Long-Term Outcomes of Multiple-Wire Localizations for More Extensive Breast Cancer: Multiple-Wire Excision Does Not Increase Recurrence, Unplanned Imaging, or Biopsies.

BACKGROUND: We previously reported that breast conservation was feasible for women with large or irregularly shaped breast cancers when tumor resection was guided by multiple localizing wires. We now report long-term outcomes of multiple-wire versus single-wire localized lumpectomies for breast cancer. PATIENTS AND METHODS: We retrospectively reviewed wire-localized lumpectomies at our institution from May 2000 to November 2006. Rates of ipsilateral in-breast tumor recurrence, metastasis, and subsequent unplanned diagnostic imaging and biopsy were compared between multiple-wire and single-wire cohorts. RESULTS: We identified 112 multiple-wire and 160 single-wire breast cancer lumpectomies that achieved clear margins. Median age was 64 years in the multiple-wire cohort and 57 years in the single-wire cohort. Mean lumpectomy volume was 75 mL in multiple-wire patients and 49 mL in single-wire patients (P = .003). Invasive tumor size, axillary node status, and use of radiation and systemic therapy were similar, but the multiple-wire group had more patients with ductal carcinoma-in-situ only (38% vs. 28%). At 108 months' median follow-up, there was no significant difference in local or distant recurrence rates between multiple-wire and single-wire cohorts. Six (5%) multiple-wire patients and 6 (4%) single-wire patients had local recurrences and 3 (3%) multiple-wire and 5 (3%) single-wire patients developed metastatic disease. Unplanned diagnostic imaging was required for 53 (47%) multiple-wire and 65 (41%) single-wire patients. Subsequent ipsilateral biopsy occurred in 15 (13%) multiple-wire and 19 (12%) single-wire patients. CONCLUSION: Breast-conserving surgery with multiple localizing wires is a safe alternative to mastectomy for breast cancer patients with large mammographic lesions.

Caracterización de las lesiones no palpables de la mama / Characterization of non-palpable breast lesions

Introducción: la detección de lesiones neoplásicas de la mama cuando aún no han llegado a hacerse palpables, representan un importante avance en el manejo y pronóstico del cáncer de mama.Objetivo: Caracterizar las lesiones no palpables de la mama en pacientes atendidas en el Hospital General Docente "Dr. Enrique Cabrera". Material y Métodos: se realizó un estudio descriptivo y prospectivo en pacientes femeninas con lesiones no palpables de mama desde febrero de 2009 a febrero de 2014 en el Servicio de Cirugía del Hospital General Docente "Dr. Enrique Cabrera". La muestra fue de 65 pacientes, se clasificó según Breast Imaging Reporting and Data System (BIRADS). Las variables estudiadas fueron: edad, hallazgos mamográficos y anatomopatológicos. Se calculó la asociación a la malignidad mediante el Riesgo Relativo (RR) y el Odd Ratio (OR) con un intervalo de confianza (IC) de 95 por ciento. Resultados: se encontraron 18 (27,7 por ciento) lesiones malignas y 47 (72,3 por ciento) lesiones benignas. El mayor número de casos (52,3 por ciento) se registró en el grupo de 50-64 años. Se observaron 25 imágenes nodulares, 31 microcalcificaciones, asociación de ambos 7 y 2 distorsiones del patrón mamario. Los nódulos mostraron mayor asociación al cáncer de mama (36 por ciento), seguido por las microcalcificaciones (25,8 por ciento), predominó el carcinoma ductal 72,2 por ciento. Conclusiones: el carcinoma de origen ductal fue predominante en nuestro estudio, además de demostrar que el riesgo decáncer en la categoría BIRAD 5 fuecuatro veces mayor que en las categorías BIRADS 3 y 4(AU)

Introduction: a great advance in management and prognostic of breast cancer is the early detection represented by non-palpable breast lesions. Objective: characterize the non-palpable breast lesions in the Service of General Surgery at the Enrique Cabrera Hospital from February of 2009 to February of 2014. Material and Methods: it was carried out an observational, descriptive and prospective study. The sample constituted by 65female patients who had non-palpable breast lesions and classified according to Breast Imaging Reporting and Data System1993. The studied variables were: age, mammographic and anatomicopathological findings. To sum up, percent and absolute frequencies were used for statistical analysis and Chi-Square of Pearson test with significance of 0,05. The malignant incidence was calculates according to Relative risk (RR) and Odd Ratio (OR) with confidence interval (IC) 95 percent.Results: there were 1366 patients under screening, 65 of them had non-palpable breast lesions, 18 (27, 7 percent) malignant lesions and 47 (72, 3 percent) benign lesions. A major illness was found within 50 - 64 year old group. Twenty five nodules were found tightly associated with breast cancer (36 percent), 31 micro calcifications, both association seven and two patients with distortion of mammary structure. The ductal carcinoma was the most frequent neoplasm (72, 2 percent). Conclusions: screen is a safety option for early diagnostic of non-palpable breast lesions(AU)