Background: Optimal margin width for breast-conserving therapy (BCT) after neoadjuvant chemotherapy (NAC) is unknown. We sought to determine the impact of margin width on local recurrence and survival after NAC and BCT.
Methods: Patients treated with NAC and BCT for stage I-III breast cancer from 2002 to 2014 were identified. Multivariate Cox regression was performed to determine the relationship between margin width and local recurrence free-survival (LRFS), disease-free survival (DFS), and overall survival (OS).
Results: A total of 382 patients were included. Median age was 51 years [range 22-79], median tumor size 3.0 cm [range 0.6-11.0], and receptor subtypes included 144 (37.7%) HR-/HER2-, 47 (12.3%) HR-/HER2+, 118 (30.9%) HR+/HER2-, and 70 (18.3%) HR+/HER2+. Breast pathologic complete response (pCR) was achieved in 105 (27.5%) patients. Final margin status was positive in 8 (2.1%) patients, ≤ 1 mm in 65 (17.0%), 1.1-2 mm in 30 (7.9%), and > 2 mm in 174 (45.5%). The 5-year LRFS was 96.3% (95% CI 94.0-98.6), DFS was 85.5% (95% CI 81.8-90.7), and OS was 90.8% (95% CI 87.4-94.2). There was no difference in LRFS, DFS, or OS for margins ≤ 2 versus > 2 mm, and no difference in DFS or OS for margins ≤ 1 versus > 1 mm. HR+ subtype (p = 0.04) and pCR (p = 0.03) were correlated with favorable DFS and node negativity (p < 0.001) with favorable DFS and OS.
Conclusions: In this cohort treated with NAC and BCT, there was no association between margin width and LRFS, DFS, or OS. Although further studies are needed, the excellent long-term outcomes demonstrated in patients with close (≤ 2 mm) margins following NAC suggest that a margin of "no-ink-on-tumor" may be acceptable in appropriately selected patients.
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http://dx.doi.org/10.1245/s10434-018-6702-4 | DOI Listing |
Int Dent J
January 2025
Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates.
Objectives: The aim of this randomised controlled trial was to assess clinical, radiographic and patient reported outcomes of narrow versus standard diameter titanium zirconium (TiZr) implants supporting single crown restorations in posterior sites with limited bone width.
Materials And Methods: Participants requiring replacement of single missing posterior teeth with implant-supported crowns were randomly allocated into 2 treatment groups: narrow (3.3 mm) or standard (4.
J Clin Med
January 2025
Department of Anesthesiology and Oral Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
: The aim of this study is to identify the most accurate and consistent landmarks for determining the precise location of the mandibular foramen (MF) and the mandibular ramus, suggesting appropriate adjustments to anesthesia techniques based on these variations in order to improve the success rate of the inferior alveolar nerve (IAN) block. : CT scans of the mandibles from 100 patients were analyzed to measure the distance between the MF and various landmarks, including the sigmoid notch, gonion, posterior and anterior margins of the ramus, temporal crest, and the mandibular ramus height from the condyle to the gonion. The width of the mandibular ramus was also assessed, with correlations made to age and gender.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Department of Radiology, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea.
: This study aimed to compare ultrasound (US) findings between automated and handheld breast ultrasound (ABUS and HHUS, respectively) in small breast cancers, based on the breast imaging reporting and data system (BI-RADS) category. : We included 51 women (mean age: 52 years; range: 39-66 years) with breast cancer (invasive or DCIS), all of whom underwent both ABUS and HHUS. Patients with tumors measuring ≤1 cm on either modality were enrolled.
View Article and Find Full Text PDFBeijing Da Xue Xue Bao Yi Xue Ban
February 2025
Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Objective: To compare the influence of different emergence profile of implants in mandibular molar on the peri-implant soft tissue.
Methods: Forty-four implants were divided into two equal groups by mucosal thickness, ≥2 mm (group A) or < 2 mm (group B), and were randomly included in the test group and the control group. In the control group, the patients were treated by a prosthesis with no transmucosal modifications (subgroups A1 and B1).
Eur J Nucl Med Mol Imaging
January 2025
A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01, Nanos, Singapore, 138669, Republic of Singapore.
Purpose: Basal Cell Carcinoma (BCC), the most common subtype of non-melanoma skin cancers (NMSC), is prevalent worldwide and poses significant challenges due to their increasing incidence and complex treatment considerations. Existing clinical approaches, such as Mohs micrographic surgery, are time-consuming and labour-intensive, requiring meticulous layer-by-layer excision and examination, which can significantly extend the duration of the procedure. Current optical imaging solutions also lack the necessary spatial resolution, penetration depth, and contrast for effective clinical use.
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