José H. Volders

Cosmetic outcome and quality of life are inextricably linked in breast-conserving therapy

Cosmetic results and quality of life (QoL) are increasingly important in the treatment of breast cancer. This study was designed to determine the relationship between QoL and both subjectively and objectively measured cosmetic outcomes of breast‐conserving therapy (BCT), and its course over time.

Discordance between number of scintigraphic and perioperatively identified sentinel lymph nodes and axillary tumour recurrence

BACKGROUND In breast cancer, sentinel node biopsy is considered the standard method to assess the lymph node status of the axilla. Preoperative identification of sentinel lymph nodes (SLN) is performed by injecting a radioactive tracer, followed by lymphoscintigraphy. In some patients there is a discrepancy between the number of lymphoscintigraphically identified sentinel nodes and the number of nodes found during surgery. We hypothesized that the inability to find peroperatively all the lymphoscintigraphically identified sentinel nodes, might lead to an increase in axillary recurrence because of positive SLNs not being removed. METHODS Patients who underwent sentinel node biopsy between January 2000 and July 2010 were identified from a prospectively collected database. The number of lymphoscintigraphically and peroperatively identified sentinel nodes were reviewed and compared. Axillary recurrences were scored. RESULTS 1368 patients underwent a SLN biopsy. Median follow up was 58.5 months (range 12-157). Patient and tumour characteristics showed no significant differences. In 139 patients (10.2%) the number of radioactive nodes found during surgery was less than preoperative scanning (group 1) and in 89.8% (N = 1229) there were equal or more peroperative nodes identified than seen lymphoscintigraphically (group 2). In group 1, 0/139 patients (0%) developed an axillary recurrence and in the second group this was 25/1229 (2.0%) respectively. No significant difference between groups regarding axillary recurrence, sentinel node status and distant metastasis was found. CONCLUSION Axillary recurrence rate is not influenced by the inability to remove all sentinel nodes during surgery that have been identified preoperatively by scintigraphy.

Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy: Results from the randomized COBALT study

To identify breast‐specific factors and the role of tumor, treatment, and patient‐related items in influencing patient opinion on cosmesis and satisfaction after breast‐conserving therapy (BCT).

Response to “The CUBE Technique: Continuous Ultrasound-Guided Breast Excision,” Published in August 2014 by Tummel et al. Amsterdam, 28th January 2015

We read the article ‘‘The CUBE technique: continuous ultrasound-guided breast excision,’’ published in August 2014 by Tummel et al. We congratulate the authors on their study and the positive results concerning intraoperative ultrasonography for breast cancer surgery. However, if the authors had performed a review of the literature on this subject, they would have realized that the described technique is actually not as ‘‘novel’’ as they opine. Over the past years, our study group has extensively published on this subject, resulting in a multicenter, randomized controlled trial including 134 patients. Although the term ‘‘CUBE’’ is indeed novel, the technique itself is an exact copy of the technique we—among other authors—have repeatedly described. Needless to say, it would have been appropriate for the authors to refer to these studies while presenting their results, and we are somewhat disappointed that the journal did not revise the literature list on behalf of the authors. We recommend that the authors repeat our randomized controlled trial on use of intraoperative ultrasound, so we can convince all surgical oncologists to use this excellent technique in the operating theater. It would be highly appreciated if the authors could respond to our letter, and we await their reply. REFERENCES