An Innovative Scoring System to Select the Optimal Surgery in Breast Cancer after Neoadjuvant Chemotherapy.
aesthetic outcomes
breast cancer
breast-conserving surgery
conservative mastectomy
neoadjuvant treatment
oncological outcomes
oncoplastic techniques
personalized medicine
scoring system
surgery
Journal
Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269
Informations de publication
Date de publication:
21 Aug 2023
21 Aug 2023
Historique:
received:
29
06
2023
revised:
05
08
2023
accepted:
15
08
2023
medline:
25
8
2023
pubmed:
25
8
2023
entrez:
25
8
2023
Statut:
epublish
Résumé
The selection of surgery post-neoadjuvant chemotherapy (NACT) is difficult and based on surgeons' expertise. The aim of this study was to create a post-NEoadjuvant Score System (pNESSy) to choose surgery, optimizing oncological and aesthetical outcomes. Patients (stage I-III) underwent surgery post-NACT (breast-conserving surgery (BCS), oncoplastic surgery (OPS), and conservative mastectomy (CMR) were included. Data selected were BRCA mutation, ptosis, breast volume, radiological response, MRI, and mammography pre- and post-NACT prediction of excised breast area. pNESSy was created using the association between these data and surgery. Area under the curve (AUC) was assessed. Patients were divided into groups according to correspondence (G1) or discrepancy (G2) between score and surgery; oncological and aesthetic outcomes were analyzed. A total of 255 patients were included (118 BCS, 49 OPS, 88 CMR). pNESSy between 6.896-8.724 was predictive for BCS, 8.725-9.375 for OPS, and 9.376-14.245 for CMR; AUC was, respectively, 0.835, 0.766, and 0.825. G1 presented a lower incidence of involved margins (5-14.7%; A score system based on clinical and radiological features was created to select the optimal surgery post-NACT and improve oncological and aesthetic outcomes.
Identifiants
pubmed: 37623530
pii: jpm13081280
doi: 10.3390/jpm13081280
pmc: PMC10455579
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Ann Surg. 2009 Oct;250(4):558-66
pubmed: 19730235
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
Ann Surg. 2009 Mar;249(3):448-54
pubmed: 19247033
Curr Med Res Opin. 2013 Apr;29(4):405-14
pubmed: 23402224
Ann Ital Chir. 2018;89:290
pubmed: 30352955
Breast Cancer Res Treat. 2016 Nov;160(2):297-304
pubmed: 27704226
Surgeon. 2023 Apr 21;:
pubmed: 37088639
J Pers Med. 2021 Apr 21;11(5):
pubmed: 33919061
Pract Radiat Oncol. 2016 Nov - Dec;6(6):e219-e234
pubmed: 27659727
Ann Surg Oncol. 2018 Nov;25(12):3541-3547
pubmed: 30128902
Eur Rev Med Pharmacol Sci. 2008 Nov-Dec;12(6):387-96
pubmed: 19146201
Breast. 2023 Jun;69:323-329
pubmed: 37001289
BMC Cancer. 2021 Jan 19;21(1):78
pubmed: 33468087
Int J Radiat Oncol Biol Phys. 2006 Oct 1;66(2):352-7
pubmed: 16887286
J Clin Oncol. 1997 Jul;15(7):2483-93
pubmed: 9215816
Cancers (Basel). 2022 Mar 01;14(5):
pubmed: 35267583
Recent Results Cancer Res. 1998;152:193-201
pubmed: 9928558
Breast J. 2020 Feb;26(2):125-132
pubmed: 31562686
Breast Care (Basel). 2021 Jun;16(3):243-253
pubmed: 34248465
Am J Surg. 2003 Jun;185(6):525-31
pubmed: 12781879
Ann Oncol. 1998 Nov;9(11):1179-84
pubmed: 9862047
Ann Surg. 2002 Sep;236(3):295-302; discussion 302-3
pubmed: 12192316
Bull Cancer. 2023 Jun;110(6):605-615
pubmed: 37080848
Lancet Oncol. 2018 Jan;19(1):27-39
pubmed: 29242041
Cancers (Basel). 2022 Nov 24;14(23):
pubmed: 36497265
Breast Cancer Res Treat. 2018 Feb;168(1):1-12
pubmed: 29214416
Minerva Chir. 2007 Aug;62(4):249-55
pubmed: 17641585
Chirurgia (Bucur). 2021 Mar-Apr;116(2):143-149
pubmed: 33950809
Ann Surg Oncol. 2021 Sep;28(9):5142-5148
pubmed: 33635409
Clin Plast Surg. 1976 Apr;3(2):193-203
pubmed: 1261176
J Clin Oncol. 2004 Jun 15;22(12):2303-12
pubmed: 15197191
Cancers (Basel). 2022 Aug 23;14(17):
pubmed: 36077601
Medicine (Baltimore). 2017 Oct;96(43):e8367
pubmed: 29069026
J Clin Oncol. 2020 Jul 10;38(20):2281-2289
pubmed: 32442069
Ann Surg Oncol. 2012 May;19(5):1508-16
pubmed: 22193884
Am J Surg. 2001 Dec;182(6):601-8
pubmed: 11839324
Breast Cancer Res Treat. 1996;41(1):15-9
pubmed: 8932872
J Clin Oncol. 2021 May 1;39(13):1485-1505
pubmed: 33507815
Cancer. 2023 Feb 1;129(3):356-366
pubmed: 36401611
J Clin Oncol. 2011 Sep 1;29(25):3351-7
pubmed: 21788566
Surg Oncol. 2008 Dec;17(4):301-11
pubmed: 18467090
N Engl J Med. 2019 Feb 14;380(7):617-628
pubmed: 30516102
J Pers Med. 2021 Feb 22;11(2):
pubmed: 33671712
Chirurgia (Bucur). 2021 Mar-Apr;116(2):193-200
pubmed: 33950815
Breast Cancer Res Treat. 2021 Jan;185(2):441-451
pubmed: 33073303
Ther Adv Med Oncol. 2019 Feb 25;11:1758835919827714
pubmed: 30833989
BMC Cancer. 2009 Jul 27;9:254
pubmed: 19635166
Lancet Oncol. 2012 Jul;13(7):e311-7
pubmed: 22748270
Plast Reconstr Surg Glob Open. 2017 Jun 20;5(6):e1369
pubmed: 28740781
Breast Care (Basel). 2021 Dec;16(6):590-597
pubmed: 35087362
Am J Surg. 1998 Dec;176(6):502-9
pubmed: 9926779
Ann Surg Oncol. 2021 Oct;28(11):5920-5928
pubmed: 33778905
Tumori. 2012 Jan-Feb;98(1):79-85
pubmed: 22495705
J Surg Oncol. 2021 Feb;123(2):439-445
pubmed: 33259649
Int J Surg. 2006;4(2):106-14
pubmed: 17462324
N Engl J Med. 2017 Jun 1;376(22):2147-2159
pubmed: 28564564
Ann Oncol. 2008 Jul;19 Suppl 5:v113-6
pubmed: 18611867
Minerva Surg. 2021 Dec;76(6):564-574
pubmed: 34338470
Am J Clin Oncol. 2018 Dec;41(12):1246-1251
pubmed: 29782362