SurgOnc Today®

Historically, mastectomy was recommended for women with multiple ipsilateral breast cancer due to perceptions regarding high rates of local recurrence with breast conservation. A recent prospective clinical trial demonstrated that breast conservation therapy may be appropriate to consider for women with multiple ipsilateral breast cancer. This episode of SurgOnc Today® features Ashley Woodfin, MD, discussing with Judy C. Boughey, MD, and Kari Rosenkranz, MD, the findings of the Alliance Z11102 clinical trial and how to implement these into practice.

In patients with invasive breast cancer presenting with node positive disease, neoadjuvant chemotherapy is often recommended and can result in surgical downstaging in a significant proportion of cases. Management of the axilla in this setting has evolved. For those found to have a nodal pathologic complete response (ypN0), an axillary lymph node dissection (ALND) can potentially be avoided. Astrid Botty van den Bruele, MD, FACS, and Giacomo Montagna, MD, MPH, discuss the newly presented OPBC-04/EUBREAST-06 study, which supports omission of ALND in this population. The axillary staging techniques (SLNB vs TAD) are also addressed.

On SurgOnc Today®, Jeffrey J. Pelton, MD, and Randall P. Scheri, MD, discuss the use and efficiency of four-dimensional CT scanning in preoperatively localizing adenomas in patients with primary hyperparathyroidism prior to cervical exploration.

The discussion includes:

• The anatomic body planes and the “fourth dimension” of CT scanning.
• How the 4D CT scan is performed and how this achieves localization of abnormal parathyroid glands.
• The role 4D CT scanning plays in the pre-operative work-up for primary hyperparathyroidism.
• What the surgeon wants to know from the radiologist on a 4D CT report.
• Potential risks and pitfalls in interpreting a 4D CT scan prior to proceeding with surgical exploration.

Dr. Pelton and Dr. Scheri also discuss what the literature has reported on this subject, how they approach surgical exploration using the information and their own experiences with this test.

This session will review state of the art therapy for peritoneal mesothelioma. The discussion includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as well as systemic chemotherapy and immunotherapy.

Edward Levine, MD, moderates this podcast and is Professor of Surgery and Chief, Surgical Oncology at Wake Forest University. Trang Nguyen, MD, is an Assistant Professor of Surgery at Indiana University and Sinziana Dumitra, MD, MSc, FRCSC, FSSO, is an Assistant Professor of Surgery at McGill University.

In this episode of SurgOnc Today®, Dr. Patricio Polanco from the University of Texas Southwestern and Vice-chair of the SSO HPB disease site working group and Dr. Sandra DiBrito from Albany Medical College and member of the HPB disease site working group are joined by Dr. Asmund Fretland of the University of Oslo and Dr. Laleh Melstrom of City of Hope. This is the first episode in our Minimally Invasive Techniques in Hepatobiliary Surgery Series. We will focus on the minimally invasive surgery techniques on the liver, discussing patient selection, benefits of the MIS approach, potential drawbacks, and the impact of this approach on patient outcomes.