Christiana Care Breast Center

Newark, DE, United States

Christiana Care Breast Center

Newark, DE, United States

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Dickson-Witmer D.,Christiana Care Breast Center | Dickson-Witmer D.,Thomas College | Bleznak A.D.,John and Dorothy Morgan Cancer Center | Bleznak A.D.,University of South Florida | And 5 more authors.
Surgical Oncology Clinics of North America | Year: 2011

In the USA, 80% of patients with breast cancer are treated by community breast surgeons. NCDB data indicate that there are only small differences in outcomes between lower volume cancer programs and higher volume programs. There is some evidence that breast cancer patients of high-volume breast focused surgeons may have improved outcomes. This article discusses the challenges community breast surgeons face and some ways that the quality of care could be monitored and improved. Quality reporting programs of the Commission on Cancer and Mastery of Breast Surgery Program of the American Society of Breast Surgeons are recommended as tools to track and improve outcomes in breast cancer care. © 2011 Elsevier Inc.


Ko E.C.,Helen aham Cancer Center | Koprowski C.D.,Helen aham Cancer Center | Dickson-Witmer D.,Christiana Care Breast Center | Penman E.,Christiana Care Breast Center | And 5 more authors.
Brachytherapy | Year: 2010

Purpose: We compared patients undergoing partial breast irradiation (PBI) with the MammoSite applicator (Cytyc Corp., Marlborough, MA) to a similar group of patients who underwent whole breast irradiation with external beam radiotherapy. Methods and Materials: Stage 0-IIA breast cancer patients satisfying American Brachytherapy Society selection criteria and receiving accelerated PBI with the MammoSite system (n=100) were compared for toxicities with similarly staged patients receiving whole breast irradiation using tangential portals (n=100). The MammoSite applicator treatment was prescribed to a total dose of 34. Gy. External beam doses generally ranged from 60 to 66. Gy. Results: Based on common toxicity criteria scores for acute toxicities, MammoSite patients experienced less cutaneous toxicity, fatigue, and breast pain and had higher Karnofsky performance status scores during the acute period than external beam patients but experienced more seroma pain during followup. These results were both statistically significant and clinically meaningful. Conclusions: In our institutional experience, PBI using the MammoSite applicator produces less acute toxicity than external beam radiotherapy of the whole breast but is associated with an increased incidence of seroma pain. The rate of disease recurrence in both cohorts was low. © 2010 American Brachytherapy Society.

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