Bilateral mastectomy and the retreat from breast-conserving surgery.

The purpose of this study is to assess the consequences for breast cancer patients of the trend away from breast conservation in favor of bilateral and contralateral mastectomy. The methods are followed from the review of the literature from 1991 to 2015. Breast-conserving surgery and sentinel lymph node biopsy, introduced into mainstream practice in the 1980s and 1990s, respectively, are now the standard of care for early-stage breast cancer.

Factors associated with contralateral preventive mastectomy.

Introduction: Contralateral prophylactic mastectomy (CPM) is an option for women who wish to reduce their risk of breast cancer or its local recurrence. There is limited data on demographic differences among patients who choose to undergo this procedure.

Methods: The population-based Florida cancer registry, Florida's Agency for Health Care Administration data, and US census data were linked and queried for patients diagnosed with invasive breast cancer from 1996 to 2009.

The thrombophilic state in cancer part II: cancer outcomes, occult malignancy, and cancer suppression.

The association between malignancy and thrombosis has long been appreciated but remains incompletely understood. This is the second of a two-part review of the complex, integral relationship between these two entities, and addresses the specifics of cancer outcomes, occult malignancy in the presence of thrombosis, and the possibilities of cancer suppression by modulating thrombogenesis.

Thrombophilic state in cancer, part I: biology, incidence, and risk factors.

The association between malignancy and thrombosis has long been appreciated but remains incompletely understood. This is the first of a two-part review of the complex, integral relationship between these two entities, and addresses the mechanisms and pathogenesis of this relationship and the clinical risk factors for thromboembolism in cancer patients.

Screening criteria for breast cancer.

Breast cancer screening constitutes an integral part of surgical practice for many surgeons and is an important tool in the war against breast cancer. Among many modalities, mammography plays a central role, with MRI now being increasingly used for women with high risk for breast cancer. Current guidelines for screening are in the process of evolution as more scientific knowledge is gained.

African American and poor patients have a dramatically worse prognosis for head and neck cancer: an examination of 20,915 patients.

Background: Differences in cancer survival based on race, ethnicity, and socioeconomic status (SES) are a major issue. To identify points of intervention and improve survival, the authors sought to determine the impact of race, ethnicity, and socioeconomic status for patients with cancers of the head and neck (HN).

Methods: HN cancer patients diagnosed between 1998 and 2002 were examined using a linked Florida Cancer Data System and Florida Agency for Health Care Administration data set.

Internal mammary sentinel node biopsy for breast cancer.

Background: The purpose of this study was to determine the value of lymphoscintigraphy (LS) for internal mammary sentinel node (IMSN) identification, the metastatic rate, and the change in staging and treatment.

Methods: Between 2001 and 2007 a prospective database was obtained of all patients undergoing IMSN biopsies using an open or thoracoscopic approach. Radiotracer injection was peritumoral.

Targeting gold at the end of the rainbow: surgical gamma probes in the 21st century.

Surgical gamma detection probes (GDPs) have become important in the surgical management of neoplastic disease in the past 20 years. Their history and radiophysics are discussed, with consideration of the overarching issue of tumor-to-background ratio (TBR). GDPs are currently most commonly used in sentinel node applications in a variety of tumors.

Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients.

Objective: : To define the prognostic significance of surgical center case volume on outcome for soft tissue sarcoma (STS).

Methods: : STS cases registered in the Florida Cancer Data System (FCDS) between 1981 and 2001 were analyzed. Medical facilities were ranked by STS operative volume.

Outcomes for soft-tissue sarcoma in 8249 cases from a large state cancer registry.

Background And Objectives: To date, outcome reports for soft-tissue sarcoma (STS) have largely been limited to single or paired institutional series. To more accurately elucidate population-based outcomes and prognostic factors associated with STS, a large cancer registry was examined.

Methods: STS arising in the Florida Cancer Data System were examined (1981-2004).

Results of 23,810 cases of ductal carcinoma-in-situ.

Background: 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.

Retroperitoneal and truncal sarcomas: prognosis depends upon type not location.

Background: Prognostication of truncal and retroperitoneal soft tissue sarcomas has traditionally been predicated on tumor location and grade.

Objective: To compare outcomes for patients with retroperitoneal or truncal sarcomas.

Methods: Retrospective analysis of a prospective cancer data registry from 1977 to 2004 was performed and outcomes were determined.

Lymphatic mapping and sentinel lymphadenectomy for 106 head and neck lesions: contrasts between oral cavity and cutaneous malignancy.

Objectives: The objectives of this prospective series were to present our results in 106 sequential cases of lymphatic mapping and sentinel lymph node biopsy (SLNB) in the head and neck region and contrast the experience in oral cancer with that for cutaneous lesions.

Hypotheses: SLNB has an acceptably low complication rate in the head and neck. Lymphatic mapping and gamma probe-guided lymphadenectomy can improve the management of malignancies of the head and neck by more accurate identification of the nodal basins at risk and more accurate staging of the lymphatics.

Cyclosporine A, alpha-lnterferon and interleukin-2 following chemotherapy with BCNU, DTIC, cisplatin, and tamoxifen: a phase II study in advanced melanoma.

Preclinical data suggest that one method of inducing autoimmunity to tumor is the administration and subsequent withdrawal of cyclosporine A following chemotherapy and that this effect may be enhanced with interferon and interleukin-2. Consequently, we performed a phase II trial in patients with advanced melanoma to explore this approach. Thirty-three patients were treated with BCNU (150 mg/m2 iv every 8 weeks), cisplatin (25 mg/m2 iv days 1-3) every 4 weeks, DTIC (220 mg/m2 iv days 1-3 every 4 weeks) along with tamoxifen (10 mg po BID days 1-4).

Prerandomization Surgical Training for the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 trial: a randomized phase III clinical trial to compare sentinel node resection to conventional axillary dissection in clinically node-negative breast cancer.

Objective: To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial.

Summary Background Data: The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training phase of surgeons performed by a group of core surgical trainers.

Male breast cancer: is the incidence increasing?

Background: Male breast cancer is rare, and little is known about state population-level patterns of incidence. The primary objective of this study was to determine the incidence of MBC in Florida in comparison with the Surveillance, Epidemiology, and End RESULTS (SEER) program data.

Methods: Study data were obtained from the Florida Cancer Data System (FCDS).

Surgical management of primary breast sarcoma.

Primary sarcoma constitutes less than one per cent of breast malignancies. A retrospective review of this disease at our institution was undertaken to assess the effect of different treatment modalities on outcome. Over a 24-year period 28 patients were identified.