Annals of surgical oncology
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The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3-15 days) and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB plus immediate or delayed axillary lymph node dissection (ALND). ⋯ Prevalence, severity, and level of distress of sensations were lower after SLNB compared with ALND, but some morbidity existed after SLNB. Certain sensations remained highly prevalent in both groups for up to 5 years.
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Screening mammography has increased the number of patients diagnosed with ductal carcinoma-in-situ (DCIS) in the past 20 years. The Florida Cancer Data System is the largest single source incident cancer registry in the United States. We analyzed this registry to determine the changing incidence and treatment patterns for DCIS. ⋯ The incidence of DCIS has risen dramatically with the advent of screening mammography. Increasing numbers of these patients are treated with BCT, although a large proportion are still treated with mastectomy, in some cases combined with axillary dissection. Sentinel lymph node biopsy and tamoxifen are important components of therapy, the use of which is slowly increasing in the treatment of DCIS.
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We investigated factors affecting 5-year survival in patients undergoing hepatic resection for colorectal cancer metastases, including events long after initial hepatectomy. Although retrospective studies have demonstrated survival benefit of hepatectomy for metastatic colorectal cancer, few have included sufficient 5-year survivors to identify survival-related factors throughout the clinical course. ⋯ Reoperations for each recurrence of metastases, followed by additional chemotherapy, frequently resulted in long survival.
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The aim of this study was to test a new strategy for radioguided management of malignant or suspicious nonpalpable breast lesions, with a combination of radioguided occult lesion localization (ROLL), sentinel lymph node (SLN) mapping, and, if necessary, immediate local surgery and SLN biopsy with a single injection of (99m)Tc-labeled dextran for the whole procedure. ⋯ ROLL and SLN biopsy are emerging procedures that can be used simultaneously. They permit exact breast lesion excision, immediate local breast surgery, and intraoperative SLN biopsy in a single procedure. The combination of radioguided nonpalpable lesion localization and SLN biopsy is a suitable alternative to working up subclinical imaging-detected breast carcinomas.
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Positive/close margins are associated with higher in-breast failure rates after breast-conserving surgery (BCS). We investigated whether intraoperative margin assessment aids in obtaining negative margins, and to evaluate the local control thus achieved. ⋯ Intraoperative assessment of margins assisted in identifying positive/close margins and allowed over a quarter of the patients to be rendered margin-negative with intraoperative re-excision at their original operation. This approach resulted in excellent local control in patients treated with BCS and radiation.