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https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#1
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049205/using-a-novel-t-lymph-node-ratio-model-to-evaluate-the-prognosis-of-nonmetastatic-breast-cancer-patients-who-received-preoperative-radiotherapy-followed-by-mastectomy-an-observational-study
#2
Yang Wang, Yuanyuan Zhao, Song Liu, Weifang Tang, Hong Gao, Xucai Zheng, Shikai Hong, Shengying Wang
We aimed to investigate the prognostic value of postpathological characters in nonmetastatic breast cancer (NMBC) patients who received preoperative radiotherapy (PRT) followed by mastectomy (MAST).We conducted retrospective analyses using the data collected from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute. Univariate and multivariate analyses were performed to identify prognostic factors. Disease-specific survival was calculated by the Kaplan-Meier curve and validated by log rank test...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29048329/measurement-and-modeling-of-out-of-field-doses-from-various-advanced-post-mastectomy-radiotherapy-techniques
#3
Jihyung Yoon, David Heins, Xiaodong Zhao, Mary Sanders, Rui Zhang
More and more advanced radiotherapy techniques have been adopted for post-mastectomy radiotherapies (PMRT). Patient dose reconstruction is challenging for these advanced techniques because they increase the low out-of-field dose area while the accuracy of out-of-field dose calculations by current commercial treatment planning systems (TPSs) is poor. We aim to measure and model the out-of-field radiation doses from various advanced PMRT techniques. PMRT treatment plans for an anthropomorphic phantom were generated, including volumetric modulated arc therapy (VMAT) with standard and flattening-filter-free (FFF) photon beams, mixed beam therapy, 4-field intensity modulated radiation therapy (IMRT), and Tomotherapy...
October 19, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29047418/primary-small-cell-carcinoma-of-the-breast-a-case-report
#4
Iman Abou Dalle, Jaber Abbas, Fouad Boulos, Ziad Salem, Hazem I Assi
BACKGROUND: Neuroendocrine breast cancer is a rare entity that was defined in 2003 by the World Health Organization as a separate breast cancer subtype. The diagnosis of neuroendocrine breast cancer requires the presence of neuroendocrine features in at least 50% of malignant cells, the exclusion of non-mammary primary tumors, as well as the presence of an in situ component in breast histology. The treatment and prognosis of neuroendocrine breast cancer are still not well established...
October 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29044475/the-site-of-care-matters-an-examination-of-the-relationship-between-high-medicaid-burden-hospitals-and-the-use-cost-and-complications-of-immediate-breast-reconstruction-after-mastectomy
#5
Anaeze C Offodile, L Daniel Muldoon, Faiz Gani, Joseph K Canner, Lisa K Jacobs
BACKGROUND: Diminished use and worse outcomes after immediate breast reconstruction (IBR) have been documented for Medicaid beneficiaries. However, to the authors' knowledge, the contribution of patient clustering at hospitals with a high percentage of Medicaid patients to these inequalities in IBR delivery is unknown. METHODS: A cross-sectional analysis of patients undergoing IBR after mastectomy using the 2007 to 2011 Nationwide Inpatient Sample database was performed...
October 17, 2017: Cancer
https://www.readbyqxmd.com/read/29043480/body-mass-index-bmi-postoperative-appearance-satisfaction-and-sexual-function-in-breast-cancer-survivorship
#6
K E Rojas, N Matthews, C Raker, M A Clark, M Onstad, A Stuckey, J Gass
PURPOSE: We sought to explore the correlation between BMI and postoperative sexual function, body image, and breast-specific sensuality before and after breast cancer surgery. METHODS: A cross-sectional survey of patients at least 1 year from surgery employed the Female Sexual Function Index (FSFI) and investigator-generated questions. Patients who underwent lumpectomy (L), mastectomy (M), and mastectomy with reconstruction (MR) were compared across three BMI groups: normal weight, overweight, and obese...
October 17, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29040349/female-to-male-gender-affirming-top-surgery-a-single-surgeon-s-15-year-retrospective-review-and-treatment-algorithm
#7
Giancarlo McEvenue, Fang Zhou Xu, Runting Cai, Hugh McLean
Background: Mastectomy, referred to here as "Top Surgery," is an important surgical step for female-to-male (FTM) transgender patients. The goal is to excise breast tissue and create a masculine chest contour. Despite the rising demand for Top Surgery, debate still exists regarding how to select the most appropriate surgical technique to optimize aesthetic outcomes safely. Objectives: To determine the safety profile and aesthetic outcome of one surgeon's 15-year FTM Top Surgery experience...
July 24, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29040037/influence-of-risk-category-and-screening-round-on-the-performance-of-an-mr-imaging-and-mammography-screening-program-in-carriers-of-the-brca-mutation-and-other-women-at-increased-risk
#8
Suzan Vreemann, Albert Gubern-Mérida, Margrethe S Schlooz-Vries, Peter Bult, Carla H van Gils, Nicoline Hoogerbrugge, Nico Karssemeijer, Ritse M Mann
Purpose To evaluate the real-life performance of a breast cancer screening program for women with different categories of increased breast cancer risk with multiple follow-up rounds in an academic hospital with a large screening population. Materials and Methods Screening examinations (magnetic resonance [MR] imaging and mammography) for women at increased breast cancer risk (January 1, 2003, to January 1, 2014) were evaluated. Risk category, age, recall for workup of screening-detected abnormalities, biopsy, and histopathologic diagnosis were recorded...
October 16, 2017: Radiology
https://www.readbyqxmd.com/read/29039136/cancer-risk-management-in-tasmanian-women-with-brca1-and-brca2-mutations
#9
Stephanie Kearton, Karen Wills, Michael Bunting, Penny Blomfield, Paul A James, Jo Burke
Women carrying germline mutations in BRCA1 or BRCA2 have significantly increased lifetime risks of breast and tubo-ovarian cancer. To manage the breast cancer risk women may elect to have breast screening by MRI/mammogram from age 30, to take risk-reducing medication, or to have a prophylactic bilateral mastectomy. To manage the tubo-ovarian cancer risk, the only effective strategy is to have a bilateral salpingo-oophorectomy, recommended by age 40 (BRCA1) or 'around' age 40 (BRCA2). Early studies suggested that uptake of these cancer risk-reducing strategies was low...
October 16, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29039119/clinical-implications-of-germline-mutations-in-breast-cancer-tp53
#10
REVIEW
Katherine Schon, Marc Tischkowitz
PURPOSE: This review describes the prevalence of germline TP53 mutations, the risk of breast cancer and other cancers in mutation carriers and management implications for women with breast cancer and unaffected women. METHODS: Literature review of English language papers available through PubMed. RESULTS: Women who carry germline mutations in the TP53 gene have a very high risk of breast cancer of up to 85% by age 60 years. Most of these breast cancers are early onset with a median age at diagnosis of 34 years...
October 16, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29039118/a-systematic-review-of-flap-fixation-techniques-in-reducing-seroma-formation-and-its-sequelae-after-mastectomy
#11
REVIEW
J van Bastelaar, L van Roozendaal, R Granzier, G Beets, Y Vissers
BACKGROUND: Seroma formation is a common complication after mastectomy. This review aims to elucidate which surgical techniques are most effective in reducing the dead space and therefore seroma formation in patients undergoing mastectomy. METHODS: A literature search was performed to identify clinical studies comparing any form of flap fixation to conventional closure technique in patients undergoing mastectomy with or without axillary clearance. Studies were eligible for inclusion if outcome was described in terms of seroma formation and/or complications of seroma formation...
October 16, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29039025/cost-effectiveness-analysis-of-contralateral-prophylactic-mastectomy-compared-to-unilateral-mastectomy-with-routine-surveillance-for-unilateral-sporadic-breast-cancer
#12
Robert C Keskey, A Scott LaJoie, Brad S Sutton, In K Kim, William G Cheadle, Kelly M McMasters, Nicolas Ajkay
BACKGROUND: Contralateral prophylactic mastectomy (CPM) rates in younger women with unilateral breast cancer have more than doubled. Studies of cost and quality of life of the procedure remain inconclusive. METHODS: A cost-effectiveness analysis using a decision-tree model in TreeAge Pro 2015 was used to compare long-term costs and quality of life following unilateral mastectomy (UM) with routine surveillance versus CPM for sporadic breast cancer in women aged 45 years...
October 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29037204/thoracodorsal-artery-perforator-flap-as-an-autologous-alternative-to-acellular-dermal-matrix
#13
Tarek Hashem, Ahmed Farahat
BACKGROUND: Thoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction. This pedicled flap retains the benefits of perforator flaps as regards minimal donor site morbidity without the need for microvascular anastomosis. Its role in partial breast reconstruction has been well documented. However, there are few reports about the role of this flap in total breast reconstruction. METHODS: This study included 47 cases who presented to the breast unit of the National Cancer Institute of Cairo University from 2013 to 2015...
October 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29036941/breast-implant-associated-anaplastic-large-cell-lymphoma-in-a-transgender-woman
#14
Mintsje de Boer, Wouter B van der Sluis, Jan P de Boer, Lucy I H Overbeek, Flora E van Leeuwen, Hinne A Rakhorst, René R W J van der Hulst, Nathalie J Hijmering, Mark-Bram Bouman, Daphne de Jong
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare but serious complication in patients with breast implants, Patients are at risk of BIA-ALCL whether they receive breast implants for cosmetic reasons or for reconstructive purposes after surgery for breast cancer or prophylactic mastectomy. During the past decade, an increased number of reports have addressed BIA-ALCL. Herein, we describe BIA-ALCL in a transgender woman. The patient received breast implants as part of her gender transition and was diagnosed with BIA-ALCL 20 years later...
September 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29031121/facilitating-decision-making-in-women-undergoing-genetic-testing-for-hereditary-breast-cancer-breconda-randomized-controlled-trial-results
#15
Kerry A Sherman, Christopher J Kilby, Laura-Kate Shaw, Caleb Winch, Judy Kirk, Kathy Tucker, Elisabeth Elder
BACKGROUND: Decision-making concerning risk-reducing mastectomy for women at hereditary risk of breast cancer entails complex personal choices. Deciding whether and how to restore breast shape after risk-reducing mastectomy is a key part of this process. We developed a web-based decision aid, BRECONDA (Breast Reconstruction Decision Aid), to assist women in decision-making regarding breast reconstruction. METHOD: This study assessed the efficacy of BRECONDA to assist women at increased risk of breast cancer in making decisions regarding risk-reducing mastectomy in terms of decisional conflict, knowledge, and satisfaction with information...
October 11, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29030030/oncological-safety-of-nipple-sparing-prophylactic-mastectomy-a-review-of-the-literature-on-3716-cases
#16
T Muller, A Baratte, C Bruant-Rodier, F Bodin, C Mathelin
INTRODUCTION: The objective of our study was to evaluate the risk of cancer after prophylactic nipple-sparing mastectomy (PNSM). MATERIAL AND METHODS: The PubMed database was consulted using the following key-words: "nipple-sparing mastectomy", "prophylactic", "locoregional recurrence", "oncological risk". Articles published between January 1995 and December 2016 were searched. RESULTS: Out of the 270 articles found, 19 were included. Overall, 15 studies were retrospective, 2 prospective, 2 prospective and retrospective and 3 were multicentric...
October 10, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29029462/the-appropriate-number-of-elns-for-lymph-node-negative-breast-cancer-patients-underwent-mrm-a-population-based-study
#17
Huiying Chi, Chenyue Zhang, Haiyong Wang, Zhehai Wang
Whether number of examed lymph nodes (ELNs) would bring survival benefit for patients with negative lymph nodes after modified radical mastectomy (MRM) is uncertain. In our study, using the Surveillance Epidemiology and End Results (SEER) database between 2004 and 2009, we screened the appropriate patients with negative lymph nodes underwent MRM. The Cox proportional hazard analysis was used to determine the effect of number of ELNs on cancer specific survival (CSS). The results showed that the number of ELNs was not an independent prognostic factor on CSS (P = 0...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29026955/indolent-rib-osteomyelitis-following-breast-implant-reconstruction-an-unusual-case-and-review-of-the-literature
#18
Luke Watson, Darryl Dunn, Grant Fraser-Kirk
Rib osteomyelitis is an infrequently occurring but important complication of breast implant surgery. Although prosthetic or surgical site infection (SSI) and rib osteomyelitis as separate entities are well described in the literature, only five cases of rib or sternal osteomyelitis related to implant placement have been reported globally. Historically patients who experience this complication have not demonstrated an identifiable prevalence of the traditional risk factors associated with SSI or rib osteomyelitis...
October 12, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29026820/a-qualitative-assessment-of-the-journey-to-delayed-breast-reconstruction
#19
Ho Man Cheng, Catherine McMillan, Joan E Lipa, Laura Snell
BACKGROUND: Canada has low immediate breast reconstruction (IBR) rates compared to the United States and Europe. Breast cancer survivors live with mastectomy defects sometimes for years, and this represents an area for improvement in cancer care. PURPOSE: This study qualitatively assessed (1) information provided about breast reconstruction at the time of cancer diagnosis among women seeking delayed breast reconstruction (DBR) and (2) referral practices for plastic surgery consultation for DBR...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29025228/commentary-on-patient-reported-outcomes-of-aesthetics-and-satisfaction-in-immediate-breast-reconstruction-after-nipple-sparing-mastectomy-with-implants-and-fat-grafting
#20
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