Publications by authors named "Astrid Botty Van den Bruele"

Bilateral risk-reducing mastectomy (BRRM) is the surgical removal of both breasts to reduce the risk of cancer. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, outcomes, and risks of BRRM to update the society's 2017 statement. We held a virtual meeting to outline key topics and conducted a literature search using PubMed to identify relevant articles.

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Background: Axillary management after neoadjuvant chemotherapy (NAC) is evolving but axillary lymph node dissection (ALND) remains the standard of care for patients with residual nodal disease. The results of the Alliance A011202 trial evaluating the oncologic safety of ALND omission in this cohort are pending but we hypothesize that ALND omission is already increasing.

Methods: The National Cancer Database was queried to identify patients diagnosed with cT1-3N1M0 breast cancer who underwent NAC and had residual nodal disease (ypN1mi-2) from 2012 to 2021.

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Background: Older breast cancer patients represent a heterogeneous population. Studies demonstrate that sentinel lymph node biopsy (SLNB) omission may be appropriate in some clinical scenarios, yet patients with triple-negative breast cancer (TNBC) are often excluded from these studies. This study evaluated differences in treatment and survival for older patients with TNBC based on SLNB receipt and result.

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Article Synopsis
  • Patients with inflammatory breast cancer (IBC) experience worse overall survival compared to non-IBC patients, despite similar treatment approaches.
  • The study analyzed data from 38,390 women with stage III breast cancer, showing that IBC patients had lower pathologic complete response (pCR) rates (20.7% vs. 23.3% for non-IBC), and higher 5-year mortality for those achieving pCR (16.4% vs. 9.1%).
  • The findings suggest that even when IBC patients achieve pCR, their survival outcomes remain poorer than those of non-IBC patients, indicating the need for more effective treatment strategies for IBC.
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Background: The utility of sentinel lymph node biopsy (SLNB) in older patients remains controversial. Advancements in human epidermal growth factor receptor 2 (HER2)-directed therapy have revolutionized disease response rates and prognosis, supporting efforts to re-evaluate the utility of SLNB. We aimed to assess the differences in treatment and overall survival (OS) in older patients with HER2-positive breast cancer based on SLNB.

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Importance: Data on oncological outcomes after omission of axillary lymph node dissection (ALND) in patients with breast cancer that downstages from node positive to negative with neoadjuvant chemotherapy are sparse. Additionally, the best axillary surgical staging technique in this scenario is unknown.

Objective: To investigate oncological outcomes after sentinel lymph node biopsy (SLNB) with dual-tracer mapping or targeted axillary dissection (TAD), which combines SLNB with localization and retrieval of the clipped lymph node.

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Purpose: Black women have higher rates of death from triple-negative breast cancer (TNBC) than White women. We hypothesized that pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) and overall survival (OS) may vary by race/ethnicity in patients with TNBC.

Methods: We identified women 18 years and older with stage I-III TNBC who received NAC followed by surgery from the National Cancer Database (2010-2019).

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Introduction: With the increasing utilization of genomic assays, such as the Oncotype DX recurrence score (RS), the relevance of anatomic staging has been questioned for select older patients with breast cancer. We sought to evaluate differences in chemotherapy receipt and/or survival among older patients based on RS and sentinel lymph node biopsy (SLNB) receipt/result.

Methods: Patients aged ≥ 65 diagnosed with pT1-2/cN0/M0 hormone-receptor-positive (HR+)/HER2-breast cancer (2010-2019) were selected from the National Cancer Database.

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Article Synopsis
  • The study investigates the relationship between the recurrence score (RS) and lymph node involvement in postmenopausal women with HR+/HER2- invasive breast cancer (IBC), particularly those with small tumors that are clinically node negative (cN0).
  • Researchers analyzed data from patients over 50 years old diagnosed between 2015 and 2019 to compare tumor characteristics and rates of nodal involvement (pN0 vs. pN1) based on their RS.
  • The findings suggest that pN0 and pN1 tumors share similar biological characteristics, indicating that tumor biology (as measured by RS) may be a more significant factor than the presence of cancer in limited lymph nodes, which raises questions about the necessity of routine
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Article Synopsis
  • - Rates of contralateral mastectomy (CM) for unilateral breast cancer are rising in the U.S., with patients considering factors like the risk of contralateral breast cancer (CBC) and aesthetic concerns, while surgeons focus mainly on CBC risk.
  • - Although CM can lower the risk of developing new breast cancer in high-risk patients, it hasn't been shown to improve overall survival rates.
  • - Recommendations include performing mammograms within a year before CM but not routine preoperative MRIs or postoperative imaging, and it's advised that shared decision-making can help manage the rates of CM.
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Background: Multiple studies have demonstrated a link between obesity and breast cancer; however, the potential association between obesity and atypical high-risk breast lesions has not been well characterized. We sought to evaluate the characteristics and clinical outcomes of patients with breast atypia based on a woman's body mass index (BMI).

Methods: We retrospectively identified adult women diagnosed with atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and/or lobular carcinoma in situ (LCIS) at a single institution from 2008 to 2017.

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Introduction: Ownership may influence trauma center (TC) location. For-profit (FP) TCs require a favorable payor mix to thrive, whereas not-for-profit (NFP) centers may rely on government funding, grants, and patient volume. We hypothesized that the demographics of trauma patients would be different for NFP and FP TCs due to ownership type.

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Mobile mammography vans (mammovans) may help close the gap to access of breast cancer screening by providing resources to underserved communities. Minimal data exists on the populations served, the ability of mammovans to reach underserved populations, and the outcomes of participants. We sought to determine the demographic characteristics, number of breast cancers diagnosed, and number of women who used the American Italian Cancer Foundation (AICF) Mobile, No-Cost Breast Cancer Screening Program within the five boroughs of New York City.

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Background: For-profit (FP) trauma centers (TCs) charge more for trauma care than not-for-profit (NFP) centers. We sought to determine charges, length of stay (LOS), and complications associations with TC ownership status (FP, NFP, and government) for three diagnoses among patients with overall low injury severity.

Methods: Adult patients treated at TCs with an International Classification of Diseases-based injury severity score (ICISS) survival probability ≥ 0.

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Purpose: HER2 +- amplified breast cancer patients derive benefit from treatment with anti-HER2-targeted therapy. Though adjuvant treatment is based on final pathology, decisions regarding neoadjuvant chemotherapy are made in the preoperative setting with imaging playing a key role in staging. We examined the accuracy of pre-operative imaging in determining pathological tumor size  (pT) in patients undergoing upfront surgery.

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Purpose: Mastectomy has long been the preferred approach for local salvage of recurrent breast cancer following breast-conservation therapy (BCT). Growing interest in avoiding mastectomy prompted RTOG 1014, a landmark phase two study demonstrating the feasibility of repeat BCT using a novel radiotherapy (RT) regimen (i.e.

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Background: Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tumor recurrence (IBTR), for whom mastectomy is generally recommended.

Methods: We identified women who underwent BCT for invasive or ductal carcinoma in situ and developed IBTR as a first event, comparing the pattern of subsequent events and survival for those treated by RCT versus mastectomy.

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Background: Neoadjuvant chemotherapy (NAC) is increasingly used for clinically node-positive (cN+) tumors with intact primary breast cancer (IPBC) to downstage the axilla, and those who convert to cN0 may be eligible for sentinel lymph node biopsy (SLNB). Rates of axillary downstaging in occult primary breast cancer (OPBC) are unknown.

Objective: The aim of this study was to determine the frequency of nodal pathologic complete response (pCR) following NAC in a cohort of patients with OPBC.

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Article Synopsis
  • * Historically, these cancers were deemed aggressive with low survival rates; for example, a 1995 study showed only 9.4% survival beyond four years.
  • * Recent advancements in treatment and survival rates have been noted, yet there's ongoing debate about the necessity of removing a supernumerary nipple during initial breast cancer diagnosis, illustrated by a case of a patient whose tumor developed there after a mastectomy.
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Elder abuse is generally defined as the maltreatment of individuals over the age of 60, although no precise definition exists in the literature. Types of abuse include, but are not limited to, psychological/emotional, physical, sexual abuse, and financial exploitation. Certain risk factors exist leaving an individual more susceptible to abuse, and many obstacles exist preventing the elimination of abuse.

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Background: Re-excision rates after breast conservation surgery are reported to be 20%-40%. Inaccuracies with specimen orientation may affect margin assessment. This study examined whether the addition of surgeon performed intraoperative inking of the lumpectomy specimen after adoption of margin guidelines would be cost-effective.

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To determine whether low-income status as demonstrated by insurance type has any association with aggressive tumor biology and breast cancer outcomes. Retrospective review of 535 women with new diagnosis of breast cancer from January 2009 to March 2013 was performed. There was no significant association between race and stage at diagnosis.

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Synopsis of recent research by authors named "Astrid Botty Van den Bruele"

  • - Astrid Botty van den Bruele's recent research primarily focuses on the management and treatment outcomes of breast cancer, especially concerning surgical interventions like axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) in various patient cohorts.
  • - Key findings include the potential benefit of omitting ALND in patients with residual nodal disease post-neoadjuvant chemotherapy, as well as an investigation into the impact of racial and ethnic disparities on treatment responses and survival rates in triple-negative breast cancer patients.
  • - Additionally, her studies highlight the complexities of treatment decisions in older patients, considering factors such as tumor biology versus anatomy, while advocating for updated guidelines on when to consider genetic testing in breast cancer management.

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