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Article ; Online: Adrenalectomy for metastases.

Zaborowski, Alexandra M / Prichard, Ruth S

2022 Volume 109, Issue 11, Page(s) 1030–1031

MeSH term(s)	Adrenal Gland Neoplasms/surgery ; Adrenalectomy ; Humans ; Kidney Neoplasms
Language	English
Publishing date	2022-09-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znac315
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Article ; Online: The accuracy of MRI in detecting pathological complete response following neoadjuvant chemotherapy in different breast cancer subtypes.

Kuzmova, Miroslava / Cullinane, Carolyn / Rutherford, Claire / McCartan, Damian / Rothwell, Jane / Evoy, Denis / Geraghty, James / Prichard, Ruth S

Surgical oncology

2023 Volume 51, Page(s) 102011

Abstract: Background: Pathological complete response (pCR) following neo-adjuvant chemotherapy (NACT) for breast cancer is associated with improved disease-free and overall survival in certain breast cancer subtypes. Magnetic Resonance Imaging (MRI) is ... ...

Abstract	Background: Pathological complete response (pCR) following neo-adjuvant chemotherapy (NACT) for breast cancer is associated with improved disease-free and overall survival in certain breast cancer subtypes. Magnetic Resonance Imaging (MRI) is increasingly used as standard to assess treatment response in patients receiving NACT. The aim of this study was to determine the clinical utility of MRI in accurately predicting pCR post-NACT. Methods: A single-centre, retrospective study was conducted in breast cancer patients, who received NACT between 2013 and 2020. Patients who had an MRI before and after NACT were included. Pathological and MRI radiological response rates to NACT were analyzed and MRI accuracy assessed in detecting pCR according to breast cancer subtype. Results: One hundred and sixty-seven patients were included in the study. Forty-one of the 167 patients achieved pCR (24.6 %), with the highest proportion in HR- HER2+ subgroup (58.3 %), followed by triple negative breast cancer (TNBC) (35 %). Only 22.2 % and 10.5 % of patients with HR + HER2+ and HR + HER2-respectively achieved pCR. The overall accuracy of MRI in predicting pCR after NACT was 77.3 %. The greatest accuracy was in TNBC (87.5 %) with a specificity and positive predictive value (PPV) of 100 % and the highest number of correctly diagnosed complete responses (14 of 40). MRI was less accurate in predicting response rates in HR + HER2- (PPV 91.2 %) and HR + HER2+ groups (PPV 90.5 %). MRI performed significantly better in predicting complete response in TNBC compared to HR + HER2-subtype (p = 0.0057). Conclusion: MRI is a clinically useful adjunct in assessing pCR following NACT and appears to predict pathological response more accurately in TNBC compared to HR + HER2-breast cancer subtypes. This has significant clinical implications in terms of surgical planning, adjuvant treatment options and prognosis.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Neoadjuvant Therapy/methods ; Triple Negative Breast Neoplasms/diagnostic imaging ; Triple Negative Breast Neoplasms/drug therapy ; Retrospective Studies ; Prognosis ; Magnetic Resonance Imaging ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Adjuvant ; Receptor, ErbB-2
Chemical Substances	Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2023-10-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1107810-8
ISSN	1879-3320 ; 0960-7404
ISSN (online)	1879-3320
ISSN	0960-7404
DOI	10.1016/j.suronc.2023.102011
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Article ; Online: Fertility treatment and breast-cancer incidence: meta-analysis.

Cullinane, Carolyn / Gillan, Hannah / Geraghty, James / Evoy, Denis / Rothwell, Jane / McCartan, Damian / McDermott, Enda W / Prichard, Ruth S

BJS open

2022 Volume 6, Issue 1

Abstract: Background: The significance of exogenous hormone manipulation as part of fertility treatment and its relationship to the development of breast cancer remains uncertain. Several historical reviews have been performed with conflicting results. This study ...

Abstract	Background: The significance of exogenous hormone manipulation as part of fertility treatment and its relationship to the development of breast cancer remains uncertain. Several historical reviews have been performed with conflicting results. This study is an updated meta-analysis to determine whether there is a causal relationship between different fertility treatments and breast cancer. Methods: The study report is based on the guidelines of PRISMA and Meta-Analysis of Observational Studies in Epidemiology. Studies published within the last 20 years were included to reflect up to date in vitro fertilization (IVF) practice. This study was prospectively registered on PROSPERO on 07/04/2021, registration identification CRD42021247706. The primary outcome of the study was to determine whether there is an increased incidence of breast cancer in women treated with hormonal fertility treatment. The secondary outcomes were to determine whether fertility treatments were individually associated with excess breast-cancer risk. Results: Overall, 25 studies, including 617 479 participants, were eligible for inclusion. There was no significant breast-cancer risk association with fertility treatment (compared with general and subfertility reference groups). Summary odds ratio of all included studies was 0.97 (95 per cent c.i. 0.90 to 1.04). Women who received six or more IVF cycles did not have an increased risk of breast cancer. Similarly, there was no excess breast-cancer risk associated with clomiphene, human chorionic gonadotropin, gonadotropin analogues and progesterone when examined individually. Comparably, there was no significant association between fertility treatment and excess breast-cancer risk in patients with more than 10 years' follow-up. Summary odds ratio was 0.97 (95 per cent c.i. 0.85 to 1.12). Conclusion: This meta-analysis did not find a significant association between fertility treatments and excess breast-cancer risk. Women considering IVF should be informed that it does not appear to increase breast-cancer risk.
MeSH term(s)	Breast Neoplasms/epidemiology ; Female ; Fertilization in Vitro/adverse effects ; Fertilization in Vitro/methods ; Humans ; Ovulation Induction/adverse effects ; Ovulation Induction/methods
Language	English
Publishing date	2022-02-10
Publishing country	England
Document type	Journal Article ; Meta-Analysis
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrab149
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Article ; Online: A systematic review of oncological outcomes after nipple-sparing mastectomy for breast cancer.

Zaborowski, Alexandra M / Roe, Simon / Rothwell, Jane / Evoy, Denis / Geraghty, James / McCartan, Damian / Prichard, Ruth S

Journal of surgical oncology

2022 Volume 127, Issue 3, Page(s) 361–368

Abstract: Nipple-sparing mastectomy is an alternative to skin-sparing mastectomy in select patients. Increasing evidence supports its use in the setting of breast cancer, however concerns still exist regarding oncological safety. The aim of this systematic review ... ...

Abstract	Nipple-sparing mastectomy is an alternative to skin-sparing mastectomy in select patients. Increasing evidence supports its use in the setting of breast cancer, however concerns still exist regarding oncological safety. The aim of this systematic review was to evaluate long-term oncological outcomes of patients who underwent nipple-sparing mastectomy for breast cancer. A systematic review of the literature was performed to evaluate oncological outcomes in patients with breast cancer who underwent nipple-sparing mastectomy. Five major databases (PubMed, Embase, Scopus, Web of Science and Cochrane) were searched. The review included all original articles published in English reporting long-term oncological outcomes. 2334 studies were identified. After applying inclusion and exclusion criteria, 17 retrospective studies involving 7107 patients were included. The indication for nipple-sparing mastectomy was invasive carcinoma in 6069 patients (85.4%) and in situ disease in 1038 (14.6%). Median follow up was 48 months (range 25-94). The weighted mean rates of local recurrence and recurrence involving the nipple-areola complex were 5.4% (0.9-11.9) and 1.3% (0-4.9), respectively. The weighted mean distant failure rate was 4.8% (1.5-23.0). Therapeutic nipple-sparing mastectomy is oncologically safe in select patients with breast cancer.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/pathology ; Mastectomy/adverse effects ; Nipples/surgery ; Nipples/pathology ; Retrospective Studies ; Neoplasm Recurrence, Local/pathology ; Mastectomy, Subcutaneous ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Mammaplasty
Language	English
Publishing date	2022-10-08
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.27115
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Zs.A 706: Show issues

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Article ; Online: A mimic of breast carcinoma 1-year post vacuum-assisted excision of a benign breast lesion.

Murphy, Mark Conal / Quinn, Cecily M / Prichard, Ruth S / Pender, Susan / McNally, Sorcha

BMJ case reports

2019 Volume 12, Issue 11

Abstract: A 64-year-old woman underwent vacuum-assisted excision (VAE) for a biopsy-proven radial scar in the right breast detected during screening mammography. A follow-up mammogram was performed at 1 year following multidisciplinary team discussion. This ... ...

Abstract	A 64-year-old woman underwent vacuum-assisted excision (VAE) for a biopsy-proven radial scar in the right breast detected during screening mammography. A follow-up mammogram was performed at 1 year following multidisciplinary team discussion. This demonstrated a 1 cm mass adjacent to the biopsy clip at the site of the prior VAE. A repeat biopsy of the mass was performed which revealed benign scar tissue. This is the first reported case of post-VAE scar tissue mimicking breast carcinoma on mammography.
MeSH term(s)	Breast Diseases/diagnostic imaging ; Breast Diseases/therapy ; Breast Neoplasms/diagnostic imaging ; Cicatrix/diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Time Factors ; Vacuum
Language	English
Publishing date	2019-11-28
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2019-230237
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Article ; Online: Real-World Analysis of the Clinical and Economic Impact of the 21-Gene Recurrence Score (RS) in Invasive Lobular Early-Stage Breast Carcinoma in Ireland.

Current oncology (Toronto, Ont.)

2024 Volume 31, Issue 3, Page(s) 1302–1310

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Female ; Retrospective Studies ; Ireland ; Gene Expression Profiling/methods ; Breast Neoplasms/drug therapy ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/pathology
Language	English
Publishing date	2024-03-01
Publishing country	Switzerland
Document type	Observational Study ; Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol31030098
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Zs.A 4305: Show issues

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Article ; Online: The Impact of Neoadjuvant Chemotherapy on Margin Re-excision in Breast-Conserving Surgery.

Devane, Liam A / Baban, Chwanrow K / O'Doherty, A / Quinn, Cecily / McDermott, Enda W / Prichard, Ruth S

World journal of surgery

2020 Volume 44, Issue 5, Page(s) 1547–1551

Abstract: Background: Neoadjuvant chemotherapy (NAC) can improve cosmesis by reducing resection volume. Breast-conserving surgery (BCS) aims to achieve clear excision margins while optimizing cosmesis. However, the influence of NAC on margin re-excision after BCS ...

Abstract	Background: Neoadjuvant chemotherapy (NAC) can improve cosmesis by reducing resection volume. Breast-conserving surgery (BCS) aims to achieve clear excision margins while optimizing cosmesis. However, the influence of NAC on margin re-excision after BCS is unclear. This study examines the rate and determinants of margin re-excision in patients undergoing BCS following NAC in our institution. Methods: From 2011-2015, all patients treated with NAC prior to BCS were identified from a prospectively maintained database. Mann-Whitney and Fisher's exact test tests were used to compare variables in patients who did and did not require re-excision. Patients undergoing primary surgical treatment in 2015 comprised an unmatched comparison group. Results: Of 211 patients treated with NAC, 69 initially underwent BCS. The re-excision rate was 32% (n = 22) compared to 17% in the primary operable group (38 of 221, p = 0.02). Re-excision rates were lowest in triple-negative and HER2+ tumors (0% and 10%, respectively). Lobular carcinoma and ER+ tumors had a significantly higher rate of re-excision (100% and 42%, respectively). Of 22 patients undergoing re-excision, 9 had further BCS and 13 had a mastectomy. Conclusion: The re-excision rate following NAC is almost twice that of patients who underwent primary operative management. Her2+ and triple-negative tumors have lower re-excision rates and may represent a selected cohort most suitable for BCS. Patients with invasive lobular carcinoma or ER+ disease have significantly higher rates of margin positivity, and these patients should be considered for a cavity shave during primary surgery to reduce the rates of re-excision.
MeSH term(s)	Antineoplastic Agents/therapeutic use ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/metabolism ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/metabolism ; Carcinoma, Lobular/surgery ; Female ; Humans ; Margins of Excision ; Mastectomy, Segmental ; Middle Aged ; Neoadjuvant Therapy ; Receptor, ErbB-2/metabolism ; Receptors, Estrogen/metabolism ; Reoperation ; Retrospective Studies ; Triple Negative Breast Neoplasms/drug therapy ; Triple Negative Breast Neoplasms/surgery
Chemical Substances	Antineoplastic Agents ; Receptors, Estrogen ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2020-01-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05383-8
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Article ; Online: Value of a 21-gene expression assay on core biopsy to predict neoadjuvant chemotherapy response in breast cancer: systematic review and meta-analysis.

Boland, M R / Al-Maksoud, A / Ryan, É J / Balasubramanian, I / Geraghty, J / Evoy, D / McCartan, D / Prichard, R S / McDermott, E W

The British journal of surgery

2021 Volume 108, Issue 1, Page(s) 24–31

Abstract: Background: A recurrence score based on a 21-gene expression assay predicts the benefit of adjuvant chemotherapy in oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. This systematic review aimed to ...

Abstract	Background: A recurrence score based on a 21-gene expression assay predicts the benefit of adjuvant chemotherapy in oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. This systematic review aimed to determine whether the 21-gene expression assay performed on core biopsy at diagnosis predicted pathological complete response (pCR) to neoadjuvant chemotherapy. Methods: The study was performed according to PRISMA guidelines. Relevant databases were searched to identify studies assessing the value of the 21-gene expression assay recurrence score in predicting response to neoadjuvant chemotherapy in patients with breast cancer. The Newcastle-Ottawa Scale was used to assess the quality of the studies. Results are reported as risk ratio (RR) with 95 per cent confidence interval using the Cochrane-Mantel-Haenszel method for meta-analysis. Sensitivity analyses were carried out where appropriate. Results: Seven studies involving 1744 patients reported the correlation between pretreatment recurrence score and pCR. Of these, 777 patients (44.6 per cent) had a high recurrence score and 967 (55.4 per cent) a low-intermediate score. A pCR was achieved in 94 patients (5.4 per cent). The pCR rate was significantly higher in the group with a high recurrence score than in the group with a low-intermediate score (10.9 versus 1.1 per cent; RR 4.47, 95 per cent c.i. 2.76 to 7.21; P < 0.001). A significant risk difference was observed between the two groups (risk difference 0.10, 0.04 to 0.15; P = 0.001). Conclusion: A high recurrence score is associated with higher pCR rates and a low-intermediate recurrence score may indicate chemoresistance. Routine assessment of recurrence score by the 21-gene expression assay on core biopsy might be of value when considering neoadjuvant chemotherapy in patients with ER-positive, HER2-negative breast cancer.
MeSH term(s)	Antineoplastic Agents/therapeutic use ; Breast Neoplasms/drug therapy ; Breast Neoplasms/genetics ; Female ; Gene Expression Profiling/methods ; Humans ; Neoadjuvant Therapy/methods ; Predictive Value of Tests ; Treatment Outcome
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2021-02-10
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znaa048
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Article ; Online: Optimal timing of surgery following breast cancer neoadjuvant chemotherapy: A systematic review and meta-analysis.

Cullinane, Carolyn / Shrestha, Amber / Al Maksoud, Ahmed / Rothwell, Jane / Evoy, Denis / Geraghty, James / McCartan, Damian / McDermott, Enda W / Prichard, Ruth S

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2021 Volume 47, Issue 7, Page(s) 1507–1513

Abstract: Background: Administration of chemotherapy before breast surgery has the potential to reduce the risk of distant recurrence by targeting micrometastasis as well as allowing a more minimalistic approach to surgical intervention. We performed a systematic ...

Abstract	Background: Administration of chemotherapy before breast surgery has the potential to reduce the risk of distant recurrence by targeting micrometastasis as well as allowing a more minimalistic approach to surgical intervention. We performed a systematic review to determine the optimum timing of surgery post breast cancer neoadjuvant chemotherapy (NACT). Methods: The primary outcome was to determine whether the timing of surgery post NACT impacted overall survival (OS) and disease-free survival (DFS). We compared patient outcomes between those who had surgery within 8 weeks of completion of NACT to those that had surgery after 8 weeks. An outcome comparison between <4 weeks and 4-8 weeks was also performed. Secondary outcome included complete pathological response (pCR) post NACT. A meta-analysis was performed using the Mantel-Haenszel method. Results: Five studies, including 8794 patients were eligible for inclusion. Patients that had surgery within 8 weeks of completion of NACT had a statistically significant improved OS(OR 0.47, 95% c. i 0.34-0.65) and DFS(OR 0.71 (95% c. i 0.52-0.98, P = 0.04). There were no survival advantages associated with having surgery less than 4 weeks post completion of NACT (OR 0.78, 95% c. i 0.46-1.33, P = 0.37). There was no difference in pCR rate between those that had surgery <4 weeks and 4-8 weeks (OR 1.01, 95% c. i 0.80-1.28, P = 0.93). Conclusion: This meta-analysis shows that the optimum timing of surgery post completion of NACT is 4-8 weeks as it is associated with increased OS and DFS.
MeSH term(s)	Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Neoadjuvant Therapy ; Time-to-Treatment
Language	English
Publishing date	2021-02-09
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2021.01.025
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Clinical and Survival Outcomes Using Percutaneous Cholecystostomy Tube Alone or Subsequent Interval Cholecystectomy to Treat Acute Cholecystitis.

Fleming, Christina A / Ismail, M / Kavanagh, R G / Heneghan, H M / Prichard, R S / Geoghegan, J / Brophy, D P / McDermott, E W

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2019 Volume 24, Issue 3, Page(s) 627–632

Abstract: Background: Percutaneous cholecystostomy (PCT) is a safe method of gallbladder drainage in the setting of severe or complicated acute cholecystitis (AC), particularly in patients who are high-risk surgical candidates. Small case series suggest that PCT ... ...

Abstract	Background: Percutaneous cholecystostomy (PCT) is a safe method of gallbladder drainage in the setting of severe or complicated acute cholecystitis (AC), particularly in patients who are high-risk surgical candidates. Small case series suggest that PCT aids resolution of acute cholecystitis in up to 90% of patients. However, reluctance is observed in utilising PCT more frequently, due to concerns that we are committing comorbid patients to an interval surgical procedure for which they may not be suitable. Aim: The aim of this study was to assess the clinical and survival outcomes of PCT use, with particular emphasis on a subgroup of patients who did not proceed to cholecystectomy. Methods: A retrospective analysis was performed of all patients with severe acute cholecystitis who required PCT insertion in a tertiary referral hospital from 2010 to 2015. Patient demographics and clinical data including systemic inflammatory response (SIRS) scores at presentation, readmissions and clinical and survival outcomes were analysed. Statistical analysis was performed using SPSS v.22 and GraphPad Prism v.7. Results: In total, 157 patients (59% males) with AC underwent PCT insertion during the study period. Median age at presentation was 71 years (range 29-94). A median SIRS score of 3 was noted at presentation. Patients required a median of two cholecystostomy tube changes/replacements (range 1-10) during treatment. Transhepatic tube placement was the preferred approach (69%) with 31% of tubes being placed via transabdominal approach. Only 55% proceeded to interval cholecystectomy. Of the 70 patients treated with PCT alone, their median age was 75 years. In this subgroup, only 12.9% (n = 9) developed recurrent biliary sepsis necessitating readmission following initial resolution of symptoms and tube removal. All episodes of recurrent biliary sepsis presented within 6 months of index presentation, and definitive PCT removal in this group was performed at a median of 3 months. No difference in survival was observed between both groups. Conclusion: Almost 90% of patients with AC who are managed definitively with a PCT will recover uneventfully without recurrent sepsis following PCT removal. This is a viable option for older, comorbid patients who are unfit for surgical intervention and is not associated with significantly increased mortality.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cholecystectomy ; Cholecystitis, Acute/surgery ; Cholecystostomy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2019-03-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-019-04194-0
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