Scholars@Duke
Astrid Botty

Astrid Botty

Assistant Professor of Surgery
Surgical Oncology

Selected Publications

Utility of the Singapore recurrence nomogram in a US cohort with a higher proportion of borderline and malignant phyllodes tumours.

Journal Article J Clin Pathol · October 17, 2025 AIMS: For phyllodes tumours (PT), local and distant recurrence rates increase with higher grades and are difficult to predict. The Singapore nomogram has been used to predict recurrence events for PT. We aimed to test this nomogram for accuracy in a US coh ... Full text Link to item Cite

Surgical Considerations for Patients With de Novo Metastatic Breast Cancer Based on Prognostic Group.

Journal Article J Surg Res · October 9, 2025 INTRODUCTION: Advances in systemic therapy for de novo metastatic breast cancer (dnMBC) led to the development of a novel staging system (IVA-D), which stratifies patients into prognostic subgroups based on tumor characteristics and metastatic extent. Over ... Full text Link to item Cite

Neoadjuvant Chemotherapy is Not Associated with Improved Overall Survival in Metaplastic Breast Cancer Regardless of Tumor Subtype.

Journal Article Ann Surg Oncol · October 2025 INTRODUCTION: Metaplastic breast cancer (MpBC) is a rare breast cancer subtype historically less responsive to neoadjuvant chemotherapy (NAC), regardless of receptor status. Given increasing NAC administration in recent years, we analyzed contemporary trea ... Full text Link to item Cite

Contemporary Trends in Axillary Surgery for ER-Positive, HER2-Negative Breast Cancer Stratified by Neoadjuvant Endocrine Therapy, Neoadjuvant Chemotherapy, or Upfront Surgery.

Journal Article Ann Surg Oncol · September 23, 2025 BACKGROUND: De-escalation of axillary surgery for hormone receptor-positive breast cancer has gained traction, but guidelines for axillary management after neoadjuvant endocrine therapy (NET) remain ill-defined. METHODS: Female patients age ≥50 years with ... Full text Link to item Cite

Survival outcomes after pathologic complete response with neoadjuvant endocrine therapy vs. neoadjuvant chemotherapy: a retrospective national database study.

Journal Article Breast Cancer Res Treat · July 2025 BACKGROUND: Neoadjuvant therapies can result in pathologic complete response (pCR) in patients with breast cancer, which can be predictive of long-term outcomes. Patients with estrogen receptor positive (ER +) tumors may receive either neoadjuvant chemothe ... Full text Link to item Cite

High risk surveillance MRI may not be necessary in BRCA1/2 mutation carriers over 70 years old.

Journal Article Breast Cancer Res Treat · June 2025 BACKGROUND: The risk of developing breast cancer up to age 80 for women with BRCA1/2 mutations is approximately 69-72%. The risk estimates, however, become labile in the later years of life. Many older BRCA1/2 mutation carriers who have not developed breas ... Full text Link to item Cite

Commentary and Updates on the Management of Male Breast Cancer.

Journal Article Annals of surgical oncology · April 2025 Full text Cite

Risk Stratification for Sentinel Lymph Node Positivity in Older Women With Early-Stage Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2 Neu-Negative Invasive Breast Cancer.

Journal Article JCO Clin Cancer Inform · March 2025 PURPOSE: Guidelines recommend omission of sentinel lymph node biopsy (SLNB) for axillary staging in select patients age 70 years and older with early-stage estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 neu-negative (HER2-) inva ... Full text Link to item Cite

Surgical Perspectives on the Updated ASTRO Guideline on Partial Breast Irradiation for Breast Cancer.

Journal Article Ann Surg Oncol · September 2024 This is an executive summary of the most recent American Society for Radiation Oncology (ASTRO) guidelines on use of partial breast irradiation in early-stage breast cancer.In the conscientious pursuit of "right-sizing" the management of patients with earl ... Full text Link to item Cite

Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla.

Journal Article Am J Surg · July 2024 BACKGROUND: The predictive and prognostic value of the recurrence score (RS) has emphasized the importance of tumor biology and has reduced the prognostic implications of limited nodal burden in post-menopausal women with HR+/HER2-invasive breast cancer (I ... Full text Link to item Cite

Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.

Journal Article J Clin Oncol · May 10, 2024 PURPOSE: Black women have higher rates of death from triple-negative breast cancer (TNBC) than White women. We hypothesized that pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) and overall survival (OS) may vary by race/ethnicity in pa ... Full text Link to item Cite

Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks.

Journal Article Ann Surg Oncol · April 2024 Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits ... Full text Link to item Cite

Disparities in Demographics and Outcomes Based on Trauma Center Ownership.

Journal Article J Surg Res · May 2022 INTRODUCTION: Ownership may influence trauma center (TC) location. For-profit (FP) TCs require a favorable payor mix to thrive, whereas not-for-profit (NFP) centers may rely on government funding, grants, and patient volume. We hypothesized that the demogr ... Full text Link to item Cite

Does preoperative MRI accurately stratify early-stage HER2 + breast cancer patients to upfront surgery vs neoadjuvant chemotherapy?

Journal Article Breast Cancer Res Treat · September 2021 PURPOSE: HER2 +- amplified breast cancer patients derive benefit from treatment with anti-HER2-targeted therapy. Though adjuvant treatment is based on final pathology, decisions regarding neoadjuvant chemotherapy are made in the preoperative setting with i ... Full text Link to item Cite

Salvage of locally recurrent breast cancer with repeat breast conservation using 45 Gy hyperfractionated partial breast re-irradiation.

Journal Article Breast Cancer Res Treat · July 2021 PURPOSE: Mastectomy has long been the preferred approach for local salvage of recurrent breast cancer following breast-conservation therapy (BCT). Growing interest in avoiding mastectomy prompted RTOG 1014, a landmark phase two study demonstrating the feas ... Full text Link to item Cite

Axillary Downstaging in Occult Primary Breast Cancer After Neoadjuvant Chemotherapy.

Journal Article Ann Surg Oncol · February 2021 BACKGROUND: Neoadjuvant chemotherapy (NAC) is increasingly used for clinically node-positive (cN+) tumors with intact primary breast cancer (IPBC) to downstage the axilla, and those who convert to cN0 may be eligible for sentinel lymph node biopsy (SLNB). ... Full text Link to item Cite

Management of ipsilateral supernumerary nipple at time of breast cancer diagnosis.

Journal Article Breast J · October 2020 Supernumerary breast components occur predominantly between the breast and umbilicus. Carcinoma of this ectopic, or accessory breast tissue (ABT), is exceedingly rare, accounting for <1% of breast cancer cases. Historically, ectopic breast carcinoma was co ... Full text Link to item Cite

Elder Abuse

Journal Article Clinics in Geriatric Medicine · February 2019 Full text Cite

The Effect of Insurance and Race on Breast Cancer Tumor Biology and Short-Term Outcomes

Journal Article The American Surgeon™ · July 2018 To determine whether low-income status as demonstrated by insurance type has any association with aggressive tumor biology and breast cancer outcomes. Retrospective review of 535 women with new diagnosis of breast cancer from January 2009 to March ... Full text Cite

Local Recurrence, the Augmented Breast, and the Contralateral Breast

Chapter · September 1, 2017 The book chapter addresses the complex multidisciplinary management of lororegional recurrence (LRR), breast cancer in the augmented breast and breast cancer risk in the contralateral breast ... Cite

Sound preconditioning therapy inhibits ototoxic hearing loss in mice

Journal Article Journal of Clinical Investigation · November 1, 2013 Therapeutic drugs with ototoxic side effects cause significant hearing loss for thousands of patients annually. Two major classes of ototoxic drugs are cisplatin and the aminoglycoside antibiotics, both of which are toxic to mechanosensory hair cells, the ... Full text Cite