Laura Rosenberger

Positions:

Associate Professor of Surgery

Surgical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 2003

Eastern Mennonite University

M.D. 2008

Thomas Jefferson University, Sidney Kimmel Medical College

M.S. 2011

University of Virginia

General Surgery Resident, Surgery

University of Virginia School of Medicine

Breast Surgical Oncology Fellow, Surgery

Memorial Sloan-Kettering Cancer Center

Publications:

Racial-ethnic variations in phyllodes tumors among a multicenter United States cohort.

BACKGROUND AND OBJECTIVES: Previous studies have identified racial-ethnic differences in the diagnostic patterns and recurrence outcomes of women with phyllodes tumors (PT). However, these studies are generally limited in size and generalizability. We therefore sought to explore racial-ethnic differences in age, tumor size, subtype, and recurrence in a large US cohort of women with PT. METHODS: We performed an 11-institution retrospective review of women with PT from 2007 to 2017. Differences in age at diagnosis, tumor size and subtype, and recurrence-free survival according to race-ethnicity. RESULTS: Women of non-White race or Hispanic ethnicity were younger at the time of diagnosis with phyllodes tumor. Non-Hispanic Other women had a larger proportion of malignant PT. There were no differences in recurrence-free survival in our cohort. CONCLUSIONS: Differences in age, tumor size, and subtype were small. Therefore, the workup of young women with breast masses and the treatment of women with PT should not differ according to race-ethnicity. These conclusions are supported by our finding that there were no differences in recurrence-free survival.
Authors
Nash, AL; Thomas, SM; Nimbkar, SN; Hieken, TJ; Ludwig, KK; Jacobs, LK; Miller, ME; Gallagher, KK; Wong, J; Neuman, HB; Tseng, J; Hassinger, TE; King, TA; Hwang, ES; Jakub, JW; Rosenberger, LH
MLA Citation
Nash, Amanda L., et al. “Racial-ethnic variations in phyllodes tumors among a multicenter United States cohort.J Surg Oncol, Oct. 2022. Pubmed, doi:10.1002/jso.27117.
URI
https://scholars.duke.edu/individual/pub1553526
PMID
36206024
Source
pubmed
Published In
J Surg Oncol
Published Date
DOI
10.1002/jso.27117

ASO Visual Abstract: The Influence of BMI on the Histopathology and Outcomes of Patients with a Diagnosis of Atypical Breast Lesions.

Authors
Miller, KN; Thomas, SM; Sergesketter, AR; Rosenberger, LH; DiLalla, G; van den Bruele, AB; Hwang, ES; Plichta, JK
MLA Citation
Miller, Krislyn N., et al. “ASO Visual Abstract: The Influence of BMI on the Histopathology and Outcomes of Patients with a Diagnosis of Atypical Breast Lesions.Ann Surg Oncol, vol. 29, no. 10, Oct. 2022, p. 6495. Pubmed, doi:10.1245/s10434-022-12445-9.
URI
https://scholars.duke.edu/individual/pub1533583
PMID
36002701
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
29
Published Date
Start Page
6495
DOI
10.1245/s10434-022-12445-9

ASO Visual Abstract: Margin Management and Adjuvant Therapy for Phyllodes Tumors-Practice Patterns of the American Society of Breast Surgeons Members.

Authors
Diego, EJ; Rosenberger, LH; Deng, X; McGuire, KP
MLA Citation
Diego, Emilia J., et al. “ASO Visual Abstract: Margin Management and Adjuvant Therapy for Phyllodes Tumors-Practice Patterns of the American Society of Breast Surgeons Members.Ann Surg Oncol, vol. 29, no. 10, Oct. 2022, p. 6162. Pubmed, doi:10.1245/s10434-022-12232-6.
URI
https://scholars.duke.edu/individual/pub1553179
PMID
35917010
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
29
Published Date
Start Page
6162
DOI
10.1245/s10434-022-12232-6

Does Angiosarcoma of the Breast Need Nodal Staging?

BACKGROUND: Breast angiosarcoma is a rare malignancy classically associated with hematogenous metastases. We sought to determine the prevalence of pathologic nodal involvement in patients with nonmetastatic, resected breast angiosarcoma and its association with overall survival. STUDY DESIGN: The National Cancer Database was used to identify patients with nonmetastatic angiosarcoma of the breast who underwent surgical resection from 2004 to 2017. The prevalence of regional lymph node operation and nodal positivity was calculated. The Kaplan-Meier method was used to evaluate overall survival among node-positive and node-negative patients. Cox proportional hazard modeling was used to evaluate the adjusted association of nodal positivity with overall survival. RESULTS: We included 991 patients with angiosarcoma. The median age was 69 years (interquartile range 57 to 78), and the cohort was 99% female. A total of 298 patients (30%) had pathologic regional nodal evaluation. Of those, 15 (5.0%) had positive regional lymph nodes. Node-positive patients had significantly worse survival than patients with negative regional lymph nodes. After adjusting for patient, tumor, and treatment factors, a positive regional lymph node was associated with worse overall survival compared with patients with no nodal evaluation (hazard ratio 3.20; 95% CI 1.75 to 5.86; p < 0.001). CONCLUSIONS: Patients with nonmetastatic angiosarcoma of the breast have a 5% regional lymph node positivity rate, which is at a common threshold to consider evaluation, and identifies patients with poor survival. A prospective study to determine performance characteristics of sentinel lymph node biopsy is warranted.
Authors
Herb, J; Maduekwe, UN; Goel, N; Rosenberger, LH; Spanheimer, PM
MLA Citation
Herb, Joshua, et al. “Does Angiosarcoma of the Breast Need Nodal Staging?J Am Coll Surg, vol. 234, no. 5, May 2022, pp. 774–82. Pubmed, doi:10.1097/XCS.0000000000000131.
URI
https://scholars.duke.edu/individual/pub1519413
PMID
35426390
Source
pubmed
Published In
J Am Coll Surg
Volume
234
Published Date
Start Page
774
End Page
782
DOI
10.1097/XCS.0000000000000131

Measuring intraoperative surgical instrument use with radio-frequency identification.

OBJECTIVE: Surgical instrument oversupply drives cost, confusion, and workload in the operating room. With an estimated 78%-87% of instruments being unused, many health systems have recognized the need for supply refinement. By manually recording instrument use and tasking surgeons to review instrument trays, previous quality improvement initiatives have achieved an average 52% reduction in supply. While demonstrating the degree of instrument oversupply, previous methods for identifying required instruments are qualitative, expensive, lack scalability and sustainability, and are prone to human error. In this work, we aim to develop and evaluate an automated system for measuring surgical instrument use. MATERIALS AND METHODS: We present the first system to our knowledge that automates the collection of real-time instrument use data with radio-frequency identification (RFID). Over 15 breast surgeries, 10 carpometacarpal (CMC) arthroplasties, and 4 craniotomies, instrument use was tracked by both a trained observer manually recording instrument use and the RFID system. RESULTS: The average Cohen's Kappa agreement between the system and the observer was 0.81 (near perfect agreement), and the system enabled a supply reduction of 50.8% in breast and orthopedic surgery. Over 10 monitored breast surgeries and 1 CMC arthroplasty with reduced trays, no eliminated instruments were requested, and both trays continue to be used as the supplied standard. Setup time in breast surgery decreased from 23 min to 17 min with the reduced supply. CONCLUSION: The RFID system presented herein achieves a novel data stream that enables accurate instrument supply optimization.
Authors
Hill, I; Olivere, L; Helmkamp, J; Le, E; Hill, W; Wahlstedt, J; Khoury, P; Gloria, J; Richard, MJ; Rosenberger, LH; Codd, PJ
MLA Citation
Hill, Ian, et al. “Measuring intraoperative surgical instrument use with radio-frequency identification.Jamia Open, vol. 5, no. 1, Apr. 2022, p. ooac003. Pubmed, doi:10.1093/jamiaopen/ooac003.
URI
https://scholars.duke.edu/individual/pub1509896
PMID
35156004
Source
pubmed
Published In
Jamia Open
Volume
5
Published Date
Start Page
ooac003
DOI
10.1093/jamiaopen/ooac003