Skip to main content

Advertisement

SpringerLink
Log in

Recent developments in breast-conserving surgery for breast cancer patients

  • Overview
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

This invited review deals with the latest knowledge regarding breast conserving therapy in breast conserving patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. EBCTCG (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106

    Google Scholar 

  2. EBCTCG (2002) Radiotherapy for early breast cancer. Cochrane Database Syst Rev CD003647

  3. Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106

    PubMed  CAS  Google Scholar 

  4. Atkins H, Hayward JL, Klugman DJ, Wayte AB (1972) Treatment of early breast cancer: a report after ten years of a clinical trial. BMJ 2:423–429

    Article  PubMed  CAS  Google Scholar 

  5. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241, doi:10.1056/NEJMoa022152

    Article  PubMed  Google Scholar 

  6. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232, doi:10.1056/NEJMoa020989

    Article  PubMed  Google Scholar 

  7. Blichert-Toft M, Rose C, Andersen JA, Overgaard M, Axelsson CK, Andersen KW et al (1992) Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. Danish Breast Cancer Cooperative Group. J Natl Cancer Inst Monogr 11:19–25

    PubMed  Google Scholar 

  8. Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ et al (2003) Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer 98:697–702, doi:10.1002/cncr.11580

    Article  PubMed  Google Scholar 

  9. van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D et al (2000) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 92:1143–1150, doi:10.1093/jnci/92.14.1143

    Article  PubMed  Google Scholar 

  10. Arriagada R, Le MG, Rochard F, Contesso G (1996) Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. J Clin Oncol 14:1558–1564

    PubMed  CAS  Google Scholar 

  11. Fitzal F, Riedl O, Jakesz R (2007) Local therapy of early breast cancer. Breast Care 2:143–147, doi:10.1159/000103247

    Article  Google Scholar 

  12. Komoike Y, Akiyama F, Iino Y, Ikeda T, Akashi-Tanaka S, Ohsumi S et al (2006) Ipsilateral breast tumor recurrence (IBTR) after breast-conserving treatment for early breast cancer: risk factors and impact on distant metastases. Cancer 106:35–41, doi:10.1002/cncr.21551s

    Article  PubMed  Google Scholar 

  13. Kurtz JM, Jacquemier J, Amalric R, Brandone H, Ayme Y, Hans D et al (1990) Risk factors for breast recurrence in premenopausal and postmenopausal patients with ductal cancers treated by conservation therapy. Cancer 65:1867–1878, doi:10.1002/1097-0142(19900415)65:8<1867::AID-CNCR2820650833>3.0.CO;2-I

    Article  PubMed  CAS  Google Scholar 

  14. McBain CA, Young EA, Swindell R, Magee B, Stewart AL (2003) Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcome. Clin Oncol (R Coll Radiol) 15:25–31, doi:10.1053/clon.2002.0165

    CAS  Google Scholar 

  15. Hanna WM, Kahn HJ, Chapman JA, Fish EB, Lickley HL, McCready DR (1999) Pathologic characteristics of breast cancer that predict for local recurrence after lumpectomy alone. Breast J 5:105–111, doi:10.1046/j.1524-4741.1999.00133.x

    Article  PubMed  Google Scholar 

  16. Kurtz JM (1992) Factors influencing the risk of local recurrence in the breast. Eur J Cancer 28:660–666, doi:10.1016/S0959-8049(05)80121-2

    Article  PubMed  CAS  Google Scholar 

  17. Zavagno G, Goldin E, Mencarelli R, Capitanio G, Bianco PD, Marconato R et al (2008) Role of resection margins in patients treated with breast conservation surgery. Cancer 112:1923–1931

    Article  PubMed  Google Scholar 

  18. Kurtz JM, Jacquemier J, Amalric R, Brandone H, Ayme Y, Hans D et al (1991) Is breast conservation after local recurrence feasible? Eur J Cancer 27:240–244

    PubMed  CAS  Google Scholar 

  19. Fitzal F, Riedl O, Wutzl L, Draxler W, Rudas M, Pluschnig U et al (2007) Breast-conserving surgery for T3/T4 breast cancer: an analysis of 196 patients. Breast Cancer Res Treat 103:45–52, doi:10.1007/s10549-006-9325-6

    Article  PubMed  Google Scholar 

  20. Khanna MM, Mark RJ, Silverstein MJ, Juillard G, Lewinsky B, Giuliano AE (1992) Breast conservation management of breast tumors 4 cm or larger. Arch Surg 127:1038–1041 discussion 1041–3

    PubMed  CAS  Google Scholar 

  21. Taghian A, Mohiuddin M, Jagsi R, Goldberg S, Ceilley E, Powell S (2005) Current perceptions regarding surgical margin status after breast-conserving therapy: results of a survey. Ann Surg 241:629–639, doi:10.1097/01.sla.0000157272.04803.1b

    Article  PubMed  Google Scholar 

  22. Park CC, Mitsumori M, Nixon A, Recht A, Connolly J, Gelman R et al (2000) Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence. J Clin Oncol 18:1668–1675

    PubMed  CAS  Google Scholar 

  23. Freedman G, Fowble B, Hanlon A, Nicolaou N, Fein D, Hoffman J et al (1999) Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy. Int J Radiat Oncol Biol Phys 44:1005–1015, doi:10.1016/S0360-3016(99)00112-1

    PubMed  CAS  Google Scholar 

  24. Horst KC, Smitt MC, Goffinet DR, Carlson RW (2005) Predictors of local recurrence after breast-conservation therapy. Clin Breast Cancer 5:425–438

    Article  PubMed  Google Scholar 

  25. Fisher B (1995) Lumpectomy versus quadrantectomy for breast conservation: a critical appraisal. Eur J Cancer 31A:1567–1569, doi:10.1016/0959-8049(95)00461-Q

    Article  PubMed  CAS  Google Scholar 

  26. Veronesi U, Volterrani F, Luini A, Saccozzi R, Del Vecchio M, Zucali R et al (1990) Quadrantectomy versus lumpectomy for small size breast cancer. Eur J Cancer 26:671–673

    PubMed  CAS  Google Scholar 

  27. Bartelink H, Borger JH, van Dongen JA, Peterse JL (1988) The impact of tumor size and histology on local control after breast-conserving therapy. Radiother Oncol 11:297–303, doi:10.1016/0167-8140(88)90200-9

    Article  PubMed  CAS  Google Scholar 

  28. Borger J, Kemperman H, Hart A, Peterse H, van Dongen J, Bartelink H (1994) Risk factors in breast-conservation therapy. J Clin Oncol 12:653–660

    PubMed  CAS  Google Scholar 

  29. Burke MF, Allison R, Tripcony L (1995) Conservative therapy of breast cancer in Queensland. Int J Radiat Oncol Biol Phys 31:295–303, doi:10.1016/0360-3016(94)E0210-B

    PubMed  CAS  Google Scholar 

  30. Clarke DH, Le MG, Sarrazin D, Lacombe MJ, Fontaine F, Travagli JP et al (1985) Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: experience of the Institut Gustave-Roussy. Int J Radiat Oncol Biol Phys 11:137–145

    PubMed  CAS  Google Scholar 

  31. Cowen D, Houvenaeghel G, Bardou V, Jacquemier J, Bautrant E, Conte M et al (2000) Local and distant failures after limited surgery with positive margins and radiotherapy for node-negative breast cancer. Int J Radiat Oncol Biol Phys 47:305–312, doi:10.1016/S0360-3016(99)00553-2

    Article  PubMed  CAS  Google Scholar 

  32. Dewar JA, Arriagada R, Benhamou S, Benhamou E, Bretel JJ, Pellae-Cosset B et al (1995) Local relapse and contralateral tumor rates in patients with breast cancer treated with conservative surgery and radiotherapy (Institut Gustave Roussy 1970–1982). IGR Breast Cancer Group.. Cancer 76:2260–2265, doi:10.1002/1097-0142(19951201)76:11<2260::AID-CNCR2820761113>3.0.CO;2-D

    Article  PubMed  CAS  Google Scholar 

  33. DiBiase SJ, Komarnicky LT, Schwartz GF, Xie Y, Mansfield CM (1998) The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma. Cancer 82:2212–2220, doi:10.1002/(SICI)1097-0142(19980601)82:11<2212::AID-CNCR16>3.0.CO;2-X

    Article  PubMed  CAS  Google Scholar 

  34. Hartsell WF, Recine DC, Griem KL, Murthy AK (1995) Delaying the initiation of intact breast irradiation for patients with lymph node positive breast cancer increases the risk of local recurrence. Cancer 76:2497–2503, doi:10.1002/1097-0142(19951215)76:12<2497::AID-CNCR2820761214>3.0.CO;2-6

    Article  PubMed  CAS  Google Scholar 

  35. Heimann R, Powers C, Halpem HJ, Michel AG, Ewing CA, Wyman B et al (1996) Breast preservation in stage I and II carcinoma of the breast. The University of Chicago experience. Cancer 78:1722–1730, doi:10.1002/(SICI)1097-0142(19961015)78:8<1722::AID-CNCR12>3.0.CO;2-#

    Article  PubMed  CAS  Google Scholar 

  36. Kini VR, White JR, Horwitz EM, Dmuchowski CF, Martinez AA, Vicini FA (1998) Long term results with breast-conserving therapy for patients with early stage breast carcinoma in a community hospital setting. Cancer 82:127–133, doi:10.1002/(SICI)1097-0142(19980101)82:1<127::AID-CNCR15>3.0.CO;2-4

    Article  PubMed  CAS  Google Scholar 

  37. Leborgne F, Leborgne JH, Ortega B, Doldan R, Zubizarreta E (1995) Breast conservation treatment of early stage breast cancer: patterns of failure. Int J Radiat Oncol Biol Phys 31:765–775, doi:10.1016/0360-3016(94)00414-5

    PubMed  CAS  Google Scholar 

  38. Mansfield CM, Komarnicky LT, Schwartz GF, Rosenberg AL, Krishnan L, Jewell WR et al (1995) Ten-year results in 1070 patients with stages I and II breast cancer treated by conservative surgery and radiation therapy. Cancer 75:2328–2336, doi:10.1002/1097-0142(19950501)75:9<2328::AID-CNCR2820750923>3.0.CO;2-L

    Article  PubMed  CAS  Google Scholar 

  39. Peterson ME, Schultz DJ, Reynolds C, Solin LJ (1999) Outcomes in breast cancer patients relative to margin status after treatment with breast-conserving surgery and radiation therapy: the University of Pennsylvania experience. Int J Radiat Oncol Biol Phys 43:1029–1035, doi:10.1016/S0360-3016(98)00519-7

    Article  PubMed  CAS  Google Scholar 

  40. Pierce LJ, Strawderman MH, Douglas KR, Lichter AS (1997) Conservative surgery and radiotherapy for early-stage breast cancer using a lung density correction: the University of Michigan experience. Int J Radiat Oncol Biol Phys 39:921–928, doi:10.1016/S0360-3016(97)00464-1

    PubMed  CAS  Google Scholar 

  41. Slotman BJ, Meyer OW, Njo KH, Karim AB (1994) Importance of timing of radiotherapy in breast conserving treatment for early stage breast cancer. Radiother Oncol 30:206–212, doi:10.1016/0167-8140(94)90459-6

    Article  PubMed  CAS  Google Scholar 

  42. Smitt MC, Nowels KW, Zdeblick MJ, Jeffrey S, Carlson RW, Stockdale FE et al (1995) The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer 76:259–267, doi:10.1002/1097-0142(19950715)76:2<259::AID-CNCR2820760216>3.0.CO;2-2

    Article  PubMed  CAS  Google Scholar 

  43. van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G et al (1992) Factors influencing local relapse and survival and results of salvage treatment after breast-conserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and II breast cancer. Eur J Cancer 28A:801–805, doi:10.1016/0959-8049(92)90118-L

    PubMed  Google Scholar 

  44. Veronesi U, Salvadori B, Luini A, Greco M, Saccozzi R, del Vecchio M et al (1995) Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients. Eur J Cancer 31A:1574–1579, doi:10.1016/0959-8049(95)00271-J

    Article  PubMed  CAS  Google Scholar 

  45. Wazer DE, Schmidt-Ullrich RK, Ruthazer R, Schmid CH, Graham R, Safaii H et al (1998) Factors determining outcome for breast-conserving irradiation with margin-directed dose escalation to the tumor bed. Int J Radiat Oncol Biol Phys 40:851–858, doi:10.1016/S0360-3016(97)00861-4

    Article  PubMed  CAS  Google Scholar 

  46. Gage I, Schnitt SJ, Nixon AJ, Silver B, Recht A, Troyan SL et al (1996) Pathologic margin involvement and the risk of recurrence in patients treated with breast-conserving therapy. Cancer 78:1921–1928, doi:10.1002/(SICI)1097-0142(19961101)78:9<1921::AID-CNCR12>3.0.CO;2-#

    Article  PubMed  CAS  Google Scholar 

  47. Darvishian F, Hajdu SI, DeRisi DC (2003) Significance of linear extent of breast carcinoma at surgical margin. Ann Surg Oncol 10:48–51, doi:10.1245/ASO.2003.05.030

    Article  PubMed  Google Scholar 

  48. Veronesi U, Luini A, Del Vecchio M, Greco M, Galimberti V, Merson M et al (1993) Radiotherapy after breast-preserving surgery in women with localized cancer of the breast. N Engl J Med 328:1587–1591, doi:10.1056/NEJM199306033282202

    Article  PubMed  CAS  Google Scholar 

  49. Veronesi U, Marubini E, Del Vecchio M, Manzari A, Andreola S, Greco M et al (1995) Local recurrences and distant metastases after conservative breast cancer treatments: partly independent events. J Natl Cancer Inst 87:19–27, doi:10.1093/jnci/87.1.19

    Article  PubMed  CAS  Google Scholar 

  50. Fyles AW, McCready DR, Manchul LA, Trudeau ME, Merante P, Pintilie M et al (2004) Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 351:963–970, doi:10.1056/NEJMoa040595

    Article  PubMed  CAS  Google Scholar 

  51. Hughes KS, Schnaper LA, Berry D, Cirrincione C, McCormick B, Shank B et al (2004) Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 351:971–977, doi:10.1056/NEJMoa040587

    Article  PubMed  CAS  Google Scholar 

  52. Malmstrom P, Holmberg L, Anderson H, Mattsson J, Jonsson PE, Tennvall-Nittby L et al (2003) Breast conservation surgery, with and without radiotherapy, in women with lymph node-negative breast cancer: a randomised clinical trial in a population with access to public mammography screening. Eur J Cancer 39:1690–1697, doi:10.1016/S0959-8049(03)00324-1

    Article  PubMed  CAS  Google Scholar 

  53. Lim M, Bellon JR, Gelman R, Silver B, Recht A, Schnitt SJ et al (2006) A prospective study of conservative surgery without radiation therapy in select patients with Stage I breast cancer. Int J Radiat Oncol Biol Phys 65:1149–1154, doi:10.1016/j.ijrobp.2006.02.006

    PubMed  Google Scholar 

  54. Gnant M, Poetter R, Kwasny W, Tausch C, Handl-Zeller E, Pakesch B et al (2005) Breast conservation without radiotherapy in low risk breast cancer patients—results of 2 prospective clinical trials of the Austrian Breast and Colorectal Cancer Study Group involving 1518 postmenopausal patients with endocrine responsive cancer. Breast Cancer Res Treat ▪▪▪:94.

  55. Kurtz JM, Jacquemier J, Amalric R, Brandone H, Ayme Y, Hans D et al (1990) Why are local recurrences after breast-conserving therapy more frequent in younger patients? J Clin Oncol 8:591–598

    PubMed  CAS  Google Scholar 

  56. Kurtz JM, Spitalier JM, Amalric R, Brandone H, Ayme Y, Bressac C et al (1988) Mammary recurrences in women younger than forty. Int J Radiat Oncol Biol Phys 15:271–276, doi:10.1016/S0360-3016(98)90004-9

    Article  PubMed  CAS  Google Scholar 

  57. Dubsky PC, Gnant MF, Taucher S, Roka S, Kandioler D, Pichler-Gebhard B et al (2002) Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer. Clin Breast Cancer 3:65–72

    Article  PubMed  Google Scholar 

  58. Jakesz R, Hausmaninger H (2002) Randomized adjuvant trial of tamoxifen and goserelin vs. CMF: evidence for the superiority of treatment with endocrine blockade in premenopausal patients with hormone-responsive breast cancer—ABCCSG Trial 5. J Clin Oncol ▪▪▪:20.

  59. Arriagada R, Le MG, Contesso G, Guinebretiere JM, Rochard F, Spielmann M (2002) Predictive factors for local recurrence in 2006 patients with surgically resected small breast cancer. Ann Oncol 13:1404–1413, doi:10.1093/annonc/mdf227

    Article  PubMed  CAS  Google Scholar 

  60. Fisher B, Wickerham DL, Deutsch M, Anderson S, Redmond C, Fisher ER (1992) Breast tumor recurrence following lumpectomy with and without breast irradiation: an overview of recent NSABP findings. Semin Surg Oncol 8:153–160

    PubMed  CAS  Google Scholar 

  61. Fisher ER, Anderson S, Redmond C, Fisher B (1992) Ipsilateral breast tumor recurrence and survival following lumpectomy and irradiation: pathological findings from NSABP protocol B-06. Semin Surg Oncol 8:161–166

    PubMed  CAS  Google Scholar 

  62. Cutuli B (2004) Is radiotherapy needed after adequate local excision of localized DCIS? Int J Fertil Womens Med 49:231–236

    PubMed  Google Scholar 

  63. Bijker N, Meijnen P, Peterse JL, Bogaerts J, Van Hoorebeeck I, Julien JP et al (2006) Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853–a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol 24:3381–3387, doi:10.1200/JCO.2006.06.1366

    Article  PubMed  Google Scholar 

  64. Coulombe G, Tyldesley S, Speers C, Paltiel C, Aquino-Parsons C, Bernstein V et al (2007) Is mastectomy superior to breast-conserving treatment for young women? Int J Radiat Oncol Biol Phys 67:1282–1290, doi:10.1016/j.ijrobp.2006.11.032

    PubMed  Google Scholar 

  65. Neuschatz AC, DiPetrillo T, Safaii H, Price LL, Schmidt-Ullrich RK, Wazer DE (2003) Long-term follow-up of a prospective policy of margin-directed radiation dose escalation in breast-conserving therapy. Cancer 97:30–39, doi:10.1002/cncr.10981

    Article  PubMed  Google Scholar 

  66. Eberlein TJ, Connolly JL, Schnitt SJ, Recht A, Osteen RT, Harris JR (1990) Predictors of local recurrence following conservative breast surgery and radiation therapy. The influence of tumor size. Arch Surg 125:771–775 discussion 775–7

    PubMed  CAS  Google Scholar 

  67. Ferreiro JA, Gisvold JJ, Bostwick DG (1995) Accuracy of frozen-section diagnosis of mammographically directed breast biopsies. Results of 1,490 consecutive cases. Am J Surg Pathol 19:1267–1271

    PubMed  CAS  Google Scholar 

  68. Fessia L, Ghiringhello B, Arisio R, Botta G, Aimone V (1984) Accuracy of frozen section diagnosis in breast cancer detection. A review of 4436 biopsies and comparison with cytodiagnosis. Pathol Res Pract 179:61–66

    PubMed  CAS  Google Scholar 

  69. Weber S, Storm FK, Stitt J, Mahvi DM (1997) The role of frozen section analysis of margins during breast conservation surgery. Cancer J Sci Am 3:273–277

    PubMed  CAS  Google Scholar 

  70. Sauter ER, Hoffman JP, Ottery FD, Kowalyshyn MJ, Litwin S, Eisenberg BL et al (1994) Is frozen section analysis of reexcision lumpectomy margins worthwhile? Margin analysis in breast reexcisions An evaluation of frozen section biopsy in 4434 cases. Cancer 73:2607–2612, doi:10.1002/1097-0142(19940515)73:10<2607::AID-CNCR2820731023>3.0.CO;2-1

    Article  PubMed  CAS  Google Scholar 

  71. Niemann TH, Lucas JG, Marsh WL Jr (1996) To freeze or not to freeze. A comparison of methods for the handling of breast biopsies with no palpable abnormality. Am J Clin Pathol 106:225–228

    PubMed  CAS  Google Scholar 

  72. Cendan JC, Coco D, Copeland EM 3rd (2005) Accuracy of intraoperative frozen-section analysis of breast cancer lumpectomy-bed margins. J Am Coll Surg 201:194–198, doi:10.1016/j.jamcollsurg.2005.03.014

    Article  PubMed  Google Scholar 

  73. Huston TL, Pigalarga R, Osborne MP, Tousimis E (2006) The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery. Am J Surg 192:509–512, doi:10.1016/j.amjsurg.2006.06.021

    Article  PubMed  Google Scholar 

  74. Schmidt-Ullrich R, Wazer DE, Tercilla O, Safaii H, Marchant DJ, Smith TJ et al (1989) Tumor margin assessment as a guide to optimal conservation surgery and irradiation in early stage breast carcinoma. Int J Radiat Oncol Biol Phys 17:733–738

    PubMed  CAS  Google Scholar 

  75. O’Sullivan MJ, Li T, Freedman G, Morrow M (2007) The effect of multiple reexcisions on the risk of local recurrence after breast conserving surgery. Ann Surg Oncol 14:3133–3140, doi:10.1245/s10434-007-9523-4

    Article  PubMed  Google Scholar 

  76. Bianchi S, Palli D, Ciatto S, Galli M, Giorgi D, Vezzosi V et al (1995) Accuracy and reliability of frozen section diagnosis in a series of 672 nonpalpable breast lesions. Am J Clin Pathol 103:199–205

    PubMed  CAS  Google Scholar 

  77. Guski H, Winzer KJ, Aldinger HU, Frohberg HD, Bick U (1998) Zentralbl Chir 123:19–22. Possibilities and limits of diagnostic frozen section in breast carcinoma

    Google Scholar 

  78. Association of Directors of Anatomic and Surgical Pathology (1993) Immediate management of mammographically detected breast lesions. Am J Surg Pathol 17:850–851, doi:0.1097/00000478-199308000-00011

    Article  Google Scholar 

  79. Fechner RE (1995) Frozen section examination of breast biopsies. Practice parameter. Am J Clin Pathol 103:6–7

    CAS  Google Scholar 

  80. Cheng L, Al-Kaisi NK, Liu AY, Gordon NH (1997) The results of intraoperative consultations in 181 ductal carcinomas in situ of the breast. Cancer 80:75–79, doi:10.1002/(SICI)1097-0142(19970701)80:1<75::AID-CNCR10>3.0.CO;2-C

    Article  PubMed  CAS  Google Scholar 

  81. Fechner RE (1988) Frozen section (intraoperative consultation). Hum Pathol 19:999–1000, doi:10.1016/S0046-8177(88)80076-5

    Article  PubMed  CAS  Google Scholar 

  82. Cabioglu N, Hunt KK, Sahin AA, Kuerer HM, Babiera GV, Singletary SE et al (2007) Role for intraoperative margin assessment in patients undergoing breast-conserving surgery. Ann Surg Oncol 14:1458–1471, doi:10.1245/s10434-006-9236-0

    Article  PubMed  Google Scholar 

  83. Chagpar A, Yen T, Sahin A, Hunt KK, Whitman GJ, Ames FC et al (2003) Intraoperative margin assessment reduces reexcision rates in patients with ductal carcinoma in situ treated with breast-conserving surgery. Am J Surg 186:371–377, doi:10.1016/S0002-9610(03)00264-2

    Article  PubMed  Google Scholar 

  84. Pinotti JA, Carvalho FM (2002) Intraoperative pathological monitorization of surgical margins: a method to reduce recurrences after conservative treatment for breast cancer. Eur J Gynaecol Oncol 23:11–16

    PubMed  Google Scholar 

  85. Balch GC, Mithani SK, Simpson JF, Kelley MC (2005) Accuracy of intraoperative gross examination of surgical margin status in women undergoing partial mastectomy for breast malignancy. Am Surg 71:22–27 discussion 27–8

    PubMed  Google Scholar 

  86. Klimberg VS, Harms S, Korourian S (1999) Assessing margin status. Surg Oncol 8:77–84, doi:10.1016/S0960-7404(99)00031-6

    Article  PubMed  CAS  Google Scholar 

  87. Sickles EA (1989) Breast masses: mammographic evaluation. Radiology 173:297–303

    PubMed  CAS  Google Scholar 

  88. Hoorntje LE, Schipper ME, Kaya A, Verkooijen HM, Klinkenbijl JG, Rinkes IH (2004) Tumour cell displacement after 14G breast biopsy. Eur J Surg Oncol 30:520–525, doi:10.1016/j.ejso.2004.03.001

    Article  PubMed  CAS  Google Scholar 

  89. Grabau DA, Andersen JA, Graversen HP, Dyreborg U (1993) Needle biopsy of breast cancer. Appearance of tumour cells along the needle track. Eur J Surg Oncol 19:192–194

    PubMed  CAS  Google Scholar 

  90. Harter LP, Curtis JS, Ponto G, Craig PH (1992) Malignant seeding of the needle track during stereotaxic core needle breast biopsy. Radiology 185:713–714

    PubMed  CAS  Google Scholar 

  91. Thurfjell MG, Jansson T, Nordgren H, Bergh J, Lindgren A, Thurfjell E (2000) Local breast cancer recurrence caused by mammographically guided punctures. Acta Radiol 41:435–440, doi:10.1080/028418500127345884

    Article  PubMed  CAS  Google Scholar 

  92. Chao C, Torosian MH, Boraas MC, Sigurdson ER, Hoffman JP, Eisenberg BL et al (2001) Local recurrence of breast cancer in the stereotactic core needle biopsy site: case reports and review of the literature. Breast J 7:124–127, doi:10.1046/j.1524-4741.2001.007002124.x

    Article  PubMed  CAS  Google Scholar 

  93. Chen AM, Haffty BG, Lee CH (2002) Local recurrence of breast cancer after breast conservation therapy in patients examined by means of stereotactic core-needle biopsy. Radiology 225:707–712, doi:10.1148/radiol.2253011698

    Article  PubMed  Google Scholar 

  94. Knight R, Horiuchi K, Parker SH, Ratzer ER, Fenoglio ME (2002) Risk of needle-track seeding after diagnostic image-guided core needle biopsy in breast cancer. Jsls 6:207–209

    PubMed  Google Scholar 

  95. Taxin A, Tartter PI, Zappetti D (1997) Breast cancer diagnosis by fine needle aspiration and excisional biopsy. Recurrence and survival. Acta Cytol 41:302–306

    PubMed  CAS  Google Scholar 

  96. King TA, Hayes DH, Cederbom GJ, Champaign JL, Smetherman DH, Farr GH et al (2001) Biopsy technique has no impact on local recurrence after breast-conserving therapy. Breast J 7:19–24, doi:10.1046/j.1524-4741.2001.007001019.x

    Article  PubMed  CAS  Google Scholar 

  97. Fitzal F, Sporn EP, Draxler W, Mittlbock M, Taucher S, Rudas M et al (2006) Preoperative core needle biopsy does not increase local recurrence rate in breast cancer patients. Breast Cancer Res Treat 97:9–15, doi:10.1007/s10549-005-6935-3

    Article  PubMed  Google Scholar 

  98. Mamounas EP (1998) Overview of National Surgical Adjuvant Breast Project neoadjuvant chemotherapy studies. Semin Oncol 25:31–35

    PubMed  CAS  Google Scholar 

  99. Mamounas EP, Fisher B (2001) Preoperative (neoadjuvant) chemotherapy in patients with breast cancer Overview of National Surgical Adjuvant Breast Project neoadjuvant chemotherapy studies. Semin Oncol 28:389–399, doi:10.1016/S0093-7754(01)90132-0

    Article  PubMed  CAS  Google Scholar 

  100. Wolmark N, Wang J, Mamounas E, Bryant J, Fisher B (2001) Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr 30:96–102

    PubMed  Google Scholar 

  101. Veronesi U, Bonadonna G, Zurrida S, Galimberti V, Greco M, Brambilla C et al (1995) Conservation surgery after primary chemotherapy in large carcinomas of the breast. Ann Surg 222:612–618, doi:10.1097/00000658-199511000-00002

    Article  PubMed  CAS  Google Scholar 

  102. Rouzier R, Extra JM, Carton M, Falcou MC, Vincent-Salomon A, Fourquet A et al (2001) Primary chemotherapy for operable breast cancer: incidence and prognostic significance of ipsilateral breast tumor recurrence after breast-conserving surgery. J Clin Oncol 19:3828–3835

    PubMed  CAS  Google Scholar 

  103. van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L (2001) Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol 19:4224–4237

    PubMed  Google Scholar 

  104. Mauri D, Pavlidis N, Ioannidis JP (2005) Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Cancer Inst 97:188–194

    PubMed  Google Scholar 

  105. Singletary SE, McNeese MD, Hortobagyi GN (1992) Feasibility of breast-conservation surgery after induction chemotherapy for locally advanced breast carcinoma. Cancer 69:2849–2852, doi:10.1002/1097-0142(19920601)69:11<2849::AID-CNCR2820691134>3.0.CO;2-P

    Article  PubMed  CAS  Google Scholar 

  106. Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER et al (1998) Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol 16:2672–2685

    PubMed  CAS  Google Scholar 

  107. Buchholz TA, Lehman CD, Harris JR, Pockaj BA, Khouri N, Hylton NF et al (2008) Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference. J Clin Oncol 26:791–797, doi:10.1200/JCO.2007.15.0326

    Article  PubMed  Google Scholar 

  108. Gentilini O, Intra M, Gandini S, Peruzzotti G, Winnikow E, Luini A et al (2006) Ipsilateral breast tumor reappearance in patients treated with conservative surgery after primary chemotherapy. The role of surgical margins on outcome. J Surg Oncol 94:375–379, doi:10.1002/jso.20583

    Article  PubMed  Google Scholar 

  109. Chen AM, Meric-Bernstam F, Hunt KK, Thames HD, Oswald MJ, Outlaw ED et al (2004) Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience. J Clin Oncol 22:2303–2312, doi:10.1200/JCO.2004.09.062

    Article  PubMed  Google Scholar 

  110. Fowble B, Solin LJ, Schultz DJ, Rubenstein J, Goodman RL (1990) Breast recurrence following conservative surgery and radiation: patterns of failure, prognosis, and pathologic findings from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys 19:833–842

    PubMed  CAS  Google Scholar 

  111. Voogd AC, van Oost FJ, Rutgers EJ, Elkhuizen PH, van Geel AN, Scheijmans LJ et al (2005) Long-term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer. Eur J Cancer 41:2637–2644, doi:10.1016/j.ejca.2005.04.040

    Article  PubMed  CAS  Google Scholar 

  112. Kurtz JM, Amalric R, Brandone H, Ayme Y, Spitalier JM (1988) Results of salvage surgery for mammary recurrence following breast-conserving therapy. Ann Surg 207:347–351, doi:10.1097/00000658-198803000-00021

    Article  PubMed  CAS  Google Scholar 

  113. Komoike Y, Akiyama F, Iino Y, Tanaka-Akashi S, Ohsumi S, Ikeda T et al (2005) Analysis of ipsilateral breast tumor recurrences after breast-conserving treatment based on the classification of true recurrences and new primary tumors. Breast Cancer 12:104–111, doi:10.2325/jbcs.12.104

    Article  PubMed  Google Scholar 

  114. Smith TE, Lee D, Turner BC, Carter D, Haffty BG (2000) True recurrence vs. new primary ipsilateral breast tumor relapse: an analysis of clinical and pathologic differences and their implications in natural history, prognoses, and therapeutic management. Int J Radiat Oncol Biol Phys 48:1281–1289, doi:10.1016/S0360-3016(00)01378-X

    PubMed  CAS  Google Scholar 

  115. Kurtz JM, Amalric R, Brandone H, Ayme Y, Jacquemier J, Pietra JC et al (1989) Local recurrence after breast-conserving surgery and radiotherapy. Frequency, time course, and prognosis. Cancer 63:1912–1917, doi:10.1002/1097-0142(19890515)63:10<1912::AID-CNCR2820631007>3.0.CO;2-Y

    Article  PubMed  CAS  Google Scholar 

  116. Huang E, Buchholz TA, Meric F, Krishnamurthy S, Mirza NQ, Ames FC et al (2002) Classifying local disease recurrences after breast conservation therapy based on location and histology: new primary tumors have more favorable outcomes than true local disease recurrences. Cancer 95:2059–2067, doi:10.1002/cncr.10952

    Article  PubMed  Google Scholar 

  117. Schnitt SJ, Abner A, Gelman R, Connolly JL, Recht A, Duda RB et al (1994) The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast-conserving surgery and radiation therapy. Cancer 74:1746–1751, doi:10.1002/1097-0142(19940915)74:6<1746::AID-CNCR2820740617>3.0.CO;2-Y

    Article  PubMed  CAS  Google Scholar 

  118. Kurtz JM, Spitalier JM, Amalric R, Brandone H, Ayme Y, Jacquemier J et al (1990) The prognostic significance of late local recurrence after breast-conserving therapy. Int J Radiat Oncol Biol Phys 18:87–93

    PubMed  CAS  Google Scholar 

  119. Abner AL, Recht A, Eberlein T, Come S, Shulman L, Hayes D et al (1993) Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early-stage breast cancer. J Clin Oncol 11:44–48

    PubMed  CAS  Google Scholar 

  120. Osborne MP, Borgen PI, Wong GY, Rosen PP, McCormick B (1992) Salvage mastectomy for local and regional recurrence after breast-conserving operation and radiation therapy. Surg Gynecol Obstet 174:189–194

    PubMed  CAS  Google Scholar 

  121. Kurtz JM, Amalric R, Brandone H, Ayme Y, Spitalier JM (1988) Results of wide excision for mammary recurrence after breast-conserving therapy. Cancer 61:1969–1972, doi:10.1002/1097-0142(19880515)61:10<1969::AID-CNCR2820611006>3.0.CO;2-O

    Article  PubMed  CAS  Google Scholar 

  122. Komoike Y, Motomura K, Inaji H, Kasugai T, Koyama H (2003) Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary results. Oncology 64:1–6, doi:10.1159/000066512

    Google Scholar 

  123. Salvadori B, Marubini E, Miceli R, Conti AR, Cusumano F, Andreola S et al (1999) Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Br J Surg 86:84–87, doi:10.1046/j.1365-2168.1999.00961.x

    Article  PubMed  CAS  Google Scholar 

  124. Resch A, Fellner C, Mock U, Handl-Zeller L, Biber E, Seitz W et al (2002) Locally recurrent breast cancer: pulse dose rate brachytherapy for repeat irradiation following lumpectomy—a second chance to preserve the breast. Radiology 225:713–718, doi:10.1148/radiol.2253011913

    Article  PubMed  Google Scholar 

  125. Deutsch M (2002) Repeat high-dose external beam irradiation for in-breast tumor recurrence after previous lumpectomy and whole breast irradiation. Int J Radiat Oncol Biol Phys 53:687–691, doi:10.1016/S0360-3016(02)02785-2

    PubMed  Google Scholar 

  126. Wahl AO, Rademaker A, Kiel KD, Jones EL, Marks LB, Croog V et al (2008) Multi-institutional review of repeat irradiation of chest wall and breast for recurrent breast cancer. Int J Radiat Oncol Biol Phys 70:477–484, doi:10.1016/j.ijrobp.2007.06.035

    PubMed  Google Scholar 

  127. Galper S, Blood E, Gelman R, Abner A, Recht A, Kohli A et al (2005) Prognosis after local recurrence after conservative surgery and radiation for early-stage breast cancer. Int J Radiat Oncol Biol Phys 61:348–357, doi:10.1016/j.ijrobp.2004.06.011

    PubMed  Google Scholar 

  128. Rauschecker H, Clarke M, Gatzemeier W, Recht A (2001) Systemic therapy for treating locoregional recurrence in women with breast cancer. Cochrane Database Syst Rev CD002195

  129. Babiera GV, Rao R, Feng L, Meric-Bernstam F, Kuerer HM, Singletary SE et al (2006) Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol 13:776–782, doi:10.1245/ASO.2006.03.033

    Article  PubMed  Google Scholar 

  130. Blanchard DK, Bhatia P, Hilsenbeck SG, Elledge RM (2006) Does surgical management of stage IV breast cancer effect outcome? SABCC

  131. Carmichael AR, Anderson ED, Chetty U, Dixon JM (2003) Does local surgery have a role in the management of stage IV breast cancer? Eur J Surg Oncol 29:17–19, doi:10.1053/ejso.2002.1339

    Article  PubMed  CAS  Google Scholar 

  132. Khan SA, Stewart AK, Morrow M (2002) Does aggressive local therapy improve survival in metastatic breast cancer? Surgery 132:620–626 discussion 626–7doi:10.1067/msy.2002.127544

    Article  PubMed  Google Scholar 

  133. Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP et al (2006) Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol 24:2743–2749, doi:10.1200/JCO.2005.04.2226

    Article  PubMed  Google Scholar 

  134. Gnerlich J, Jeffe DB, Deshpande AD, Beers C, Zander C, Margenthaler JA (2007) Surgical Removal of the Primary Tumor Increases Overall Survival in Patients With Metastatic Breast Cancer: Analysis of the 1988–2003 SEER Data. Ann Surg Oncol 14:2187–2194, doi:10.1245/s10434-007-9438-0

    Article  PubMed  Google Scholar 

  135. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC et al (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 345:1655–1659, doi:10.1056/NEJMoa003013

    Article  PubMed  CAS  Google Scholar 

  136. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R (2001) Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 358:966–970, doi:10.1016/S0140-6736(01)06103-7

    Article  PubMed  CAS  Google Scholar 

  137. Norton L, Massague J (2006) Is cancer a disease of self-seeding? Nat Med 12:875–878, doi:10.1038/nm0806-875

    Article  PubMed  CAS  Google Scholar 

  138. Al-Hajj M, Clarke MF (2004) Self-renewal and solid tumor stem cells. Oncogene 23:7274–7282, doi:10.1038/sj.onc.1207947

    Article  PubMed  CAS  Google Scholar 

  139. Bao S, Wu Q, McLendon RE, Hao Y, Shi Q, Hjelmeland AB et al (2006) Glioma stem cells promote radioresistance by preferential activation of the DNA damage response. Nature 444:756–760, doi:10.1038/nature05236

    Article  PubMed  CAS  Google Scholar 

  140. Al-Hajj M, Wicha MS, Benito-Hernandez A, Morrison SJ, Clarke MF (2003) Prospective identification of tumorigenic breast cancer cells. Proc Natl Acad Sci USA 100:3983–3988, doi:10.1073/pnas.0530291100

    Article  PubMed  CAS  Google Scholar 

  141. Kong FM, Anscher MS, Murase T, Abbott BD, Iglehart JD, Jirtle RL (1995) Elevated plasma transforming growth factor-beta 1 levels in breast cancer patients decrease after surgical removal of the tumor. Ann Surg 222:155–162, doi:10.1097/00000658-199508000-00007

    Article  PubMed  CAS  Google Scholar 

  142. Tang B, Vu M, Booker T, Santner SJ, Miller FR, Anver MR et al (2003) TGF-beta switches from tumor suppressor to prometastatic factor in a model of breast cancer progression. J Clin Invest 112:1116–1124

    PubMed  CAS  Google Scholar 

  143. Yang YA, Dukhanina O, Tang B, Mamura M, Letterio JJ, MacGregor J et al (2002) Lifetime exposure to a soluble TGF-beta antagonist protects mice against metastasis without adverse side effects. J Clin Invest 109:1607–1615

    PubMed  CAS  Google Scholar 

  144. Kim KJ, Li B, Winer J, Armanini M, Gillett N, Phillips HS et al (1993) Inhibition of vascular endothelial growth factor-induced angiogenesis suppresses tumour growth in vivo. Nature 362:841–844, doi:10.1038/362841a0

    Article  PubMed  CAS  Google Scholar 

  145. Linderholm B, Grankvist K, Wilking N, Johansson M, Tavelin B, Henriksson R (2000) Correlation of vascular endothelial growth factor content with recurrences, survival, and first relapse site in primary node-positive breast carcinoma after adjuvant treatment. J Clin Oncol 18:1423–1431

    PubMed  CAS  Google Scholar 

  146. Linderholm BK, Lindh B, Beckman L, Erlanson M, Edin K, Travelin B et al (2003) Prognostic correlation of basic fibroblast growth factor and vascular endothelial growth factor in 1307 primary breast cancers. Clin Breast Cancer 4:340–347

    Article  PubMed  CAS  Google Scholar 

  147. Nishimura R, Nagao K, Miyayama H, Matsuda M, Baba K, Yamashita H et al (2003) Higher plasma vascular endothelial growth factor levels correlate with menopause, overexpression of p53, and recurrence of breast cancer. Breast Cancer 10:120–128

    Article  PubMed  Google Scholar 

  148. Wu Y, Saldana L, Chillar R, Vadgama JV (2002) Plasma vascular endothelial growth factor is useful in assessing progression of breast cancer post surgery and during adjuvant treatment. Int J Oncol 20:509–516

    PubMed  Google Scholar 

  149. Kummel S, Eggemann H, Luftner D, Thomas A, Jeschke S, Zerfel N et al (2006) Changes in the circulating plasma levels of VEGF and VEGF-D after adjuvant chemotherapy in patients with breast cancer and 1 to 3 positive lymph nodes. Anticancer Res 26:1719–1726

    PubMed  Google Scholar 

  150. Caine GJ, Stonelake PS, Lip GY, Blann AD (2007) Changes in plasma vascular endothelial growth factor, angiopoietins, and their receptors following surgery for breast cancer. Cancer Lett 248:131–136, doi:10.1016/j.canlet.2006.06.011

    Article  PubMed  CAS  Google Scholar 

  151. Curigliano G, Petit JY, Bertolini F, Colleoni M, Peruzzotti G, de Braud F et al (2005) Systemic effects of surgery: quantitative analysis of circulating basic fibroblast growth factor (bFGF), Vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-beta) in patients with breast cancer who underwent limited or extended surgery. Breast Cancer Res Treat 93:35–40, doi:10.1007/s10549-005-3381-1

    Article  PubMed  CAS  Google Scholar 

  152. Joffe JK, Banks RE, Forbes MA, Hallam S, Jenkins A, Patel PM et al (1996) A phase II study of interferon-alpha, interleukin-2 and 5-fluorouracil in advanced renal carcinoma: clinical data and laboratory evidence of protease activation. Br J Urol 77:638–649

    PubMed  CAS  Google Scholar 

  153. Wagner JR, Walther MM, Linehan WM, White DE, Rosenberg SA, Yang JC (1999) Interleukin-2 based immunotherapy for metastatic renal cell carcinoma with the kidney in place. J Urol 162:43–45, doi:10.1097/00005392-199907000-00011

    Article  PubMed  CAS  Google Scholar 

  154. Baildam A, Bishop H, Boland G, Dalglish M, Davies L, Fatah F et al (2007) Oncoplastic breast surgery—a guide to good practice. Eur J Surg Oncol 33(Suppl 1):S1–S23

    PubMed  Google Scholar 

  155. Anderson BO, Masetti R, Silverstein MJ (2005) Oncoplastic approaches to partial mastectomy: an overview of volume-displacement techniques. Lancet Oncol 6:145–157, doi:10.1016/S1470-2045(05)01765-1

    Article  PubMed  Google Scholar 

  156. Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD (2005) Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol 31:817–823, doi:10.1016/j.ejso.2005.05.010

    Article  PubMed  CAS  Google Scholar 

  157. Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC (2003) Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 237:26–34, doi:10.1097/00000658-200301000-00005

    Article  PubMed  Google Scholar 

  158. Fitzal F, Nehrer G, Deutinger M, Jakesz R, Gnant M (2007) Novel strategies in oncoplastic surgery for breast cancer: immediate partial reconstruction of breast defects. Eur Surg 39:330–339, doi:10.1007/s10353-007-0373-x

    Article  Google Scholar 

  159. Fitzal F, Nehrer G, Hoch D, Riedl O, Gutharc S, Deutinger M et al (2007) An oncoplastic procedure for central and medio-cranial breast cancer. Eur J Surg Oncol 33:1158–1163, doi:10.1016/j.ejso.2007.04.004

    PubMed  CAS  Google Scholar 

  160. Fitzal F, Nehrer G, Mittlbock M, Trischler H, Krois W, Deutinger M, Jakesz R, Gnant M (2008) Breast conserving therapy for centrally located breast cancer. Ann Surg 247:470–476

    Article  PubMed  Google Scholar 

  161. McCulley SJ, Durani P, Macmillan RD (2006) Therapeutic mammaplasty for centrally located breast tumors. Plast Reconstr Surg 117:366–373, doi:10.1097/01.prs.0000200874.31320.c2

    Article  PubMed  CAS  Google Scholar 

  162. Clough KB, Kroll SS, Audretsch W (1999) An approach to the repair of partial mastectomy defects. Plast Reconstr Surg 104:409–420, doi:10.1097/00006534-199908000-00014

    Article  PubMed  CAS  Google Scholar 

  163. Cochrane RA, Valasiadou P, Wilson AR, Al-Ghazal SK, Macmillan RD (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 90:1505–1509, doi:10.1002/bjs.4344

    Article  PubMed  CAS  Google Scholar 

  164. Fedorcik GG, Sachs R, Goldfarb MA (2006) Oncologic and aesthetic results following breast-conserving therapy with 0.5 cm margins in 100 consecutive patients. Breast J 12:208–211, doi:10.1111/j.1075-122X.2006.00243.x

    Article  PubMed  Google Scholar 

  165. Vrieling C, Collette L, Fourquet A, Hoogenraad WJ, Horiot JH, Jager JJ et al (2000) The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ‘boost vs. no boost’ trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. Radiother Oncol 55:219–232, doi:10.1016/S0167-8140(00)00210-3

    Article  PubMed  CAS  Google Scholar 

  166. Van Limbergen E, Rijnders A, van der Schueren E, Lerut T, Christiaens R, Van Tongelen K (1989) Cosmetic evaluation of breast conserving treatment for mammary cancer. 2. A quantitative analysis of the influence of radiation dose, fractionation schedules and surgical treatment techniques on cosmetic results. Radiother Oncol 16:253–267, doi:10.1016/0167-8140(89)90037-6

    Article  PubMed  Google Scholar 

  167. Moody AM, Mayles WP, Bliss JM, A’Hern RP, Owen JR, Regan J et al (1994) The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity. Radiother Oncol 33:106–112, doi:10.1016/0167-8140(94)90063-9

    Article  PubMed  CAS  Google Scholar 

  168. Fitzal F, Gnant M (2006) Breast conservation: evolution of surgical strategies. Breast J 12:S165–S173, doi:10.1111/j.1075-122X.2006.00330.x

    Article  PubMed  Google Scholar 

  169. Morrow M, Bucci C, Rademaker A (1998) Medical contraindications are not a major factor in the underutilization of breast conserving therapy. J Am Coll Surg 186:269–274, doi:10.1016/S1072-7515(97)00153-1

    Article  PubMed  CAS  Google Scholar 

  170. Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N (2002) Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med 347:567–575, doi:10.1056/NEJMoa020128

    Article  PubMed  Google Scholar 

  171. Giacalone PL, Dubon O, Roger P, El Gareh N, Rihaoui S, Daures JP (2007) Doughnut mastopexy lumpectomy versus standard lumpectomy in breast cancer surgery: a prospective study. Eur J Surg Oncol 33:301–306, doi:10.1016/j.ejso.2006.09.014

    Article  PubMed  CAS  Google Scholar 

  172. Petit JY, Garusi C, Greuse M, Rietiens M, Youssef O, Luini A et al (2002) One hundred and eleven cases of breast conservation treatment with simultaneous reconstruction at the European Institute of Oncology (Milan). Tumori 88:41–47

    PubMed  Google Scholar 

  173. Giacalone PL, Roger P, Dubon O, El Gareh N, Rihaoui S, Taourel P et al (2007) Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 14:605–614, doi:10.1245/s10434-006-9098-5

    Article  PubMed  Google Scholar 

  174. Kaur N, Petit JY, Rietjens M, Maffini F, Luini A, Gatti G et al (2005) Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 12:539–545, doi:10.1245/ASO.2005.12.046

    Article  PubMed  Google Scholar 

  175. Chang E, Johnson N, Webber B, Booth J, Rahhal D, Gannett D et al (2004) Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia. Am J Surg 187:647–650 discussion 650–1doi:10.1016/j.amjsurg.2004.01.002

    Article  PubMed  Google Scholar 

  176. Munhoz AM, Filassi JR, Aldrighi C, Ricci MD, Martella E, de Barros AC et al (2007) Bilateral reduction mammaplasty for immediate breast conservation surgery reconstruction and intraoperative radiotherapy: a preliminary report. Aesthetic Plast Surg 31:94–100, doi:10.1007/s00266-006-0200-y

    Article  PubMed  Google Scholar 

  177. Munhoz AM, Montag E, Arruda EG, Aldrighi C, Gemperli R, Aldrighi JM et al (2006) Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment. Plast Reconstr Surg 117:1091–1103 discussion 1104–7, doi:10.1097/01.prs.0000202121.84583.0d

    Article  PubMed  CAS  Google Scholar 

  178. Munhoz AM, Montag E, Arruda EG, Aldrighi C, Gemperli R, Aldrighi JM et al (2006) Superior-medial dermoglandular pedicle reduction mammaplasty for immediate conservative breast surgery reconstruction: technical aspects and outcome. Ann Plast Surg 57:502–508, doi:10.1097/01.sap.0000233969.25031.cb

    Article  PubMed  CAS  Google Scholar 

  179. Giuliano AE, Jones RC, Brennan M, Statman R (1997) Sentinel lymphadenectomy in breast cancer. J Clin Oncol 15:2345–2350

    PubMed  CAS  Google Scholar 

  180. Kim T, Giuliano AE, Lyman GH (2006) Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer 106:4–16, doi:10.1002/cncr.21568

    Article  PubMed  Google Scholar 

  181. Gallowitsch H, Konstantiniuk P, Jörg L, Urbania A, Kugler F, Peschina W et al (2002) Identification of sentinel lymph nodes in breast cancer by lymphoscintigraphy and gamma probe guidance: dependence on rout of injection and tumor location. Eur Surg 34:267–271, doi:10.1046/j.1563-2563.2002.02072.x

    Article  Google Scholar 

  182. Blessing WD, Stolier AJ, Teng SC, Bolton JS, Fuhrman GM (2002) A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping. Am J Surg 184:341–345, doi:10.1016/S0002-9610(02)00948-0

    Article  PubMed  Google Scholar 

  183. Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N et al (1996) Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 276:1818–1822, doi:10.1001/jama.276.22.1818

    Article  PubMed  CAS  Google Scholar 

  184. McMasters KM, Tuttle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL et al (2000) Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol 18:2560–2566

    PubMed  CAS  Google Scholar 

  185. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T et al (2007) Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol 8:881–888, doi:10.1016/S1470-2045(07)70278-4

    Article  PubMed  CAS  Google Scholar 

  186. Haid A, Schrenk P, Roka S, Taucher S, Pichler-Gebhard B, Rudas M et al (2002) The importance of sentinel node biopsy in breast surgery. Eur Surg 34:262–266, doi:10.1046/j.1563-2563.2002.02065.x

    Article  Google Scholar 

  187. Klimberg VS, Rubio IT, Henry R, Cowan C, Colvert M, Korourian S (1999) Subareolar versus peritumoral injection for location of the sentinel lymph node. Ann Surg 229:860–864 discussion 864–5, doi:10.1097/00000658-199906000-00013

    Article  PubMed  CAS  Google Scholar 

  188. Morrow M, Rademaker AW, Bethke KP, Talamonti MS, Dawes LG, Clauson J et al (1999) Learning sentinel node biopsy: results of a prospective randomized trial of two techniques. Surgery 126:714–720 discussion 720–2

    PubMed  CAS  Google Scholar 

  189. Cody HS 3rd, Hill AD, Tran KN, Brennan MF, Borgen PI (1999) Credentialing for breast lymphatic mapping: how many cases are enough? Ann Surg 229:723–726 discussion 726–8, doi:10.1097/00000658-199905000-00015

    Article  PubMed  Google Scholar 

  190. Martin RC 2nd, Chagpar A, Scoggins CR, Edwards MJ, Hagendoorn L, Stromberg AJ et al (2005) Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer. Ann Surg 241:1005–1012 discussion 1012–5doi:10.1097/01.sla.0000165200.32722.02

    Article  PubMed  Google Scholar 

  191. Tafra L, Lannin DR, Swanson MS, Van Eyk JJ, Verbanac KM, Chua AN et al (2001) Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg 233:51–59, doi:10.1097/00000658-200101000-00009

    Article  PubMed  CAS  Google Scholar 

  192. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V et al (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349:546–553, doi:10.1056/NEJMoa012782

    Article  PubMed  Google Scholar 

  193. Zavagno G, De Salvo GL, Scalco G, Bozza F, Barutta L, Del Bianco P et al (2008) A Randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Ann Surg 247:207–213

    Article  PubMed  Google Scholar 

  194. Bergkvist L, de Boniface J, Jonsson PE, Ingvar C, Liljegren G, Frisell J (2008) Axillary recurrence rate after negative sentinel node biopsy in breast cancer: three-year follow-up of the Swedish Multicenter Cohort Study. Ann Surg 247:150–156

    Article  PubMed  Google Scholar 

  195. Veronesi U, Galimberti V, Mariani L, Gatti G, Paganelli G, Viale G et al (2005) Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection. Eur J Cancer 41:231–237, doi:10.1016/j.ejca.2004.05.009

    Article  PubMed  Google Scholar 

  196. Swenson KK, Mahipal A, Nissen MJ, Tuttle TM, Heaton K, Lally RM et al (2005) Axillary disease recurrence after sentinel lymph node dissection for breast carcinoma. Cancer 104:1834–1839, doi:10.1002/cncr.21357

    Article  PubMed  Google Scholar 

  197. Palesty JA, Foster JM, Hurd TC, Watroba N, Rezaishiraz H, Edge SB (2006) Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer. J Surg Oncol 93:129–132, doi:10.1002/jso.20408

    Article  PubMed  Google Scholar 

  198. Kuijt GP, van de Poll-Franse LV, Voogd AC, Nieuwenhuijzen GA, Roumen RM (2007) Survival after negative sentinel lymph node biopsy in breast cancer at least equivalent to after negative extensive axillary dissection. Eur J Surg Oncol 33:832–837, doi:10.1016/j.ejso.2006.11.017

    PubMed  CAS  Google Scholar 

  199. Naik AM, Fey J, Gemignani M, Heerdt A, Montgomery L, Petrek J et al (2004) The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 240:462–468 discussion 468–71 doi:10.1097/01.sla.0000137130.23530.19

    Article  PubMed  Google Scholar 

  200. Kim HJ, Son BH, Park EW, Lim WS, Seo JY, Jang MA et al (2008) Axillary recurrence after negative sentinel lymph node biopsy. Breast Cancer Res Treat

  201. Julian T, Fourchotte V, Anderson S, Mamounas E, Constantino J, Boudros N et al (2006) Predictive factors that identify patients not requiring a sentinel node biopsy: Continued analysis of the NSABP-B32 sentinel node trial. SABCS

  202. Viale G, Zurrida S, Maiorano E, Mazzarol G, Pruneri G, Paganelli G et al (2005) Predicting the status of axillary sentinel lymph nodes in 4351 patients with invasive breast carcinoma treated in a single institution. Cancer 103:492–500, doi:10.1002/cncr.20809

    Article  PubMed  Google Scholar 

  203. Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM et al (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98:599–609

    Article  PubMed  Google Scholar 

  204. Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP et al (2005) Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol 23:4312–4321, doi:10.1200/JCO.2005.03.228

    Article  PubMed  Google Scholar 

  205. Wong SL, Edwards MJ, Chao C, Tuttle TM, Noyes RD, Carlson DJ et al (2001) Sentinel lymph node biopsy for breast cancer: impact of the number of sentinel nodes removed on the false-negative rate. J Am Coll Surg 192:684–689 discussion 689–91, doi:10.1016/S1072-7515(01)00858-4

    Article  PubMed  CAS  Google Scholar 

  206. Salama JK, Heimann R, Lin F, Mehta N, Chmura SJ, Singh R et al (2005) Does the number of lymph nodes examined in patients with lymph node-negative breast carcinoma have prognostic significance? Cancer 103:664–671, doi:10.1002/cncr.20830

    Article  PubMed  Google Scholar 

  207. Yi M, Meric-Bernstam F, Ross MI, Akins JS, Hwang RF, Lucci A et al (2008) How many sentinel lymph nodes are enough during sentinel lymph node dissection for breast cancer? Cancer 113:30–37, doi:10.1002/cncr.23514

    Article  PubMed  Google Scholar 

  208. Schrenk P, Rehberger W, Shamiyeh A, Wayand W (2002) Sentinel node biopsy for breast cancer: does the number of sentinel nodes removed have an impact on the accuracy of finding a positive node? J Surg Oncol 80:130–136, doi:10.1002/jso.10112

    Article  PubMed  Google Scholar 

  209. Schrenk P, Wayand W (2001) Sentinel-node biopsy in axillary lymph-node staging for patients with multicentric breast cancer. Lancet 357:122, doi:10.1016/S0140-6736(00)03550-9

    Article  PubMed  CAS  Google Scholar 

  210. Tousimis E, Van Zee KJ, Fey JV, Hoque LW, Tan LK, Cody HS 3rd et al (2003) The accuracy of sentinel lymph node biopsy in multicentric and multifocal invasive breast cancers. J Am Coll Surg 197:529–535, doi:10.1016/S1072–7515(03)00677-X

    Article  PubMed  Google Scholar 

  211. Kim HJ, Hong SJ, Lee SJ, Jeong MS, Son BH, Ahn SH (2006) Sentinel biopsy in patients with multifocal breast cancer. SABCS

  212. Kim HJ, Lee JS, Park EH, Choi SL, Lim WS, Chang MA et al (2008) Sentinel node biopsy in patients with multiple breast cancer. Breast Cancer Res Treat 109:503–506, doi:10.1007/s10549-007-9674-9

    Article  PubMed  CAS  Google Scholar 

  213. Gentilini O, Trifiro G, Soteldo J, Luini A, Intra M, Galimberti V et al (2006) Sentinel lymph node biopsy in multicentric breast cancer. The experience of the European Institute of Oncology. Eur J Surg Oncol 32:507–510, doi:10.1016/j.ejso.2006.02.018

    Article  PubMed  CAS  Google Scholar 

  214. Ferrari A, Dionigi P, Rovera F, Boni L, Limonta G, Garancini S et al (2006) Multifocality and multicentricity are not contraindications for sentinel lymph node biopsy in breast cancer surgery. World J Surg Oncol 4:79, doi:10.1186/1477-7819-4-79

    Article  PubMed  Google Scholar 

  215. Xing Y, Foy M, Cox DD, Kuerer HM, Hunt KK, Cormier JN (2006) Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg 93:539–546, doi:10.1002/bjs.5209

    Article  PubMed  CAS  Google Scholar 

  216. Cserni G, Gregori D, Merletti F, Sapino A, Mano MP, Ponti A et al (2004) Meta-analysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer. Br J Surg 91:1245–1252, doi:10.1002/bjs.4725

    Article  PubMed  CAS  Google Scholar 

  217. Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ et al (2005) American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23:7703–7720, doi:10.1200/JCO.2005.08.001

    Article  PubMed  Google Scholar 

  218. Cody HS 3rd (2006) Reoperative sentinel lymph node biopsy: adding nuance to the management of locally recurrent breast cancer. Ann Surg Oncol

  219. Port ER, Fey J, Gemignani ML, Heerdt AS, Montgomery LL, Petrek JA et al (2002) Reoperative sentinel lymph node biopsy: a new option for patients with primary or locally recurrent breast carcinoma. J Am Coll Surg 195:167–172, doi:10.1016/S1072-7515(02)01268-1

    Article  PubMed  Google Scholar 

  220. Port ER, Garcia-Etienne CA, Park J, Fey J, Borgen PI, Cody HS 3rd (2007) Reoperative sentinel lymph node biopsy: a new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol 14:2209–2214, doi:10.1245/s10434-006-9237-z

    Article  PubMed  Google Scholar 

  221. Newman EA, Cimmino VM, Sabel MS, Diehl KM, Frey KA, Chang AE et al (2006) Lymphatic mapping and sentinel lymph node biopsy for patients with local recurrence after breast-conservation therapy. Ann Surg Oncol 13:52–57, doi:10.1245/ASO.2006.12.002

    Article  PubMed  Google Scholar 

  222. Newman LA (2007) Lymphatic mapping and sentinel lymph node biopsy for locally recurrent breast cancer: new clues to understanding the biology of chest wall relapse. Ann Surg Oncol 14:2182–2184, doi, doi:10.1245/s10434–007–9374-z

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Medical University Vienna, Vienna, Austria

    F. Fitzal, O. Riedl & R. Jakesz

Authors
  1. F. Fitzal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. Riedl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Jakesz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Jakesz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fitzal, F., Riedl, O. & Jakesz, R. Recent developments in breast-conserving surgery for breast cancer patients. Langenbecks Arch Surg 394, 591–609 (2009). https://doi.org/10.1007/s00423-008-0412-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-008-0412-5

Keywords

Search

Navigation