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
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 therapyACR 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 stainingBreast 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 assessment
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® 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 proceduresBreast cancers in U.S. residing Indian-Pakistani versus non-Hispanic White women: comparative analysis of clinical-pathologic features, treatment, and survival
Moran MS, Gonsalves L, Goss DM, Ma S. Breast cancers in U.S. residing Indian-Pakistani versus non-Hispanic White women: comparative analysis of clinical-pathologic features, treatment, and survival. Breast Cancer Research And Treatment 2011, 128: 543-551. PMID: 21301957, PMCID: PMC3235412, DOI: 10.1007/s10549-011-1362-0.Peer-Reviewed Original ResearchConceptsBreast conservation surgeryAge-adjusted incidenceBreast cancerAdjuvant radiationNHW womenInvasive diseaseHormone receptor-negative diseaseFemale breast cancer patientsNon-Hispanic white womenPost-mastectomy RTRates of breastClinical-pathologic featuresInvolved lymph nodesPercentage of patientsReceptor-negative diseasePost-mastectomy radiationBreast cancer mortalityBreast cancer patientsLarger tumor sizeYounger median ageRelative survival ratesSignificant differencesMultivariate regression analysisSEER databaseLymph nodes
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 VEGFDuctal Carcinoma In Situ With Microinvasion: Prognostic Implications, Long-Term Outcomes, and Role of Axillary Evaluation
Parikh RR, Haffty BG, Lannin D, Moran MS. Ductal Carcinoma In Situ With Microinvasion: Prognostic Implications, Long-Term Outcomes, and Role of Axillary Evaluation. International Journal Of Radiation Oncology • Biology • Physics 2010, 82: 7-13. PMID: 20950955, DOI: 10.1016/j.ijrobp.2010.08.027.Peer-Reviewed Original ResearchConceptsDistant relapse-free survivalLocal-regional relapseClinical-pathologic featuresRelapse-free survivalBreast conservation therapyLong-term outcomesOverall survivalAxillary evaluationAxillary metastasesIndependent predictorsDuctal carcinomaCox proportional hazards analysisPresence of microinvasionSurgical axillary evaluationAdjuvant hormonal therapyProportional hazards analysisHormonal therapyAggressive treatmentDistant failureMargin statusSurgical evaluationConservation therapyPrognostic implicationsMean ageUnivariate analysis
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 ResearchConceptsBreast 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
1998
Lobular carcinoma in situ as a component of breast cancer: The long-term outcome in patients treated with breast-conservation therapy
Moran M, Haffty B. Lobular carcinoma in situ as a component of breast cancer: The long-term outcome in patients treated with breast-conservation therapy. International Journal Of Radiation Oncology • Biology • Physics 1998, 40: 353-358. PMID: 9457821, DOI: 10.1016/s0360-3016(97)00573-7.Peer-Reviewed Original ResearchConceptsPercentage of patientsBreast cancer patientsLong-term outcomesConservative surgeryControl groupRadiation therapyHistologic componentsPrimary histologyLobular carcinomaCancer patientsBreast cancerComparable local control ratesDistant disease-free survivalTumor recurrence-free survivalDisease-free survivalLocal control rateRecurrence-free survivalAge of presentationBreast conservation therapyEstrogen receptor statusSignificant differencesReexcision specimenResidual LCISAdjuvant therapyBilateral disease