Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy
Objectives. The “Sick Lobe” hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lo...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2011-01-01
|
| Series: | International Journal of Breast Cancer |
| Online Access: | http://dx.doi.org/10.4061/2011/726384 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850224763650179072 |
|---|---|
| author | W. Dooley J. Bong J. Parker |
| author_facet | W. Dooley J. Bong J. Parker |
| author_sort | W. Dooley |
| collection | DOAJ |
| description | Objectives. The “Sick Lobe” hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units.
Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision. Results. Breast conservation surgery for stage 0–2 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases). With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their “sick lobe.” Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series. |
| format | Article |
| id | doaj-art-535bcdbb05e549cba37fd4ad770fdae1 |
| institution | OA Journals |
| issn | 2090-3189 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Breast Cancer |
| spelling | doaj-art-535bcdbb05e549cba37fd4ad770fdae12025-08-20T02:05:32ZengWileyInternational Journal of Breast Cancer2090-31892011-01-01201110.4061/2011/726384726384Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal AnatomyW. Dooley0J. Bong1J. Parker2Department of Surgery, The University of Oklahoma Breast Institute and Division of Surgical Oncology, The University of Oklahoma Health Sciences Center, Oklahoma, OK 73104, USADepartment of Surgery, The University of Oklahoma Breast Institute and Division of Surgical Oncology, The University of Oklahoma Health Sciences Center, Oklahoma, OK 73104, USADepartment of Surgery, The University of Oklahoma Breast Institute and Division of Surgical Oncology, The University of Oklahoma Health Sciences Center, Oklahoma, OK 73104, USAObjectives. The “Sick Lobe” hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units. Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision. Results. Breast conservation surgery for stage 0–2 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases). With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their “sick lobe.” Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series.http://dx.doi.org/10.4061/2011/726384 |
| spellingShingle | W. Dooley J. Bong J. Parker Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy International Journal of Breast Cancer |
| title | Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy |
| title_full | Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy |
| title_fullStr | Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy |
| title_full_unstemmed | Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy |
| title_short | Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy |
| title_sort | redefining lumpectomy using a modification of the sick lobe hypothesis and ductal anatomy |
| url | http://dx.doi.org/10.4061/2011/726384 |
| work_keys_str_mv | AT wdooley redefininglumpectomyusingamodificationofthesicklobehypothesisandductalanatomy AT jbong redefininglumpectomyusingamodificationofthesicklobehypothesisandductalanatomy AT jparker redefininglumpectomyusingamodificationofthesicklobehypothesisandductalanatomy |