Publications by authors named "Susan Kesmodel"
Background: The lymphatic microsurgical preventive healing approach reduces the risk of lymphedema after axillary lymph node dissection. We identified surgical factors of Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) that influence lymphedema rates focusing on the vein caliber used.
Methods: A single-institution retrospective cohort study included breast cancer patients undergoing axillary lymph node dissection and LYMPHA (April 2021-November 2022) with a follow-up of at least 1 year.
Background: Low false negative rates can be achieved with sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with clinical N1 (cN1) disease. We examined changes in axillary management and oncologic outcomes in BC patients with cN1 disease receiving NAC.
Methods: BC patients with biopsy proven cN1 disease treated with NAC were selected from our institutional cancer registry (2014-2017).
Background: Despite higher breast cancer screening rates, black women still are more likely to have late-stage disease diagnosed. This disparity is influenced in part by structural and interpersonal racism. This prospective study sought to determine how interpersonal factors, including perceived discrimination, influence screening and stage of disease at diagnosis.
View Article and Find Full Text PDFPurpose: Disparities in breast cancer survival remain a challenge. We aimed to analyze the effect of structural racism, as measured by the Index of Concentration at the Extremes (ICE), on receipt of National Cancer Center Network (NCCN) guideline-concordant breast cancer treatment.
Methods: We identified patients treated at two institutions from 2005 to 2017 with stage I-IV breast cancer.
Purpose: Radiation therapy for early-stage breast cancer is typically delivered in a hypofractionated regimen to the whole breast followed by a tumor bed boost. This results in a treatment course of approximately 4 weeks. In this study, the tumor bed boost was delivered in a single fraction as part of a safety and feasibility study for FDA clearance of the device.
View Article and Find Full Text PDFObjective: To determine the association between objective (geospatial) and subjective (perceived) measures of neighborhood disadvantage (ND) and aggressive breast cancer tumor biology, defined using validated social adversity-associated transcription factor (TF) activity and clinical outcomes.
Background: ND is associated with shorter breast cancer recurrence-free survival (RFS), independent of individual, tumor, and treatment characteristics, suggesting potential unaccounted biological mechanisms by which ND influences RFS.
Methods: We quantified TF-binding motif prevalence within promoters of differentially expressed genes for 147 tissue samples prospectively collected on the protocol.
Article Synopsis
- Implant-based breast augmentations are common in the U.S., but silicone lymphadenopathy (SL) is a rare complication where silicone migrates to lymph nodes and soft tissue.
- A study analyzed 101 of 598 articles about SL, finding that 33% of cases were discovered incidentally, with painless lymphadenopathy being the most common symptom, particularly in patients with silicone implants.
- Although many SL cases are asymptomatic, some require surgical intervention, like biopsies or explantation of ruptured implants, and management should be personalized based on the individual's condition.
Article Synopsis
- * Conducted between 2020 and 2023, the research involved patients with invasive breast cancer from both an underserved hospital and a cancer center, analyzing data collected through a social needs screening tool.
- * Results showed that 76% of patients with access to city-funded mammograms underwent screening, but those at the underserved hospital were more likely to be diagnosed at a later stage of cancer.
Background: The use of preoperative magnetic resonance imaging (MRI) for early-stage breast cancer (ESBC) is increasing, but its utility in detecting additional malignancy is unclear and delays surgical management (Jatoi and Benson in Future Oncol 9:347-353, 2013. https://doi.org/10.
View Article and Find Full Text PDFBackground: Previous studies on disparities in triple-negative breast cancer (TNBC) focus on race/ethnicity, with few exploring the impact of contextual factors such as neighborhood-level income. This study evaluates the effect of neighborhood-level income on disparities in TNBC among a racially and ethnically diverse cohort, after accounting for granular individual-level risk factors of TNBC.
Patients And Methods: Patients with stage I-IV breast cancer from 2005 to 2017 were identified from our local tumor registry.
Background/aim: The purpose was to analyze the impact of post-mastectomy radiation therapy (PMRT) on implant-based breast reconstruction (IBR) in self-identified Hispanic patients compared to non-Hispanic counterparts.
Patients And Methods: We retrospectively reviewed patients who underwent IBR between January 1, 2017 and December 31, 2019 at a single hospital system. Patients were cisgender women, assigned female at birth, 18 years or older, and underwent mastectomy with immediate IBR +/- PMRT.
Article Synopsis
- Recent studies suggest there's no significant difference in long-term survival between head and neck melanoma patients receiving only sentinel lymph node biopsy (SLNB) versus those also undergoing completion lymph node dissection (CLND).
- An analysis of 634 patients with SLNB+ showed similar overall survival rates in both treatment groups, regardless of various risk factors like lymphovascular invasion, comorbidities, or whether patients received immunotherapy.
- The findings indicate that for HN melanoma patients, CLND does not necessarily improve outcomes over SLNB alone, highlighting the need for more research to clarify the role of CLND in treatment.
Article Synopsis
- Digital interventions like CBSM websites help women with breast cancer, but initial engagement often drops; factors like disease stage, race, and timing impact this engagement.
- A study tracked engagement among older women with nonmetastatic breast cancer, finding that those with later-stage disease engaged more deeply and used more features than those with earlier stages.
- The research suggests delivering CBSM later in treatment and supporting engagement among racial and ethnic minorities to improve outcomes for cancer survivors.
Importance: Neighborhood-level disadvantage is an important factor in the creation and persistence of underresourced neighborhoods with an undue burden of disparate breast cancer-specific survival outcomes. Although studies have evaluated neighborhood-level disadvantage and breast cancer-specific survival after accounting for individual-level socioeconomic status (SES) in large national cancer databases, these studies are limited by age, socioeconomic, and racial and ethnic diversity.
Objective: To investigate neighborhood SES (using a validated comprehensive composite measure) and breast cancer-specific survival in a majority-minority population.
Natural killer (NK) cells are cytotoxic lymphocytes that accumulate within the tumor microenvironment and are generally considered to be antitumorigenic. Using single-cell RNA sequencing and functional analysis of multiple triple-negative breast cancer (TNBC) and basal tumor samples, we observed a unique subcluster of Socs3CD11bCD27 immature NK cells that were present only in TNBC samples. These tumor-infiltrating NK cells expressed a reduced cytotoxic granzyme signature and, in mice, were responsible for activating cancer stem cells through Wnt signaling.
View Article and Find Full Text PDFResistance to cancer treatment remains a major clinical hurdle. Here, we demonstrate that the CoREST complex is a key determinant of endocrine resistance and ER breast cancer plasticity. In endocrine-sensitive cells, CoREST is recruited to regulatory regions co-bound to ERα and FOXA1 to regulate the estrogen pathway.
View Article and Find Full Text PDFIntroduction: The rate of mastectomy in lumpectomy-eligible patients with unilateral breast cancer is increasing. We sought to investigate the association between magnetic resonance imaging (MRI) and surgical management of patients with early-stage breast cancer by comparing the rate of mastectomy as first surgery in patients with and without preoperative MRI.
Methods: A bi-institutional retrospective study included patients diagnosed between 2016 and 2020.
Objective: To investigate the impact of global and local genetic ancestry and neighborhood socioeconomic status (nSES), on breast cancer (BC) subtype, and gene expression.
Background: Higher rates of aggressive BC subtypes [triple negative breast cancer (TNBC)] and worse overall BC survival are seen in black women [Hispanic Black (HB) and non-Hispanic Black (NHB)] and women from low nSES. However, the complex relationship between genetic ancestry, nSES, and BC subtype etiology remains unknown.
Purpose: Post-mastectomy breast reconstruction (PMBR) is an important component of breast cancer treatment, but disparities relative to insurance status persist despite legislation targeting the issue. We aimed to study this relationship in a large health system combining a safety-net hospital and a private academic center.
Methods: Data were collected on all patients who underwent mastectomy for breast cancer from 2011 to 2019 in a private academic center and an adjacent public safety-net hospital served by the same surgical teams.
Purpose: Genomic profiling in early-stage breast cancer provides prognostic and predictive information. Genomic profiling assays have not been validated in locally advanced breast cancer (LABC). We examined a large cancer registry to evaluate genomic profiling in LABC and its effect on treatment decisions and survival.
View Article and Find Full Text PDFBackground: Lymphedema is a serious complication of axillary lymph node dissection (ALND) with an incidence rate of 20%. Simplified Lymphatic Microsurgical Preventing Healing Approach (SLYMPHA) is a safe and relatively simple method, which decreases incidence of lymphedema dramatically. Our initial study showed an 88% decrease in clinical lymphedema rate.
View Article and Find Full Text PDFArticle Synopsis
- Neoadjuvant therapy (NAT) may help patients with node-positive, ER+, HER2- breast cancer achieve axillary downstaging, potentially avoiding axillary dissection.
- *The study evaluated the effectiveness of chemotherapy (NCT) and endocrine therapy (NET) in achieving pathologic complete response (pCR) in axillary lymph nodes, finding an overall pCR rate of 12.3%.
- *Patients diagnosed at clinical stage II showed a significantly higher pCR rate compared to stage III, suggesting that early-stage diagnosis may improve treatment outcomes and reduce the need for additional surgery.*