2016
Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ
Morrow M, Van Zee KJ, Solin LJ, Houssami N, Chavez-MacGregor M, Harris JR, Horton J, Hwang S, Johnson PL, Marinovich ML, Schnitt SJ, Wapnir I, Moran MS. Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ. Journal Of Clinical Oncology 2016, 34: 4040-4046. PMID: 27528719, PMCID: PMC5477830, DOI: 10.1200/jco.2016.68.3573.Peer-Reviewed Original ResearchConceptsIpsilateral breast tumor recurrenceWhole breast irradiationRisk of IBTRNegative marginsDuctal carcinomaRate of IBTRSurgical Oncology–American SocietyMargin widthMultidisciplinary consensus panelBreast tumor recurrenceBreast conserving surgeryBreast-conserving surgeryNegative margin widthOptimal negative margin widthRe-excision ratesHealth care costsFurther surgeryPositive marginsBreast irradiationConsensus guidelinesCosmetic outcomeTumor recurrenceClear marginsConsensus panelBackground Controversy
2015
Assessment of Practice Patterns Following Publication of the SSO–ASTRO Consensus Guideline on Margins for Breast-Conserving Therapy in Stage I and II Invasive Breast Cancer
DeSnyder SM, Hunt KK, Smith BD, Moran MS, Klimberg S, Lucci A. Assessment of Practice Patterns Following Publication of the SSO–ASTRO Consensus Guideline on Margins for Breast-Conserving Therapy in Stage I and II Invasive Breast Cancer. Annals Of Surgical Oncology 2015, 22: 3250-3256. PMID: 26202554, PMCID: PMC4696114, DOI: 10.1245/s10434-015-4666-1.Peer-Reviewed Original ResearchConceptsConsensus guidelinesInked marginInvasive breast cancerBreast-Conserving TherapyTriple-negative tumorsCurrent clinical practiceIndividual clinical judgmentDuctal carcinomaBreast surgeonsPractice patternsBreast cancerStage IClinical practiceClinical judgmentTumorsMethodsA surveyAdequate marginsPractice typeMultiple fociAmerican SocietySurgeonsGuidelinesMultiple marginsCarcinomaTherapy
2014
In Reply to Morgan and Vaidya
Truong PT, Smith SL, Moran MS. In Reply to Morgan and Vaidya. International Journal Of Radiation Oncology • Biology • Physics 2014, 90: 967-968. PMID: 25585789, DOI: 10.1016/j.ijrobp.2014.07.047.Peer-Reviewed Original ResearchThe Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer: Perspectives for Pathologists
Schnitt SJ, Moran MS, Houssami N, Morrow M. The Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer: Perspectives for Pathologists. Archives Of Pathology & Laboratory Medicine 2014, 139: 575-7. PMID: 25153620, DOI: 10.5858/arpa.2014-0384-ed.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsConsensusFemaleHumansMastectomy, SegmentalNeoplasm StagingPractice Guidelines as TopicRadiation OncologySocieties, MedicalUnited StatesIntraoperative Accelerated Partial Breast Irradiation: Caution Still Warranted
Moran MS, Truong PT. Intraoperative Accelerated Partial Breast Irradiation: Caution Still Warranted. International Journal Of Radiation Oncology • Biology • Physics 2014, 89: 496-498. PMID: 24929161, DOI: 10.1016/j.ijrobp.2014.01.034.Peer-Reviewed Original ResearchSociety of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer
Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, Horton J, Klimberg S, Chavez-MacGregor M, Freedman G, Houssami N, Johnson PL, Morrow M. Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer. Annals Of Surgical Oncology 2014, 21: 704-716. PMID: 24515565, DOI: 10.1245/s10434-014-3481-4.Peer-Reviewed Original ResearchConceptsIpsilateral breast tumor recurrenceInvasive breast cancerBreast cancerClear marginsRate of IBTRRisk of IBTRRadiation Oncology consensus guidelinesSurgical Oncology–American SocietyMargin widthMultidisciplinary consensus panelOptimal margin widthBreast tumor recurrenceExtensive intraductal componentBreast conserving surgeryBreast-conserving surgeryRe-excision ratesHealth care costsUnfavorable biologyEndocrine therapyMultidisciplinary therapyRadiation boostYounger patientsIntraductal componentLobular cancerNegative margins
2013
Is Ki-67 Expression Prognostic for Local Relapse in Early-Stage Breast Cancer Patients Treated With Breast Conservation Therapy (BCT)?
Hafeez F, Neboori HJ, Harigopal M, Wu H, Haffty BG, Yang Q, Schiff D, Moran MS. Is Ki-67 Expression Prognostic for Local Relapse in Early-Stage Breast Cancer Patients Treated With Breast Conservation Therapy (BCT)? International Journal Of Radiation Oncology • Biology • Physics 2013, 87: 344-348. PMID: 23910708, DOI: 10.1016/j.ijrobp.2013.05.052.Peer-Reviewed Original ResearchConceptsBreast conservation therapyEarly-stage breast cancer patientsHuman epidermal growth factor receptor 2Recurrence-free survivalBreast cancer patientsKi-67 expressionKi-67Clinicopathologic featuresConservation therapyCancer patientsIndependent associationLocoregional recurrence-free survivalDistant metastasis-free survivalLocal relapse-free survivalEpidermal growth factor receptor 2Univariate/multivariate analysisPrognostic clinicopathologic featuresCause-specific survivalHormone receptor statusGrowth factor receptor 2Metastasis-free survivalRelapse-free survivalKi-67 overexpressionSignificant independent associationKi-67 stainingThe Relative Benefits of Tamoxifen in Older Women with T1 Early‐Stage Breast Cancer Treated with Breast‐Conserving Surgery and Radiation Therapy
Khan AJ, Parikh RR, Neboori HJ, Goyal S, Haffty BG, Moran MS. The Relative Benefits of Tamoxifen in Older Women with T1 Early‐Stage Breast Cancer Treated with Breast‐Conserving Surgery and Radiation Therapy. The Breast Journal 2013, 19: 490-495. PMID: 23800027, DOI: 10.1111/tbj.12150.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic Agents, HormonalBreast NeoplasmsCombined Modality TherapyFemaleHumansMastectomy, SegmentalNeoplasm StagingTamoxifenConceptsDistant metastasis-free survivalLocal relapse-free survivalUse of tamoxifenOverall survivalBreast relapseBreast cancerRadiation therapyOlder womenHormone receptor-positive breast carcinomaElderly breast cancer patientsNode-negative breast cancerEarly-stage breast cancerLow local recurrence rateInstitutional data baseIpsilateral breast relapseT1N0M0 breast cancerAdjuvant hormonal therapyAdjuvant radiation therapyBreast conserving surgeryContralateral breast cancerLocal recurrence rateBreast-conserving surgeryMetastasis-free survivalRelapse-free survivalBreast cancer patientsBreast conservation therapy for ductal carcinoma in situ (DCIS): does presentation of disease affect long-term outcomes?
Bai HX, Motwani SB, Higgins SA, Haffty BG, Wilson LD, Lannin DR, Evans SB, Moran MS. Breast conservation therapy for ductal carcinoma in situ (DCIS): does presentation of disease affect long-term outcomes? International Journal Of Clinical Oncology 2013, 19: 460-466. PMID: 23780727, DOI: 10.1007/s10147-013-0575-0.Peer-Reviewed Original ResearchConceptsBreast conservation treatmentLocal relapse-free survivalRelapse-free survivalSigns/symptomsLong-term outcomesDCIS patientsPhysical signs/symptomsTumor sizeER/PR/HERWorse long-term prognosisSignificant overall survival differenceAdjuvant hormone treatmentLong-term prognosisOverall survival differenceBreast conservation therapyLarger tumor sizeStatus of marginsNon-white racePresentation of diseaseMedian followClinicopathological differencesNodal involvementOverall survivalIndependent predictorsConservation therapy
2012
Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy
Nelson C, Bai H, Neboori H, Takita C, Motwani S, Wright JL, Hobeika G, Haffty BG, Jones T, Goyal S, Moran MS. Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2012, 84: e279-e283. PMID: 22672752, DOI: 10.1016/j.ijrobp.2012.03.068.Peer-Reviewed Original ResearchConceptsWhole breast radiation therapyLocal relapse-free survivalRelapse-free survivalBreast-conserving surgeryBreast radiation therapyDCIS patientsRadiation therapyBreast conservationBlack patientsDuctal carcinomaRacial disparitiesUniversity-based cancer centerSignificant overall survival differenceFunction of raceAdjuvant radiation therapyBreast conserving surgeryOverall survival differenceEstrogen receptor statusMulti-institutional cohortMulti-institutional experiencePositive margin rateSignificant racial differencesTreatment delivery parametersPaucity of dataHormonal therapy
2011
ACR Appropriateness Criteria® Ductal Carcinoma in Situ
Moran MS, Bai HX, Harris EE, Arthur DW, Bailey L, Bellon JR, Carey L, Goyal S, Halyard MY, Horst KC, MacDonald SM, Haffty BG. ACR Appropriateness Criteria® Ductal Carcinoma in Situ. The Breast Journal 2011, 18: 8-15. PMID: 22107336, DOI: 10.1111/j.1524-4741.2011.01197.x.Peer-Reviewed Original ResearchConceptsWhole breast radiationDuctal carcinomaAppropriateness CriteriaMultiple phase III studiesAppropriateness of imagingPhase III studyACR Appropriateness CriteriaExpert panelRadiology Appropriateness CriteriaEvidence-based guidelinesMultidisciplinary expert panelOmission of radiationPartial breast radiationSpecific clinical conditionsCurrent medical literatureNon-invasive tumorsInvasive relapseBreast radiationLimited diseaseIII studyPeer-reviewed journalsLocal recurrenceAppropriate patientsTumor bedClinical guidelinesACR Appropriateness Criteria® Locally Advanced Breast Cancer
MacDonald SM, Harris EE, Arthur DW, Bailey L, Bellon JR, Carey L, Goyal S, Halyard MY, Moran M, Horst K, Haffty BG. ACR Appropriateness Criteria® Locally Advanced Breast Cancer. The Breast Journal 2011, 17: 579-585. PMID: 21906206, DOI: 10.1111/j.1524-4741.2011.01150.x.Peer-Reviewed Original ResearchConceptsAdvanced breast cancerAppropriateness CriteriaBreast cancerRadiation therapyAmerican CollegeAppropriateness of imagingManagement of LABCACR Appropriateness CriteriaRadiology Appropriateness CriteriaEvidence-based guidelinesMultidisciplinary expert panelSpecific clinical conditionsCurrent medical literatureLABC casesPeer-reviewed journalsMultidisciplinary managementBreast reconstructionBreast CommitteeClinical conditionsGuideline developmentIntegration of radiationMedical literatureConsensus methodologyExpert panelTreatment proceduresACR Appropriateness Criteria® Conservative surgery and Radiation – Stage I and II Breast Carcinoma
Bellon JR, Harris EE, Arthur DW, Bailey L, Carey L, Goyal S, Halyard MY, Horst KC, Moran MS, MacDonald SM, Haffty BG. ACR Appropriateness Criteria® Conservative surgery and Radiation – Stage I and II Breast Carcinoma. The Breast Journal 2011, 17: 448-455. PMID: 21790842, DOI: 10.1111/j.1524-4741.2011.01132.x.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsCarcinomaContraindicationsFemaleHumansMastectomy, SegmentalNeoplasm StagingOrgan Sparing TreatmentsRadiotherapy, AdjuvantConceptsRadiation therapySide effectsEarly-stage breast cancerLong-term side effectsAdjuvant radiation therapyAcute side effectsACR Appropriateness CriteriaWhole breast irradiationRisk of recurrenceAtherosclerotic heart diseasePartial breast irradiationMajority of womenConservative surgerySurvival benefitAppropriate patientsBreast conservationRandomized studyAppropriateness CriteriaHeart diseaseBreast carcinomaBreast cancerTherapyShort treatmentEffective alternativeTreatment
2010
Evaluation of Vascular Endothelial Growth Factor as a Prognostic Marker for Local Relapse in Early-Stage Breast Cancer Patients Treated With Breast-Conserving Therapy
Moran MS, Yang Q, Goyal S, Harris L, Chung G, Haffty BG. Evaluation of Vascular Endothelial Growth Factor as a Prognostic Marker for Local Relapse in Early-Stage Breast Cancer Patients Treated With Breast-Conserving Therapy. International Journal Of Radiation Oncology • Biology • Physics 2010, 81: 1236-1243. PMID: 21093162, DOI: 10.1016/j.ijrobp.2010.07.031.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnalysis of VarianceBiomarkers, TumorBlack PeopleBreast NeoplasmsDisease-Free SurvivalFemaleFollow-Up StudiesHumansMastectomy, SegmentalMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPrognosisRadiotherapyTissue Array AnalysisVascular Endothelial Growth Factor AWhite PeopleConceptsEarly-stage breast cancerBreast-conserving therapyLocal relapse-free survivalRelapse-free survivalVascular endothelial growth factorEarly-stage breast cancer patientsLocal relapseBreast cancer patientsBreast cancerEndothelial growth factorVEGF expressionOverall survivalPrognostic valueCancer patientsTissue microarrayEstrogen receptor/progesterone receptor statusDistant metastasis-free survivalNodal relapse-free survivalGrowth factorProgesterone receptor statusInstitutional review board approvalMetastasis-free survivalLong-term outcomesMargin-negative patientsOverexpression of VEGF
2009
Does Compliance with Radiation Therapy Differ in African‐American Patients with Early‐Stage Breast Cancer?1
Sharma C, Harris L, Haffty BG, Yang Q, Moran MS. Does Compliance with Radiation Therapy Differ in African‐American Patients with Early‐Stage Breast Cancer?1. The Breast Journal 2009, 16: 193-196. PMID: 20030649, DOI: 10.1111/j.1524-4741.2009.00874.x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlack or African AmericanBreast NeoplasmsFemaleHumansMastectomy, SegmentalMiddle AgedNeoplasm StagingPatient ComplianceSEER ProgramWhite PeopleConceptsBreast conservation therapyAA patientsWhite patientsWorse outcomesRadiation therapyAfrican American breast cancer patientsEarly-stage breast cancerAdjuvant chemotherapy regimensMedian radiation doseBreast cancer patientsLarge institutional seriesAfrican American patientsDate of treatmentChemotherapy regimenChemotherapy regimensSame radiation dosesChart reviewInstitutional seriesTherapy differsTreatment breaksConservation therapyCancer patientsBreast cancerMedian numberTreatment daysThe Yale University Experience of Early‐Stage Invasive Lobular Carcinoma (ILC) and Invasive Ductal Carcinoma (IDC) Treated with Breast Conservation Treatment (BCT): Analysis of Clinical‐Pathologic Features, Long‐Term Outcomes, and Molecular Expression of COX‐2, Bcl‐2, and p53 as a Function of Histology
Moran MS, Yang Q, Haffty BG. The Yale University Experience of Early‐Stage Invasive Lobular Carcinoma (ILC) and Invasive Ductal Carcinoma (IDC) Treated with Breast Conservation Treatment (BCT): Analysis of Clinical‐Pathologic Features, Long‐Term Outcomes, and Molecular Expression of COX‐2, Bcl‐2, and p53 as a Function of Histology. The Breast Journal 2009, 15: 571-578. PMID: 19995377, DOI: 10.1111/j.1524-4741.2009.00833.x.Peer-Reviewed Original ResearchConceptsBreast conservation treatmentInvasive lobular carcinomaInvasive ductal carcinomaEarly-stage invasive lobular carcinomaClinical-pathologic featuresContralateral breast cancerCOX-2Breast relapseILC patientsDuctal carcinomaBreast cancerER/PR/HERBcl-2Cause-specific survivalLong-term outcomesTriple-negative tumorsChemo-preventive strategiesYears of ageImmuno-histochemical analysisExpression of p53Function of histologyDistant relapseInvasive lobularNodal statusContralateral breastClinicopathologic Significance of Excision Repair Cross-Complementation 1 Expression in Patients Treated With Breast-Conserving Surgery and Radiation Therapy
Goyal S, Parikh RR, Green C, Schiff D, Moran MS, Yang Q, Haffty BG. Clinicopathologic Significance of Excision Repair Cross-Complementation 1 Expression in Patients Treated With Breast-Conserving Surgery and Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2009, 76: 679-684. PMID: 19464815, DOI: 10.1016/j.ijrobp.2009.02.050.Peer-Reviewed Original ResearchConceptsDistant metastasis-free survivalHuman epidermal growth factor receptor 2Cause-specific survivalLower T stageMetastasis-free survivalBreast conservation therapyERCC-1 expressionERCC1 expressionAdjuvant chemotherapyHormonal therapyER positivityOverall survivalT stageConservation therapyProgesterone receptorBreast cancerEstrogen receptorNodal negativityRadiation therapyWorse distant metastasis-free survivalEarly-stage breast cancer patientsLocoregional recurrence-free survivalEarly-stage breast cancerEpidermal growth factor receptor 2Adjuvant hormonal therapyClinical-Pathologic Features and Long-Term Outcomes of Tubular Carcinoma of the Breast Compared With Invasive Ductal Carcinoma Treated With Breast Conservation Therapy
Liu GF, Yang Q, Haffty BG, Moran MS. Clinical-Pathologic Features and Long-Term Outcomes of Tubular Carcinoma of the Breast Compared With Invasive Ductal Carcinoma Treated With Breast Conservation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2009, 75: 1304-1308. PMID: 19386432, DOI: 10.1016/j.ijrobp.2008.12.070.Peer-Reviewed Original ResearchConceptsClinical-pathologic featuresInvasive ductal carcinomaRelapse-free survivalBreast conservation therapyLong-term outcomesConservation therapyTC cohortTumor RegistryDuctal carcinomaTubular carcinomaInstitutional experienceBreast cancer-related deathsNodal relapse-free survivalInstitution's tumor registryCentral pathology reviewHormone receptor positivityCancer-related deathPT1 diseaseConservative surgeryPN0 diseasePathology reviewClinical outcomesDistant metastasisRare subtypeRadiation therapy
2008
Bcl-2 expression predicts local relapse for early-stage breast cancer receiving conserving surgery and radiotherapy
Yang Q, Moran MS, Haffty BG. Bcl-2 expression predicts local relapse for early-stage breast cancer receiving conserving surgery and radiotherapy. Breast Cancer Research And Treatment 2008, 115: 343. PMID: 18516673, DOI: 10.1007/s10549-008-0068-4.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerBreast conservation treatmentStage breast cancerBcl-2 expressionBreast cancerIpsilateral breast tumor recurrenceCox proportional hazards modelBreast tumor recurrenceIndependent prognostic factorProgesterone receptor statusOptimal treatment optionsBcl-2Proportional hazards modelBcl-2 antibodyApoptosis-related proteinsBreast recurrenceLocal relapseLocal recurrencePrognostic factorsReceptor statusClinical outcomesPrognostic significanceTreatment optionsTumor recurrencePrimary tumor