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Lumarie Santiago

Bio: Lumarie Santiago is an academic researcher from University of Texas MD Anderson Cancer Center. The author has contributed to research in topics: Breast cancer & Medicine. The author has an hindex of 14, co-authored 47 publications receiving 1125 citations.


Papers
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Journal ArticleDOI
TL;DR: Marking nodes with biopsy-confirmed metastatic disease allows for selective removal and improves pathologic evaluation for residual nodal disease after chemotherapy, as determined in patients undergoing complete axillary lymphadenectomy.
Abstract: PurposePlacing clips in nodes with biopsy-confirmed metastasis before initiating neoadjuvant therapy allows for evaluation of response in breast cancer. Our goal was to determine if pathologic changes in clipped nodes reflect the status of the nodal basin and if targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of clipped nodes, improves the false-negative rate (FNR) compared with SLND alone.MethodsA prospective study of patients with biopsy-confirmed nodal metastases with a clip placed in the sampled node was performed. After neoadjuvant therapy, patients underwent axillary surgery and the pathology of the clipped node was compared with other nodes. Patients undergoing TAD had SLND and selective removal of the clipped node using iodine-125 seed localization. The FNR was determined in patients undergoing complete axillary lymphadenectomy (ALND).ResultsOf 208 patients enrolled in this study, 191 underwent ALND, with residual dise...

584 citations

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TL;DR: The changes made to the BI-RADS® atlas 5th edition by comparison with its predecessor are highlighted to provide a useful resource for a radiologist attempting to review the recent changes to the new edition, and serve as a quick reference to those who have previously become familiar with the material.
Abstract: The Breast Imaging Reporting and Data System (BI-RADS®) is a standardized system of reporting breast pathology as seen on mammogram, ultrasound, and magnetic resonance imaging. It encourages consistency between reports and facilitates clear communication between the radiologist and other physicians by providing a lexicon of descriptors, a reporting structure that relates assessment categories to management recommendations, and a framework for data collection and auditing. This article highlights the changes made to the BI-RADS® atlas 5th edition by comparison with its predecessor, provide a useful resource for a radiologist attempting to review the recent changes to the new edition, and serve as a quick reference to those who have previously become familiar with the material.

206 citations

Journal ArticleDOI
21 Nov 2018
TL;DR: Recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D print, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
Abstract: Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.

185 citations

Journal ArticleDOI
TL;DR: A prospective clinical trial has commenced in which breast surgery is omitted in patients with a breast pCR after NST according to image-guided biopsy, suggesting that surgery might be avoided in some patients.
Abstract: Objective:To determine the accuracy of fine-needle aspiration (FNA) and vacuum-assisted core biopsy (VACB) in assessing the presence of residual cancer in the breast after neoadjuvant systemic therapy (NST)Summary Background Data:Pathologic complete response (pCR) rates after NST have improved dram

133 citations

Journal ArticleDOI
TL;DR: Acute and chronic inflammation, physiologic lactation, and benign breast masses, including silicone granuloma, fat necrosis, fibroadenoma, and postsurgical changes, may show increased FDG uptake on PET/CT.
Abstract: OBJECTIVE. Incidental 18F-FDG-avid breast lesions are commonly encountered in patients with cancer who undergo staging PET/CT. This pictorial essay discusses breast lesions that show increased FDG activity, mimicking breast cancer, with biopsy-confirmed benign diagnosis. CONCLUSION. Acute and chronic inflammation, physiologic lactation, and benign breast masses, including silicone granuloma, fat necrosis, fibroadenoma, and postsurgical changes, may show increased FDG uptake on PET/CT. These conditions can often be differentiated from malignancy by correlative imaging, including mammography, sonography, or MRI.

116 citations


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Journal ArticleDOI
TL;DR: This work presents the results of a meta-analysis conducted at the 2016 European Oncology and Radiotherapy Guidelines Working Group (ESMO) workshop on breast cancer diagnosis and prognosis of women with atypical central giant cell granuloma (CGM) who have previously had surgery.

2,274 citations

Journal ArticleDOI
TL;DR: In this article, the authors compared approaches to determine TMB and identify the correlation between predicted neoantigen load and CD8 T cells, and found that TMB-H tumors exhibited a 39.8% ORR to ICB [95% confidence interval (CI) 34.9-44.8], which was significantly higher than that observed in low TMB (TMB-L) tumors.

441 citations

Journal ArticleDOI
TL;DR: Continuous RCB index was prognostic for long-term survival after neoadjuvant chemotherapy in all three phenotypic subsets of breast cancer and stratified prognostic risk overall, within each phenotypesic subset, and within yp-stage categories.
Abstract: PurposeTo determine the long-term prognosis in each phenotypic subset of breast cancer related to residual cancer burden (RCB) after neoadjuvant chemotherapy alone, or with concurrent human epidermal growth factor receptor 2 (HER2)–targeted treatment.MethodsWe conducted a pathologic review to measure the continuous RCB index (wherein pathologic complete response has RCB = 0; residual disease is categorized into three predefined classes of RCB index [RCB-I, RCB-II, and RCB-III]), and yp-stage of residual disease. Patients were prospectively observed for survival. Three patient cohorts received paclitaxel (T) followed by fluorouracil, doxorubicin, and cyclophosphamide (T/FAC): original development cohort (T/FAC-1), validation cohort (T/FAC-2), and independent validation cohort (T/FAC-3). Another validation cohort received FAC chemotherapy only, and a fifth cohort received concurrent trastuzumab (H) with sequential paclitaxel and fluorouracil, epirubicin, and cyclophosphamide (FEC; H+T/FEC). Phenotypic subse...

414 citations

18 Dec 2014
TL;DR: Triple-negative breast cancers affect younger, non-Hispanic black and Hispanic women in areas of low SES, and the tumors were diagnosed at later stage and were more aggressive, and these women had poorer survival regardless of stage.
Abstract: BACKGROUND Tumor markers are becoming increasingly important in breast cancer research because of their impact on prognosis, treatment, and survival, and because of their relation to breast cancer subtypes. The triple-negative phenotype is important because of its relation to the basal-like subtype of breast cancer. METHODS Using the population-based California Cancer Registry data, we identified women diagnosed with triple-negative breast cancer between 2010 and 2013. We examined differences between triple-negative breast cancers compared with other breast cancers in relation to age, race/ethnicity, socioeconomic status (SES), stage at diagnosis, tumor grade, and relative survival. RESULTS A total of 670 women were identified as having triple-negative breast cancer and were compared with the 4704 women with other breast cancers. Women with triple-negative breast cancers were significantly more likely to be under age 40 (odds ratio [OR], 1.53), and non-Hispanic black (OR, 1.77) or Hispanic (OR, 1.23). Regardless of stage at diagnosis, women with triple-negative breast cancers had poorer survival than those with other breast cancers, and non-Hispanic black women with late-stage triple-negative cancer had the poorest survival, with a 5-year relative survival of only 14%. CONCLUSIONS Triple-negative breast cancers affect younger, non-Hispanic black and Hispanic women in areas of low SES. The tumors were diagnosed at later stage and were more aggressive, and these women had poorer survival regardless of stage. In addition, non-Hispanic black women with late-stage triple-negative breast cancer had the poorest survival of any comparable group.

390 citations

Journal ArticleDOI
TL;DR: The evidence for the role of risk factors in breast cancer incidence and their inclusion in risk estimation tools are presented as a step towards precision prevention to specifically target those women at increased risk for appropriate risk-reducing interventions.
Abstract: Despite decades of laboratory, epidemiological and clinical research, breast cancer incidence continues to rise. Breast cancer remains the leading cancer-related cause of disease burden for women, affecting one in 20 globally and as many as one in eight in high-income countries. Reducing breast cancer incidence will likely require both a population-based approach of reducing exposure to modifiable risk factors and a precision-prevention approach of identifying women at increased risk and targeting them for specific interventions, such as risk-reducing medication. We already have the capacity to estimate an individual woman's breast cancer risk using validated risk assessment models, and the accuracy of these models is likely to continue to improve over time, particularly with inclusion of newer risk factors, such as polygenic risk and mammographic density. Evidence-based risk-reducing medications are cheap, widely available and recommended by professional health bodies; however, widespread implementation of these has proven challenging. The barriers to uptake of, and adherence to, current medications will need to be considered as we deepen our understanding of breast cancer initiation and begin developing and testing novel preventives.

308 citations