Breast cancer recurrence after mastectomy survival rate,where are all the upgrades for ed-e in fallout new vegas km,cars for sale in raleigh nc craigslist,id ego and superego psychology definition uno - Try Out

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Breast cancer recurrence can be a nagging concern for survivors — even for patients who have had a double mastectomy. Residual disease after BCS is suggested by positive margins on pathologic examination and is best shown by MRI. MRI will also demonstrate foci of cancer away from the initial surgical site which might require additional excision (Fig. Right: MRI follow-up 14 months later (image on right) showing only discrete residual enhancement. Recurrent disease will manifest with identical or similar morphologic and functional characteristics as primary cancer. Secondary angiosarcoma is a rare long-term complication of breast cancer treated with conserving surgery and radiotherapy. Physical and conventional imaging findings are often non-specific and only skin-changes may be appreciated [14].
Post-radiation skin changes are most pronounced at 6 months after treatment and decrease in prominence with time.
Recurrence after mastectomy without reconstruction will usually present as a small palpable lump in the mastectomy scar or under the skin.
Local recurrences in patients with prosthetic implants are most often found in front of the implant. Reliable differentiation from mastitis cannot be made with clinical and imaging findings alone [13]. In addition to signs of breast edema seen on physical examination and conventional imaging MRI will show linear and branching non-mass areas of T2 hyperintensity with corresponding diffusion restriction that does not go along with postcontrast enhancement. 2 clicks for more privacy: On the first click the button will be activated and you can then share the poster with a second click.
Digital breast tomosynthesis (DBT) occult breast cancers: clinical, radiological and histopathological features. Pre-operative Diffusion-weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) ratio in assessment of axillary lymph node status in patients with breast cancer: personal experience and literature review.
To discuss the role of multimodality imaging in the evaluation of locoregional breast cancer recurrence. The follow up of breast cancer patients after curative primary therapy focuses on early detection of recurrent disease. The interpretation of imaging findings after breast cancer treatment requires an understanding of the expected postoperative changes and the imaging characteristics of tumor recurrence in a multimodality setting.
Positron Emission Mammography: Can it help evaluation of breast lesions when used together with other imaging modalities? Breast pain, Mastodynia or Mastalgia represents the most common reason that women come to the doctor asking for a breast exam, says Dr. With or without publicity campaigns, with or without monthly self breast exam, if you have Mastodynia it is mandatory to go to the doctor. There are cases in which the breast pain accompanies a condition and a more aggressive treatment is needed (treatment of an infection, surgical removal of tumors, etc.). The specialist however counsels you to enjoy a balanced lifestyle, to have a healthy diet and to do outdoor sports. At what age you can start doing mammography, how often and how conclusive are these analysis.
In November 2009, the institution which handles the analysis of prophylaxis in the United States began to promote a current to diminuate or even to stop mammography for women under 50 years.
At least two-thirds of breast recurrences are clinically detectable by physical examination with or without mammographic findings, and approximately one-third are detectable by mammography alone.[10,116-122] Philpotts et al[123] observed that, on mammogram, 81% of breast recurrences had a similar appearance to their initial tumors (eg, tumors initially presenting as masses without calcifications usually recurred as masses, and tumors initially presenting with calcifications recurred with calcifications).
The recurrence occurs in the same quadrant as the original primary tumor in approximately 50% to 90% of cases.[4,6,10,11,14,59-61,63,65,86,108,116-123] The distinction between an IBTR as a recurrence of the original tumor vs a new primary tumor arising in the breast is generally made on clinical grounds.
Kurtz et al[11] also considered recurrences ? 5 cm from the initial tumor site as new primary tumors. Kurtz et al[127] reported a series of 50 patients with stage I or II breast cancer treated with breast-conserving surgery and radiation who subsequently underwent wide local excision for a clinically isolated IBTR, with or without axillary recurrence. Salvadori et al[125] reported a second local failure rate of 19% at 5 years after reexcision, compared to 4% after mastectomy.
Abner et al[122] reported a study of 17 patients who refused a salvage mastectomy after IBTR; 11 had noninvasive and 6 had invasive tumors. Stotter et al[10] reported local control in five of seven patients treated with local excision for breast only relapse. Deutsch[128] reported on a series of 26 women treated for IBTR by repeat wide local excision and an electron boost of an additional 50 Gy. Maulard et al[129] studied 15 patients treated for IBTR by second tumorectomy and brachytherapy (30-Gy single implant) and 23 patients treated for IBTR by brachytherapy alone (60 to 70 Gy in two implants).
Jolicoeur et al[130] reported a series of 32 patients with isolated IBTR treated by repeat wide local excision and perioperative interstitial brachytherapy to a mean dose of 33 Gy (range: 29 to 50 Gy). In summary, the risk of second local failure in these retrospective series using wide excision and radiation for salvage of an IBTR does not appear to be significantly different than it is in series using wide excision alone.
The high 5-year survivals in these retrospective series of reirradiation, which are attributable to selection of patients with favorable prognostic favors for survival after IBTR (ie, isolated breast relapse, location away from the original tumor, long interval to failure, or no skin involvement), make the avoidance of serious local complications from salvage therapy clinically relevant.
Similar to the setting of chest wall failure, the interval to IBTR is an important prognostic factor following IBTR. Haffty et al[9] reported a 50% rate of distant metastases with an interval to IBTR ? 4 years vs 17% for more than 4 years.
Kurtz et al[11] found the same 15-year survival between patients with a late interval to IBTR of 5 to 10 years and those who never had an IBTR. In a large series reported by Gage et al,[124] only 8% of all breast recurrences were skin recurrences without associated parenchymal disease. Voogd et al[118] reported a series of 266 patients with IBTR after breast-conserving surgery and radiation. Van Tienhoven et al[108] studied 67 patients with first isolated locoregional recurrences after breast-conserving surgery and radiation, from the randomized trials vs mastectomy conducted by the EORTC and DBCG.
A comparison of the characteristics of local failures following mastectomy or breast-conserving surgery and radiation is shown in Table 3.
Simultaneous regional failures are uncommon after either treatment, but there generally is a higher incidence of simultaneous distant metastases with chest wall failure than with IBTR.
A comparison of overall survival following salvage of an IBTR or chest wall recurrence, with or without systemic therapy, is shown in Table 4. The interval to recurrence, a larger initial tumor size, and initial node-positive disease are unfavorable prognostic factors after local recurrence following either treatment.
The interval to local recurrence is the most important prognostic factor following either mastectomy or conservative surgery and radiation (Table 6). Approximately 10% to 15% of patients with invasive breast cancer treated by mastectomy or breast-conserving surgery and radiation will have a clinically isolated local recurrence.
Management of a clinically isolated chest wall failure following initial mastectomy involves wide local excision of all gross disease whenever possible, followed by postoperative chest wall and supraclavicular radiation in those not previously given postmastectomy radiation. After either mastectomy or breast-conserving surgery and radiation, a long interval to the development of local failure, early stage of initial disease, and isolated local recurrence are important prognostic factors. This is why it’s so important to stay on top of your appointments, continue to get have regular follow-up appointments over the years, and to pay attention to any changes you see or feel in the breast area. Jay Harness from Breast Cancer Answers shares possible recurrence locations in the breast area, and describes in detail how to go about finding any potential changes near or around the original site of the cancer.
2: MRI of a 28 year old patient following operative biopsy of two masses in right breast that were found to represent IDC. 4: An 80 year old patient who underwent BCS 22 years ago for IDC of the left breast was referred for MRI after a new lesion of the same breast was identified on conventional imaging.
5: MMG depicting an irregular focal lesion lateraly in left breast of a 46 year old patient who underwent BCS for IDC 15 years ago. 7: A 73 year old patient who was treated with BCS and RT for IDC 9 years ago presented with progressive skin edema of left breast and was referred for MRI following inconclusive findings on conventional imaging. 8: MMG depicting an irregular focal lesion in upper lateral quadrant of right breast of a 55 year old patient with history of undergoing BCS and RT for IDC 3 years ago.
10: MRI in a 45 year old patient who underwent mastectomy with reconstruction using a prosthetic implant 1 year prior to examination. 11: Postcontrast subtraction MR image showing an irregular enhancing lesion adjacent to a latissimus dorsi (LD) flap in a reconstructed breast. 12: A 56 year old patient presented with persistent skin edema of medial aspect of left breast 10 years after she underwent mastectomy for invasive carcinoma followed by muscular flap reconstruction. 14: 9 years after bilateral mastectomy with reconstruction following diagnosis of invasive cancer of left breast.
3: Example of breast cancer recurrence after mastectomy with a peripheral small irregular mass on the reconstructed breast. Christian Jumuga, obstetrics and gynecology specialist at the Clinic of Senology Gynecoland.
Sometimes Mastalgia represents only a sign of physiological changes related to menstrual cycle, sometimes it is a fibrous degeneration of the mammary gland (Fibrocystic breast disease) or even a disease: infections, benign or malignant tumors. In fact, most women go to the doctor not because they wouldn’t bear such pain, but from the fear of severe conditions (such as breast cancer). This will help your health in general, by eliminating the risk factors responsible for the occurrence of several diseases. Veronesi et al[59] considered 79% of cases as true local recurrences (ie, in the region of the original tumor) and 21% as new ipsilateral breast tumors (ie, in a separate quadrant from the original tumor). Haffty et al[126] classified recurrences as new primaries if they occurred at a different site in the breast, had a different histology than the original tumor, or had discordant DNA flow cytometry.
Several series have found that survival decreased with local failures in the same location as the initial tumor (compared to elsewhere in the breast),[5,118,126] but others have not.[6,11,122] However, this may be related to the longer interval to failure for the recurrences elsewhere in the breast rather than the location itself. Fowble et al[116] reported that only 42% of patients with an IBTR after breast-conserving surgery and radiation had no residual tumor at salvage mastectomy after a wide local excision, and half of those with residual disease had involvement of two or more quadrants.
Of the recurrences, 80% were less than 2 cm in size, 62% were in the vicinity of the original tumor, and all were without skin involvement.
However, the 5-year survival rate was 85% after reexcision, compared to 70% after mastectomy. Two of the 10 noninvasive tumors treated with excisional biopsy experienced a second local failure, and two others developed distant metastases and died. Voogd et al[118] reported that two of four patients treated for noninvasive recurrences with wide excision had a second local failure, compared to none of 21 patients treated with mastectomy. In the previously mentioned series of wide local excision for IBTR by Kurtz et al[127], 11 of 50 patients who had recurrences away from the original tumor bed were given additional radiation. After an average of 40 months follow-up, the rate of second local failures was 21% and 5-year survival was 55%.


The 5-year rates of second local relapse and overall survival were 27% and 80%, respectively. Other studies have also found that an interval of 2 years or less is an important predictor of survival,[5,6,133] but many series suggest that the interval to IBTR critical for determining prognosis may be longer. Van Dongen et al[1] observed a 92% rate of distant metastases following isolated locoregional recurrence when the interval from primary treatment was less than 2 years, 53% when the interval was 2 to 5 years, and 22% when the interval was more than 5 years. Fowble et al[116] observed a 5-year survival of 62% for initial T2 tumors, compared with 95% for T1 tumors following salvage mastectomy for isolated IBTR (P = .03).
Uncontrolled local failure was more common with a skin recurrence, compared to other recurrences (50% vs 14%, P = .0007).
The prognostic factors for survival on multivariate analysis were skin involvement, initial tumor grade, and initial nodal status.
On multivariate analysis, only initial pathologic nodal status was significant for survival after salvage treatment. There is no clear association between the location of the recurrence on the chest wall and involvement of the mastectomy scar. Following chest wall failure, survival ranges from 35% to 80% at 5 years and 25% to 60% at 10 years.
Local recurrence only, noninvasive histology of the recurrence, small size of the recurrence, and the absence of inflammatory symptoms are also favorable prognostic factors for both. Most chest wall recurrences within 2 years are associated with distant metastases and a 5-year survival of 20% to 30%. Factors predictive of a significant risk (20% or higher) of local failure after either treatment are patient age ? 35 to 40 years, tumor size ? 5 cm, lymphovascular invasion, and close or positive resection margins. A complete wide excision of disease and ER-positive recurrence are also favorable prognostic factors following chest wall failure, as is the absence of skin involvement following IBTR.
She has an adorable dog-child, and enjoys reading, writing, going to the theatre, and finding pins on Pinterest. T2 weighted image (a) shows postoperative seroma (arrow), while an avidly enhancing mass is visible posteriorly on first dynamic contrast enhanced T1 weighted image (b).
US with SWE depicted a lobulated stiff hypoechoic lesion that manifested significant contrast uptake on the subtracted MR image, with an additional focus of enhancement being shown anteriorly. US with SWE depicted a vertically oriented inhomogeneous soft lesion which on MR showed central necrosis with peripheral enhancement.
An irregular hypoechoic stiff lesion is visible in the postoperative scar region, showing wash-out type enhancement on MR. Two focal enhancing lesions are visible in right breast anterior to the implant, both showing wash-out curves.
MR images demonstrate a non-mass area of hyperintensity on T2 (a) and diffusion weighted images (b) without postcontrast enhancement (c). It is true that the risk of breast cancer is relatively high and that, therefore, marketing actions on breast cancer took a planetary scale, but you shouldn’t automatically think that you have cancer when you feel breast pains.
The doctor will examine your breasts and will palpate, including the armpits and above the collarbones (places in the case of formations frequently appear malignant ganglions), then most likely it will recommend you some tests.
And if That doesn’t work, your doctor may recommend some hormonal preparations, which certainly will be more efficient but may have some unwanted side effects.
Meanwhile, statistics show that between 40 and 49 years old most of the false positive results appear, subjecting a lot of women to a huge emotional stress and spending the extra money for unnecessary biopsies.
After the recommendations concerning reducing the mammograms, very soon appeared similar recommendations regarding the frequency of Papanicolau test for cervical cancer. They could not identify characteristics that would permit prospective identification of an appropriate subgroup for wide local excision alone after IBTR.
The second local failure rate in the salvaged breast was 38% at 5 years, with a 5- and 10-year survival of 67% and 42%, respectively.
One patient with a noninvasive tumor treated by incisional biopsy had a second local failure treated with mastectomy. In the same series for invasive tumors, the recurrence rates were 38% for wide excision and 25% for mastectomy (P = .27).
Seven patients received a boost by electron beam to doses of 20 to 30 Gy, and four underwent an interstitial implant to a dose of 50 Gy.
The subsequent breast recurrence rate was 19% at a follow-up of 7 to 139 months, without reported serious sequelae from the additional radiation. The cosmetic result was good or acceptable in 16 patients, but there were serious complications from treatment in three patients, who required salvage mastectomy. A good or acceptable cosmetic result was achieved in 75%, with only one case of skin necrosis requiring salvage mastectomy. Fortin et al[5] reported an improved 10-year post-IBTR survival of 59% for initial T1 tumors, compared with 16% for T2 tumors (P = .0009). The interval to first locoregional recurrence, and whether the recurrence was solitary and ? 3 cm, were the only prognostic factors for subsequent local control. However, the majority of IBTRs occur in the same quadrant as the original tumor, although the location is more likely to be elsewhere in the breast when intervals to recurrence are longer. Estrogen-receptor positivity and a gross total wide excision have been shown to be favorable prognostic factors following chest wall recurrence, while the absence of skin involvement is associated with a better prognosis following IBTR. Factors increasing the risk of chest wall failure (but not IBTR) include 4 or more positive axillary nodes, negative estrogen receptors, and p53 positivity, while extracapsular extension, 1 to 3 positive nodes, and high histologic grade are variably associated with increased risk. Systemic therapy should be considered in most patients following local failure, depending upon the perceived risk of subsequent distant relapse. In most cases, local failure within 2 years is a marker of more aggressive disease and simultaneous distant micrometastases. Postoperative MRI 6 months later (b,c) demonstrates an enhancing mass (arrow) adjacent to a large seroma. On second-look US with SWE (c) and CD (d) the lesion demonstrated lobular shape, dominantly hypoechoic stiff structure, and hypervascularity with multple periferal vessels. The only significant factors for local control on multivariate analysis were a disease-free interval greater than 5 years (92% vs 49%) and negative resection margins (73% vs 36%). Of the six patients with invasive tumors, three had a second local relapse, and one other developed isolated distant metastases and died. Second local failures occurred in 36% of patients given the supplemental irradiation, compared with 31% of those not given additional radiation.
Although the size of the recurrence was prognostic in one series,[118] the presence of invasion [118,120,122] or skin involvement[5,6,117,118] is of greater importance. While the median interval to chest wall failure is 2 to 3 years, the median interval to IBTR is 3 to 4 years and may be prolonged significantly by the use of adjuvant systemic therapy.
Local control following salvage treatment for chest wall failure ranges from 50% to 70%, and is generally higher—from 85% to 95%—for salvage mastectomy following IBTR. Between 30% and 40% of patients with IBTR will have a favorable combination of prognostic factors, compared with only 20% to 25% of patients with chest wall failure. While an IBTR within 2 years is also associated with a poor prognosis, the 5-year survival following salvage of an IBTR is 80% to 90% for intervals greater than 4 to 5 years.
Factors increasing the risk for IBTR following breast-conserving surgery and radiation include extensive intraductal component positivity and gross multifocal or multicentric disease. In contrast, the prognosis improves for the favorable subgroups of patients with late local failures, so that salvage treatment is associated with survival rates of 70% or higher at 5 years.
Fisher B, Anderson S, Redmond CK, et al: Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy, with or without irradiation, in the treatment of breast cancer. Postcontrast imaging demonstrates an extensive enhancing mass lesion of left breast that was found to be angiosarcoma on pathologic examination.
3 years later contralateral recurrent mass (lower image, arrow) is shown accompanied by involved lymph nodes. Overall, 5 of 16 patients (31%) had a second local recurrence after wide excision for IBTR. A comparison of prognostic factors for survival following chest wall recurrence vs IBTR is shown in Table 5. On US (c) the mass presented as an irregular, vertically oriented hypoechoic lesion that was confirmed to be malignant by FNAC. Pathologic examination revealed dilated lymphatic vessels filled with tumor cells – lymphangiosis carcinomatosa. Touboul E, Buffat L, Belkacemi Y, et al: Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer. Second-look US with shear-wave elastography (SWE)(d) shows a hypoechoic, elastographically stiff lesion that was confirmed to be residual cancer by US-guided core biopsy. Fortin A, Larochelle M, Laverdiere J, et al: Local failure is responsible for the decrease in survival for patients with breast cancer treated with conservative surgery and postoperative radiotherapy. Kini VR, Vicini FA, Frazier R, et al: Mammographic, pathologic, and treatment-related factors associated with local recurrence in patients with early-stage breast cancer treated with breast conserving therapy. Jacobson JA, Danforth DN, Cowan KH, et al: Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer.
Stotter AT, McNeese MD, Ames FC, et al: Predicting the rate and extent of locoregional failure after breast conservation therapy for early breast cancer. Kurtz JM, Spitalier J-M, Amalric R, et al: The prognostic significance of late local recurrence after breast-conserving therapy. Kim SH, Simkovich-Heerdt A, Tran KN, et al: Women 35 years of age or younger have higher locoregional relapse rates after undergoing breast conservation therapy.
Pisansky TM, Ingle JN, Schaid DJ, et al: Patterns of tumor relapse following mastectomy and adjuvant systemic therapy in patients with axillary lymph node-positive breast cancer. Crowe Jr JP, Gordon NH, Antunez AR, et al: Locoregional breast cancer recurrence following mastectomy. Stefanik D, Goldberg R, Byrne P, et al: Locoregional failure in patients treated with adjuvant chemotherapy for breast cancer. Lewis D, Rienhoff WFJ: A study of the results of operations for the cure of cancer of the breast, performed at Johns Hopkins Hospital from 1889 to 1931.
Donegan WL, Perez-Mesa CM,Watson FR: A biostatistical study of locally recurrent breast carcinoma.
Matthews RH, McNeese MD, Montague ED, et al: Prognostic implications of age in breast cancer patients treated with tumorectomy and irradiation or with mastectomy. Bouvet M, Babiera GV, Tucker SL, et al: Does breast conservation therapy in young women with breast cancer adversely affect local disease control and survival rate? Rosenman J, Bernard S, Kober C, et al: Local recurrences in patients with breast cancer at the North Carolina Memorial Hospital (1970-1982). Overgaard M, Hansen PS, Overgaard J, et al: Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Fowble B, Yeh I-T, Schultz DJ, et al: The role of mastectomy in patients with stage I-II breast cancer presenting with gross multifocal or multicentric disease or diffuse microcalcifications.


Iyer RV, Hanlon A, Fowble B, et al: Accuracy of the extent of axillary nodal positivity related to primary tumor size, number of involved nodes, and number of nodes examined. Benson EA,Thorogood J: The effect of surgical technique on local recurrence rates following mastectomy. Perera F, Fisher BJ, Cooke A, et al: Locoregional recurrence and extranodal extension in patients receiving systemic therapy for axillary node positive breast cancer (abstract).
Donegan WL, Stine SB, Samter TG: Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer. Leonard C, Corkill M, Tompkin J, et al: Are axillary recurrence and overall survival affected by axillary extranodal tumor extension in breast cancer? Fowble B, Gray R, Gilchrist K, et al: Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy. Freedman GM, Fowble BL, Hanlon AL, et al: A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged 50 or younger.
Mentzer SJ, Osteen RT,Wilson RE: Local recurrence and the deep resection margin in carcinoma of the breast.
Ahlborn TN, Gump FE, Bodian C, et al: Tumor to fascia margin as a factor in local recurrence after modified radical mastectomy. Schnitt SJ, Connolly JL, Khettry U, et al: Pathologic findings on re-excision of the primary site in breast cancer patients considered for treatment by primary radiation therapy. Rosen PP, Kinne DW, Lesser M, et al: Are prognostic factors for local control of breast cancer treated by primary radiotherapy significant for patients treated by mastectomy? Houghton J, Baum M,Haybittle JL: Role of radiotherapy following total mastectomy in patients with early breast cancer.
Pierce LJ, Merino MJ, D’Angelo T, et al: Is c-erb B-2 predicator for recurrent disease in early stage breast cancer? Zellars RC, Hilsenbeck SG, Clark GM, et al: Prognostic value of p53 for local failure in mastectomy-treated breast cancer patients.
Bonadonna G, Valagussa P, Moliterni A, et al: Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer. Veronesi U, Salvadori B, Luini A, et al: Breast conservation is a safe method in patients with small cancer of the breast.
Fisher B, Dignam J, Bryant J, et al: Five vs more than 5 years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors. Goldhirsch A, Gelber RD, Price KN, et al: Effect of systemic adjuvant treatment on first sites of breast cancer relapse. Fowble BL, Schultz DJ, Overmoyer B, et al: The influence of young age on outcome in early stage breast cancer. Kurtz JM, Jacquemier J, Amalric R, et al: Why are local recurrences after breast-conserving therapy more frequent in younger patients? Voogd AC, Peterse JL, Crommelin MA, et al: Histological determinants for different types of local recurrence after breast-conserving therapy of invasive breast cancer.
Dewar JA, Arriagada R, Benhamou S, et al: Local relapse and contralateral tumor rates in patients with breast cancer treated with conservative surgery and radiotherapy (Institut Gustave Roussy 1970-1982). Cowen D, Houvenaeghel G, Bardou V-J, et al: Local and distant failures after limited surgery with positive margins and radiotherapy for node-negative breast cancer. Khanna MM, Mark RJ, Silverstein MJ, et al: Breast conservation management of breast tumors 4 cm or larger.
Fisher B, Bryant J, Wolmark N, et al: Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. Danforth Jr DN, Zujewski J, O’Shaughnessy J, et al: Selection of local therapy after neoadjuvant chemotherapy in patients with stage IIIA, B breast cancer. Ellis P, Smith I, Ashley S, et al: Clinical prognostic and predictive factors for primary chemotherapy in operable breast cancer. Buzdar AU, Singletary SE, Booser DJ, et al: Combined modality treatment of stage III and inflammatory breast cancer. Kurtz JM, Jacquemier J, Amalric R, et al: Breast-conserving therapy for macroscopically multiple cancers.
Leopold KA, Recht A, Schnitt SJ, et al: Results of conservative surgery and radiation for multiple synchronous cancers of one breast. Wilson LD, Beinfield M, Mckhann CF, et al: Conservative surgery and radiation in the treatment of synchronous ipsilateral breast cancers. Hartsell WF, Recine DC, Griem KL, et al: Should multicentric disease be an absolute contraindication to the use of breast-conserving therapy?
Chabner E, Nixon A, Gelman R, et al: Family history and treatment outcome in young women after breast-conserving surgery and radiation therapy for early-stage breast cancer.
Pierce L, Strawderman M, Narod S, et al: No deleterious effects of radiotherapy in women who are heterozygote for a BRCA-1 or BRCA-2 mutation following breast-conserving therapy (abstract). Robson M, Levin D, Federici M, et al: Breast conservation therapy for invasive breast cancer in Ashkenazi women with BRCA gene founder mutations.
Seynaeve C, van den Bosch LMC, Brekelmans CTM, et al: Local recurrence following lumpectomy and irradiation in familial and hereditary vs sporadic breast cancer patients (abstract 457). Pierce LJ, Oberman H, Strawderman MH, et al: Microscopic extracapsular extension in the axilla: Is this an indication for axillary radiotherapy?
Hetelekidis S, Schnitt SJ, Silver B, et al: The significance of extracapsular extension of axillary lymph node metastases in early-stage breast cancer.
Freedman G, Fowble B, Hanlon A, et al: Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy. Wazer DE, Schmidt-Ullrich RK, Ruthazer R, et al: Factors determining outcome for breast-conserving irradiation with margin-directed dose escalation to the tumor bed. Smitt MC, Nowels KW, Zdeblick MJ, et al: The importance of lumpectomy surgical margin status in long-term results of breast conservation. Obedian E, Haffty BG: Negative margin status improves local control in conservatively managed breast cancer patients. Recht A, Come SE, Henderson IC, et al: The sequencing of chemotherapy and radiation therapy after conservative surgery for early-stage breast cancer.
Markiewicz DA, Fox KR, Schultz DJ, et al: Concurrent chemotherapy and radiation for breast conservation treatment of early-stage breast cancer.
Nixon AJ, Schnitt SJ, Gelman R, et al: Relationship of tumor grade to other pathologic features and to treatment outcome of patients with early stage breast carcinoma treated with breast-conserving therapy.
Silvestrini R, Veneroni S, Benini E, et al: Expression of p53, glutathione s-transferaase-n, and Bcl-2 proteins and benefit from adjuvant radiotherapy in breast cancer.
Wazer DE, Morr J, Erban JK, et al: The effects of postradiation treatment with tamoxifen on local control and cosmetic outcome in the conservatively treated breast.
Fowble B, Fein DA, Hanlon AL, et al: The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen-receptor positive early-stage breast cancer. Dalberg K, Johansson H, Johansson U, et al: A randomized trial of long-term adjuvant tamoxifen plus postoperative radiation therapy vs radiation therapy alone for patients with early-stage breast carcinoma treated with breast-conserving surgery. Schwaibold F, Fowble BL, Solin LJ, et al: The results of radiation therapy for isolated local regional recurrence after mastectomy. Ballo MT, Strom EA, Prost H, et al: Locoregional control of recurrent breast carcinoma after mastectomy: Does hyperfractionated accelerated radiotherapy improve local control? Willner J, Kiricuta IC, Kolbl O: Locoregional recurrence of breast cancer following mastectomy: Always a fatal event? Hsi RA, Antell A, Schultz DJ, et al: Radiation therapy for chest wall recurrence of breast cancer after mastectomy in a favorable subgroup of patients. Aberizk W, Silver B, Henderson IC, et al: The use of radiotherapy for treatment of isolated locoregional recurrence of breast carcinoma after mastectomy. Magno L, Bignardi M, Micheletti E, et al: Analysis of prognostic factors in patients with isolated chest wall recurrence of breast cancer.
Borner MM, Bacchi M, Castiglione M: Possible deleterious effect of tamoxifen in premenopausal women with locoregional recurrence of breast cancer. Chauvet B, Reynaud-Bougnoux A, Calais G, et al: Prognostic significance of breast relapse after conservative treatment in node-negative early breast cancer.
Voogd AC, van Tienhoven G, Peterse HL, et al: Local recurrence after breast conservation therapy for early-stage breast carcinoma. Francis M, Cakir B, Ung O, et al: Prognosis after breast recurrence following conservative surgery and radiotherapy in patients with node-negative breast cancer.
Dalberg K, Mattsson A, Sandelin K, et al: Outcome of treatment for ipsilateral breast tumor recurrence in early-stage breast cancer.
Haffty B, Fischer D, Beinfield M, et al: Prognosis following local recurrence in the conservatively treated breast cancer patient. Abner AL, Recht A, Eberlein T, et al: Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early-stage breast cancer.
Gage I, Schnitt SJ, Recht A, et al: Skin recurrences after breast-conserving therapy for early-stage breast cancer. Salvadori B, Marubini E, Miceli R, et al: Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Kurtz JM, Jacquemier J, Amalric R, et al: Is breast conservation after local recurrence feasible? Deutsch M: Repeat high-dose partial breast irradiation after lumpectomy for in-breast tumor recurrences following initial lumpectomy and radiotherapy.
Maulard C, Housset M, Brunel P, et al: Use of perioperative or split-course interstitial brachytherapy techniques for salvage irradiation of isolated local recurrences after conservative management of breast cancer.
Jolicoeur M, d’Hombres A, Bone-Lepinoy MC, et al: Second tumorectomy and perioperative interstital brachytherapy for salvage of breast conservation therapy recurrences. Pierce SM, Recht A, Lingos TI, et al: Long-term radiation complications following conservative surgery (CS) and radiation therapy in patients with early stage breast cancer.
Brenin CM, Small Jr W, Talamonti MS, et al: Radiation-induced sarcoma following treatment of breast cancer. Osborne MP, Borgen PI, Wong GY, et al: Salvage mastectomy for local and regional recurrence after breast-conserving operation and radiation therapy.
Fisher B, Redmond C, Poisson R, et al: Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. Eek RW, Falkson CI: Extended survival in 80 patients with operable, locoregionally recurrent breast cancer treated with chemotherapy.
Kemperman H, Borger J, Hart A, et al: Prognostic factors for survival after breast conserving therapy for stage I and II breast cancer.



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  1. | RAMMSTEIN — 25.06.2015 at 10:57:24 Gearbox on the driving force's facet - possibly.
  2. | Delfin — 25.06.2015 at 16:20:48 Broken blood vessels also muscle tissues within.
  3. | SimpotyagaChata — 25.06.2015 at 19:46:15 Risky than beforehand mentioned middle of the these symptoms in someone you care about, these indicators.