Browsing by Author "Keenan, Donald"

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    Placement technique and the early complications of balloon breast brachytherapy - magee-womens hospital experience
    (Lippincott Williams & Wilkins, 2007-04-01) Soran, Atilla; Beriwal, Sushil; Mogus, Robert; Keenan, Donald; Kelley, Joseph L.; Balkan, Mujdat; Harlak, Ali; Bonaventura, Marguerite A.; Johnson, Ronald; Falk, Jeffrey S.; Evrensel, Türkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0002-3398-7230; 0000-0002-9015-5617; AAJ-1027-2021
    Backgrounds and Objectives: Open (OT) and percutaneous closed (PCT) techniques have been described for placement of the MammoSite catheter to deliver accelerated partial breast brachytherapy. We report early complications of both techniques.Methods: A total of 125 patients underwent catheter placement for MammoSite high-dose rate brachytherapy, with 108 patients successfully completing treatment. The OT was used in 85 patients and PCT in 40 patients. The mean distance between the balloon surface and breast skin was 1.44 cm and 1.31 cm, respectively. Average skin dose was 278 cGy in the OT group and 295 cGy in the PCT group (P > 0.05). Average gross specimen size was 43.16 cm(3) in the OT group and 62.19 cm(3) in the PCT group. Median follow-up was I I months for the OT group and 5 months for the PCT group.Results: In 17 cases, the catheter was subsequently removed without the patient completing treatment. Two of the patients in the OT group (3%) developed a delayed abscess. The overall incidence of persistent seroma (>6 months) was 20% with all occurring in the OT group, 30% of those patients. There were no acute skin toxicities higher than grade 2. The overall cosmesis is excellent or good in 95% of patients.Conclusion: Despite short follow-up and a small sample size in this study, it seems that the MammoSite brachytherapy was well tolerated by patients with early stage breast cancer when using either the OT or PCT.
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    The predicted probability of having positive non-sentinel lymph nodes in patients who received neoadjuvant chemotherapy for large operable breast cancer
    (Wiley, 2008-09) Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Falk, Jeffrey; Keenan, Donald; Soran, Atilla; Evrensel, Türkkan; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021; 6603942124
    The accuracy of the nomogram in women with positive sentinel nodes following neoadjuvant chemotherapy (NCT) is unknown. The aim of this study was to evaluate the accuracy of the nomogram in patients receiving NCT. Between December 1999 and December 2005, we identified 233 patients who had a positive sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection at Magee-Womens Hospital of University of Pittsburgh Medical Center. Thirty-two patients (14%) had presented with clinically N0 breast cancer (BC) for which NCT was administered. The computerised BC nomogram was used to calculate the probability of non-sentinel node metastases utilising tumour size before NCT and after NCT for the same patient. The discrimination of the nomogram was assessed by calculating the area under (AUC) the receiver operating characteristic curve (ROC). The median patient age was 51.5 (range: 39-66) years in the NCT group of patients. Twelve patients (37%) had positive axillary non-sentinel lymph nodes (NSLNs). The nomogram was first validated in our institution for 201 patients without NCT and the predicted accuracy of the nomogram by the AUC was 0.73. The area under the ROC was identical regardless of whether pre- or posttreatment tumour size was used to determine predicted probability of NSLN metastases (0.66). The predictive accuracy of the nomogram was found to have less power for patients receiving NCT (0.66) than the non-NCT group of patients.
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    What is the predicted probability of having positive non-sentinel lymph nodes in patients who received neoadjuvant chemotherapy (NCT) for locally advanced breast cancer?
    (Elsevier, 2006) Soran, Atilla; Ahrendt, Gretchen; Koçer, Belma; Bonaventura, Marguerite; Falk, Jeffrey; Keenan, Donald; Johnson, Ronald; Evrensel, Türkkan; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021