Surgical Oncology

Questions discussed in this category

When do you recommend endocrine therapy for chemoprevention in women with high-risk benign breast lesions?

Do you recommend axillary dissection for women with ER+ breast cancer and low risk Oncotype or Mammaprint if single node positive with only 1-2 SLN removed, to ensure <4 nodes positive?

4 Answers available

What criteria do you use to determine the resectability of mucosal melanoma of the H&N region?

Is T4 disease a contraindication?

1 Answer available

For a pedunculated rectal polyp found to be adenocarcinoma after endoscopic removal, with PNI as the only adverse feature, would you recommend additional treatment such as surgery or chemoradiation?

Consider some stalk invasion, but no deep submucosal extent and negative margins by 9 mm.

1 Answer available

Would you recommend axillary lymph node dissection in a pre-menopausal woman with ER+ PR+ HER2- IDC, s/p lumpectomy and SLN with pT1c pN1 cM0 disease, where 2 sentinel nodes are positive for macrometastasis and 1 SN is positive for micrometastasis?

1 Answer available

What is your local control approach to localized relapse of Ewing sarcoma in a site that was previously unresectable and received definitive radiation?

1 Answer available

What is your approach to young healthy women with locally advanced breast cancer and biopsy-proven low cervical lymph nodes?

Would you treat this as a locally advanced breast cancer and offer surgery, radiation, and systemic therapy? Does your management change depending on ...

2 Answers available

For a patient with breast cancer s/p lumpectomy found to have a heterozygous RAD50 mutation, is adjuvant radiation appropriate therapy or would you recommend completion mastectomy?

1 Answer available

How do you counsel your PALB2 mutation positive breast cancer patients with regards to risk reducing surgery?

How does this mutation compare to BRCA mutations in terms of risk and screening implications for family members?

1 Answer available

Should one perform a sentinel node biopsy in a clinically negative axilla prior to neoadjuvant chemotherapy?

NSABP B51 and B52 specifically prohibit this.

2 Answers available

In light of RxPonder results for postmenopausal women with early stage node positive HR+HER2- breast cancer, when is there a role for full axillary LN dissection to confirm degree of nodal involvement and when would sentinel LN evaluation be sufficient?

How would this affect adjuvant radiation plan in breast conservation therapy patients and mastectomy patients?

1 Answer available

In a patient with localized TNBC, how would you decide in whom to perform breast MRI prior to starting neoadjuvant systemic therapy?

1 Answer available

How does a close DCIS margin factor into surgical and radiation decision making for Stage I invasive ductal carcinoma after breast conserving surgery?

Do you use no tumor on ink for margin even if DCIS is the component close to the margin?

1 Answer available

In patients with inflammatory bowel disease with low rectal cancer with planned proctocolectomy, would you consider creation of a pouch?

1 Answer available

Would you consider an axillary dissection in a young patient with high grade breast cancer and one sentinel LN with isolated tumor cells?

2 Answers available

Do you skip sentinel lymph node biopsy for women >70 years old with small (< 2cm) HR+ node-negative breast cancer?

Is this new SSO choosing widely guideline being widely adopted and are there any concerns regarding this for clinical practice?

1 Answer available

What is the threshold for negative surgical margins in multifocal microinvasive carcinoma of the breast?

Do you follow invasive or DCIS guidelines? Would you consider re-excision in a patient with multifocal microinvasive carcinoma of the breast arising i...

2 Answers available

How do you counsel your breast-cancer survivors about weight-loss/dietary modifications?

Do your recommendations differ if patients are pre or postmenopausal given the data?

3 Answers available

Is sentinel lymph node biopsy several weeks after partial mastectomy as reliable as sentinel lymph node biopsy done at the time of partial mastectomy?

2 Answers available

How do you counsel women with a history of breast cancer who have dense breasts, with regards to mammography screening?

Is there a role for routine use of additional or alternative imaging modalities for these patients, such as tomosynthesis, MRI, or ultrasound? I...

2 Answers available

How do you approach prostate cancer patients with persistent obstructive lower urinary tract symptoms after primary radiation therapy?

Or in patients with metastatic disease on ADT who have not had primary therapy? In what situations do you consider palliative prostatectomy?

1 Answer available