Challenges and Innovations in Breast Cancer Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 11158

Special Issue Editor

National Health Service | NHS · Department of General Surgery, Lincoln, UK
Interests: breast cancer; breast reconstruction; lipomodelling

Special Issue Information

Dear Colleagues,

Breast cancer is the most common type of cancer in women worldwide. In most of the countries in the world, its incidence is on the rise. There has been significant improvement in diagnostic tests, imaging, and surgical and oncological treatment for breast cancer in recent decades. Breast cancer surgery is no longer a purely ablative specialty. Oncoplastic breast surgery has gained popularity across the world. There is a paradigm shift towards the de-escalation of various aspects of breast cancer surgery at present without compromising the oncological outcome. Wider use of perforator chest wall flaps and various mammoplasty techniques has helped to expand the scope of breast conservation surgery. Newer localisation techniques for clinically non-palpable cancers have significantly helped surgeons to use theatre time more efficiently with a better patient experience. Likewise, the availability of better implants and acellular dermal matrices and other meshes has been instrumental in widening the reconstructive options available to our patients. The future of breast surgery is exciting with ongoing innovations in various fields such as resection margin assessment methods and with the wider application of artificial intelligence in various aspects of breast cancer management.

Given the relevance of this topic, Medicina is launching a Special Issue titled “Challenges and Innovations in Breast Cancer Surgery”. I would be delighted if you could be part of this exciting project, by submitting your work.

Dr. Dinesh K. Thekkinkattil
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • breast reconstruction
  • mammoplasty
  • breast implants
  • perforator flaps
  • artificial intelligence
  • augmented reality

Published Papers (7 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

10 pages, 536 KiB  
Article
A Simple Technique Using Peri-Prosthetic Irrigation Improves Implant Salvage Rates in Immediate Implant-Based Breast Reconstruction
by Manoj Srinivas Gowda, Sadaf Jafferbhoy, Sekhar Marla, Sankaran Narayanan and Soni Soumian
Medicina 2023, 59(11), 2039; https://doi.org/10.3390/medicina59112039 - 19 Nov 2023
Viewed by 881
Abstract
Background and objectives: Implant-related complications leading to implant loss contribute to major morbidity in immediate breast reconstruction (IBR). Various techniques have been advocated to improve rates of reconstruction salvage. The objective of our study was to assess if a peri-prosthetic irrigation system [...] Read more.
Background and objectives: Implant-related complications leading to implant loss contribute to major morbidity in immediate breast reconstruction (IBR). Various techniques have been advocated to improve rates of reconstruction salvage. The objective of our study was to assess if a peri-prosthetic irrigation system was an effective adjunct to the conventional wash-out technique in improving reconstruction salvage rates. Methods: The study included patients who had immediate implant-based breast reconstruction from January 2015 to November 2020. The conventional technique of reconstruction salvage, using debridement, wash-out, and implant/expander exchange with systemic use of antibiotics, was performed for patients undergoing exploration for infection until May 2019. A simple technique using a continuous peri-prosthetic irrigation system with vancomycin (1 g/L normal saline over 24 h) for 2 days was added as an adjunct to the conventional technique. Treatment details and clinical outcomes were compared between the groups. The study was approved by the Clinical Governance department. Results: During the study period, 335 patients underwent IBR. A total of 65 patients (19.4%) returned to the theatre due to post-operative complications, of which 45 (13.4%) were due to infection. A conventional technique was used in 38 (84.4%) patients, and peri-prosthetic irrigation was used as an adjunct in 7 patients (15.6%). A total of 16 (42.1%) in the conventional group and all 7 (100%) in the irrigation group had successful reconstruction salvage. No patients had complications due to antibiotic irrigation. Conclusions: The peri-prosthetic irrigation system is a simple, safe, and effective adjunct to conventional techniques in improving reconstruction salvage in IBR. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
Show Figures

Figure 1

Review

Jump to: Research, Other

14 pages, 688 KiB  
Review
Current Role and Future Prospects of Positron Emission Tomography (PET)/Computed Tomography (CT) in the Management of Breast Cancer
by Nicole Robson and Dinesh Kumar Thekkinkattil
Medicina 2024, 60(2), 321; https://doi.org/10.3390/medicina60020321 - 14 Feb 2024
Viewed by 840
Abstract
Breast cancer has become the most diagnosed cancer in women globally, with 2.3 million new diagnoses each year. Accurate early staging is essential for improving survival rates with metastatic spread from loco regional to distant metastasis, decreasing mortality rates by 50%. Current guidelines [...] Read more.
Breast cancer has become the most diagnosed cancer in women globally, with 2.3 million new diagnoses each year. Accurate early staging is essential for improving survival rates with metastatic spread from loco regional to distant metastasis, decreasing mortality rates by 50%. Current guidelines do not advice the routine use of positron emission tomography (PET)-computed tomography (CT) in the staging of early breast cancer in the absence of symptoms. However, there is a growing body of evidence to suggest that the use of PET-CT in this early stage can benefit the patient by improving staging and as a result treatment and outcomes, as well as psychological burden, without increasing costs to the health service. Ongoing research in PET radiomics and artificial intelligence is showing promising future prospects in its use in diagnosis, staging, prognostication, and assessment of responses to the treatment of breast cancer. Furthermore, ongoing research to address current limitations of PET-CT by improving techniques and tracers is encouraging. In this narrative review, we aim to evaluate the current evidence of the usefulness of PET-CT in the management of breast cancer in different settings along with its future prospects, including the use of artificial intelligence (AI), radiomics, and novel tracers. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
Show Figures

Figure 1

19 pages, 1016 KiB  
Review
Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis
by Shahram Shirazi, Hamed Hajiesmaeili, Muskaan Khosla, Saima Taj, Tapan Sircar and Raghavan Vidya
Medicina 2023, 59(7), 1297; https://doi.org/10.3390/medicina59071297 - 13 Jul 2023
Cited by 2 | Viewed by 1719
Abstract
Background and Objectives: Wide local excision is a common procedure in the treatment of breast cancer. Wire-guided localisation (WGL) has been the gold standard for many years; however, several issues have been identified with this technique, and therefore, wire-free techniques have been developed. [...] Read more.
Background and Objectives: Wide local excision is a common procedure in the treatment of breast cancer. Wire-guided localisation (WGL) has been the gold standard for many years; however, several issues have been identified with this technique, and therefore, wire-free techniques have been developed. This scoping review synthesises the available literature comparing wire-guided localisation with the wire-free techniques used in breast-conserving cancer surgery. Materials and Methods: Multiple databases including Pubmed and MEDLINE were used to search articles between 1 January 2000 and 31 December 2022. Terms included “breast neoplasms”, “margins of excision”, and “reoperation”. In total, 34/256 papers were selected for review. Comparisons were made between positive margins and re-excision rates of WGL with wire-free techniques including SAVI SCOUT, Magseed, ROLL, and RSL. Pooled p-values were calculated using chi-square testing to determine statistical significance. Results: Pooled analysis demonstrated statistically significant reductions in positive margins and re-excision rates when SAVI SCOUT, RSL, and ROLL were compared with WGL. When SAVI SCOUT was compared to WGL, there were fewer re-excisions {(8.6% vs. 18.8%; p = 0.0001) and positive margins (10.6% vs. 15.0%; p = 0.0105)}, respectively. This was also the case in the ROLL and RSL groups. When compared to WGL; lower re-excision rates and positive margins were noted {(12.6% vs. 20.8%; p = 0.0007), (17.0% vs. 22.9%; p = 0.0268)} for ROLL and for RSL, respectively {(6.8% vs. 14.9%),(12.36% vs. 21.4%) (p = 0.0001)}. Magseed localisation demonstrated lower rates of re-excision than WGL (13.44% vs. 15.42%; p = 0.0534), but the results were not statistically significant. Conclusions: SAVI SCOUT, Magseed, ROLL, and RSL techniques were reviewed. Pooled analysis indicates wire-free techniques, specifically SAVI SCOUT, ROLL, and RSL, provide statistically significant reductions in re-excision rates and positive margin rates compared to WGL. However, additional studies and systematic analysis are required to ascertain superiority between techniques. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
Show Figures

Figure 1

11 pages, 314 KiB  
Review
Innovations and Challenges in Breast Cancer Care: A Review
by Sharat Chopra, Muskaan Khosla and Raghavan Vidya
Medicina 2023, 59(5), 957; https://doi.org/10.3390/medicina59050957 - 16 May 2023
Cited by 3 | Viewed by 2465
Abstract
Breast cancer care has seen tremendous advancements in recent years through various innovations to improve early detection, diagnosis, treatment, and survival. These innovations include advancements in imaging techniques, minimally invasive surgical techniques, targeted therapies and personalized medicine, radiation therapy, and multidisciplinary care. It [...] Read more.
Breast cancer care has seen tremendous advancements in recent years through various innovations to improve early detection, diagnosis, treatment, and survival. These innovations include advancements in imaging techniques, minimally invasive surgical techniques, targeted therapies and personalized medicine, radiation therapy, and multidisciplinary care. It is essential to recognize that challenges and limitations exist while significant advancements in breast cancer care exist. Continued research, advocacy, and efforts to address these challenges are necessary to make these innovations accessible to all patients while carefully considering and managing the ethical, social, and practical implications. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)

Other

Jump to: Research, Review

21 pages, 11071 KiB  
Case Report
Aggressive Male Breast Cancer—Clinical and Therapeutic Aspects Correlated with the Histopathological Examination: A Case Report and Literature Review
by Ana-Maria Petrescu, Nicolae-Daniel Pirici, Anca-Ileana Ruxanda, Liviu Vasile, Mircea Pîrșcoveanu, Ștefan Paitici, Gabriel-Sebastian Petrescu, Alexandru Claudiu Munteanu, Ramona-Andreea Matei, Daniel Dumitrache, Andreas Donoiu and Stelian-Ștefăniță Mogoantă
Medicina 2023, 59(12), 2167; https://doi.org/10.3390/medicina59122167 - 14 Dec 2023
Viewed by 943
Abstract
Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become [...] Read more.
Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become malignant in a similar way to women, although much less frequently. A patient presented with advanced local invasion due to the low amount of breast tissue, with the tumor quickly invading the adjacent structures. Histopathological and immunohistochemical examinations have an extremely important role in the pathology of breast cancer. Given that male breast cancer is rare and there are not enough surgeons specializing in breast surgery in our country, there is a lack of experience in the management and early diagnosis of this type of cancer, which will be highlighted in this article. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
Show Figures

Figure 1

8 pages, 260 KiB  
Perspective
The Magnetic Technique—A Novel and Promising Method to Improve Axillary Staging Localisation from a Swedish Perspective
by Fredrik Wärnberg, Christine Obondo and Kian Chin
Medicina 2023, 59(10), 1727; https://doi.org/10.3390/medicina59101727 - 27 Sep 2023
Viewed by 759
Abstract
The magnetic technique using superparamagnetic nanoparticles of iron oxide has been well established for sentinel lymph node detection. Its main advantage is in the context of logistics, with the possibility to inject several weeks before surgery and the possibility to give access to [...] Read more.
The magnetic technique using superparamagnetic nanoparticles of iron oxide has been well established for sentinel lymph node detection. Its main advantage is in the context of logistics, with the possibility to inject several weeks before surgery and the possibility to give access to sentinel lymph node biopsy for women worldwide in places without nuclear medicine facilities. We have not yet seen the full potential of this technique, and new implications have been developed for breast tumour localisation with paramagnetic clips and axillary staging after neoadjuvant chemotherapy using paramagnetic clips inserted in lymph node metastases before chemotherapy. In this report, we have presented our experience of the magnetic technique starting in 2014, and we have highlighted our current and future research directions. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
6 pages, 1406 KiB  
Case Report
Basosquamous Cell Carcinoma of the Nipple-Areola Complex—Report of a Case
by Gabriele Raimondo, Gaetano Gallo, Giuliano D’Onghia, Giovanni Gabriele, Luciano Izzo, Andrea Polistena, Luca Esposito, Paola Giancontieri, Leonardo Macci, Vito D’Andrea, Enrico Fiori and Luigi Basso
Medicina 2023, 59(2), 316; https://doi.org/10.3390/medicina59020316 - 08 Feb 2023
Viewed by 2700
Abstract
Basosquamous cell carcinoma (BSCC) is a rare malignancy usually arising on sun-exposed areas of the skin. BSCC is described as a rare variant of Basal cell carcinoma (BCC) which shows clinical and microscopic features of both BCC and of Squamous cell carcinoma (SCC). [...] Read more.
Basosquamous cell carcinoma (BSCC) is a rare malignancy usually arising on sun-exposed areas of the skin. BSCC is described as a rare variant of Basal cell carcinoma (BCC) which shows clinical and microscopic features of both BCC and of Squamous cell carcinoma (SCC). We report the case of a 70-year-old male with a cutaneous lesion of the nipple-areola complex (NAC); to the best of our knowledge, this is the first ever reported patient with BSCC in this area. The lesion had a fast growth, but, due to the COVID19 crisis, the patient only came to our observation one year after onset of this condition. Physical examination showed a bleeding red ulcerated lesion that involved the NAC, measuring 27 mm × 20 mm. Biopsy showed a BSCC. Pre-operative breast ultrasound scan, mammogram and MRI were all performed before surgery, which consisted of simple mastectomy and sentinel lymph-node biopsy. The patient was discharged home on the 4th post-operative day, and at 18-month follow-up there are no signs or clinical evidence of local recurrence or metastases. Diagnosis of BSCC of the nipple-areola complex requires high index of suspicion and a thorough differential diagnosis, management, and suitable radical treatment due to well described high rates of recurrence and of metastases. Differential diagnosis with similar lesions (e.g., Paget’s disease, Bowen’s disease, BCC, and SCC) should also be taken into account. Full article
(This article belongs to the Special Issue Challenges and Innovations in Breast Cancer Surgery)
Show Figures

Figure 1

Back to TopTop