Multidisciplinary Breast Cancer Clinic: A Novel Approach to Decrease Time to Intervention.

Multidisciplinary clinics (MDCs) were created at high-volume surgical oncology centers to optimize breast cancer care, in which patients are seen by multiple subspecialists at one visit. We aim to evaluate our experience with this novel approach. We examined 492 patients with newly diagnosed invasive breast cancer from January 1, 2020, to September 1, 2022.

Institutional Analysis of Metaplastic Breast Cancer.

Triple-negative breast cancer (TNBC) is typically managed with neoadjuvant chemotherapy (NAC). Metaplastic breast cancer (MBC), a subtype of TNBC, demonstrates different histologic characteristics and less responsiveness to NAC. We performed this study to achieve a better understanding of MBC, including the impact of neoadjuvant chemotherapy.

Factors That Predict Biological Aggressiveness in Estrogen Receptor-Positive / Human Epidermal Growth Factor Receptor 2-Negative / Lymph Node-Negative Breast Cancer.

Traditionally, breast cancer is staged using TNM criteria: tumor size (T), nodal status (N), and metastasis (M). The Oncotype DX assay provides a recurrence score (RS) based on genomics that predicts the likelihood of distant recurrence in estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-)/lymph node-negative (LN-) tumors. We retrospectively reviewed the medical records of patients with ER+/HER2-/LN- breast cancer tumors who were evaluated between 2007 and 2017 with Oncotype DX RS.

Use of Postmastectomy Radiation in Patients Treated for Invasive Breast Cancer with Mastectomy and Immediate Reconstruction.

Immediate reconstruction after mastectomy helps women manage the psychological impact of deforming surgery. Postmastectomy radiation therapy (PMRT) can negatively impact the aesthetic result after breast reconstruction. We performed this study to achieve a better understanding of how PMRT is used after reconstruction in our institution.

The Angel Wings Incision: A novel solution for mastectomy patients with increased lateral adiposity.

Many techniques have been proposed to address the problem of increased lateral adiposity in patients undergoing mastectomy, however, there is no standard approach. This cosmetic deformity at the lateral end of the mastectomy scar, also known as a dog ear, is especially common in obese patients. This defect can be unsightly and uncomfortable.

Four-Year Analysis of a Novel Milestone-Based Assessment of Faculty by General Surgical Residents.

Objective: In response to our faculty's concerns about the quality and reliability of feedback from general surgery residents, we developed a novel faculty assessment tool. This study was designed as an interim analysis of the tool's effectiveness and discriminatory ability.

Methods: Our department's educational leadership developed milestones in 7 domains that were scored from 1 to 4, with each level representing an educational approach that ranged from ineffective (1) to ideal (4).

Hip and Knee Arthroplasty Outcomes After Abdominal Organ Transplantation.

This case control study retrospectively compares patients who underwent solid organ transplantation and total joint replacement with a control group that only underwent joint replacement. The study compares 42 transplant patients who underwent liver or kidney transplantation and total hip arthroplasty (THA) or total knee arthroplasty (TKA) to a matched group of 42 nontransplant patients who underwent only THA or TKA. The transplant cohort had significantly more complications (18) than the nontransplant cohort (7) (p D .

A Potential Additional Variable to Consider in the Surgical Treatment of Ductal Carcinoma in Situ.

Background: HER2/neu is a potentially interesting variable that has been demonstrated to have a profound impact on the management of invasive breast carcinoma, and we performed this study to evaluate the differences between HER2-positive and HER2-negative ductal carcinoma in situ. The impetus for this study was our poor recruitment to the National Surgical Adjuvant Breast and Bowel Project Protocol B-43 trial that was designed to evaluate the potential role of trastuzumab in breast conservation therapy for patients with HER2-positive ductal carcinoma in situ.

Methods: All patients with ductal carcinoma in situ and an assessment for the HER2/neu receptor were identified.

Ultrasound image-guided core biopsy of the breast.

Results of partial mastectomy or lumpectomy including margin negativity are improved when preoperative diagnosis is obtained. This article describes the various techniques, instruments, utility and complications of the techniques. Emphasis is given to ultrasound (US) usefulness and effectiveness.

Alternatives to whole breast irradiation in early breast cancer.

Partial breast irradiation (PBI) when added to lumpectomy demonstrates equivalent local recurrence and survival when compared to whole breast radiation. However, PBI can be delivered in much shorter time (5 days as compared to 6 weeks) and even intraoperatively as an one time dose. This article describes the many alternative techniques available for delivering PBI.

An Assessment of Margins after Lumpectomy in Breast Cancer Management.

We performed this study to evaluate our indications for margin re-excision (MRE) in the management of cancer patients opting for breast conservation therapy (BCT). We identified patients choosing breast conservation therapy from January 2012 to May 2014. Margins were considered negative if >2 mm, close if <2 mm, and positive if ink was detected abutting tumor.

Parathyroid hormone levels predict posttotal thyroidectomy hypoparathyroidism.

We hypothesized that parathyroid hormone (PTH) determination would be the most effective strategy to identify posttotal thyroidectomy hypoparathyroidism (PTTHP) compared with other clinical and laboratory parameters. We retrospectively reviewed our recent experience with total thyroidectomy. We recorded demographics, malignancy, thyroid weight, parathyroid autotransplantation, hospital stay, use of postoperative calcium and hormonally active vitamin D3 (calcitriol), and postoperative serum calcium and PTH levels.