The quality of preoperative diagnostics and surgery and their impact on delays in breast cancer treatment – A population based study

Ojala, Kaisu; Meretoja, Tuomo J.; Mattson, Johanna; Salminen-Peltola, P; Leutola, S; Berggren, Marianne; Leidenius, Marjut

doi:10.1016/j.breast.2015.12.009

Cited by 13 publications

(14 citation statements)

References 32 publications

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“…Group-2 Group-3 p-value differ among the three groups, with mean values of 34e35 days, consistent with prior studies with mean values of 30e47 days [28,29]. The mean time from referral to surgery ranged from 25 to 30 days, being shorter in the sMRI group and longest in the WLE group.…”

Section: Group-1supporting

confidence: 86%

“…The mean time from referral to surgery ranged from 25 to 30 days, being shorter in the sMRI group and longest in the WLE group. However, the time from referral to surgery was longer in our population than in other Nordic studies (17e24 days) [29,30]. In this study, patients in sMRI Group had the shortest waiting time (25.5 days), even though they all needed to undergo further evaluation and more preoperative studies, including MRI.…”

Section: Group-1mentioning

confidence: 51%

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Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Joukainen

Okuma

Kaarela

et al. 2021

European Journal of Surgical Oncology

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Objectives: To evaluate the clinical value of supine magnetic resonance imaging (MRI) for tumor localization in breast cancer patients with large or multifocal tumors detected by prone MRI, scheduled for oncoplastic breast conserving surgery (OBCS). Outcomes were compared with those of patients who underwent wide local excision (WLE) or OBCS without MRI guidance. Methods: Over a 2-year period, consecutive patients with large or multifocal disease scheduled for OBCS with MRI-only findings were invited to participate (Group-1). Supplementary supine MRI was performed, and tumor margins were marked in the surgical position. Consecutive patients with early, nonpalpable breast cancer who underwent WLE (Group-2) or OBCS (Group-3) were included for comparisons. The primary outcome was reoperation due to an insufficient margin. Secondary outcomes included surgical complications and delayed adjuvant treatment. Results: Altogether, 102 breasts (98 patients) were analyzed. All preoperative demographic data were comparable among the three groups. Multifocality, tumor-to-breast volume ratio, and the volume of excised breast tissue were significantly greater in Group-1 than in Groups-2 and 3. Operation time was longer and the need for axillary clearance or surgery for both breasts was more common in Groups-1 and 3 than in Group-2. Adequate margins were achieved in all patients in Groups-1 and 2, and one patient underwent re-excision in Group-3. Conclusions: Supine MRI in the surgical position is a new, promising method to localize multifocal, large tumors visible on MRI. Its short-term outcomes were comparable with those of conventional WLE and OBCS.

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Section: Group-1supporting

confidence: 86%

Section: Group-1mentioning

confidence: 51%

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Joukainen

Okuma

Kaarela

et al. 2021

European Journal of Surgical Oncology

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“…Due to study plan, patients receiving mastectomy as a second operation were excluded. In our previous study 18 of this same population including also mastectomies we have shown re-excision rate of 7.6% of which 78% were mastectomies. There was no difference in surgical complications requiring a re-operation, that is 5 (2%) in the conventional group and 3 (3%) in the oncoplastic group, p ¼ 0.309.…”

Section: Surgerymentioning

confidence: 67%

Aesthetic and functional outcome after breast conserving surgery – Comparison between conventional and oncoplastic resection

Ojala

Meretoja

Leidenius

2017

European Journal of Surgical Oncology (EJSO)

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“…Thus, mastectomy was performed more often as the second procedure in the oncoplastic BCS group. Waiting time for adjuvant treatment is discussed in our previous study, which included patients who underwent BCS in 2010 at our institution [21]. There was no difference in median waiting time between conventional and oncoplastic surgery (47 vs. 48 days).…”

Section: Resection Margins and Reoperationsmentioning

confidence: 97%

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

Niinikoski

Leidenius

Vaara

et al. 2019

European Journal of Surgical Oncology

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Background: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques. Material and methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N ¼ 1707) or ductal carcinoma in situ (N ¼ 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012. Results: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p < 0.001), larger (p < 0.001), palpable tumours (p < 0.001) with larger resection specimens (p < 0.001). The amount of resected tissue varied substantially depending on the oncoplastic technique. Patients treated with oncoplastic BCS were younger (p < 0.001) and their tumours were more aggressive according to histological grade (p < 0.001), T-stage (p < 0.001), Ki-67 (p < 0.001) and lymph node status (p < 0.001). There was no difference, however, in surgical margins (p ¼ 0.578) or reoperation rates (p ¼ 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2e94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p ¼ 0.172). Conclusions: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy.

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The quality of preoperative diagnostics and surgery and their impact on delays in breast cancer treatment – A population based study

Cited by 13 publications

References 32 publications

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Aesthetic and functional outcome after breast conserving surgery – Comparison between conventional and oncoplastic resection

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

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