NICE guidance

Endoscopic mastectomy and endoscopic wide local excision for breast cancer
Guidance issued
Number: IPG296
Summary:
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic mastectomy and endoscopic wide local excision for breast cancer.
Description:
Treatment for early breast cancer usually involves surgery to remove all or part of the breast. In this keyhole procedure, part or all of the breast tissue is removed using special instruments inserted through small skin incisions. The skin envelope of the breast and nipple are left intact, ready for an implant that can be inserted during the same operation.

The Breast Journal Vol 15 No 3 2009

EDITORIAL
p. 221-222
"Early View": A New Initiative of The Breast Journal
Shahla Masood
AbstractPublished Online: 5 May 2009

ORIGINAL ARTICLES
p. 223-229
Curcumin Suppresses the Paclitaxel-Induced Nuclear Factor-κB in Breast Cancer Cells and Potentiates the Growth Inhibitory Effect of Paclitaxel in a Breast Cancer Nude Mice Model
Hee Joon Kang, Sang Hun Lee, Janet E. Price, Lee Su Kim
AbstractPublished Online: 5 May 2009
p. 230-235
Pathologic Nipple Discharge in Patients with Radiologically Invisible Mass: Review of 28 Consecutive Sub-areolar Explorations
Mehmet Ali Kocdor, Ali Ibrahim Sevinc, Tulay Canda, Pinar Balci, Serdar Saydam, Ozgur Cavdaroglu, Omer Harmancioglu
AbstractPublished Online: 5 May 2009
p. 236-241
Axillary Recurrence after Negative Sentinel Lymph Node Biopsy: Frequency and Factors Influencing Recurrence on the Long Term
Ilknur Sanli, Bea martine Desiree Lemaire, Alinda Janine Muller, Herman Jan van Kleffens, Lonneke V. Van Poll-Franse, Mari van Dijk
AbstractPublished Online: 5 May 2009
p. 242-246
Prognostic Implications of Positive Nonsentinel Lymph Nodes Removed During Selective Sentinel Lymphadenectomy for Breast Cancer
Julie E. Lang, Liang-Chih Liu, Ying Lu, Tyler Jenkins, Shelley E. Hwang, Laura J. Esserman et al
AbstractPublished Online: 5 May 2009
p. 247-253
Fulvestrant in Advanced Breast Cancer Following Tamoxifen and Aromatase Inhibition: A Single Center Experience
Jayson Wang, Sandeep Jain, Charles R. Coombes, Carlo Palmieri
AbstractPublished Online: 5 May 2009
p. 254-260
Mammary Ductoscopy and Ductal Washings for the Evaluation of Patients with Pathologic Nipple Discharge
Aislinn Vaughan, Joseph P. Crowe, Jennifer Brainard, Andrea Dawson, Julian Kim, Jill R. Dietz
AbstractPublished Online: 5 May 2009
p. 261-267
Significance of Periductal Lymphatic and Blood Vascular Densities in Intraductal Carcinoma of the Breast
Yasser M. EL-Gohary, Ghada Metwally, Reda S. Saad, Morton J. Robinson, Thomas Mesko, Robert J. Poppiti
AbstractPublished Online: 5 May 2009
p. 268-278
Ipsilateral Breast Tumor Recurrence: Is There Any Evidence for Benefit of Further Systemic Therapy?
Bhawna Sirohi, Alexandra Leary, Stephen R. D. Johnston
AbstractPublished Online: 5 May 2009
p. 279-286
Aesthetic Correction of Tuberous Breast Deformity—Lessons Learned with a Single-Stage Procedure
Alexander D. Bach, Ulrich Kneser, Justus P. Beier, Christiane Breuel, Raymund E. Horch, Mareike Leffler
AbstractPublished Online: 5 May 2009

SHORT COMMUNICATIONS
p. 287-290
Sexual Adjustment and Body Image Scale (SABIS): A New Measure for Breast Cancer Patients
E. Jane Dalton, Valaire Naisbitt Rasmussen, Catherine C. Classen, Mareile Grumann et al
AbstractPublished Online: 5 May 2009
p. 291-295
Rethinking TNM: A Breast Cancer Classification to Guide to Treatment and Facilitate Research
Umberto Veronesi, Stefano Zurrida, Giuseppe Viale et al
AbstractPublished Online: 5 May 2009
296-298
Long-Term Results of Breast Conservation in Chinese Women with Breast Cancer
Juin Liu, Xi-Shan Hao, Yong Yu, Zhi-Yi Fang, Jun-Tian Liu, Yun Niu, Ian S. Fentiman
AbstractPublished Online: 5 May 2009

CASE REPORT
p. 299-301
Calcifying Fibrous Pseudotumor of the Breast
Amrit Mangat, Carol Schiller, Patricia Mengoni, Carol Reynolds, Jacqueline S. Jeruss
AbstractPublished Online: 5 May 2009

BREAST IMAGES
p. 302-303
Signet Ring Cell Histiocytosis in Axillary Lymph Nodes: A Sheep in Wolves' Clothing? A Potentially Under-recognized Pitfall in the Diagnosis of Metastatic Breast Cancer
Renuka Pathi, W. Dwayne Lawrence, Julieta E. Barroeta
AbstractPublished Online: 5 May 2009
p. 303-304
"Cholesteroloma": A Rare Cause of "Indeterminate" Microcalcifications on Mammography
Michael A. Seidman, Theresa Scognamiglio, Syed A. Hoda
AbstractPublished Online: 5 May 2009
p. 305-306
Barium Sulphate Particles in Breast Mimicking Malignant Type Microcalcification
Louise Bamford, Tong F. Lioe, Declan M. O'Rourke, Miriam R.E. Buckley
AbstractPublished Online: 5 May 2009
p. 307-308
Unilateral Calcifying Lupus Mastitis in a Male Breast
Jeroen Crevits, Andreas Van Steen, Chantal Van Ongeval, Guy Marchal
AbstractPublished Online: 5 May 2009
p. 309-309
Spontaneous Expulsion of Benign Phyllodes
Rajshekhar C. Jaka, Kariappa Mohan Kumar, Kodaganur S. Gopinath
AbstractPublished Online: 5 May 2009

LETTERS TO THE EDITOR
p. 310-312
Comparison of Two Score Systems in Bcl-2 and Bax Protein Expression in Invasive Ductal Carcinoma of Breast and Relation with Oestrogen and Progestrone Receptors
Ayatollahi Hossein, Ghaffarzadegan Kamran, Sharifi Noorieh et al
AbstractPublished Online: 5 May 2009
p. 313-314
Internal Mammary Chain Sentinel Biopsy in Invasive Breast Cancer: An Investigational Procedure?
Augusto García-Villanueva, Maria Vicenta Collado-Guirao, Roberto Rojo-Blanco et al
AbstractPublished Online: 5 May 2009
p. 315-317
Humeral Metastasis in Breast Cancer Patients: Radiotherapeutic Management of 21 Cases
Federico L. Ampil, Gloria Caldito, Guillermo P. Sangster, Victor A. Ursua
AbstractPublished Online: 5 May 2009
p. 318-320
The Impact of Mammography in a Public University Affiliated Hospital in an Urban Community
Saman Hazany, Iraj Khalkhali
AbstractPublished Online: 5 May 2009
p. 321-323
Shared Management of a Rare Necrotizing Soft Tissue Infection of the Breast
Jason D. Keune, Spencer Melby, John P. Kirby, Rebecca L. Aft
AbstractPublished Online: 5 May 2009

Annals of Surgery May 2009 Vol 249 Iss 5

p828-833
Surgeon Characteristics and Use of Breast Conservation Surgery in Women With Early Stage Breast Cancer
Dawn L. Hershman, MD, MS; Donna Buono, MS; Judith S. Jacobson, PhD, MBA; Russell B. McBride, MPH; Wei Yann Tsai, PhD; Kathie Ann Joseph, MD, MPH; Alfred I. Neugut, MD, PhD

p834-839
The Value of Level III Clearance in Patients With Axillary and Sentinel Node Positive Breast Cancer
Mary F. Dillon, MD; Vriti Advani, MB; Catherine Masterson, RN; Christina O'Loughlin, PhD; Cecily M. Quinn, MD; Niall O'Higgins, MCh; Denis Evoy, MCh; Enda W. McDermott, MCh

British Journal of Surgery Vol 96 Iss 4 2009

p. 376-380
Prognosis of synchronous bilateral breast cancer
T. Irvine, D. S. Allen, C. Gillett, H. Hamed, I. S. Fentiman
Abstract
Published Online: 12 Mar 2009DOI 10.1002/bjs.6553

BMJ 2009 no. 338

Will ductal carcinoma in situ defeat breast cancer screening?
John R Benson
BMJ 2009;338 b957
Reality of ductal carcinoma in situ
Jane Flanders
BMJ 2009;338 b958
Tissue screening after breast reduction
Mohammed Keshtgar, Alireza Hamidian Jahromi, Tim Davidson, Paula Escobar, Patrick Mallucci, Afshin Mosahebi, and Michael Baum
BMJ 2009;338 b630

NICE guidelines - management of breast cancer

NICE guidelines on the management of breast cancer
Clinical guidelines 80 and 81

The Breast journal Vol 15 Iss 2 2009

Early View (Articles Available Online in Advance of Print)
EDITORIAL
117-119
Therapeutic Decisions for Ductal Carcinoma In Situ:
A Gordian KnotMichael Lagios
AbstractPublished Online: 9 Mar 2009DOI 10.1111/j.1524-4741.2009.00685.x

ORIGINAL ARTICLES
120-132
Prognostic Significance of Oncogenic Markers in Ductal Carcinoma In Situ of the Breast: A Clinicopathologic Study
Sevilay Altintas, Kathleen Lambein, Manon T. Huizing, Geert Braems et al
AbstractPublished Online: 9 Mar 2009

133-139
Early Detection of Breast Cancer through Population-Based Mammographic Screening in Asian Women: A Comparison Study between Screen-Detected and Symptomatic Breast Cancers
Esther W. L. Chuwa, Allen W. Y. Yeo, Heng Nung Koong et al
AbstractPublished Online: 9 Mar 2009

140-145
Intraoperative High-Dose-Rate Brachytherapy—A Novel Technique in the Surgical Management of Axillary Recurrence
Manjeet Chadha, Par Mehta, Sheldon Feldman, Susan K. Boolbol, Louis B. Harrison
AbstractPublished Online: 9 Mar 2009

146-154
Should Histologic Type be Taken into Account when Considering Neoadjuvant Chemotherapy in Breast Carcinoma?
Peggy S. Sullivan, Sophia K. Apple
AbstractPublished Online: 9 Mar 2009

155-162
Identification and Management of Women at High Risk for Hereditary Breast/Ovarian Cancer Syndrome
Elissa M. Ozanne, Andrea Loberg, Sherwood Hughes, Christine Lawrence et al
AbstractPublished Online: 9 Mar 2009

163-167
Locoregional Relapse After Breast Cancer: Most Relapses Occur Late and are not Clinically Detected
David A. Montgomery, Katherine Krupa, Timothy G. Cooke
AbstractPublished Online: 9 Mar 2009

168-175
Fiberoptic Ductoscopy-Guided Intraductal Biopsy Improve the Diagnosis of Nipple Discharge
Hong Ling, Guang-yu Liu, Jin-song Lu, Susan Love, Jia-xin Zhang, Xiao-li Xu et al
AbstractPublished Online: 9 Mar 2009

176-181
Primary Peritoneal Serous Carcinoma Presenting as Inflammatory Breast Cancer
Ibrahim Khalifeh, Michael T. Deavers, Massimo Cristofanilli, Robert L. Coleman, Anais Malpica, Michael Z. Gilcrease
AbstractPublished Online: 9 Mar 2009

182-188
Breast Cancer in the Middle Eastern Population of California, 1988–2004
Kiumarss Nasseri
AbstractPublished Online: 9 Mar 2009

SHORT COMMUNICATIONS
189-193
MRI of the Breast: Does the Internet Accurately Report its Beneficial Uses and Limitations?
Larissa Nekhlyudov, Keith Kiarsis, Joann G. Elmore
AbstractPublished Online: 9 Mar 2009

194-198
Enhancing the Adjuvant Treatment of Hormone Receptor Positive Breast Cancer
Mitchel Barry, Malcolm R. Kell
AbstractPublished Online: 9 Mar 2009

CASE REPORT
199-201
First Report of a Necrotising Fasciitis of the Breast Following a Core Needle Biopsy
Anaig Flandrin, Caroline Rouleau, Chaible Azar, Olivier Dubon, Pierre Ludovic Giacalone
AbstractPublished Online: 9 Mar 2009

BREAST IMAGES
202-203
Metastatic Breast Cancer Presenting as Cancer of Unknown Primary Associated with Superior Vena Cava Syndrome
Hyun-Jeong Shim, Se-Ryeon Lee, Jae-Sok Ahn, Duk-Hwan Yang et al
AbstractPublished Online: 9 Mar 2009

203-205
Synchronous Primary Breast and Ovarian Cancer with Ovarian Cancer Metastases to a Breast Sentinel Lymph Node
Erin F. Wolff, Maritza Martel, Katja Gwin, Donald Lannin
AbstractPublished Online: 9 Mar 2009

205-206
Solid Neuroendocrine Carcinoma of the Breast with Osteoclast-Like Giant Cells
Oluwole Fadare, Stephen A. Gill
AbstractPublished Online: 9 Mar 2009

206-207
Primary Well Differentiated Liposarcoma: An Unusual Tumor in the Breast
Lamia Charfi, Maha Driss, Karima Mrad, Imen Abbes, Rym Dhouib, Samia Sassi, Khaled Ben Romdhane
AbstractPublished Online: 9 Mar 2009

208-209
Spider Bite on a Male Breast: A Rare Case in the Capital
Flora Zagouri, Theodoros N. Sergentanis, Nikolaos V. Michalopoulos, Aphrodite Nonni, Georgia Giannakopoulou, George C. Zografos
AbstractPublished Online: 9 Mar 2009

LETTERS TO THE EDITOR
210-211
Precipitating Factors for Lymphedema Following Surgical Treatment of Breast Cancer: Implications for Patients Undergoing Axillary Lymph Node Dissection
Murat Dayangac, Özer Makay, Levent Yeniay, Murat Aynaci, Murat Kapkac, Rasih Yilmaz
AbstractPublished Online: 9 Mar 2009

212-213
Isolated Tumor Cells in Bone Marrow and its Relation with known Prognostic Factors in Breast Cancer Patients
Renata Sánchez, Luis González, Luis Betancourt, Juan J. Rodríguez et al
AbstractPublished Online: 9 Mar 2009

214-215
Vacuum-Assisted Closure Dressing as an Aid to Salvage Breast Following Severe Postoperative Infection
Shakeel Dustagheer, Mel Tohill B, Khalid Khan
AbstractPublished Online: 9 Mar 2009

216-217
Travel Distance to Mammography and the Early Detection of Breast Cancer
Anneke T. Schroen, Megan E. Lohr
AbstractPublished Online: 9 Mar 2009

218-220
Dendritic Cell Infiltration in Lymph Node Positive Breast Carcinomas
Huiying He, G Somlo, Yen Yun, Peiguo G Chu
AbstractPublished Online: 9 Mar 2009

Annals of Surgery March 2009 Vol 249 Iss 3

448-454
Impact of MRI-Evaluated Neoadjuvant Chemotherapy Response on Change of Surgical Recommendation in Breast Cancer
Jeon-Hor Chen, MD; Byron A. Feig, BS; David J-B Hsiang, MD; John A. Butler, MD; Rita S. Mehta, MD; Shadfar Bahri, MD; Orhan Nalcioglu, PhD; Min-Ying Su, PhD

455-460
Can Sentinel Node Biopsy Be Avoided in Some Elderly Breast Cancer Patients?
for the North American Fareston Tamoxifen Adjuvant Trial

461-468
The Oncological Safety of Skin Sparing Mastectomy with Conservation of the Nipple-Areola Complex and Autologous Reconstruction: An Extended Follow-Up Study
Bernd Gerber, MD, PhD; Annette Krause, MD; Max Dieterich, MD; Günther Kundt, PhD,†; Toralf Reimer, MD, PhD

BMJ 24 Feb 2009

Editorial
Minimally invasive surgery for breast cancer
Monica Morrow
BMJ 2009;338 b557

News
Breast cancer incidence falls as women give up HRT
Roger Dobson
BMJ 2009;338 b791

Familial breast cancer - NICE

Familial breast cancer
NICE guideline October 2006
Summary
The NICE clinical guideline on familial breast cancer covers the care of adult women who may be at increased risk of developing breast cancer because of a family history of breast or other cancers.
It does not specifically look at: women who have already been diagnosed with breast cancer or men, but the recommendations may be relevant to some men because, although rarer than in women, men may get breast cancer and this may run in families.
This guideline is an update of advice on familial breast cancer that NICE produced in 2004. The advice on magnetic resonance imaging (MRI) for breast cancer screening has changed, but all the other advice is the same.

Articles from Cases Journal

Cutaneous metastases of breast carcinoma: a case report
Vano-Galvan S, Moreno-Martin P, Salguero I, Jaen P
Cases Journal 2009, 2:71 (21 January 2009)
[Abstract] [Provisional PDF]

''Signt-ring'' cell invasive lobular carcinoma of the breast - accidental finding associated with intraductal papilloma: a case report
Blazicevic V, Staklenac B, Kristek J, Pajtler M, Krajinovic Z, Stimac D, Ivezic Z, Kotromanovic Z, Tomas I, Biljan M
Cases Journal 2009, 2:130 (6 February 2009)
[Abstract] [Provisional PDF]

Breast Reconstruction after Breast-Cancer Surgery

New England Journal of Medicine
Volume 360, Issue 4: January 22, 2009
CORRESPONDENCE
Breast Reconstruction after Breast-Cancer Surgery
Beier, Horsch and Bach

AJR March 2009 Vol. 192 No. 3

Mucinous Carcinoma of the Breast: MRI Features of Pure and Mixed Forms with Histopathologic Correlation
Shuichi Monzawa, Masaki Yokokawa, Toshiko Sakuma, Shintaro Takao et al
AJR 2009;192:125-131
http://www.ajronline.org/cgi/content/abstract/192/3/W125

Digital Mammography-Guided Skin Marking for Sonographically Guided Biopsy of Suspicious Microcalcifications
Nariya Cho and Woo Kyung Moon
AJR 2009;192:132-136
http://www.ajronline.org/cgi/content/abstract/192/3/W132

MRI and PET/CT for Triaging Stage IB Clinically Operable Cervical Cancer to Appropriate Therapy: Decision Analysis to Assess Patient Outcomes
Pari V. Pandharipande, Garry Choy, Marcela G. del Carmen et al
AJR 2009;192:802-814
http://www.ajronline.org/cgi/content/abstract/192/3/802

The Many Faces of Fat Necrosis in the Breast
Jorge L. Taboada, Tanya W. Stephens, Savitri Krishnamurthy, Kathleen R. Brandt, and Gary J. Whitman
AJR 2009;192:815-825
http://www.ajronline.org/cgi/content/abstract/192/3/815

Plastic & Reconstructive Surgery Vol 123 No 2 2009

Blondeel, Phillip N. M.D., Ph.D.; Hijjawi, John M.D.; Depypere, Herman M.D., Ph.D.; Roche, Nathalie M.D.; Van Landuyt, Koenraad M.D., Ph.D.;
Shaping the Breast in Aesthetic and Reconstructive Breast Surgery: An Easy Three-Step Principle
Plastic & Reconstructive Surgery. 123(2):455-462, February 2009.
Abstract
Creating or recreating an aesthetically pleasing breast shape in reconstructive and aesthetic breast surgery is an act that most experienced "breast" surgeons will find self-evident. We propose a simple three-step philosophical and hands-on approach that will make it easier for young and unexperienced plastic surgeons to not only analyze the problematic breast but also come up with an easy surgical strategy to create reproducible results.This is Part I of four parts describing the three-step principle being applied in reconstructive and aesthetic breast surgery. Part I explains how to analyze a problematic breast by understanding the three main anatomical features of a breast and how they interact: the footprint, the conus of the breast, and the skin envelope. Part II deals with reconstructions after complete mastectomy and Part III covers reconstruction after breast conservation surgery. Finally, Part IV applies the same principles in the field of aesthetic breast surgery. Throughout these four parts, the three-step principle will be the red line to fall back on to define the problem and to propose a solution.(C)2009American Society of Plastic Surgeons

Selective Breast Reduction: A Personal Approach with a Central-Superior Pedicle.
Giacomo Datta, M.D.; Salvatore Carlucci, M.D.
SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT.

Septum-Based Mammaplasty: A Surgical Technique Based on Wuringer's Septum for Breast Reduction.
Moustapha Hamdi, M.D., Ph.D.; Koenraad Van Landuyt, M.D., Ph.D.; Patrick Tonnard, M.D.; Alex Verpaele, M.D.; Stan Monstrey, M.D., Ph.D.
SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT.

Controversies in Breast Cancer 2008

Breast Cancer Research has published a collection of short communications from
Controversies in Breast Cancer 2008 held in Edinburgh, UK on 1-2 September 2008.

Cases Journal Dec 2008 - Jan 2009

Primary breast lymphoma: a consideration in an HIV patient when a mass is discovered by screening mammography: a case report
Akinwande O, Paley R
Cases Journal, 2008 1:387 ( 11 December 2008 )
[Abstract] [Provisional PDF]

Accessory nipple reconstruction following a central quadrantectomy: a case report
Magno S, Terribile D, Franceschini G, Fabbri C, Chiesa F, Di Leone A, Masetti R
Cases Journal, 2009 2:32 ( 8 January 2009 )
[Abstract] [Provisional PDF]

Carcinosarcoma of the breast: two case reports and review of the literature
Esses K, Hagmaier R, Blanchard S, Lazarchick J, Riker A
Cases Journal, 2009 2:15 ( 6 January 2009 )
[Abstract] [Provisional PDF] [PubMed]

Annals of Surgery January 2009 vol 249 iss 1

26-32
Total Skin-Sparing Mastectomy: Complications and Local Recurrence Rates in 2 Cohorts of Patients
Elisabeth R. Garwood, BS; Dan Moore, PhD; Cheryl Ewing, MD; E Shelley Hwang, MD; Michael Alvarado et al
Abstract
Purpose: Dissemination of the total skin-sparing mastectomy (TSSM) technique is limited by concerns of nipple viability, flap necrosis, local recurrence risk, and the technical challenge of this procedure. We sought to define the impact of surgical and reconstructive variables on complication rates and assess how changes in technique affect outcomes.
Patients and Methods: We compared the outcomes of TSSM in 2 cohorts of patients. Cohort 1: the first 64 TSSM procedures performed at our institution, between 2001 and 2005. Cohort 2: 106 TSSM performed between 2005 and 2007. Outcomes of cohort 1 were analyzed in 2005. At that time, potential risk factors for complications were identified, and efforts to minimize these risks by altering operative and reconstructive technique were then applied to patients in cohort 2. The impact of these changes on outcomes was assessed. Logistic regression was used to determine the association between predictor variables and adverse outcomes (Stata 10).
Results: The predominant incision type in cohort 2 involved less than a third of the nipple areola complex (NAC), and the most frequent reconstruction technique was tissue expander placement. Between cohort 1 and cohort 2, nipple survival rates rose from 80% to 95% (P = 0.003) and complication rates declined: necrotic complications (30% -> 13%; P = 0.01), implant loss (31% -> 10%; P = 0.005), skin flap necrosis (16%-11%; not significant), and significant infections (17%-9%, not significant). Incisions involving >30% of the NAC (P < 0.001) and reconstruction with autologous tissue (P < 0.001) were independent risk factors for necrotic complications. The local recurrence rate was 0.6% at a median follow-up of 13 months (range, 1-65), with no recurrences in the NAC.
Conclusion: Focused improvement in technique has resulted in the development of TSSM as a successful intervention at our institution that is oncologically safe with high nipple viability and early low rates of recurrence. Identifying factors that contribute to complications and changing surgical and reconstructive techniques to eliminate risk factors has greatly improved outcomes.

87-90
Breast Conserving Surgery for Multifocal Breast Cancer
Woosung Lim, MD; Eun-Hwa Park, MD; Sung-Lim Choi, MD; Jin-Young Seo, MD; Hee-Jung Kim, MD; Mi-Ae Chang et al
Abstract
Objective: The purpose of this study is to examine the oncological safety of breast conserving surgery (BCS) for patients with multifocal breast cancer.
Summary Background Data: Few studies have reported about BCS for multifocal breast cancer. BCS for multifocal cancer has a risk of local failure in previous reports, whereas recent studies reported the feasibility of BCS. However, because all studies have dealt with a small number of patients, multifocal breast cancer is still considered a relative contraindication for BCS.
Methods: This retrospective study includes 478 patients with multifocal breast cancer who underwent BCS or mastectomy and 930 with unifocal cancer who underwent BCS for stage 0-II. Multifocal cancer was defined as 2 or more distinct cancers in the same quadrant. Of 478 patients, 147 underwent BCS and 331 underwent mastectomy. We compared the local recurrence rate (LRR), disease free survival, and overall survival for BCS with mastectomy for multifocal cancer. In addition, the LRR of BCS for multifocal cancer was compared for unifocal cancer.
Results: There is no significant difference in stage distribution and other clinical and pathologic characteristics except Her-2/neu for stage IIA between BCS and mastectomy for multifocal caner. The mean follow-up period was 59.33 months (range, 1.00-177.20) for breast conserving group and 64.98 months (range, 6.23-196.03) for mastectomy group. The 5-year overall survival was 93.38% for BCS and 94.53% for mastectomy (log rank P = 0.208). The 5-year disease-free survival was 89.08% for BCS and 91.88% for mastectomy (log rank P = 0.451). The local failure occurred in 3 (2.0%) of 147 patient underwent BCS, 3 (0.9%) of 331 patients underwent mastectomy (P = 0.378). Compared with BCS for unifocal cancer patients, the LRR of patients with multifocal cancer was not statistically different (2.0% for multifocal, 1.3% for unifocal; P = 0.445).
Conclusions: Our study demonstrates that BCS for multifocal breast cancer is oncologically safe in selected patients.

91-96
Video-Assisted Skin-Sparing Breast-Conserving Surgery for Breast Cancer and Immediate Reconstruction With Autologous Tissue
Hiroo Nakajima, MD, PhD; Ikuya Fujiwara, MD, PhD; Naruhiko Mizuta, MD, PhD; Koichi Sakaguchi, MD, PhD; Yasushi Hachimine, MD

American Journal of Roentgenology Jan 2009

Timed Efficiency of Interpretation of Digital and Film-Screen Screening Mammograms
Tamara Miner Haygood, Jihong Wang, E. Neely Atkinson et al
AJR 2009;192:216-220
http://www.ajronline.org/cgi/content/abstract/192/1/216

Sonographic Surveillance for the Detection of Contralateral Metachronous Breast Cancer in an Asian Population
Min Jung Kim, Eun-Kyung Kim, Jin Young Kwak et al
AJR 2009;192:221-228
http://www.ajronline.org/cgi/content/abstract/192/1/221

Frequency and Upgrade Rates of Atypical Ductal Hyperplasia Diagnosed at Stereotactic Vacuum-Assisted Breast Biopsy: 9-Versus 11-Gauge
Peter R. Eby, Jennifer E. Ochsner, Wendy B. DeMartini et al
AJR 2009;192:229-234
http://www.ajronline.org/cgi/content/abstract/192/1/229

Image-guided radiofrequency excision biopsy of breast lesions

NICE has been notified about this procedure and will consider it as part of the Institute's work programme.
The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an Interventional Procedures Consultation Document about its safety and efficacy for 4 weeks public consultation. IPAC will then review the consultation document in the light of comments received and produce a Final Interventional Procedures Document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.

Cases Journal 2008 1:311 14 November 2008

Surgical approach to primary non-Hodgkin's breast lymphoma: a case report
Neri A, Caruso S, Cerullo G, Lenoci M, Marrelli D, Roviello F
Cases Journal, 2008 1:311 ( 14 November 2008 )
[Abstract] [Provisional PDF]