Barbara A Pockaj

..Hot flashes cause significant morbidity in postmenopausal women, including women with breast cancer. We undertook a pilot study to estimate the effectiveness of black cohosh to reduce hot flashes...

..Herein, we present a review of the current surgical therapy of invasive breast cancer...

..It is time to conduct a carefully designed randomized trial to see whether surgery in stage IV breast cancer does indeed warrant a second look...

..The purpose of this study was to evaluate the prognostic variables and clinical ramifications of melanoma of the ear...

..Although multiple studies have evaluated breast surgery quality-of-life outcomes, the data are inconsistent. This factor is important to consider when counseling patients and defining surgical quality measures...

..Proper patient selection is important for nipple-sparing mastectomy, and we aimed to identify preoperative factors predictive of pathologic nipple-areola complex (NAC) involvement to assist with surgical planning...

..Herein, we examine the influence of biopsy technique on residual disease in melanoma WLE specimens and on upstaging...

..These data support the DIEP flap as the preferred option over the pedicled TRAM flap for autologous breast reconstruction in postmastectomy patients...

..Understanding the risk factors for local and in-transit recurrences (LR/ITR) may help facilitate methods of prevention, early detection, and treatment...

..Triple-negative (TN) breast cancers lack estrogen receptor (ER), progesterone receptor (PR), and HER2/neu amplification (HER2). Few studies have been dedicated to characterizing this subset of cancer...

..015). RSL is safe, effective, and compared to WL, reduces the rates of intraoperative re-excision and reoperation for positive margins by 68%. Patient satisfaction is improved with RSL. We strongly favor RSL over WL...

..Desmoplastic melanoma (DM) is a rare variant of cutaneous melanoma. Our goal was to study the surgical management of DM, identify prognostic factors, and impact of treatment options...

..Invasive lobular cancer (ILC) of the breast is difficult to diagnose clinically and radiologically. It is hoped that preoperative magnetic resonance imaging (MRI) can improve evaluation of extent of disease...

..We therefore sought to assess the effect of LAC on QOL in the short and long term, using individual item analysis of multi-item QOL assessments...

..Although trends and variations in the use of breast conservation therapy (BCT) for ductal carcinoma have been studied, little is known about uncommon breast cancer histologies...

..Our goal was to validate the new staging system using a cancer registry...

..Vascular channels have been associated with angiogenesis without involvement of endothelial cells, and may serve as another mechanism by which tumor cells obtain nutrients to survive, especially in less vascularized regions of the tumor...

..quot; We conclude that TRAM flaps can be irradiated with few complications and acceptable cosmetic results...

..The goal of this study was to determine factors associated with CPM...

..Radioactive seed localization (RSL) is an alternative to wire localization for nonpalpable breast lesions, with reported lower rates of positive surgical margins...

....

..We investigated whether the timing of injection of (99m)Tc-labeled sulfur colloid (radiocolloid) significantly influenced the success of breast cancer sentinel lymph node (SLN) mapping...

..The significance of breast cancer sentinel lymph node (SLN) metastases detected only by immunohistochemistry staining (IHC) remains poorly understood. This study attempted to quantify the risk of non-SLN metastases...

..Leucovorin, fluorouracil, and oxaliplatin (FOLFOX) is the standard adjuvant therapy for resected stage III colon cancer. Adding cetuximab to FOLFOX benefits patients with metastatic wild-type KRAS but not mutated KRAS colon cancer...

..The value of excisional biopsy for patients with lobular neoplasia diagnosed by core needle breast biopsy is controversial...

..The accuracy of magnetic resonance imaging (MRI) in identifying residual disease after breast conservation therapy (BCT) is unclear...

..For patients with microinvasive breast cancer, the value of intraoperative analysis of sentinel lymph nodes (SLNs) and complete axillary lymph node dissection (CALND) is not well known...

..Although much work remains to be done to improve the survival of patients with melanoma, clinically meaningful results seem within reach...

..Reconstructive surgical procedures had a high rate of complications; however, overall functional outcomes were good. Stage of cancer at diagnosis was associated with systemic metastases...

..This change allowed a comparison of perioperative time intervals for patients undergoing these procedures at an outpatient facility versus a hospital...

..CONCLUSIONS: In addition to known risk factors, age independently predicts the risk of SLN metastasis in breast cancer. Angiolymphatic invasion seems to be a more powerful predictor of SLN metastasis in older patients...

..Two patients (5%) died, one of an unknown cause and the other of metastatic melanoma. We concluded that oncologic surgery can result in good local disease control in patients with upper facial melanoma...

....

....

..Surgery is the cornerstone of potentially curative therapy for upper gastrointestinal cancer. We analyzed the patterns of treatment regarding the use of surgery for early-stage upper gastrointestinal cancer in the United States...

..The study goal was to identify patients who may potentially forego excisional biopsy if the risk of upstaging is low...

..Melanoma in the elderly is more common on the head and neck. Higher incidence of local/in-transit metastases is seen among the elderly. Five-year disease-specific mortality and overall mortality are both worse for these patients...

....

..The role of sentinel lymph node (SLN) biopsy in these patients is unknown...

..This technique provides significantly improved scintigraphic localization and characterization of disease, increasingly important in this era of minimally invasive surgery and targeted radiotherapy...

..Preoperative computed tomography has been used to facilitate deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction. This study identifies the improvements in outcome that this may provide...

..Many women with nipple discharge undergo operative duct excision with few actually having carcinoma...

..Malignant peripheral nerve sheath tumors (MPNST) are a rare form of soft tissue sarcoma with few studies reporting on patient outcomes and prognostic variables...

..Effective adjuvant therapy is needed for this patient population...

..We report laparoscopic approach to treat TRAM and deep inferior epigastric perforator flap (DIEP) harvest site hernias with mesh...

..Sentinel lymph node (SLN) dissection can accomplish axillary staging with less morbidity, but it is unclear if it alters subsequent therapy...

..Incorporating these results into new approaches using multimodality treatment may enhance survival in patients with stage IV melanoma...

..In 2008, the American Society for Breast Surgeons launched its Mastery in Breast Surgery Pilot Program to demonstrate feasibility of a Web-based tool for breast surgeons to document and monitor quality outcomes...

..The infection was limited to skin and soft tissue, and treatment consisted of local debridement and liposomal amphotericin B. Outcome was successful...

..CONCLUSIONS: RSL is effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reoperation for positive margins compared to WL. We highly favor RSL over WL...

..There is disagreement regarding the preferred injection site for breast sentinel lymph node mapping...

..CONCLUSIONS: Gastrointestinal metastasis occurred more often in patients with invasive lobular carcinoma. Surgical intervention did not significantly extend overall survival but may be considered in a select group of patients...

..This review presents an overview of the pathophysiology, diagnosis, prevention, and treatment of breast cancer-related lymphedema...

..The purpose of this study was to examine the relationship between magnetic resonance imaging (MRI) and surgical treatment of invasive breast cancer (IBC)...

..Symptomatic arm lymphedema as the presenting symptom of invasive breast carcinoma is a rare occurrence...

..Thus, a novel mechanism of COX-2-induced immunosuppression via regulation of IDO has emerged that may have implications in designing future cancer vaccines...

..We review the emerging molecular landscape of melanoma and its implications for better management of patients with melanoma...

..CONCLUSIONS: COX-2-induced PGE2 may contribute to immunosuppression and may directly block antitumor immunity while promoting tumor growth, providing us with the rationale for using COX-2 inhibition combined with immunotherapy...

..6 +/- 2.1) was similar to that of a healthy control population (9.2 +/- 1.2, P = 0.17). CONCLUSIONS: Reoperation on the abdomen encased in adhesions restores most patients to good health and an excellent long-term quality of life...

..To evaluate clinical characteristics and survival outcomes among patients with locally advanced or metastatic colorectal cancer who achieve a complete response (CR) to systemic treatment either alone or with multimodality approach...

..No manifestations of Crohn disease were evident. This case represents the first diagnosis with capsule endoscopy of diaphragm disease of the small intestine with pathologic features of neuromuscular and vascular hamartoma...

..Part 2 (which will appear in the April 2007 issue) will review melanoma staging, prognosis, and treatment...

..CONCLUSION: This trial failed to provide any evidence that black cohosh reduced hot flashes more than the placebo...

..To review the state of the science with respect to diagnostic imaging and locoregional therapy for patients with breast cancer receiving preoperative chemotherapy...

..This article discusses the background information on hot flashes, SSRIs, tryptophan, and 5HTP, and possible clinical application of 5HTP for menopausal women with breast cancer risk...