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

General Surgery Resident, Surgery

University of Virginia School of Medicine

Breast Surgical Oncology Fellow, Surgery

Memorial Sloan-Kettering Cancer Center

Publications:

Variable Practice Patterns in a Contemporary Multi-institutional Cohort of 550 Cases of Phyllodes Tumors (2007-2017) Demonstrate a Need for More Individualized Margin Guidelines

Authors
Rosenberger, L; Thomas, S; Nimbkar, S; Hieken, T; Ludwig, K; Jacobs, L; Miller, M; Gallagher, K; Wong, J; Neuman, H; Tseng, J; Hassinger, T; Jakub, J
MLA Citation
URI
https://scholars.duke.edu/individual/pub1475877
Source
wos-lite
Published In
Annals of Surgical Oncology
Volume
27
Published Date
Start Page
S492
End Page
S493

Contemporary Multi-Institutional Cohort of 550 Cases of Phyllodes Tumors (2007-2017) Demonstrates a Need for More Individualized Margin Guidelines.

PURPOSE: Phyllodes tumors (PTs) are rare breast neoplasms, which have little granular data on margins. Current guidelines recommend ≥ 1 cm margins; however, recent data suggest narrower margins are sufficient, and for benign PT, a negative margin may not be necessary. METHODS: We performed an 11-institution contemporary (2007-2017) review of PT practices. Demographics, surgical, and histopathologic data were captured. Logistic regression was used to estimate the association of select covariates with local recurrence (LR). RESULTS: Of 550 PT patients, the majority underwent excisional biopsy (55.3%, n = 302/546) or lumpectomy (wide excision) (38.5%, n = 210/546). Median tumor size was 30 mm, 68.9% (n = 379) were benign, 19.6% (n = 108) borderline, and 10.5% (n = 58) malignant. Surgical margins were positive in 42% (n = 231) and negative in 57.3% (n = 311). A second operation was performed in 38.0% (n = 209) of the total cohort, including 51 patients with an initial negative margin (82.4% with < 2 mm), and 157 with an initial positive margin, with residual disease only found in six (2.9%). Notably, 32.0% (n = 74) of those with an initial positive margin did not undergo a second operation, among whom only 2.7% (n = 2) recurred. Recurrence occurred in 3.3% (n = 18) of the total cohort (n = 15 LR, n = 3 distant), at median follow-up of 36.7 months. LR (all PT grades) was not reduced with wider negative margin width (≥ 2 mm v < 2 mm: odds ratio [OR] = 0.39; 95% CI, 0.07 to 2.10; P = .27) or final margin status (positive v negative: OR = 0.96; 95% CI, 0.26 to 3.52; P = .96). CONCLUSION: In current practice, many patients are managed outside of current guidelines. For the entire cohort, a wider margin width was not associated with a reduced risk of LR. We do not recommend re-excision of a negative margin for benign PT, regardless of margin width, as a progressively wider surgical margin is unlikely to reduce LR.
Authors
Rosenberger, LH; Thomas, SM; Nimbkar, SN; Hieken, TJ; Ludwig, KK; Jacobs, LK; Miller, ME; Gallagher, KK; Wong, J; Neuman, HB; Tseng, J; Hassinger, TE; King, TA; Jakub, JW
MLA Citation
Rosenberger, Laura H., et al. “Contemporary Multi-Institutional Cohort of 550 Cases of Phyllodes Tumors (2007-2017) Demonstrates a Need for More Individualized Margin Guidelines.J Clin Oncol, vol. 39, no. 3, Jan. 2021, pp. 178–89. Pubmed, doi:10.1200/JCO.20.02647.
URI
https://scholars.duke.edu/individual/pub1468623
PMID
33301374
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
39
Published Date
Start Page
178
End Page
189
DOI
10.1200/JCO.20.02647

Isolated liver metastasis from a malignant phyllodes presenting with hemoperitoneum.

Authors
Miller, KN; McGuire, EL; Yon, JR; Sutherland, JD; Meyer, MA; Rosenberger, LH
MLA Citation
Miller, Krislyn N., et al. “Isolated liver metastasis from a malignant phyllodes presenting with hemoperitoneum.Breast J, vol. 26, no. 11, Nov. 2020, pp. 2246–47. Pubmed, doi:10.1111/tbj.14076.
URI
https://scholars.duke.edu/individual/pub1463398
PMID
33051939
Source
pubmed
Published In
Breast J
Volume
26
Published Date
Start Page
2246
End Page
2247
DOI
10.1111/tbj.14076

The Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In Situ in Patients with Intraductal Papilloma without Atypia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 034).

BACKGROUND: Available retrospective data suggest the upgrade rate for intraductal papilloma (IP) without atypia on core biopsy (CB) ranges from 0 to 12%, leading to variation in recommendations. We conducted a prospective multi-institutional trial (TBCRC 034) to determine the upgrade rate to invasive cancer (IC) or ductal carcinoma in situ (DCIS) at excision for asymptomatic IP without atypia on CB. METHODS: Prospectively identified patients with a CB diagnosis of IP who had consented to excision were included. Discordant cases, including BI-RADS > 4, and those with additional lesions requiring excision were excluded. The primary endpoint was upgrade to IC or DCIS by local pathology review with a predefined rule that an upgrade rate of ≤ 3% would not warrant routine excision. Sample size and confidence intervals were based on exact binomial calculations. Secondary endpoints included diagnostic concordance for IP between local and central pathology review and upgrade rates by central pathology review. RESULTS: The trial included116 patients (median age 56 years, range 24-82) and the most common imaging abnormality was a mass (n = 91, 78%). Per local review, 2 (1.7%) cases were upgraded to DCIS. In both of these cases central pathology review did not confirm DCIS on excision. Additionally, central pathology review confirmed IP without atypia in core biopsies of 85/116 cases (73%), and both locally upgraded cases were among them. CONCLUSION: In this prospective study of 116 IPs without atypia on CB, the upgrade rate was 1.7% by local review, suggesting that routine excision is not indicated for IP without atypia on CB with concordant imaging findings.
Authors
Nakhlis, F; Baker, GM; Pilewskie, M; Gelman, R; Calvillo, KZ; Ludwig, K; McAuliffe, PF; Willey, S; Rosenberger, LH; Parker, C; Gallagher, K; Jacobs, L; Feldman, S; Lange, P; DeSantis, SD; Schnitt, SJ; King, TA
URI
https://scholars.duke.edu/individual/pub1462551
PMID
33047246
Source
pubmed
Published In
Annals of Surgical Oncology
Published Date
DOI
10.1245/s10434-020-09215-w

Radiofrequency Identification Tracking for Tray Optimization: An Instrument Use Pilot Study in Breast Surgical Oncology

Authors
Olivere, LA; Hill, I; Thomas, SM; Codd, PJ; Rosenberger, LH
MLA Citation
Olivere, Lindsey A., et al. “Radiofrequency Identification Tracking for Tray Optimization: An Instrument Use Pilot Study in Breast Surgical Oncology.” Journal of the American College of Surgeons, vol. 231, no. 4, 2020, pp. S147–S147.
URI
https://scholars.duke.edu/individual/pub1468278
Source
wos-lite
Published In
Journal of the American College of Surgeons
Volume
231
Published Date
Start Page
S147
End Page
S147