2022
Radiation Therapy for Low-Risk Breast Cancer: Whole, Partial, or None?
Moran M, Ho A. Radiation Therapy for Low-Risk Breast Cancer: Whole, Partial, or None? Journal Of Clinical Oncology 2022, 40: 4166-4172. PMID: 36332170, DOI: 10.1200/jco.22.01751.Peer-Reviewed Original ResearchConceptsWide local excisionPartial breast irradiationBreast cancerRadiation therapyEstrogen receptor-positive/progesteroneLow-risk breast cancerOncology Grand Rounds seriesHuman epidermal growth factor receptor 2Left-sided breast cancerWhole breast radiation therapyEpidermal growth factor receptor 2Clinical-pathologic featuresPostmenopausal female patientsDose/fractionationGrowth factor receptor 2Sentinel node biopsyOmission of radiationCommon clinical scenariosFactor receptor 2Node biopsyPostoperative radiationLocal excisionFemale patientsBreast irradiationTreatment recommendations
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 ControversyRadiosensitization effect of Huaier on breast cancer cells
DING X, YANG Q, KONG X, HAFFTY BG, GAO S, MORAN MS. Radiosensitization effect of Huaier on breast cancer cells. Oncology Reports 2016, 35: 2843-2850. PMID: 26935024, DOI: 10.3892/or.2016.4630.Peer-Reviewed Original ResearchConceptsBreast cancer cellsDNA repairTraditional Chinese medicineCell cycleBreast cancerCancer cellsDNA repair pathwaysCell cycle-regulating proteinsHomologous recombination pathwayRadiosensitization effectMulti-biological functionsCell cycle phasesColony formation assaysMDA-MB-468 cellsΓ-H2AX fociCell divisionRepair pathwaysG0/G1Treatment strategiesMicroarray assayRecombination pathwayFormation assaysHuaierCancer treatmentWestern blotting
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
Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation
Wobb JL, Chen PY, Shah C, Moran MS, Shaitelman SF, Vicini FA, Mbah AK, Lyden M, Beitsch P. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation. International Journal Of Radiation Oncology • Biology • Physics 2014, 91: 312-318. PMID: 25446607, DOI: 10.1016/j.ijrobp.2014.09.029.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAlgorithmsBrachytherapyBreast NeoplasmsDose Fractionation, RadiationFemaleHumansMiddle AgedNeoplasm Recurrence, LocalNomogramsOrgan Sparing TreatmentsOutcome Assessment, Health CarePrognosisReproducibility of ResultsRisk AssessmentSensitivity and SpecificityUnited StatesConceptsLocoregional recurrencePartial breast irradiationConcordance indexBreast Surgeons MammoSite Registry TrialCox proportional hazards regression modelRisk of LRREarly-stage breast cancerProportional hazards regression modelsAccelerated Partial Breast IrradiationEstrogen receptor negativityBalloon-based brachytherapyHazards regression modelsWilliam Beaumont HospitalConformal radiation therapyBias-corrected indicesReceptor negativityRegistry trialClinicopathologic featuresPositive marginsClinicopathologic variablesBeaumont HospitalUnivariate analysisBreast cancerUse nomogramRadiation therapyIn 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 ResearchIntraoperative 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 marginsACR Appropriateness Criteria local-regional recurrence (LRR) and salvage surgery-breast cancer.
Halyard MY, Harris EE, Bailey L, Bellon JR, Freedman GM, Goyal S, Horst KC, Moran MS, Park CC, Suh WW, Toppmeyer D, Haffty BG. ACR Appropriateness Criteria local-regional recurrence (LRR) and salvage surgery-breast cancer. Oncology 2014, 28: 157-64, c3. PMID: 24701707.Peer-Reviewed Original ResearchConceptsLocal-regional recurrenceAmerican CollegeRadiology Appropriateness Criteria Expert PanelExcellent local-regional controlAppropriateness of imagingLocal-regional controlTreatment-related factorsBreast-conserving surgeryExpert panelMultidisciplinary expert panelRadiology Appropriateness CriteriaEvidence-based guidelinesSpecific clinical conditionsCurrent medical literatureEvidence-based dataHormonal therapyAppropriateness CriteriaBreast cancerClinical conditionsExpert opinionGuideline developmentClinical scenariosAvailable modalitiesMedical literaturePatient scenarios
2013
Should Low-Risk Patients Be Treated With Three-Dimensional Conformal Radiation Therapy–Accelerated Partial-Breast Irradiation in an Off-Protocol Setting?
Moran MS. Should Low-Risk Patients Be Treated With Three-Dimensional Conformal Radiation Therapy–Accelerated Partial-Breast Irradiation in an Off-Protocol Setting? Journal Of Clinical Oncology 2013, 31: 4032-4037. PMID: 24081936, DOI: 10.1200/jco.2013.51.1642.Peer-Reviewed Original ResearchIs 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 ResearchConceptsDistant 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 therapyAre Breast Cancer Subtypes Prognostic for Nodal Involvement and Associated with Clinicopathologic Features at Presentation in Early-Stage Breast Cancer?
Jones T, Neboori H, Wu H, Yang Q, Haffty BG, Evans S, Higgins S, Moran MS. Are Breast Cancer Subtypes Prognostic for Nodal Involvement and Associated with Clinicopathologic Features at Presentation in Early-Stage Breast Cancer? Annals Of Surgical Oncology 2013, 20: 2866-2872. PMID: 23661183, PMCID: PMC5731457, DOI: 10.1245/s10434-013-2994-6.Peer-Reviewed Original ResearchConceptsNodal involvementClinicopathologic featuresSignificant associationStage I/II diseaseCancer subtypesDistant metastasis-free survivalEarly-stage breast cancerResultsThe study cohortAxillary node involvementBreast-conserving surgeryMetastasis-free survivalUseful prognostic variableBreast cancer subtypesAvailable tissue blocksNode involvementNode positivityNodal metastasisPathological reviewStudy cohortT stageTumor characteristicsTumor histologyTumor sizeProgesterone receptorSurgical assessmentWhat Currently Defines a Breast Center? Initial Data From the National Accreditation Program for Breast Centers
Moran MS, Kaufman C, Burgin C, Swain S, Granville T, Winchester DP. What Currently Defines a Breast Center? Initial Data From the National Accreditation Program for Breast Centers. JCO Oncology Practice 2013, 9: e62-e70. PMID: 23814526, PMCID: PMC3595452, DOI: 10.1200/jop.2012.000636.Peer-Reviewed Original ResearchMeSH KeywordsAccreditationBreast NeoplasmsCancer Care FacilitiesData CollectionFemaleHumansProgram EvaluationConceptsBreast centerNational Accreditation ProgramHospital-based centersUltrasound-guided biopsyAccreditation programClinical trialsStereotactic biopsySurvivorship programsAmerican CollegeCenter accreditationSubspecialty practiceSignificant associationBasis of responsesMicrosoft Excel 2007Patient resourcesFree-standing facilitiesSPSS v.Group practiceBiopsyExcel 2007DeficiencySignificant changes
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 therapyA Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer
Moran MS, Ma S, Jagsi R, Yang TJ, Higgins SA, Weidhaas JB, Wilson LD, Lloyd S, Peschel R, Gaudreau B, Rockwell S. A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer. International Journal Of Radiation Oncology • Biology • Physics 2012, 85: 40-46. PMID: 22658441, DOI: 10.1016/j.ijrobp.2012.03.025.Peer-Reviewed Original ResearchConceptsBreast cancer patientsAlternative medicine utilizationCancer patientsBreast cancerCAM practicesDefinitive radiationCAM usersMedicine utilizationBreast patientsFirst prospective studyRadiation therapy useMulti-institutional studyOral CAMYounger patientsTherapy useCAM useStudy cohortCAM usageMulticenter studyProspective studyCAM utilizationStage 0Radiation therapyPatientsMultivariate analysis
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 guidelinesRaising the Bar for Breast Health Care in the United States
Moran MS, Knobf MT. Raising the Bar for Breast Health Care in the United States. Women's Health Issues 2011, 22: e129-e133. PMID: 22037415, DOI: 10.1016/j.whi.2011.08.011.Peer-Reviewed Original Research