Current situation and problems of breast conserving surgery

Abstract

Abstract:There is no difference between breast conserving surgery (BCS) combined with radiotherapy and radical surgery in outcomes. However, comparing with the radical surgery, BCS has little trauma, less bleeding and lower infection rate, which makes patients′ quality of life improved. In the practice of BCS, due to the disease, patients, physicians, socioeconomic, clinical, security and many other factors, there are still many controversial issuesin the doctorpatient communication, socioeconomic, aesthetic, margins width, precision operation procedures of BCS. At the same time, new surgical techniques such as plastic breast conserving surgery, and new intraoperative assessment equipment such as MarginProbe system and other new technology development has brought us new ideas to solve these problems.

Key words:Breast neoplasms,Mastectomy, segmental

Cai Wenrun, Yang Zhengjun, Cao Xuchen. Current situation and problems of breast conserving surgery[J]. Journal of International Oncology, 2017, 44(7): 550-553.

References

［1］ Katz SJ, Lantz PM, Janz NK, et al. Patient involvement in surgery treatment decisions for breast cancer［J］. J Clin Oncol, 2005, 23(24): 5526-5533. DOI: 10.1200/JCO.2005.06.217. ［2］ Zhang L, Jiang M, Zhou Y, et al. Survey on breast cancer patients in China toward breastconserving surgery［J］. Psychooncology, 2012, 21(5): 488-495. DOI: 10.1002/pon.1922. ［3］ Fan L, StrasserWeippl K, Li JJ, et al. Breast cancer in China［J］. Lancet Oncol, 2014, 15(7): e279-e289. DOI: 10.1016/S1470-2045(13)70567-9 . ［4］ Nguyen BC, Alawadi ZM, Roife D, et al. Do socioeconomic factors and race determine the likelihood of breastconserving surgery?［J］. Clin Breast Cancer, 2016, 16(4): e93-e97. DOI: 10.1016/j.clbc.2016.05.008. ［5］ Schwartz GF, Veronesi U, Clough KB, et al. Proceedings of the consensus conference on breast conservation, April 28 to May 1, 2005, Milan, Italy［J］. Cancer, 2006, 107(2): 242250. DOI: 10.1002/cncr.21988. ［6］ Litière S, Werutsky G, Fentiman IS, et al. Breast conserving therapy versus mastectomy for stage ⅠⅡ breast cancer: 20 year followup of the EORTC 10801 phase 3 randomised trial［J］. Lancet Oncology, 2012, 13(4): 412-419. DOI: 10.1016/S1470-2045(12)70042-6. ［7］ Shin HC, Han W, Moon HG, et al. Limited value and utility of breast MRI in patients undergoing breastconserving cancer surgery［J］. Ann SurgOncol, 2012, 19(8): 2572-2579. DOI: 10.1245/s10434-012-2289-3. ［8］ Houssami N, Ciatto S, Macaskill P, et al. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and metaanalysis in detection of multifocal and multicentric cancer［J］. J ClinOncol, 2008, 26(19): 3248-3258. DOI: 10.1200/JCO.2007.15.2108. ［9］ Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial［J］. Lancet, 2010, 375(9714): 563-571. ［10］ Arvold ND, Taghian AG, Niemierko A, et al. Age, breast cancer subtype approximation, and local recurrence after breastconserving therapy［J］. J ClinOncol, 2011, 29(29): 3885-3891. DOI: 10.1200/JCO.2011.36.1105. ［11］ Azim HA, Partridge AH. Biology of breast cancer in young women［J］. Breast Cancer Res, 2014, 16(4): 427. DOI: 10.1186/s13058-014-0427-5. ［12］ Rosenberger LH, Mamtani A, Fuzesi S, et al. Early adoption of the SSOASTRO consensus guidelines on margins for breastconserving surgery with wholebreast irradiation in stage Ⅰ and Ⅱ invasive breast cancer: initial experience from memorial sloankettering cancer center［J］. Ann SurgOncol, 2016, 23(10): 3239-3246. DOI: 10.1245/s10434-016-5397-7. ［13］ Esposito A, Criscitiello C, Curigliano G. Highlights from the 14(th) St Gallen International Breast Cancer Conference 2015 in Vienna: dealing with classification, prognostication, and prediction refinement to personalize the treatment of patients with early breast cancer［J］. Ecancermedicalscience, 2015, 9: 518. DOI: 10.3332/ecancer.2015.518. ［14］ Merrill AL, Tang R, Plichta JK, et al. Should new "no ink on tumor" lumpectomy margin guidelines be applied to ductal carcinoma in situ (DCIS)? A retrospective review using shaved cavity margins［J］. Ann SurgOncol, 2016, 23(11): 3453-3458. DOI: 10.1245/s10434-016-5251-y. ［15］ Morrow M, Van Zee KJ. Margins in DCIS: does residual disease provide an answer?［J］. Ann SurgOncol, 2016, 23(11): 3423-3425. DOI: 10.1245/s10434-016-5255-7. ［16］ Wang S, Zhang Y, Yang X, et al. Shrink pattern of breast cancer after neoadjuvant chemotherapy and its correlation with clinical pathological factors［J］. World J SurgOncol, 2013, 11(1): 166. DOI: 10.1186/1477-7819-11-166. ［17］ Akay CL, MericBernstam F, Hunt KK, et al. Evaluation of the MD anderson prognostic index for localregional recurrence after breast conserving therapy in patients receiving neoadjuvant chemotherapy［J］. Ann SurgOncol, 2012, 19(3): 901-907. DOI: 10.1245/s10434-011-2006-7. ［18］ Mittendorf EA, Buchholz TA, Tucker SL, et al. Impact of chemotherapy sequencing on localregional failure risk in breast cancer patients undergoing breastconserving therapy［J］. Ann Surg, 2013, 257(2): 173-179. DOI: 10.1097/SLA.0b013e3182805c4a. ［19］ Coates AS, Winer EP, Goldhirsch A, et al. Editor′s choice: tailoring therapiesimproving the management of early breast cancer:St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015［J］. Ann Oncol, 2015, 26(8): 1533. ［20］ HillKayser CE, Vachani C, Hampshire MK, et al. Cosmetic outcomes and complications reported by patients having undergone breastconserving treatment［J］. Int J Radiat Oncol Biol Phys, 2012, 83(3): 839-844. DOI: 10.1016/j.ijrobp.2011.08.013. ［21］曹旭晨. 整形保乳手术——乳腺外科个体化治疗的新方向［J］. 中国普外基础与临床杂志, 2013 (8): 838841. DOI: 10.7507/10079424.20130215. ［22］ Early Breast Cancer Trialists′ Collaborative Group (EBCTCG), Darby S, McGale P, et al. Effect of radiotherapy after breastconserving surgery on 10year recurrence and 15year breast cancer death:metaanalysis of individual patient data for 10 801 women in 17 randomised trials［J］. Lancet, 2011, 378(9804): 1707-1716. DOI: 10.1016/S0140-6736(11)61629-2. ［23］ Thill M. MarginProbe: intraoperative margin assessment during breast conserving surgery by using radiofrequency spectroscopy［J］. Expert Rev Med Devices, 2013, 10(3): 301-315. DOI: 10.1586/erd.13.5.

[1]	Wang Ying, Liu Nan, Guo Bing.Advances of antibody-drug conjugate in the therapy of metastatic breast cancer[J]. Journal of International Oncology, 2024, 51(6): 364-369.
[2]	Sa Qiang, Xu Hangcheng, Wang Jiayu.Advances in immunotherapy for breast cancer[J]. Journal of International Oncology, 2024, 51(4): 227-234.
[3]	Yang Zhi, Lu Yiqiao, Gu Huayan, Ding Jialing, Guo Guilong.Research progress of tumor microenvironment mediated drug resistance in targeted therapy of breast cancer[J]. Journal of International Oncology, 2024, 51(4): 235-238.
[4]	Chen Boguang, Wang Sugui, Zhang Yongjie.Role of serum cholinesterase and inflammatory markers in the prognosis of stage ⅠA -ⅢA breast cancer[J]. Journal of International Oncology, 2024, 51(2): 73-82.
[5]	Gu Huayan, Zhu Teng, Guo Guilong.Breast microbiota and breast cancer： present and future[J]. Journal of International Oncology, 2024, 51(1): 55-58.
[6]	Wang Jing, Xu Wenting.Value of NLR， CEA combined with coagulation indicators in the differential diagnosis of benign and malignant breast nodules with a diameter ≤ 1.0 cm[J]. Journal of International Oncology, 2023, 50(9): 520-526.
[7]	Feng Chengtian, Huang Furong, Cao Shiyu, Wang Jianyu, Nanding Abiyasi, Jiang Yongdong, Zhu Juanying.Relationships between HER2 protein expression and imaging features in HER2 positive breast cancer patients[J]. Journal of International Oncology, 2023, 50(9): 527-531.
[8]	Feng Dongxu, Wu Wei, Gao Pingfa, Wang Jun, Shi Lijuan, Chen Dawei, Li Wenbing, Zhang Meifeng.Effects of miR-451 on glycolysis and apoptosis of breast cancer cells by regulating Rho/ROCK1 pathway[J]. Journal of International Oncology, 2023, 50(8): 449-456.
[9]	Pan Shulan, Liu Chang, He Ping.Effect of fritinib on angiogenesis, tumor growth and IRE1-ASK1-JNK pathway in triple negative breast cancer[J]. Journal of International Oncology, 2023, 50(8): 457-462.
[10]	Wang Wende, Zeng De.Research progress on the mechanism of endocrine therapy resistance for breast cancer[J]. Journal of International Oncology, 2023, 50(6): 352-356.
[11]	Li Qingshan, Xie Xin, Zhang Nan, Liu Shuai.Research progress on the application of combining radiotherapy and systemic therapy in breast cancer[J]. Journal of International Oncology, 2023, 50(6): 362-367.
[12]	Zhu Jun, Huang Meijin, Li Yuan, Liu Zegang, Xun Xin, Chen Hong.Research progress on targeted therapy of breast cancer with low expression of HER2[J]. Journal of International Oncology, 2023, 50(4): 236-240.
[13]	Zhou Ting, Xu Shaohua, Mei Lin.Efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer[J]. Journal of International Oncology, 2023, 50(3): 144-149.
[14]	Li Lixi, Zhang Di, Luo Yang, Ma Fei.Clinical application of PARP inhibitors in breast cancer[J]. Journal of International Oncology, 2023, 50(2): 91-96.
[15]	Geng Rui, Ma Junqiang, Guo Qiang, Niu Zhaofeng.Tendency of elderly patients with breast cancer to choose comprehensive treatment mode and its influencing factors[J]. Journal of International Oncology, 2023, 50(11): 650-654.