Oncoplastic Breast Surgery versus Conservative Mastectomy in the Management of Large Ductal Carcinoma In Situ (DCIS): Surgical, Oncological, and Patient-Reported Outcomes

Mason, Elena Jane; Leone, Alba Di; Franco, Antonio; D’Archi, Sabatino; Rianna, Chiara; Sánchez, Alejandro Martín; Murando, Federica; Accetta, Cristina; Scardina, Lorenzo; Terribile, Daniela; Masetti, Riccardo; Franceschini, Gianluca

doi:10.3390/cancers14225624

Cited by 8 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To support this result, we performed a Kaplan-Meier analysis of recurrence of this sub-group of patients and margin status, and no correlation between these two parameters was observed. Shaikh et al, in a recent analysis report, produced a similar result based on a more up-to-date sample of patients compared with a previous metaanalysis [7]. Such differences in the results could be justified by the implementation of digital and contrast enhancement mammography [23,24].…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS

Vanni,

Pellicciaro,

Di Lorenzo

et al. 2024

Cancers

View full text Add to dashboard Cite

The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose of this study is to understand the importance of surgical margin width, re-excision, and treatments to avoid additional surgery on locoregional recurrence (LRR). The study is retrospective and analyzed surgical margins, adjuvant treatments, re-excision, and LRR in patients with DCIS who underwent breast-conserving surgery (BCS). A total of 197 patients were enrolled. Re-operation for a close margin rate was 13.5%, and the 3-year recurrence was 7.6%. No difference in the LRR was reported among the patients subjected to BCS regardless of the margin width (p = 0.295). The recurrence rate according to margin status was not significant (p = 0.484). Approximately 36.9% (n: 79) patients had resection margins < 2 mm. A sub-analysis of patients with margins < 2 mm showed no difference in the recurrence between the patients treated with a second surgery and those treated with radiation (p = 0.091). The recurrence rate according to margin status in patients with margins < 2 mm was not significant (p = 0.161). The margin was not a predictive factor of LRR p = 0.999. Surgical re-excision should be avoided in patients with a focally positive margin and no evidence of the disease at post-surgical imaging.

show abstract

Section: Discussionmentioning

confidence: 78%

“…Obtaining negative margins in DCIS could be difficult due to its presentations [6]. In situ lesions often present as vague masses, which cannot be clinically assessed by the physicians [7]. Nowadays, re-excision is the gold standard treatment whenever margins are positive or criteria are not met in DCIS [6].…”

Section: Introductionmentioning

confidence: 99%

Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS

Vanni,

Pellicciaro,

Di Lorenzo

et al. 2024

Cancers

View full text Add to dashboard Cite

show abstract

“…Recently, the importance of patient-reported outcomes (PROs) in the perioperative period of breast cancer has been reported [20][21][22]. However, few studies have focused on patients with metastatic or recurrent breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Survey on adverse events associated with drug therapy for breast cancer patients

Hara,

Nagasaki,

Minami

et al. 2024

Preprint

View full text Add to dashboard Cite

Background In the breast cancer treatment, there may be a gap between patients’ information needs and physicians’ perceptions. To address this issue, we conducted a comprehensive questionnaire survey aimed to assess the specific information needs of patients regarding the adverse events (AEs) associated with treatment. Methods A web-based questionnaire survey (UMIN000049280: Registered on October 31, 2022) was conducted in patients with a history of breast cancer treatment. Responses were obtained regarding AEs experienced, AEs for which remedies were identified, AEs patients sought to prevent, and pre-treatment information on AEs patients desired to have. Results Data from 435 breast cancer patients were analyzed. The most common AEs reported included hair loss (93.3%), malaise/fatigue (89.4%), nail changes (83.2%), dysgeusia (69.0%), leukopenia/white blood cell decreased (65.1%), neuropathy (62.3%), and nausea/vomiting (61.4%). Financial anxiety was reported in 35.2% of the participants. AEs for which a minority of patients found effective solutions included neuropathy (20.3%), financial anxiety (21.6%), edema (24.3%), joint pain (26.0%), and malaise/fatigue (26.7%). Patients expressed the greatest desire to avoid hair loss (34.7%), followed by nausea/vomiting (23.7%), interstitial lung disease/pneumonitis (5.5%), malaise/fatigue (5.1%), and dysgeusia (5.1%). The most commonly requested pre-treatment information regarding AEs was their duration, followed by prevention methods, management strategies, time to onset, and the impact on daily life. Conclusions This survey highlights the existence of significant unmet medical needs among breast cancer patients, due to the inadequate solutions available for managing AEs associated with various therapeutic agents. In addition, the survey revealed that patients have different information needs regarding different types of AEs.

show abstract

“…A systematic review found that women who underwent O-BCS had better sexual well-being and residual skin sensitivity compared to those who underwent mastectomy, despite the type of reconstruction ( 74 ). These findings suggest that preserving the breast tissue and improving breast appearance through oncoplastic techniques can have a positive impact on sexual well-being for breast cancer survivors ( 75 ). However, it is important to note that individual experiences may vary and additional support may still be needed.…”

Section: Qol Outcomesmentioning

confidence: 97%

Evolution of breast conserving surgery—current implementation of oncoplastic techniques in breast conserving surgery: a literature review

Torras,

Cebrecos,

Castillo

et al. 2024

Gland Surg

View full text Add to dashboard Cite

Background and Objective De-escalation in breast cancer surgery has been a natural evolution since breast conserving surgery (BCS) was introduced in the early 1980s. From Halsted mastectomies to wide local excisions, we are facing nowadays the next trend in form of oncoplastic breast surgery. Oncoplastic breast surgery combines oncological principles with plastic surgery techniques to preserve the breast shape and appearance. The aim of this work is to review recent oncological and quality of live outcomes derived from oncoplastic techniques as well as offer a perspective about its implementation in breast cancer units. Methods A literature review was conducted to explore the landscape of oncoplastic breast surgery. Key terms related to oncoplastic techniques and breast cancer were used in searches across databases such as PubMed, Embase and Cochrane Library. Inclusion criteria focused on recent articles discussing oncological and quality of life (QoL) outcomes, as well as perspectives on the role of oncoplastic surgery. Key Content and Findings The research aims to contribute valuable insights into the efficacy and impact of oncoplastic surgery in the context of breast cancer treatment. In this new era of precision medicine, it is more than just healing patients; it is about improving their well-being. We ought to consider specific oncoplasty role in leading this paradigm shift. It is also relevant to define whether these new technical-demanding surgical options can be applied to all patients and if professional training performs adequately to current demands of personalized treatments. Conclusions The global adoption of oncoplastic BCS is recommended due to its oncological safety and improvement in QoL compared to standard procedures. Emphasizing the need for skilled surgeons in complex cases, collaboration between breast surgeons and scientific societies is urged to certify ongoing educational training in oncoplastic techniques.

show abstract

Oncoplastic Breast Surgery versus Conservative Mastectomy in the Management of Large Ductal Carcinoma In Situ (DCIS): Surgical, Oncological, and Patient-Reported Outcomes

Cited by 8 publications

References 32 publications

Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS

Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS

Survey on adverse events associated with drug therapy for breast cancer patients

Evolution of breast conserving surgery—current implementation of oncoplastic techniques in breast conserving surgery: a literature review

Contact Info

Product

Resources

About