Anne Rosenberg | |
---|---|
Born | |
Alma mater | Goucher College (B.A.) Thomas Jefferson University (M.D.) |
Years active | 1981-2015 |
Title | Oncologist |
Anne Louise Rosenberg is an American surgical oncologist retired from practice in Cherry Hill, New Jersey. [1]
Rosenberg's career in medicine began in 1981, after graduating from Goucher College in Towson, Maryland and then attending medical school at Thomas Jefferson University, graduating with honors. She then completed surgical training at Thomas Jefferson University Hospital. She is board certified in Surgery by the American Board of Surgery.
Rosenberg is a clinical professor in surgery at Jefferson Medical College and was named Top Doctor by Philadelphia Magazine, [2] SJ Magazine, [3] and South Jersey Magazine [4] along with being featured in “A Day in the Life of the American Woman”. [5] Rosenberg has been published in numerous publications and scholarly journals including South Jersey Senior Magazine, [6] Journal of Ultrasound in Medicine, [7] The American Journal of Surgery, [8] International Seminars in Surgical Oncology, and Korean Nuclear Medicine Journal. [9]
In the early 1980s, Rosenberg's early clinical research efforts were focused on validating the use of mammographic location of non-palpable breast lesions. Previously, there was no directed biopsy method for these abnormalities. These studies allowed histologic and radiographic findings to be correlated, and this laid the foundation for the development of the BIRADS classification for mammographic findings. [10] [11] [12]
Rosenberg, along with ultrasonographers, developed techniques for pre- and intraoperative ultrasound lesion localization with post excision evaluation of the tumor bed for confirmation of excision. These techniques were nearly 100% accurate with adequate lesion removal. [13] This work added ultrasound localization to the biopsy and lumpectomy procedures. [14]
Based on the use of radiographic localization and acceptance of breast conservation therapy for breast cancer, Gordon Schwartz and Rosenberg described the management of the early-stage breast cancers, focusing on breast conservation. They also reported on the experience with lumpectomy, level 1 axillary node dissection followed by breast radiation (breast conservation) for the treatment of operable breast cancer (stage 1 and 2 disease). This work validated the effectiveness of breast conservation as an equivalent to mastectomy with regard to distant disease and local control and substantiated the need for radiation therapy and complete excision of the primary and established the acceptance of breast conservation therapy for breast cancer. [15] [16]
Elderly women with breast cancer were reviewed and, although it was standard of care to perform mastectomy, Rosenberg's work, along with others at Jefferson University Hospital, confirmed that elderly women could be effectively treated with breast conservation and should be offered all surgical options, as the new standard of care. [17] [18]
Introduction of neo-adjuvant chemotherapy also changes the standard of care for a more advanced stage, but localized breast cancers as 80% of women had a response to chemotherapy. The studies helped establish the length of neo-adjuvant chemotherapy needed and the increase in survival and disease-free survival when compared to women who did not receive neo-adjuvant chemotherapy. Disease-free survival improved three to four-fold and neo-adjuvant became the standard of care for a patient with larger tumors and nodal disease but no distant metastases.
In collaboration with Carl Mansfield, she reported on ten-year experience with interstitial implants in the breast to deliver the boost dose. This work changed the delivery of breast radiation by showing the complications from excessive boost radiation and also the reduced tumor recurrence when radiation was used. Interstitial implants were effective as method to deliver boost [19] and offered an abbreviated time frame to do so. [20]
In 1995, What to do if you get breast cancer was co-authored by Rosenberg with Marion Betancourt and Lydia Komarnicky, which promoted a new approach to disseminating information about diagnosis and management to patients. [21]
As a member of a cooperative group to validate the use of sentinel node biopsy for staging breast cancer, Dr. Rosenberg contributed to the study which changed the surgical management of the axilla for staging and treatment of breast cancer. [22] [23] [24] [25]
In 2006, Rosenberg reported on and discussed the management of women with a history of breast augmentation who developed breast cancer. The conclusions were that treatment was to be individualized based upon the breast size and tumor location but both breast conservation and mastectomy were associated with similar survival, disease-free interval, and local recurrence. Breast conservation was a viable option to be offered to these women. [26] [27]
Rosenberg popularized the use of brachytherapy devices (SAVI, mammosite) for local breast radiation for favorable breast cancers and she taught other surgeons the technique. [28]
Beginning in the mid-1990s, Rosenberg began to collect blood and surgical specimens of normal breast tissue, benign tumors, and malignant tumors. Evaluation of this tissue led to several observations that were important in understanding the biological behavior of malignancies. Croce and Rosenberg reported there was a loss of heterozygosity at 11q22-q23 in breast tumors. [29]
Collaborations with Croce were focused on microRNA expression and allowed the patterns of expression to be identified for target genes for tumors and by profiling the expression. These reproducible patterns of microRNA expression allowed for target tumor gene profiling, including male breast cancer. [30] [31] [32]
In collaboration with Hallguir Rui, they were the first to isolate a prolactin receptor-associated tyrosine kinase, and to identify this molecule as Janus kinase-2. These human tissue lines in a prolactin deficient mouse model allowed the definition of signal transduction by cytokine receptors and hormones with a primary goal of understanding the role of downstream JAK-STAT pathways and their aberrations in breast cancer. Together, they also demonstrated that the loss of Stat5 in estrogen-receptor-positive breast cancer is associated with increased risk of antiestrogen resistance and laid the groundwork for the patented matrix assembly technology for generation of high-density tumor tissue arrays for high-through-put molecular profiling. [33] [34] [35]
Rosenberg also has a working horse farm on 50 acres (20 ha) in Mount Laurel, New Jersey. [36] [37] and is involved in women's initiatives and breast cancer awareness, clinical research trials, as well as numerous scientific presentations. She is also active with the Alliance of Therapy Dogs, American Kennel club Club and Crisis Response Canines. [38]
She was recognized with a Community Service Award by the 101 Women Plus organization. [39]
Radiation therapy or radiotherapy is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body, and have not spread to other parts. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor. Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology. A physician who practices in this subspecialty is a radiation oncologist.
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operation as a preventive measure. Alternatively, some women can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy.
Brachytherapy is a form of radiation therapy where a sealed radiation source is placed inside or next to the area requiring treatment. Brachy is Greek for short. Brachytherapy is commonly used as an effective treatment for cervical, prostate, breast, esophageal and skin cancer and can also be used to treat tumours in many other body sites. Treatment results have demonstrated that the cancer-cure rates of brachytherapy are either comparable to surgery and external beam radiotherapy (EBRT) or are improved when used in combination with these techniques. Brachytherapy can be used alone or in combination with other therapies such as surgery, EBRT and chemotherapy.
A bone tumor is an abnormal growth of tissue in bone, traditionally classified as noncancerous (benign) or cancerous (malignant). Cancerous bone tumors usually originate from a cancer in another part of the body such as from lung, breast, thyroid, kidney and prostate. There may be a lump, pain, or neurological signs from pressure. A bone tumor might present with a pathologic fracture. Other symptoms may include fatigue, fever, weight loss, anemia and nausea. Sometimes there are no symptoms and the tumour is found when investigating another problem.
A biopsy is a medical test commonly performed by a surgeon, an interventional radiologist, or an interventional cardiologist. The process involves the extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is then fixed, dehydrated, embedded, sectioned, stained and mounted before it is generally examined under a microscope by a pathologist; it may also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous or inflammatory conditions.
Basal-cell carcinoma (BCC), also known as basal-cell cancer, basalioma or rodent ulcer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raised area with ulceration. Basal-cell cancer grows slowly and can damage the tissue around it, but it is unlikely to spread to distant areas or result in death.
Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye. In women, melanomas most commonly occur on the legs; while in men, on the back. Melanoma is frequently referred to as malignant melanoma. However, the medical community stresses that there is no such thing as a 'benign melanoma' and recommends that the term 'malignant melanoma' should be avoided as redundant.
Image-guided surgery (IGS) is any surgical procedure where the surgeon uses tracked surgical instruments in conjunction with preoperative or intraoperative images in order to directly or indirectly guide the procedure. Image guided surgery systems use cameras, ultrasonic, electromagnetic or a combination of fields to capture and relay the patient's anatomy and the surgeon's precise movements in relation to the patient, to computer monitors in the operating room or to augmented reality headsets. This is generally performed in real-time though there may be delays of seconds or minutes depending on the modality and application.
Lumpectomy is a surgical removal of a discrete portion or "lump" of breast tissue, usually in the treatment of a malignant tumor or breast cancer. It is considered a viable breast conservation therapy, as the amount of tissue removed is limited compared to a full-breast mastectomy, and thus may have physical and emotional advantages over more disfiguring treatment. Sometimes a lumpectomy may be used to either confirm or rule out that cancer has actually been detected. A lumpectomy is usually recommended to patients whose cancer has been detected early and who do not have enlarged tumors. Although a lumpectomy is used to allow for most of the breast to remain intact, the procedure may result in adverse affects that can include sensitivity and result in scar tissue, pain, and possible disfiguration of the breast if the lump taken out is significant. According to National Comprehensive Cancer Network guidelines, lumpectomy may be performed for ductal carcinoma in situ (DCIS), invasive ductal carcinoma, or other conditions.
The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasizing cancer cells from the tumor.
Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast. DCIS is classified as Stage 0. It rarely produces symptoms or a breast lump that can be felt, typically being detected through screening mammography. It has been diagnosed in a significant percentage of men.
Intraoperative radiation therapy (IORT) is radiation therapy that is administered during surgery directly in the operating room.
Intraoperative electron radiation therapy is the application of electron radiation directly to the residual tumor or tumor bed during cancer surgery. Electron beams are useful for intraoperative radiation treatment because, depending on the electron energy, the dose falls off rapidly behind the target site, therefore sparing underlying healthy tissue.
Breast cancer management takes different approaches depending on physical and biological characteristics of the disease, as well as the age, over-all health and personal preferences of the patient. Treatment types can be classified into local therapy and systemic treatment. Local therapy is most efficacious in early stage breast cancer, while systemic therapy is generally justified in advanced and metastatic disease, or in diseases with specific phenotypes.
Breast-conserving surgery refers to an operation that aims to remove breast cancer while avoiding a mastectomy. Different forms of this operation include: lumpectomy (tylectomy), wide local excision, segmental resection, and quadrantectomy. Breast-conserving surgery has been increasingly accepted as an alternative to mastectomy in specific patients, as it provides tumor removal while maintaining an acceptable cosmetic outcome. This page reviews the history of this operation, important considerations in decision making and patient selection, and the emerging field of oncoplastic breast conservation surgery.
Salivary gland tumours, also known as mucous gland adenomas or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800 to 1000 small mucus-secreting glands located throughout the lining of the oral cavity. Patients with these types of tumours may be asymptomatic.
Targeted intra-operative radiotherapy, also known as targeted IORT, is a technique of giving radiotherapy to the tissues surrounding a cancer after its surgical removal, a form of intraoperative radiation therapy. The technique was designed in 1998 at the University College London.
The abscopal effect is a hypothesis in the treatment of metastatic cancer whereby shrinkage of untreated tumors occurs concurrently with shrinkage of tumors within the scope of the localized treatment. R.H. Mole proposed the term “abscopal” in 1953 to refer to effects of ionizing radiation “at a distance from the irradiated volume but within the same organism.”
Breast hematoma is a collection of blood within the breast. It arises from internal bleeding (hemorrhage) and may arise due to trauma or due to a non-traumatic cause.
In medicine, breast imaging is a sub-speciality of diagnostic radiology that involves imaging of the breasts for screening or diagnostic purposes. There are various methods of breast imaging using a variety of technologies as described in detail below. Traditional screening and diagnostic mammography uses x-ray technology and has been the mainstay of breast imaging for many decades. Breast tomosynthesis is a relatively new digital x-ray mammography technique that produces multiple image slices of the breast similar to, but distinct from, computed tomography (CT). Xeromammography and galactography are somewhat outdated technologies that also use x-ray technology and are now used infrequently in the detection of breast cancer. Breast ultrasound is another technology employed in diagnosis and screening that can help differentiate between fluid filled and solid lesions, an important factor to determine if a lesion may be cancerous. Breast MRI is a technology typically reserved for high-risk patients and patients recently diagnosed with breast cancer. Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.