Outcome of oncoplastic breast-conserving surgery following bracketing wire localization for large breast cancer

Malhaire, Caroline; Héquet, Delphine; Falcou, Marie-Christine; Féron, Jean-Guillaume; Tardivon, A.; Leduey, Alexandre; Guillot, Eugénie; Mosseri, Véronique; Rouzier, Roman; Couturaud, Benoît; Reyal, Fabien

doi:10.1016/j.breast.2015.02.037

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…In 1985, Fisher et al introduced the concept of breast conserving therapy (BCT), demonstrating that lumpectomy – by that time regarded as segmental mastectomy – followed by adjuvant radiotherapy of the remnant breast in patients with stage I and II breast cancer was indeed associated with an increased local recurrence rate, yet resulted in equal survival rates compared to mastectomy ( 4 ). Oncoplastic breast surgery, i.e., reshaping of the breast after local tumor resection, has shown to allow larger tumor excision, yet conserving large parts of the breast, maintaining shape ( 5 ) and resulting in improved quality of life and self-esteem ( 6 ). While surgical breast cancer treatment decreased in radicalness and invasiveness, breast cancer guidelines were defined, breast cancer screening programs were initiated, and breast centers offering an interdisciplinary and comprehensive therapeutical approach for breast cancer were established.…”

Section: Introductionmentioning

confidence: 99%

Breast Reconstruction after Mastectomy

2016

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Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays, breast reconstruction should be individualized at its best, first of all taking into consideration not only the oncological aspects of the tumor, neo-/adjuvant treatment, and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction), as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue), the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

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Section: Introductionmentioning

confidence: 99%

Breast Reconstruction after Mastectomy

2016

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“…This might explain the rate of tumor negative resection margins of BWL in this study (77%) being on the high range compared with those of other studies, which range between 44% and 83%. 24,25,[27][28][29] Another explanation for the high rate of negative margins in this study is the use of preoperative magnetic resonance imaging in almost all (82%) patients to get an adequate estimation of the true tumor extent. Fillion et al, who compared 79 patients treated with BWL to 122 patients treated with WGL, reported more positive margins (39% vs. 18%; P ¼ .039) and re-excisions (44% vs. 25%; P ¼ .004) for BWL.…”

Section: Discussionmentioning

confidence: 89%

“…The solution to this problem is to demarcate the 3-dimensional borders of a tumor with bracketing wire-guided localization (BWL). [23][24][25] This technique was first described in 1987 by Silverstein et al as adequate placement of multiple wires relative to the tumor for determining total tumor arrangement intraoperatively. 26 Subsequent studies on BWL have described negative margin rates between 42.0% and 86.5%.…”

Section: Introductionmentioning

confidence: 99%

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Optimization of Wire-guided Technique With Bracketing Reduces Resection Volumes in Breast-conserving Surgery for Early Breast Cancer

Civil

Duvivier

Perin

et al. 2020

Clinical Breast Cancer

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Bracketing wire-guided localization (BWL) to demarcate tumor borders can be used to minimize resection volumes in patients with breast cancer. The sample consisted of 17 patients treated with BWL and 44 patients treated with single wire-guided localization. BWL achieved smaller resection volumes than wire-guided localization without compromising margin status for breast tumors larger than 1.5 cm, which could potentially improve cosmetic outcomes. Background: Wire-guided localization (WGL) of early breast cancer can be facilitated using multiple wires, which is called bracketing wire-guided localization (BWL). The primary aim of this study is to compare BWL and conventional WGL regarding minimization of resection volumes without compromising margin status. Secondly, BWL is evaluated as an alternative method for intraoperative ultrasound (US) guidance in poorly definable breast tumors on US. Patients and Methods: In this retrospective cohort study, patients with preoperatively diagnosed breast cancer undergoing wide local excision between January 2016 and December 2018 were analyzed. Patients with multifocal disease or neoadjuvant treatment were excluded from this study. Optimal resection with minimal healthy breast tissue removal was assessed using the calculated resection ratio (CRR). Results: BWL was performed in 17 (9%) patients, WGL in 44 (22%), and US in 139 (70%). The rate of negative margins was comparable in all 3 groups. The CRR was significantly smaller for BWL (0.6) than WGL (1.3) in tumors larger than 1.5 cm. Additionally, BWL (0.8) led to smaller CRRs than US (1.7). This could be explained by the high number of small tumors ( 1.5 cm) in the US group for which greater CRRs are obtained than for large tumors (> 1.5 cm) (1.9 vs. 1.4; P ¼ .005). Conclusion: For breast tumors larger than 1.5 cm, BWL achieves more optimal resection volumes without compromising margin status compared with WGL. Moreover, BWL seems a suitable alternative to US in patients with poorly ultrasound-visible breast tumors and patients with a small tumor in a (large) breast.

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“…Breast cancer is a leading cause of death in women with approximately 1.7 million new cases and over 522000 deaths per year [1] . However, the overall number of breast reconstructions has lately considerably increased, currently, there are about 93000 breast reconstructions performed in the United States per year [2,3] . Breast reconstruction including implant-and expander-based breast reconstruction, and nowadays, autologous fat grafting (non-vascularized autologous lipoaspirate fat) is being increasingly used for reconstructive procedures following surgery for breast cancer patients [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Isolation and identification of adipose-derived stromal/stem cells from breast cancer patients after exposure neoadjuvant chemotherapy

Hagaman

Zhang

Koko

et al. 2020

WJEM

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Hagaman AR and Zhang P performed conception and design, collected samples, the majority of experiments, analyzed the data and wrote the article; Koko KR, Nolan RS and Fromer MW collected samples, clinical analysis, and interpretation; Matthews M performed conception and design, patients selection and collected samples, clinical analysis, and interpretation; Gaughan J, a senior biostatistician performed study statistical analysis. Institutional review board statement: All patients provided written informed consent in accordance with our IRB-approved protocol by Cooper Health Care Institutional Review Board (Protocol approval number # 15-107EX/2015, name: Examining the potential impact of chemotherapy and radiation on mesenchymal stem cells in cancer patients).

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Outcome of oncoplastic breast-conserving surgery following bracketing wire localization for large breast cancer

Cited by 6 publications

References 20 publications

Breast Reconstruction after Mastectomy

Breast Reconstruction after Mastectomy

Optimization of Wire-guided Technique With Bracketing Reduces Resection Volumes in Breast-conserving Surgery for Early Breast Cancer

Isolation and identification of adipose-derived stromal/stem cells from breast cancer patients after exposure neoadjuvant chemotherapy

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