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Breast Conservative Surgery

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https://www.readbyqxmd.com/read/28933995/identification-assessment-and-management-of-breast-oedema-after-treatment-for-cancer
#1
Marie Todd
Advances in breast cancer management, including breast-conserving surgery, have resulted in an increase in the incidence of breast oedema. However, this is addressed by professionals less often than arm lymphoedema. Breast oedema results in significant physical and psychological morbidity, makes finding a comfortably fitting bra very difficult, and can act as a reminder of the initial breast cancer diagnosis. Psychological difficulties can be compounded by clinicians' failure to acknowledge the impact. Assessing and managing breast oedema requires a sensitive, skilled approach to ensure all the relevant issues are identified and addressed in a comprehensive care plan; taking time to listen to patients and acknowledging the impact can be very therapeutic...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28932733/pectoral-nerve-block-pecs-block-with-sedation-for-breast-conserving-surgery-without-general-anesthesia
#2
Eun-Jin Moon, Seung-Beom Kim, Jun-Young Chung, Jeong-Yoon Song, Jae-Woo Yi
Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28932361/imaging-of-the-treated-breast-post-breast-conservation-surgery-oncoplasty-pictorial-review
#3
REVIEW
Subhash K Ramani, Ashita Rastogi, Abhishek Mahajan, Nita Nair, Tanuja Shet, Meenakshi H Thakur
Mammographic appearance of the normal breast is altered in the post-operative setting. It is essential to be aware of the normal findings as well as to identify features of recurrent disease with particular emphasis on radiological-pathological concordance. Digital breast tomosynthesis and volumetric breast density add incremental value in this clinical setting. We present a pictorial review of various cases to illustrate normal post-operative findings as well as mammographic features suspicious for recurrent disease...
August 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28928852/dcis-margins-and-breast-conservation-md-anderson-cancer-center-multidisciplinary-practice-guidelines-and-outcomes
#4
REVIEW
Henry M Kuerer, Benjamin D Smith, Mariana Chavez-MacGregor, Constance Albarracin, Carlos H Barcenas, Lumarie Santiago, Mary E Edgerton, Gaiane M Rauch, Sharon H Giordano, Aysegul Sahin, Savitri Krishnamurthy, Wendy Woodward, Debasish Tripathy, Wei T Yang, Kelly K Hunt
Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28922685/neoadjuvant-systemic-therapy-for-breast-cancer-the-westmead-experience
#5
Annelise M Cocco, David Messer, Alexander Brown, Nina Sriram, Jenny Gilchrist, Loma Al-Mansouri, Richard Kefford, Farid Meybodi, James French, Jeremy Hsu, Elisabeth Elder
BACKGROUND: Neoadjuvant systemic therapy (NAST) can be used to treat breast cancer. Pathologic complete response (pCR) is a surrogate marker for improved survival. This study examined response in the breast and axilla to NAST and identified features associated with pCR. METHODS: Patients undergoing NAST and surgery between January 2012 and June 2016 by surgeons at Westmead Breast Cancer Institute were identified. Patients with inflammatory or metastatic disease were excluded...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28917445/margin-width-and-local-recurrence-after-breast-conserving-surgery-for-ductal-carcinoma-in-situ
#6
Gregory E Ekatah, Arran K Turnbull, Laura M Arthur, Jeremy Thomas, Christine Dodds, J Michael Dixon
INTRODUCTION: Ductal Carcinoma in situ (DCIS) represents 5% of symptomatic and 20-30% of screen detected cancers. Breast conserving surgery (BCS) ± radiotherapy is performed in over 70% of women with DCIS. What constitutes an adequate margin for BCS remains unclear. METHODS: A single institution follow up study has been conducted of 466 patients with pure DCIS treated by BCS between 2000 and 2010 of whom 292 received whole breast radiotherapy and 167 did not...
September 4, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28915209/the-expanded-use-of-auto-augmentation-techniques-in-oncoplastic-breast-surgery
#7
Albert Losken, Alexandra M Hart, James Walter Dutton, Justine S Broecker, Toncred M Styblo, Grant W Carlson
BACKGROUND: Auto-augmentation techniques have been applied to oncoplastic reductions to assist with filling larger, more remote defects and women with smaller breasts. The purpose of this report is to describe the use of auto-augmentation techniques in OR and compare the results with traditional OR. METHODS: We queried a prospectively maintained database of all women who underwent partial mastectomy and OR between 1994 and October 2015. The auto-augmentation techniques were defined as 1) extended primary nipple auto-augmentation pedicle, and 2) primary nipple pedicle and secondary auto-augmentation pedicle...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28913761/radioactive-seed-localization-versus-wire-guided-localization-for-nonpalpable-breast-cancer-a-cost-and-operating-room-efficiency-analysis
#8
Yimeng Zhang, Jean Seely, Erin Cordeiro, Joshua Hefler, Kednapa Thavorn, Mukta Mahajan, Sue Domina, Jon Aro, Andrea Marie Ibrahim, Angel Arnaout, Denis Gravel, Carolyn Nessim
BACKGROUND: This study aimed to compare the cost and resource use between our first-year experience using breast-conserving surgery (BCS) with radioactive seed localization (RSL) and the previous-year standard practice of BCS with wire-guided localization (WGL) for patients with nonpalpable breast cancer at a large Canadian tertiary center. METHODS: For this retrospective cohort study, data for BCS cases with RSL was collected from 1 April 2015 to 31 March 2016 and for BCS cases with WGL from 1 April 2014 to 31 March 2015...
September 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28910357/the-quality-of-invasive-breast-cancer-care-for-low-reimbursement-rate-patients-a-retrospective-study
#9
Shaofei Su, Han Bao, Xinyu Wang, Zhiqiang Wang, Xi Li, Meiqi Zhang, Jiaying Wang, Hao Jiang, Wenji Wang, Siyang Qu, Meina Liu
Though evidence-based treatments have been recommended for breast cancer, underuse of the treatments was still observed. To certain extent, patients' access to care, which can be enhanced by increasing the coverage of health insurance, could account for the current underuse in recommended care. This study aimed to examine the association between different proportions of reimbursement and quality of recommended breast cancer care, as well as length of hospital stay. In this retrospective study, 3669 patients diagnosed with invasive breast cancer between 1 June, 2011 and 30 June, 2013 were recruited...
2017: PloS One
https://www.readbyqxmd.com/read/28903158/surgeon-influence-on-variation-in-receipt-of-contralateral-prophylactic-mastectomy-for-women-with-breast-cancer
#10
Steven J Katz, Sarah T Hawley, Ann S Hamilton, Kevin C Ward, Monica Morrow, Reshma Jagsi, Timothy P Hofer
Importance: Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but we know little about the influence of surgeons on variability of the procedure in the community. Objective: To quantify the influence of the attending surgeon on rates of CPM and clinician attitudes that explained it. Design, Setting, and Participants: In this population-based survey study, we identified 7810 women with stages 0 to II breast cancer treated in 2013 to 2015 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County...
September 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28900322/stigma-perceived-by-women-following-surgery-for-breast-cancer
#11
Lopamudra Tripathi, Soumitra Shankar Datta, Sanjit Kumar Agrawal, Sanjoy Chatterjee, Rosina Ahmed
CONTEXT: Women undergoing treatment for breast cancer often have psychological morbidity and body image difficulties. The risk factors for increased levels of stigma in women with breast cancer have not been adequately studied. AIMS: This study aimed at investigating the associations of high levels of stigma in women with breast cancer. SETTINGS AND DESIGN: This cross-sectional study was conducted in a comprehensive cancer center in India and recruited women (n = 134) undergoing surgical treatment for breast cancer...
April 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28894737/fmeca-application-to-intraoperative-electron-beam-radiotherapy-procedure-as-a-quality-method-to-prevent-and-reduce-patient-s-risk-in-conservative-surgery-for-breast-cancer
#12
Cristiana Vidali, Mara Severgnini, Monica Urbani, Licia Toscano, Alfredo Perulli, Marina Bortul
INTRODUCTION: Failure Mode Effects and Criticalities Analysis (FMECA) represents a prospective method for risk assessment in complex medical practices. Our objective was to describe the application of FMECA approach to intraoperative electron beam radiotherapy (IOERT), delivered using a mobile linear accelerator, for the treatment of early breast cancer as an anticipated boost. MATERIALS AND METHODS: A multidisciplinary Working Group, including several different professional profiles, was created before the beginning of clinical practice in 2012, with the purpose of writing the Flow Chart and applying the FMECA methodology to IOERT procedure...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28894698/paradigm-shift-toward-reducing-overtreatment-of-ductal-carcinoma-in-situ-of-breast
#13
REVIEW
Yasuaki Sagara, Wong Julia, Mehra Golshan, Masakazu Toi
The prevalence of ductal carcinoma in situ (DCIS) of the breast has increased substantially after the introduction of breast cancer screening programs, although the clinical effects of early DCIS detection and treatment remain unclear. The standard treatment for DCIS has involved local breast-conserving surgery (BCS) followed by radiotherapy (RT) or total mastectomy with/without endocrine therapy, and the choice of local treatment is not usually based on clinicopathologic or biological factors. However, we have investigated the effectiveness of local treatment using breast surgery and RT using Surveillance, Epidemiology, and End Results data, and found that the effectiveness of breast surgery was modified by the nuclear grade...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28894694/evaluation-of-partial-breast-reirradiation-with-intraoperative-radiotherapy-after-prior-thoracic-radiation-a-single-institution-report-of-outcomes-and-toxicity
#14
Christine Chin, Priya Jadeja, Bret Taback, David P Horowitz, Sheldon M Feldman, Richard Ha, Eileen P Connolly
INTRODUCTION: Mastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI). We report our single-institution experience with breast-conserving surgery (BCS) followed by intraoperative radiotherapy (IORT) as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation. METHODS: We performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28893303/contrast-enhanced-spectral-mammography-in-neoadjuvant-chemotherapy-monitoring-a-comparison-with-breast-magnetic-resonance-imaging
#15
Valentina Iotti, Sara Ravaioli, Rita Vacondio, Chiara Coriani, Sabrina Caffarri, Roberto Sghedoni, Andrea Nitrosi, Moira Ragazzi, Elisa Gasparini, Cristina Masini, Giancarlo Bisagni, Giuseppe Falco, Guglielmo Ferrari, Luca Braglia, Alberto Del Prato, Ivana Malavolti, Vladimiro Ginocchi, Pierpaolo Pattacini
BACKGROUND: Neoadjuvant-chemotherapy (NAC) is considered the standard treatment for locally advanced breast carcinomas. Accurate assessment of disease response is fundamental to increase the chances of successful breast-conserving surgery and to avoid local recurrence. The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) and contrast-enhanced-MRI (MRI) in the evaluation of tumor response to NAC. METHODS: This prospective study was approved by the institutional review board and written informed consent was obtained...
September 11, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28890124/-sentinel-lymph-node-biopsy-and-neoadjuvant-treatment-in-breast-cancer
#16
REVIEW
Martha Duraes, Eugénie Guillot, Julien Seror, Nicolas Pouget, Roman Rouzier
Sentinel lymph node biopsy has replaced axillary lymph node dissection in those patients with clinically node-negative axilla without compromising their oncologic outcomes. Indication of neoadjuvant chemotherapy has been extended to patients to evaluate the pathologic response and to offer more conservative breast surgery. Sentinel lymph node dissection after neoadjuvant chemotherapy is feasible and accurate in patients with clinically node-negative patients. The timing of the sentinel lymph node biopsy, before or after medical treatment has been studied with benefits for each procedure...
September 7, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28887654/-critical-consideration-of-ipsilateral-axillary-recurrence-after-breast-conservative-surgery-and-the-protective-effect-of-whole-breast-radiotherapy
#17
Frederik Wenz, Elena Sperk
No abstract text is available yet for this article.
September 8, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28884470/breast-conserving-therapy-and-mastectomy-revisited-breast-cancer-specific-survival-and-the-influence-of-prognostic-factors-in-129-692-patients
#18
Mirelle Lagendijk, Marissa C van Maaren, Sepideh Saadatmand, Luc Ja Strobbe, Philip Mp Poortmans, Linetta B Koppert, Madeleine Ma Tilanus-Linthorst, Sabine Siesling
This large population-based study compared breast-conserving surgery with radiation therapy (BCT) with mastectomy on (long-term) breast cancer-specific (BCSS) and overall survival (OS), and investigated the influence of several prognostic factors. Patients with primary T1-2N0-2M0 breast cancer, diagnosed between 1999-2012, were selected from the Netherlands Cancer Registry. We investigated the 1999-2005 (long-term outcome) and the 2006-2012 cohort (contemporary adjuvant systemic therapy). Cause of death was derived from the Statistics Netherlands (CBS)...
September 7, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28884392/socioeconomic-status-and-breast-cancer-treatment
#19
REVIEW
Marie S Dreyer, Ann B Nattinger, Emily L McGinley, Liliana E Pezzin
PURPOSE: Evidence suggests substantial disparities in breast cancer survival by socioeconomic status (SES). We examine the extent to which receipt of newer, less invasive, or more effective treatments-a plausible source of disparities in survival-varies by SES among elderly women with early-stage breast cancer. METHODS: Multivariate regression analyses applied to 11,368 women (age 66-90 years) identified from SEER-Medicare as having invasive breast cancer diagnosed in 2006-2009...
September 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28877348/superparamagnetic-iron-oxide-nanoparticles-as-the-sole-method-for-sentinel-node-biopsy-detection-in-patients-with-breast-cancer
#20
A Karakatsanis, K Daskalakis, P Stålberg, H Olofsson, Y Andersson, S Eriksson, L Bergkvist, F Wärnberg
BACKGROUND: Sentinel node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles is a novel method in breast cancer. Several studies have verified the non-inferiority of SPIO compared with the standard use of radioisotope (99m) Tc with or without blue dye. The aim of the MONOS study presented here was to evaluate the use of SPIO as a sole tracer and the efficacy of tracer injection in the preoperative setting. METHODS: This prospective cohort study was carried out in two hospitals, one using (99m) Tc and the other SPIO...
September 6, 2017: British Journal of Surgery
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