Breast Care最新文献_第4页

Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection 高风险乳腺病变在真空辅助活检中无后续手术切除的长期随访

4区医学

Breast Care Pub Date : 2023-09-07 DOI: 10.1159/000533673

Constanze Elfgen, Zsuzsanna Varga, Katrin Breitling, Eliane Pauli, Daniela Schwegler-Guggemos, Gert Kampmann, Rahel A. Kubik-Huch, Cornelia Leo, Domenico Lepori, Martin Sonnenschein, Christoph Tausch, Simone Schrading

{"title":"Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection","authors":"Constanze Elfgen, Zsuzsanna Varga, Katrin Breitling, Eliane Pauli, Daniela Schwegler-Guggemos, Gert Kampmann, Rahel A. Kubik-Huch, Cornelia Leo, Domenico Lepori, Martin Sonnenschein, Christoph Tausch, Simone Schrading","doi":"10.1159/000533673","DOIUrl":"https://doi.org/10.1159/000533673","url":null,"abstract":"Introduction: B3-lesions of the breast are a heterogeneous group of neoplasms, associated with a higher risk of breast cancer. Recent studies show a low upgrade rate into malignancy after subsequent open surgical excision (OE) of most B3-lesions when proven by vacuum-assisted biopsy (VAB). However, there is a lack of long-term follow-up data after VAB of high-risk lesions. The primary aim of this study was to demonstrate whether follow-up of B3 lesions is a beneficial and reliable alternative to OE in terms of long-term outcome. The secondary aim was to identify patient and lesion characteristics of B3 lesions for which OE is still necessary. Methods: This retrospective multicenter study was conducted at 8 Swiss breast centers between 2010 and 2019. A total of 278 women (mean age: 53.5 ± 10.7 years) with 286 B3-lesions who had observation only and who had at least 24 months of follow-up were included. Any event during follow-up (ductal carcinoma in situ [DCIS], invasive cancer, new B3-lesion) was systematically recorded. Data from women who had an event during follow-up were compared with those who did not. The results for the different B3 lesions were analyzed using the t test and Fisher’s exact test. A p value of &lt;0.05 was considered statistically significant. Results: The median follow-up interval was 59 months (range: 24–143 months) with 52% (148/286) having a follow-up of more than 5 years. During follow-up, in 42 women, 44 suspicious lesions occurred, with 36.4% (16/44) being invasive cancer and 6.8% (3/44) being DCIS. Thus, 6.6% (19/286) of all women developed malignancy during follow-up after a median follow-up interval of 6.5 years (range: 31–119 months). The initial histology of the B3 lesion influenced the subsequent occurrence of a malignant lesion during follow-up (p &lt; 0.038). The highest malignancy-developing rate was observed in atypical ductal hyperplasia (ADH) (24%, 19/79), while all other B3-lesions had malignant findings ipsi- and contralateral between 0% and 6%. The results were not influenced by the VAB method (Mx-, US-, magnetic resonance imaging-guided), the radiological characteristics of the lesion, or the age or menopausal status of the patient (p &gt; 0.12). Conclusion: With a low risk of &lt;6% of developing malignancy, VAB followed by long-term follow-up is a safe alternative to OE for most B3-lesions. A higher malignancy rate only occurred in ADH (24%). Based on our results, radiological follow-up should be bilateral, preferable using the technique of initial diagnosis. As we observed a late peak (6–7 years) of breast malignancies after B3-lesions, follow-up should be continued for a longer period (&gt;10 years). Knowledge of these long-term outcome results will be helpful in making treatment decisions and determining the optimal radiological follow-up interval.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135098992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Ongoing Necessity of Sentinel Lymph Node Biopsy for cT1–2N0 Breast Cancer Patients cT1-2N0乳腺癌患者前哨淋巴结活检的持续必要性

4区医学

Breast Care Pub Date : 2023-08-17 DOI: 10.1159/000532081

Wenjun Jia, Xiao Chen, Xinyu Wang, Jianzhong Zhang, Tong Tang, Jianing Shi

{"title":"The Ongoing Necessity of Sentinel Lymph Node Biopsy for cT1–2N0 Breast Cancer Patients","authors":"Wenjun Jia, Xiao Chen, Xinyu Wang, Jianzhong Zhang, Tong Tang, Jianing Shi","doi":"10.1159/000532081","DOIUrl":"https://doi.org/10.1159/000532081","url":null,"abstract":"Background: Recent clinical trials attempt to determine whether it is appropriate to omit axillary lymph node surgery in patients with cT1–2N0 breast cancer. The study aimed to investigate the true extent of axillary node disease in patients with clinically negative nodes and explore the differences between negative axillary ultrasound (AUS-cN0) and suspicious axillary ultrasound with negative fine-needle aspiration (FNA-cN0). Methods: Pathologically identified T1–2 invasive breast cancer patients with clinically negative nodes were retrospectively analyzed at our center between January 2019 and December 2022. Patients who received any systematic treatment before surgery were excluded from this study. Results: A total of 538 patients were enrolled in this study. 134 (24.9%) patients had pathologically positive nodes, and 404 (75.1%) patients had negative nodes. Univariate analysis revealed that tumor size, T stage, Ki67 level, and vascular invasion (VI) were strongly associated with pathological axillary lymph node positivity. In multivariate analysis, VI was the only independent risk factor for node positivity in patients with cT1–2N0 disease (OR: 3.723, confidence interval [CI]: 2.380–5.824, p &lt; 0.001). Otherwise, pathological node positivity was not significantly different between AUS-cN0 and FNA-cN0 groups (23.4% vs. 28.8%, p = 0.193). However, the rate of high nodal burden (≥3 positive nodes) was significantly higher in FNA-cN0 group. Further investigation revealed that FNA-cN0 and VI were independently associated with a high nodal burden (OR: 2.650, CI: 1.081–6.496, p = 0.033; OR: 3.521, CI: 1.249–9.931, p = 0.017, respectively). Conclusions: cT1–2 breast cancer patients with clinically negative axillary lymph nodes may have pathologically positive lymph nodes and even a high nodal burden. False negatives in AUS and AUS-guided FNA should not be ignored, and sentinel lymph node biopsy remains an ongoing necessity for cT1–2N0 breast cancer patients.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136337633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sacituzumab govitecan: Trop-2 als Target Sacituzumab govitecan: Trop-2 als靶点

IF 2.1 4区医学

Breast Care Pub Date : 2023-08-01 DOI: 10.1159/000533368

引用次数: 0

PharmaNews PharmaNews

IF 2.1 4区医学

Breast Care Pub Date : 2023-06-01 DOI: 10.1159/000531327

引用次数: 0

Effects and Risks of Hormonal Therapy before and after BC Therapy BC治疗前后激素治疗的效果和风险

IF 2.1 4区医学

Breast Care Pub Date : 2023-06-01 DOI: 10.1159/000530620