Publications by authors named "Susie Sun"
Article Synopsis
- The study focuses on how palliative radiation therapy (RT) can alleviate pain and symptoms in patients with symptomatic locoregionally advanced breast cancer (SLABC).
- Analyzed data from 164 patients treated between 2016 and 2023 showed a majority experienced symptom relief within 3 months post-RT, with significant ongoing pain improvement for at least a year.
- Results indicate that while acute side effects varied with the treatment dose and fractionation, the overall effectiveness of RT in managing symptoms was consistent regardless of dosage variations, suggesting a tailored approach could be beneficial.
Purpose: The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in patients with ypN0i+ treated with and without ALND.
Methods: The Oncoplastic Breast Consortium-05/ICARO cohort study (ClinicalTrials.
Article Synopsis
- The study examines the effectiveness of targeted axillary dissection (TAD) after neoadjuvant chemotherapy (NAC) in breast cancer patients, focusing on the status of clipped nodes during axillary staging.
- Out of 680 patients analyzed, 90% had their clipped nodes identified as sentinel lymph nodes (SLN), while 10% were classified as non-SLN, with a significant proportion (60%) of non-SLNs showing metastasis.
- The findings suggest that when the clipped node is a non-SLN, it often serves as the sole positive node, highlighting the importance of clipping for accurate residual disease assessment and better informing adjuvant therapy decisions.
Background: HER2-positive breast cancer is traditionally treated with neoadjuvant systemic therapy (NST), but optimal treatment sequencing is less clear in patients with small tumors. We investigated clinicopathologic and oncologic outcomes in early stage HER2-positive breast cancer.
Patients And Methods: An institutional database was queried to identify patients with cT1-2 (≤ 3 cm) N0M0, HER2-positive breast cancer treated from 2015 to 2020 and compared upfront surgery and NST cohorts.
Article Synopsis
- Axillary dissection is commonly performed for breast cancer patients with positive sentinel lymph nodes after receiving neoadjuvant therapy, but there is limited data on using frozen section in clinically node-negative cases.
- A study involving 662 patients with non-inflammatory, clinically node-negative HER2-positive or triple-negative breast cancer found a 6.6% prevalence of positive sentinel lymph nodes, with a modest sensitivity of frozen section testing at 57.6%.
- The study concludes that since positive sentinel lymph nodes are rare in these patients, it might be reasonable to rely on final pathology instead of intraoperative frozen section for decisions regarding axillary dissection.
Background: Targeted axillary dissection (TAD) facilitates nodal staging in cN1 breast cancer after neoadjuvant chemotherapy (NAC). Completion axillary node dissection (cALND) remains the standard of care for TAD-positive patients. This study investigated factors associated with additional positive nodes at cALND (cALND+) and the impact on the residual cancer burden (RCB).
View Article and Find Full Text PDFBackground: Inflammatory breast cancer (IBC) is rare and biologically aggressive. We sought to assess diagnostic and management strategies among the American Society of Breast Surgeons (ASBrS) membership.
Patients And Methods: An anonymous survey was distributed to ASBrS members from March to May 2023.
Importance: Although most women with BRCA-associated breast cancer choose bilateral mastectomy, current guidelines support breast-conserving therapy as an option. As the indications for genetic testing expand and targeted therapies emerge, understanding the outcomes of breast-conserving therapy in the population of patients choosing breast conservation is important.
Objective: To describe the clinical outcomes of women with BRCA-associated breast cancer who were treated with breast-conserving therapy, including the risks of ipsilateral and contralateral cancer events and bilateral mastectomy-free survival.
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.
Article Synopsis
- The study aimed to evaluate surgical and clinical outcomes for patients diagnosed with lobular neoplasia (LN) via MRI biopsy, specifically looking at the rate of upgrades to malignancy and associated characteristics.
- A retrospective analysis was conducted on 94 patients from 2013 to 2022, with the findings showing a low upgrade rate of 7.4% for those treated with excision or surveillance.
- The results suggest that surgery may not be necessary for all patients with MRI-detected LN, highlighting the need for shared decision-making and further research to identify predictive factors for upgrade risk.
Article Synopsis
- - Pembrolizumab added to neoadjuvant chemotherapy (NAC) for triple-negative breast cancer (TNBC) has led to higher rates of pathologic complete responses (pCRs) compared to traditional treatments.
- - In a study of 87 patients, 67.8% achieved overall pCR, while 24.1% experienced surgical complications related to the treatment, including changes to their surgical plans.
- - The findings suggest that using pembrolizumab in NAC offers significant cancer control benefits but also presents important considerations for surgical management and potential complications.
Background: Advanced nodal disease is associated with poor prognosis. However, modern neoadjuvant systemic therapy (NST) regimens have resulted in higher pathologic complete response (pCR) rates, which are associated with improved survival. We sought to assess contemporary outcomes in patients with advanced nodal involvement and response to NST.
View Article and Find Full Text PDFImportance: Patients should have an active role in decisions about pursuing or forgoing specific therapies in treatment de-escalation trials.
Objective: To evaluate longitudinal patient-reported outcomes (PROs) encompassing decisional comfort and health-related quality of life (HRQOL) among patients who elected to enroll in a clinical trial evaluating radiotherapy alone, without breast surgery, for invasive breast cancers with exceptional response to neoadjuvant systemic therapy (NST).
Design, Setting, And Participants: Prospective, single-group, phase 2 clinical trial at 7 US medical centers.
Article Synopsis
- The study focuses on identifying factors that predict involvement of four or more positive axillary lymph nodes (ALNs) in postmenopausal women with early-stage breast cancer that initially shows no lymph node involvement (cN0).
- Researchers analyzed data from 2532 patients who underwent sentinel lymph node biopsy (SLNB) and completion axillary lymph node dissection (cALND) from 1993 to 2007, identifying key predictive factors like tumor size and lymphovascular invasion.
- The findings suggest that postmenopausal women with HR-positive, HER2-negative breast cancer and a single positive SLN have a low risk (5%) of having four or more positive nodes, indicating that aggressive treatments may not be necessary
Article Synopsis
- Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer with a historically low 5-year survival rate, but this study looked at long-term local-regional recurrence (LRR) in non-metastatic IBC patients treated at one institution.
- The research analyzed data from 262 patients who underwent trimodal therapy (neoadjuvant chemotherapy, modified radical mastectomy, and adjuvant radiation), with significant findings on recurrence and survival outcomes.
- Results showed a 6.9% local-regional recurrence rate, indicating treatment effectiveness, and those achieving a pathologic complete response had significantly better disease-free and overall survival rates.
Background: Completion axillary node dissection (CLND) is routinely omitted in cT1-2 N0 breast cancer treated with upfront, breast-conserving therapy and sentinel node biopsy (SLNB) showing one to two positive sentinel nodes (SLNs). The purpose of this study was to determine the incidence and impact of axillary treatment among patients treated with mastectomy in a contemporary cohort.
Methods: A prospective, institutional database was reviewed from 2006 to 2015 to identify patients with T1-2 breast cancer treated with upfront mastectomy and SLNB found to have one to two positive SLNs.
Background: Emergency department (ED) overuse is a large contributor to healthcare spending in the USA. We examined the rate of and risk factors for ED visits following outpatient breast cancer surgery.
Patients And Methods: Using linked data from the Surveillance, Epidemiology, and End Results (SEER) program and Medicare, we identified women who underwent curative breast cancer surgery between 2003 and 2015.
Background: Breast cancer-related lymphedema (BCRL) is a debilitating sequela of breast cancer treatment and is becoming a greater concern in light of improved long-term survival. Inflammatory breast cancer (IBC) is a rare and aggressive malignancy for which systemic therapy, surgery, and radiotherapy remain the standard of care, thereby making IBC patients highly susceptible to developing BCRL. This study evaluated BCRL in IBC following trimodal therapy.
View Article and Find Full Text PDFBackground: Inflammatory breast cancer (IBC) is a rare and aggressive subtype of breast cancer characterized by rapid progression and early metastasis, often with advanced nodal locations, including the supraclavicular (SCV) nodal basin. Previously considered M1 disease, ipsilateral clinical supraclavicular node involvement (N3c) disease is now considered locally advanced disease and warrants treatment with intent to cure. The objective of this study was to evaluate the long-term outcomes of patients with IBC and N3c disease.
View Article and Find Full Text PDFBackground: Financial toxicity (FT) depicts the burden of cancer treatment costs and is associated with lower quality of life and survival in breast cancer patients. We examined the relationship between geospatial location, represented by rurality and Area Deprivation Index (ADI), and risk of FT.
Study Design: A single-institution, cross-sectional study was performed on adult female surgical breast cancer patients using survey data retrospectively collected between January 2018 and June 2019.
Purpose: Patients with breast cancer and ipsilateral axillary and internal mammary (IM) lymph node involvement (cN3b) often forgo IM node resection. Therefore, radiation is important for curative therapy. However, prognosis is not well described in the era of modern systemic therapy, and limited data exist to guide optimal locoregional treatment recommendations.
View Article and Find Full Text PDFObjective: The purpose of this review is to outline the surgical management of inflammatory breast cancer (IBC) including the clinical decision making, operative approach and current controversies.
Background: IBC is a rare and aggressive form of breast cancer. Trimodality therapy consisting of neoadjuvant therapy, modified radical mastectomy (MRM) and radiation therapy improves survival and is the recommended course of treatment.