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Recent Advances and Challenges in Breast Cancer Surgery

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 6549

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Special Issue Editor

Dr. Antonio Piñero-Madrona

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Guest Editor

Breast Unit Surgery, Department of General Surgery, University Hospital "Virgen de la Arrixaca", BioMedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, E-30120 Murcia, Spain
Interests: surgical oncology; breast cancer; melanoma; sentinel node; lymph oncology; metastases; wound healing

Special Issue Information

Dear Colleagues,

During the last fifty years, we have witnessed a revolution in the field of breast cancer management. Therapeutic de-escalation, which has been seen in all areas of treatment, is especially visible in the case of surgical treatment, which has moved to precision treatments based on patient and tumor characteristics.

It has been replaced by less invasive procedures, and technical and technological advances change the way of facing surgical treatment of the breast and axilla.

This Special Issue of Cancers aims to review and update the surgical treatment of breast cancer through several articles focused on different aspects of the surgical technique and its relationship with technological advances and the relationship of surgery with other therapeutic and diagnostic modalities.

Dr. Antonio Piñero-Madrona
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

breast cancer surgery
axillary management
sentinel node
oncoplastic surgery
reconstructive surgery
surgical technology
cancer risk reduction surgery
radio-guided surgery

Published Papers (4 papers)

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Research

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11 pages, 896 KiB

Open AccessArticle

Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers

by Jose Ignacio Sánchez-Méndez, Mónica Horstmann, Nieves Méndez, Laura Frías, Elisa Moreno, Laura Yébenes, Mᵃ José Roca, Alicia Hernández and Covadonga Martí

Cancers 2023, 15(10), 2757; https://doi.org/10.3390/cancers15102757 - 14 May 2023

Viewed by 1094

Abstract

Human epidermal growth factor receptor 2 (HER2)-enriched breast cancers (BC) present the highest rates of pathological response to primary systemic therapy (PST), but they are also the ones that tend to be larger at diagnosis, with microcalcifications and, often, with axillary involvement. If we do not have a reliable method to predict the degree of response, we may not be able to transfer the benefits of PST to surgery. The post-PST surgery planning is guided by the findings in the magnetic resonance imaging (MRI), whose predictive capacity, although high, is far from optimal. Thus, it seems interesting to find other variables to improve it. A retrospective observational study including women with HER2 BC treated with PST and further surgery was conducted. Information regarding clinical, radiological, and histopathological variables was gathered from a total of 132 patients included. Radiological complete response (rCR) was achieved in 65.9% of the sample, and pathological complete response (pCR), according to Miller and Payne criteria, in 58.3% of cases. A higher Ki67 value, the absence of Hormonal Receptors expression, and an rCR was significantly related to a pCR finding. This information impacts directly in surgery planning, as it permits adjustment of the breast resection volume. Full article

(This article belongs to the Special Issue Recent Advances and Challenges in Breast Cancer Surgery)

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10 pages, 1437 KiB

Open AccessArticle

Sentinel Lymph Node Biopsy in Breast Cancer Patients Undergoing Neo-Adjuvant Chemotherapy: Clinical Experience with Node-Negative and Node-Positive Disease Prior to Systemic Therapy

by Corrado Tinterri, Andrea Sagona, Erika Barbieri, Simone Di Maria Grimaldi, Giulia Caraceni, Giacomo Ambrogi, Flavia Jacobs, Ersilia Biondi, Lorenzo Scardina and Damiano Gentile

Cancers 2023, 15(6), 1719; https://doi.org/10.3390/cancers15061719 - 11 Mar 2023

Cited by 9 | Viewed by 1931

Abstract

Background: Sentinel lymph node biopsy (SLNB) has emerged as the standard procedure to replace axillary lymph node dissection (ALND) in breast cancer (BC) patients undergoing neo-adjuvant chemotherapy (NAC). SLNB is accepted in clinically node-negative (cN0) patients; however, its role in clinically node-positive (cN+) patients is debatable. Methods: We performed a retrospective analysis of BC patients undergoing NAC and SLNB. Our aim was to evaluate the clinical significance of SLNB in the setting of NAC. This was accomplished by comparing the characteristics and oncological outcomes between cN0 and cN+ patients prior to NAC and type of axillary surgery. Results: A total of 291 patients were included in the analysis: 131 were cN0 and 160 were cN+ who became ycN0 after NAC. At a median follow-up of 43 months, axillary recurrence occurred in three cN0 (2.3%) and two cN+ (1.3%) patients. However, there were no statistically significant differences in oncological outcomes (disease-free survival, distant disease-free survival, overall survival, and breast-cancer-specific survival) between cN0 and cN+ patients nor between patients treated with SLNB only or ALND. Conclusions: SLNB in the setting of NAC is an acceptable procedure with a general good prognosis and low axillary failure rates for both cN0 and cN+ patients. Full article

(This article belongs to the Special Issue Recent Advances and Challenges in Breast Cancer Surgery)

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14 pages, 475 KiB

Open AccessArticle

Safety and Quality of Life in Women with Immediate Reconstruction with Polyurethane Implants after Neoadjuvant Chemotherapy: Outcomes from The Preq-20 Trial

by Benigno Acea-Nebril, Alejandra García-Novoa, Carmen Cereijo-Garea, Carmen Conde Iglesias, Alberto Bouzón Alejandro and Carlota Díaz Carballada

Cancers 2023, 15(4), 1113; https://doi.org/10.3390/cancers15041113 - 09 Feb 2023

Cited by 2 | Viewed by 1097

Abstract

Introduction: Various studies have evaluated the impact of neoadjuvant chemotherapy (NAC) on the complications of breast cancer surgery, most of which were retrospective and did not assess the variables related to postoperative risk factors. The aim of this study is to analyse the safety and satisfaction of women included in the PreQ-20 trial who underwent NAC and who underwent mastectomy and immediate reconstruction with prepectoral polyurethane implants. Material and Methods: The patients included in the study belong to the prospective study PreQ-20. The study group consisted of patients who underwent immediate reconstruction after primary systemic therapy. The control groups consisted of patients with immediate reconstruction and adjuvant chemotherapy (control group 1) and patients with an infiltrating carcinoma or in situ ductal carcinoma who did not require chemotherapy (control group 2). Results: The study included 157 women, 58 (36.9%) of whom underwent primary systemic therapy. The indication for genetic study was significantly greater for the study group (87.9%) than for control groups 1 (49.1%) or 2 (30.4%). Seventy-two (45.9%) of the patients underwent bilateral mastectomy (BM), a procedure that was performed significantly more frequently in the study group (69%) than in control groups 1 (30.2%) or 2 (34.8%). The incidence rate for BM after complete pathologic response was 78%. There were no statistically significant differences in the number of complications between the groups. Implant loss was significantly more frequent in control group 1 (13.2%) than in the study group (3.4%) and control group 2 (2.2%). Conclusions: Mastectomy with prepectoral polyurethane implant reconstruction in patients with neoadjuvant chemotherapy presented a similar incidence of complications compared with patients who underwent primary surgery. There is a high rate of BM in women with NAC. Full article

(This article belongs to the Special Issue Recent Advances and Challenges in Breast Cancer Surgery)

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Review

Jump to: Research

13 pages, 887 KiB

Open AccessReview

Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes

by Javier Sanz, Arantxa Eraso, Reyes Ibáñez, Rachel Williams and Manuel Algara

Cancers 2023, 15(16), 4025; https://doi.org/10.3390/cancers15164025 - 08 Aug 2023

Viewed by 1827

Abstract

Conservative surgery is the preferred treatment in the management of breast cancer followed by adjuvant whole-breast irradiation. Since the tumor bed is the main site of relapse, boost doses are conveniently administered according to risk factors for local relapse to increase the efficacy of the treatment. The benefit of a radiation boost is well established and it can be performed by several techniques like brachytherapy, external radiation or intraoperative radiotherapy. Greater precision in localizing the tumor cavity, immediacy and increased biological response are the main advantages of intraoperative boost irradiation. This modality of treatment can be performed by means of mobile electron accelerators or low-photon X-ray devices. There is a lot of research and some published series analyzing the results of the use of an intraoperative boost as an adjuvant treatment, after neoadjuvant systemic therapy and in combination with some reconstructive surgeries. This review discusses advantages of intraoperative radiotherapy and presents the main results of a boost in terms of local control, survival, tolerance and cosmesis. Full article

(This article belongs to the Special Issue Recent Advances and Challenges in Breast Cancer Surgery)

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