International conference on Breast Pathology and Cancer June 28-29, 2019 Quality Airport Hotel Gardermoen, Oslo, Norway

Biography:

Dr. Shahla Masood is a Persian born physician, who currently holds the positions of Professor and Chair of the Department of Pathology at University of Florida College of Medicine – Jacksonville and Chief of Pathology and Laboratory Medicine at UF Health Jacksonville. She is also the Director of the Cytopathology and Breast Pathology Fellowship Training Program. In addition, Dr. Masood is the Medical Director of UF Health Breast Center. An internationally recognized expert in breast cancer diagnosis and prognosis, Dr. Masood has fostered the concept of an integrated multidisciplinary approach in breast cancer care, research, and education. She is the founder and Editor-in-Chief of The Breast Journal, the founder and past president of the “International Society of Breast Pathology,” the Director of the “Annual Multidisciplinary Symposium on Breast Disease”, and “The Breast Cancer Public Forum”. Dr. Masood is heavily involved in the study of minimally invasive procedures such as fine needle aspiration biopsy and ductal lavage in providing diagnostic and prognostic information in high risk and breast cancer patients

Abstract:

During the last several years, increased public awareness, advances in breast imaging and enhanced screening programs have led to early breast cancer detection and attention to cancer prevention.  The numbers of image-detected biopsies have increased and pathologists are expected to provide more information with smaller tissue samples.  These biopsies have resulted in detection of increasing numbers of high-risk proliferative breast disease and in situ cancers.  The general hypothesis is that some forms of breast cancers may arise from established forms of ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) and possibly from more common forms of ductal hyperplasia.  However, this is an oversimplification of a very complex process, given the fact that the majority of breast cancers appears to arise de-novo or from a yet unknown precursor lesion.  Currently, ADH and DCIS are considered as morphologic risk factors and precursor lesions for breast cancer.  However, morphologic distinction between these two entities has remained a real issue that continues to lead to overdiagnoses and overtreatment.  Aside from morphologic similarities between ADH and low grade DCIS, biomarker studies and molecular genetic testings have shown that morphologic overlaps are reflected at the molecular levels and raise questions about the validity of separating these two entities.  It is hoped that as we better understand the genetic basis of these entities in relation to ultimate patient outcome, the suggested use of the term of “Borderline Breast Disease” can minimize the number of patients who are subject to overtreatment.
 
 

Biography:

Doctor Papanikolaou is born in Athens in 1985. In 2009 he takes the Medical Degree (MD) with Excellent votation. Afterwards, he is selected to participate in the 2 years Postgraduate Programme in Robotic Surgery, Minimally Invasive Surgery and Telesurgery, in the University of Athens, Medical School in Greece. In 2011 he is distinguished again with Excellent votation and obtains the title of “Master of Science” of the Athens Medical School in “Robotic Surgery, Minimally Invasive Surgery and Telesurgery”. In 2011 he begins his PhD research on stem cells transplantation in experimental models. In 2018 he is distinguished with the PhD (Doctor of Philosophy) in the Athens Medical School, Greece with Excellent votation. In 2016 he begins a second 1,5 years Postgraduate Programme in “Reproductive and Regenerative Medicine” in the Athens Medical School.

Abstract:

As the topic of my Lecture suggests, I will focus on certification criteria of Breast Units and Breast Surgeons across Europe, which are crucial issues for the appropriate therapeutic management of breast cancer. The last GLOBOCAN estimates for breast cancer, classify this carcinoma as the most common in the female. Treatment options have changed and modern breast surgery tends to have a more conservative and cosmesis-preserving face. Breast cancer treatment involves many medical specialties and requires deep knowledge, training, expertise and dedication. The European Board for Surgical Qualification gives guidelines on eligibility criteria for involvement in breast surgery defining metrics for operations that a breast surgeon should have performed and defines with precise metrics the numbers of procedures in which a qualified breast surgeons should be involved.  Different international societies are involved in education and certification of competency in breast surgery. Many authors highlight that treatment of breast cancer in high-volume centers is of crucial importance because it improves 5-year survival up to 33%. Furthermore, the number of breast cancer surgeries that a breast surgeon performs per year seems to be an independent prognostic factor for patients’ survival, recurrence and general outcome. For all these reasons, treatment of breast cancer in certified breast units by specialized breast surgeons is mandatory. New techniques of oncoplastic breast-conserving surgery, challenge the current armamentarium of therapeutic options, proving excellent cosmetic results with comparable oncological outcome to the standard breast-conserving surgery. Furthermore, oncoplastic techniques improve patients’ satisfaction and quality of life after breast cancer diagnosis. Genetic counseling, psychological support and multimodal treatment from a breast-dedicated team which involves many specialties are mandatory for qualitative standards of care. There is an urgent need for certified education in breast surgery, not only for breast centers but also for breast surgeons. Dedication is a key principle in breast surgery, because it improves outcomes. Considering high incidence and mortality rates in the global population, current care for breast cancer needs to be based on quality. Breast surgery is a field with which, Obstetricians and Gynecologists should deal with and begin to be involved in Europe, after an accurate and strict training process which provided final certification.

 

 

Biography:

Specialist in women's oncology, Dr. Razzouk is concerned with breast disease, from surgery for benign or malignant diseases to breast reconstruction. He is also a specialist in gynecological cancers, having a global multidisciplinary approach using minimally invasive surgery. Since 2006, the year he joined the Haute Normandie Center for Cancer Research as a cancer surgeon, Dr. Razzouk has been manager and advisor in onco-gynecology focusing above all on women's cancer care and more particularly breast cancer. He has participated in the development of certain surgical techniques which he applies to breast cancer care. The aim is to minimize the patients’ physical and psychological pains, to preserve their self-image by paying particular attention not only to their cancer results but also the aesthetic side. In 2012, Dr Razzouk started working at the St Amé private hospital near Lille. He participated in the creation of the North Artois Breast Institute, the second establishment in breast cancer care in the region. He has acquired an inner conviction that ”this work can only be a joint effort but, with the intention of giving personalized healthcare to every patient.” Arriving in Nice in 2016, he participated in the creation of a pole dedicated to breast cancer at the private hospital Santa Maria in Nice, grouping all the skills and medical specializations regarding breast care in one place. Dr Razzouk is at the origin of the One Day Breast Care, an innovative ”one day” breast cancer care programme: - 1 day to diagnose - 1 day for cancer surgery - 1 day for breast reconstruction This new approach allows the Breast Institute of Santa Maria to propose a fast and global breast cancer care. Throughout her care, the patient is supported by the teams in place "this “cocooning” approach is at the heart of our care philosophy“.

Abstract:

Introduction: Breast reconstruction after total mastectomy and irradiation is a real challenge for the surgical teams. And is a crucial step for the patient in the life after breast cancer. The effect of radiotherapy on the skin often leads to preferring the reconstructions by flaps. However, reconstructions by prosthesis carries a high risk of complications and unsatisfactory cosmetic results. The optimization of skin trophicity by lipofilling and its positive impact on the results of secondary prosthetic breast reconstruction led us to perform an autologous fat grafting prior to secondary implant breast reconstruction after mastectomy and radiotherapy.

 

Patients and method: All patients were treated at the same center between 2012 and 2015. They all had a total mastectomy and irradiation. They all had one or more sessions of lipofilling prior to breast implant reconstruction. Patients were followed to collect this data: postoperative complications, prosthesis removal, cosmetic result, and tumor recurrences.

 

Results: Fifty-four patients were included. The mean pre-pectoral lipofilling session was 1.1 (1-2). The average volume of fat injected is 150cc (80-250). The average time between the end of treatment and the first session of lipofilling is 20.4 months (3-60). The mean volume of the prosthesis is 400cc (290-620). The mean follow-up time is 22 months. No local tumor recurrence was reported. One patient had a cutaneous necrosis after lipofilling. Implant explantation was performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5).

 

Conclusion: Pre-pectoral lipofilling prior to implant breast reconstruction improves the chances of success by optimizing the trophicity of the skin. It significantly reduces the risk of prosthesis explantation. Therefore, this protocol allows us to propose a minimal invasive breast reconstruction, with no additional scar and no additional pain

Biography:

Graduated from School of Medicine,Seoul National University in 1973

2011.5: Currently Director of Ewha Womens University Cancer Center for Women, Seoul, Korea.

2009.7-2011.4; President of Konkuk University Medical Center

2006-2008; President of Asian Breast Cancer Society

2006.7 ; Selected as one of the top 100 Health Professional as of Breast and Stomach Surgical Oncologist. International Biographical center of Cambridge, England

2001.6-2003.6;.President of Korean Breast Cancer Society

2000.6-2001.5. ; President, the 3rd Asian Breast Cancer Society congress.

2006.7 ; Selected as one of the top 100 Health Professional as of Breast and Stomach Surgical Oncologist. Cambridge, England

2001.4; Selected as a Man of the Year. International Biographical center of Cambridge, England.

1986;I started BCS in Korea

Abstract:

Breast cancer is the most common cancer among Korean women, and still shows annual 6.1% increasing.. Common causes of breast cancer includes first birth at late age, early menarche and late menopause, hormone replacement therapy, high fat and high calorie diet (BMI↑), alcohol abuse, low physical activity and genetic factors 24,000 in Korea, 2017.

The survival rate of breast cancer patient in Korea was much improved with early detection with every 2 year national screeing program and new treatment modalities which includes chemotherapy, radiotherapy, immunotherapy, hormonal therapy, target therapy and multimodality therapy including precision medicine. The 5-year and 10-year survival was 91.2% and 84.8% respectively. So breast cancer specialists started to consider about patients’ quality of life and developed new surgical technic (oncoplastic surgery) without change of recurrence and survival rates.

Breast conserving surgery (BCS) has showed gradually increasing tendency in Korea, currently about 70%, which may be preferable to mastectomy in terms of psychologically and cosmetically, Recently in Korea we have much considered for Oncoplastic surgery.

The principles of oncoplastic surgery of the breast are based on complete removal of breast cancer with minimal scarring and producing optimal breast shape and size. It includes careful preoperative planning as part of a multidisciplinary approach and a surgical plan that will result in optimal cancer management and the best possible aesthetic outcome. Some cases we treat the patients with neoadjuvant chemotherapy  with or without target therapy for good results.

Conclusion: Incidence of breast cancer increases according to improvement of economic status and women’s environmental factors in Korea. So breast cancer specialists should consider not only recurrence  and survival rate but also QOL with BCS or oncoplastic surgery.