…In addition, it is a prerequisite that every professional who works within such a setting, will have a formal training in his profession in relation to breast cancer. This means, for example, that the pathologist will be a breast pathologist who specializes in breast cancer diagnoses, and the radiologist will have expertise in breast imaging, and the nurse will have a formal education in breast cancer nursing [9][10][11] .…”

Section: The Comprehensive Breast Cancer Centermentioning

confidence: 99%

Multidisciplinary approach to breast cancer: A new outlook on nursing care

Kadmon

Barak

2009

Clin. Oncol. Cancer Res.

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The treatment and general care for women diagnosed with breast cancer has made a tremendous change and advance in the last decades. Better methods for early detection and screening of the disease, higher compliance of women to go for screening, an open social and political discourse of women and the health care team and others, are just a few that both enabled and are a result of this change. Nurses have been highly involved in these changes, which resulted in the specialization of nursing in the field of breast cancer. This article will focus on the main four points that infl uence the nursing specialist care, that is，the tailoring of treatment and the ability to offer women treatment which is more specifi c to their own cancer; the importance of the multidisciplinary team as providing a State of the Art care; the involvement of women in the decision-making regarding their treatment and the specifi c developing role of the specialist breast care nurse.KEY WORDS: breast cancer nursing, decision-making, comprehensive/multi-disciplinary breast cancer center, tailored treatment.

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Multidisciplinary Care for Patients With Breast Cancer

Cited by 21 publications

References 88 publications

Induced lymphatic sinus hyperplasia in sentinel lymph nodes by VEGF-C as the earliest premetastatic indicator

Induced lymphatic sinus hyperplasia in sentinel lymph nodes by VEGF-C as the earliest premetastatic indicator

Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended?

Multidisciplinary approach to breast cancer: A new outlook on nursing care

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