Surveillance For Local Recurrence Research Articles

Patient-Friendly Summary of the ACR Appropriateness Criteria: Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women.

Stage I breast cancer is divided into two stages: stage IA and stage IB. In stage IA breast cancer, the tumor is 20 mm or smaller, and the cancer has not spread to the lymph nodes under the arm. In stage IB breast cancer, the tumor is 20 mm or smaller, and the cancer has spread to the lymph nodes under the arm on the same side as the tumor.

Variability of Mammographic Imaging Surveillance in Breast Cancer Survivors.

Variability of Mammographic Imaging Surveillance in Breast Cancer Survivors.

Linear mixed-effects models for predicting sarcoma local recurrence growth rates: Implications for optimal surveillance imaging frequency

PurposeSarcomas are rare tumours of mesenchymal origin that are often treated with surgical resection and radiation to prevent local recurrence (LR). Surveillance for LR after surgical resection is often done with contrast-enhanced MRI, however, the optimal frequency of surveillance imaging is unknown. The aims of this study are to calculate LR growth, and to evaluate the factors that affect LR growth and to use this data to predict the optimal imaging surveillance frequency. MethodRetrospective cohort study of patients with sarcoma who were treated at a tertiary care academic institution between 01/01/2007 and 01/03/2020 identified 34 patients with 60 histologically confirmed LRs. The maximum LR length was measured on each surveillance MRI. Linear mixed-effects models were used to calculate the maximum LR length growth rate. We evaluated whether age, sex, primary sarcoma tumour size, sarcoma grade, margins, chemotherapy or radiation therapy affected the growth rate of the maximum LR length. Results: One patient had 6 LRs (2.9 %), two patients (5.9 %) had 5 LRs, two patients (5.9 %) had 4 LRs, two patients (5.9 %) had 3 LRs, three patients (8.8 %) had 2 LRs, and twenty-four patients (70.6 %) had 1 LR. Most patients had high grade (Grade II/III) disease (88.2 %). 41.2 % of the patients had microscopically positive surgical margins. The median time (range) from surgery to LR was 264 days (17 – 8013) days, and 90 % occurred within 42.8 months (1284 days). Microscopically positive margins were associated with faster growth of the maximum LR length (P = 0.036). Assuming that a 1 cm sarcoma LR is actionable and that the previous surveillance MRI was negative, the data predicts that patients with microscopically positive margins should have surveillance MRIs every 6.2 months when LRs are expected to achieve a length of 1.0 cm (95 % CI (0.4–2.3 cm)). ConclusionsPatients with microscopically positive resection margins had LRs that grew faster than patients with negative margins. Surveillance imaging with contrast-enhanced MRI could be conservatively performed every 6 months when LRs are expected to be just less than 1.0 cm in length.

What Factors Are Associated with Treatment Outcomes of Japanese Patients with Clear Cell Chondrosarcoma?

What Factors Are Associated with Treatment Outcomes of Japanese Patients with Clear Cell Chondrosarcoma?

ACR Appropriateness Criteria Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women

Women newly diagnosed with stage 1 breast cancer have an early-stage disease that can be effectively treated. Evidence provides little justification for performing imaging to exclude metastasis in asymptomatic women with stage I breast cancer. No differences have been found in survival or quality of life in women regardless of whether they underwent initial workup for metastatic disease. These women generally prefer intensive follow-up to detect an early recurrence. However, survival rates do not differ between women who obtain intensive screening and surveillance, with imaging and laboratory studies, and women who undergo testing only as a result of development of symptoms or findings on clinical examinations. In addition, quality of life is similar for women who undergo intensive surveillance compared with those who do not. American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines state that annual mammography is the only imaging examination that should be performed to detect a localized breast recurrence in asymptomatic patients. Additional imaging may be needed if the patient has locoregional symptoms.The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review by the panel include extensive analysis of current medical literature from peer-reviewed journals and application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. When evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Breast carcinoma en cuirasse as a natural progression of untreated breast cancer

Objective: Breast carcinoma en cuirasse is an aggressive manifestation of breast cancer, and is most often seen as a local recurrence. It is the most common primary malignancy to metastasize to the skin and palliative care is often the only option. Methods: Retrospective review of the patient’s chart was done. Results: Our patient is a 65 year old female with no significant past medical or surgical history, who presented with a 2 year history of an enlarging left breast mass and left axillary mass, to the point where she had pain with breathing and restriction of chest wall expansion. Work-up of her breast and axillary masses showed carcinoma en cuirasse. Given the advanced stage of her disease, the patient was offered palliative care, which she declined. Conclusions: Breast carcinoma en cuirasse is a rare manifestation of cutaneous metastases from breast cancer. While it is usually seen as a local recurrence, it can also be seen, as in our patient’s case, as a natural progression of breast cancer that is difficult to treat. Our patient’s case highlights the importance of early detection and treatment of breast cancer, as well as the surveillance for local recurrence.

ACR Appropriateness Criteria Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women

Women newly diagnosed with stage 1 breast cancer have an early-stage disease that can be effectively treated. Evidence provides little justification for performing imaging to exclude metastasis in asymptomatic women with stage I breast cancer. No differences have been found in survival or quality of life in women regardless of whether they underwent initial workup for metastatic disease. These women generally prefer intensive follow-up to detect an early recurrence. However, survival rates do not differ between women who obtain intensive screening and surveillance, with imaging and laboratory studies, and women who undergo testing only as a result of development of symptoms or findings on clinical examinations. In addition, quality of life is similar for women who undergo intensive surveillance compared with those who do not. American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines state that annual mammography is the only imaging examination that should be performed to detect a localized breast recurrence in asymptomatic patients. Additional imaging may be needed if the patient has locoregional symptoms. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review by the panel include extensive analysis of current medical literature from peer-reviewed journals and application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. When evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.