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Palliative surgery of breast cancer

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https://www.readbyqxmd.com/read/30254019/qol-enhancing-surgery-for-patients-with-her2-positive-metastatic-breast-cancer
#1
Masaya Kai, Makoto Kubo, Hitomi Kawaji, Kanako Kurata, Hitomi Mori, Mai Yamada, Masafumi Nakamura
The role of the resection of primary tumour in stage IV breast cancer is unclear. Systemic therapy is recommended to prolong the survival and improve the quality of life (QOL). However, even if the systemic therapy is effective to control distant metastasis, sometimes the local lesion worsens, especially in the aggressive subtypes such as HER2-positive breast cancer. In uncontrollable tumours, the wound bed can bleed, weep and get infected, leading to dismal QOL. Our study describes two cases of patients with HER2-positive stage IV breast cancer who underwent palliative mastectomy which resulted in improvement of QOL...
September 25, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/30180725/radiotherapy-for-patients-with-unresected-locally-advanced-breast-cancer
#2
Caitlin Yee, Yasir Alayed, Leah Drost, Irene Karam, Danny Vesprini, Claire McCann, Hany Soliman, Liying Zhang, Edward Chow, Stephanie Chan, Justin Lee
BACKGROUND: Management of locally-advanced breast cancer is determined by multiple factors, but in patients without distant metastases often involves neoadjuvant systemic therapy, surgery and radiation. If the primary tumour remains unresectable following systemic therapy, radiotherapy may be used for tumour shrinkage prior to surgery. When metastatic disease is present, locoregional radiotherapy is generally reserved for management of tumour-related symptoms. We reviewed our experience of high-dose radiotherapy for unresected locally-advanced breast cancer...
October 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/30111952/palliative-mastectomy-revisited
#3
Digpal V Dharkar, Sonia Moses
Couple of decades ago, Palliative Mastectomy for locally advanced breast cancers was common, if not frequent surgical procedure in the surgical armamentarium. The advent of better understanding of tumor biology and better multidisciplinary management has certainly narrowed down its role. However there are situations where it is still a potent option. In the subset of patients where palliative mastectomy is to be performed, it is important to aim for clear surgical margins, with good clearance at the third dimension, i...
July 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/30111944/palliation-of-brain-metastases-analysis-of-prognostic-factors-affecting-overall-survival
#4
Kartick Rastogi, Sandeep Bhaskar, Shivani Gupta, Sandeep Jain, Daleep Singh, Pawan Kumar
Context: Brain metastasis is one of the most feared complications of cancer that poses significant mortality and morbidity in patients with advanced cancer. The incidence is rising because of greater use of magnetic resonance imaging and spectroscopy; and increased survival from recent advances in immunotherapy and modern radiotherapy techniques. Despite all, the prognosis remains poor. Aims: This study aimed to analyze prognostic factors and overall survival in patients with brain metastases...
July 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/30095201/surgical-oncology-at-a-major-referral-center-in-ghana-burden-staging-and-outcomes
#5
Adam Gyedu, Cameron E Gaskill, Kwabena Agbedinu, Daniela Rebollo Salazar, T Peter Kingham
BACKGROUND AND OBJECTIVES: Outcome data after surgery for cancer in Sub-Saharan Africa are insufficient. We aimed to describe the presentation and outcomes of patients with solid cancers managed at a tertiary hospital in Ghana. METHODS: Records of cancer patients admitted to Komfo Anokye Teaching Hospital general surgery wards from 2013 to 2016 were reviewed for data on presentation, staging, management, and mortality. Patients discharged alive were followed-up by biannual telephone calls to establish their postdischarge status...
September 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/30056732/management-of-breast-cancer-brain-metastases
#6
Hideaki Takahashi, Mizuho Isogawa
Brain metastases are usual in breast cancer with poor prognosis and few available therapeutic options. The efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) against brain metastases from EGFR mutation-positive non-small cell lung cancer (NSCLC) showed promising antitumor activity, on the other hand, the main treatment of breast cancer brain metastases (BCBMs) is only local therapy such as surgery or radiotherapy. The goal of treatment includes stabilizing or improving neurological function and palliating neurological symptom...
June 2018: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/30005779/role-of-operative-management-in-stage-iv-breast-cancer
#7
REVIEW
Mediget Teshome
The role of operative therapy in stage IV breast cancer continues to evolve with advances in therapy and improvements in survival among this population. Traditionally surgery was performed with palliative intent to alleviate symptoms related to the intact breast primary. Several retrospective studies have challenged this paradigm, demonstrating survival advantage with surgery in de novo metastatic disease. Prospective studies are ongoing and maturing data. A comprehensive approach to local therapy following systemic therapy may be beneficial to achieve improved survival outcome associated with stage IV- no evidence of disease and to decrease local failure in inflammatory breast cancer...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29958815/using-a-geriatric-oncology-assessment-to-link-with-services-goal
#8
Leah L Zullig, Gretchen Kimmick, Valerie Smith, Katie Little, Hayden B Bosworth, Sarah Gonzales, Megan M Oakes, Rebecca A Shelby, Lynda Owen, Ivy P Altomare
OBJECTIVE: Geriatric screening tools assess functional limitations and inform clinical decision-making for older adults with cancer. Our objective was to evaluate the feasibility and effectiveness of a screener in community-based oncology clinics. MATERIALS AND METHODS: Eligible patients were from two rural, underserved community-based cancer clinics; within 12 months of a cancer diagnosis (breast, lung, colorectal, pancreas, esophageal); aged ≥60 years; and not exclusively pursuing palliative care...
June 26, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29939840/recommendations-on-disease-management-for-patients-with-advanced-human-epidermal-growth-factor-receptor-2-positive-breast-cancer-and-brain-metastases-asco-clinical-practice-guideline-update
#9
Naren Ramakrishna, Sarah Temin, Sarat Chandarlapaty, Jennie R Crews, Nancy E Davidson, Francisco J Esteva, Sharon H Giordano, Jeffrey J Kirshner, Ian E Krop, Jennifer Levinson, Shanu Modi, Debra A Patt, Jane Perlmutter, Eric P Winer, Nancy U Lin
Purpose To update the formal expert consensus-based guideline recommendations for practicing oncologists and others on the management of brain metastases for patients with human epidermal growth factor receptor 2-positive advanced breast cancer to 2018. Methods An Expert Panel conducted a targeted systematic literature review (for both systemic treatment and CNS metastases) and identified 622 articles. Outcomes of interest included overall survival, progression-free survival, and adverse events. In 2014, the American Society of Clinical Oncology (ASCO) convened a panel of medical oncology, radiation oncology, guideline implementation, and advocacy experts, and conducted a systematic review of the literature...
September 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29931061/successful-targeted-therapies-for-breast-cancer-the-worcester-foundation-and-future-opportunities-in-women-s-health
#10
Balkees Abderrahman, V Craig Jordan
The signing of the National Cancer Act in 1971 was designed to take laboratory discoveries rapidly from the bench to the bedside. A "war on cancer" had been declared. Combination cytotoxic chemotherapy was predicted to cure all cancers, based on the stunning success in treating childhood leukemia. Breast cancer treatments were primitive; radical mastectomy and radiation were standard of care for disease that had not spread. Ablative endocrine surgery (oophorectomy, hypophysectomy, and adrenalectomy) was a palliative last option for metastatic breast cancer...
August 1, 2018: Endocrinology
https://www.readbyqxmd.com/read/29903550/radiotherapy-utilization-and-fractionation-patterns-during-the-first-course-of-cancer-treatment-in-the-united-states-from-2004-to-2014
#11
Trevor J Royce, Muhammad M Qureshi, Minh Tam Truong
BACKGROUND: The changing use of radiation as a first-line cancer therapy in the United States is poorly characterized. This study aims to report radiotherapy utilization and fractionation patterns during the first course of cancer treatment. METHODS: We extracted all solid tumor cases from 2004 to 2014 in the National Cancer Data Base, which captures only the first course of treatment. Patients were subcategorized by disease site: breast, central nervous system (CNS), gastrointestinal, genitourinary, gynecologic, head and neck (HN), musculoskeletal, skin, or thoracic...
June 11, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29628613/locoregional-therapies-for-the-treatment-of-hepatic-metastases-from-breast-and-gynecologic-cancers
#12
REVIEW
Samdeep K Mouli, Ramona Gupta, Neil Sheth, Andrew C Gordon, Robert J Lewandowski
Breast cancer is the most common women's malignancy in the United States and is the second leading cause of cancer death. More than half of patients with breast cancer will develop hepatic metastases; this portends a poorer prognosis. In the appropriately selected patient, there does appear to be a role for curative (surgery, ablation) or palliative (intra-arterial treatments) locoregional therapy. Gynecologic malignancies are less common and metastases to the liver are most often seen in the setting of disseminated disease...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29604436/investigational-chemotherapy-and-novel-pharmacokinetic-mechanisms-for-the-treatment-of-breast-cancer-brain-metastases
#13
REVIEW
Neal Shah, Afroz S Mohammad, Pushkar Saralkar, Samuel A Sprowls, Schuyler D Vickers, Devin John, Rachel M Tallman, Brandon P Lucke-Wold, Katherine E Jarrell, Mark Pinti, Richard L Nolan, Paul R Lockman
In women, breast cancer is the most common cancer diagnosis and second most common cause of cancer death. More than half of breast cancer patients will develop metastases to the bone, liver, lung, or brain. Breast cancer brain metastases (BCBM) confers a poor prognosis, as current therapeutic options of surgery, radiation, and chemotherapy rarely significantly extend life and are considered palliative. Within the realm of chemotherapy, the last decade has seen an explosion of novel chemotherapeutics involving targeting agents and unique dosage forms...
June 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29582633/cancer-related-pain-prevalence-severity-and-management-in-a-tertiary-care-center-in-the-middle-east
#14
Nadine M Hamieh, Reem Akel, Bilal Anouti, Cindy Traboulsi, Iman Makki, Lana Hamieh, Arafat Tfayli
Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017...
March 27, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29579478/surgical-resection-versus-systemic-therapy-for-breast-cancer-liver-metastases-results-of-a-european-case-matched-comparison
#15
A Ruiz, R van Hillegersberg, S Siesling, C Castro-Benitez, M Sebagh, D A Wicherts, K M de Ligt, L Goense, S Giacchetti, D Castaing, J Morère, R Adam
BACKGROUND: Resection of breast cancer liver metastases (BCLM) combined with systemic treatment is increasingly accepted but not offered as therapeutic option. New evidence of the additional value of surgery in these patients is scarce while prognoses without surgery remains poor. PATIENTS AND METHODS: For this case matched analysis, all nationally registered patients with BCLM confined to the liver in the Netherlands (systemic group; N = 523) were selected and compared with patients who received systemic treatment and underwent hepatectomy (resection group; N = 139) at a hepatobiliary centre in France...
May 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29492945/management-of-triple-negative-breast-cancer-in-older-patients-how-is-it-different
#16
REVIEW
Shlomit Strulov Shachar, Trevor A Jolly, Ellen Jones, Hyman B Muss
Triple-negative breast cancer, which affects about 10% of older women with breast cancer, represents a major treatment challenge in this population. Treatment decisions for these patients can best be made based on geriatric assessment, estimated life expectancy, whether the treatment goal is prolonged survival or palliation, the potential benefits and toxicities of a specific treatment, and the patient's personal goals for treatment. Treatment outcomes for healthy older and younger women are similar, but great challenges exist in managing the vulnerable and frail patient...
February 15, 2018: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/29480890/is-total-femur-replacement-a-reliable-treatment-option-for-patients-with-metastatic-carcinoma-of-the-femur
#17
Florian Sevelda, Wenzel Waldstein, Joannis Panotopoulos, Alexandra Kaider, Philipp Theodor Funovics, Reinhard Windhager
BACKGROUND: The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. QUESTIONS/PURPOSES: In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? METHODS: Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29286911/primary-breast-angiosarcoma-a-single-institution-experience-from-a-tertiary-cancer-center-in-south-india
#18
D Lokanatha, Abhishek Anand, K C Lakshmaiah, K Govind Babu, Linu Abraham Jacob, M C Suresh Babu, K N Lokesh, A H Rudresha, L K Rajeev, Smitha C Saldanha, G V Giri, Deepak Koppaka, Rekha V Kumar
INTRODUCTION: Primary angiosarcoma of the breast is a rare entity with incidence of less than 0.05% of all malignant breast neoplasms. It occurs in young females without any associated risk factors. The tumor behaves aggressively and has a poor prognosis compared to invasive ductal carcinoma. METHOD: It was a retrospective observational study done at a tertiary cancer center from January 2012 to December 2016. The medical records of patients diagnosed with primary breast angiosarcoma were reviewed for the study...
2018: Breast Disease
https://www.readbyqxmd.com/read/29243490/percutaneous-cryoablation-of-breast-tumours-in-patients-with-stable-metastatic-breast-cancer-safety-feasibility-and-efficacy
#19
Hédi Beji, Frank Pilleul, Raphaelle Picard, Olivier Tredan, Amine Bouhamama, Marie Peix, Erti Mavrovi, Charles Mastier
PURPOSE: To evaluate safety, feasibility and efficacy of percutaneous cryoablation of breast tumours in patients with clinically stable metastatic breast cancer, and to compare the findings with reports on alternative procedures, namely surgery and local radiotherapy. METHODS: 17 female patients (average age of 54.8 years ± 10.8; range 37-72) with primary breast tumour not surgically treated because of metastatic disease were included. Patients were treated for their primary lesion by percutaneous cryotherapy in period of stable disease...
February 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29185295/complications-and-survival-of-megaprostheses-after-resection-of-bone-metastases
#20
M De Gori, A D’Arienzo, L Andreani, G Beltrami, D A Campanacci, P De Biase, F Frenos, S Giannotti, F Sacchetti, F Totti, P Parchi, R Capanna
Treatment of bone metastases is often palliative, aiming at pain control and stabilization or prevention of pathological fractures. However, a complete resection with healing purposes can be performed in selected cases. The aim of our work was to evaluate the survival of megaprostheses used for reconstruction after bone metastases. Between January 2001 and March 2015, we implanted 169 Megasystem-C® (Waldemar LINK® GmbH & Co. KG, Hamburg, Germany) after bone metastasis resection. Patients, 95 females and 74 males, were operated at an average age of 61 (12-87) years for proximal femoral resection in 135 (79...
October 2017: Journal of Biological Regulators and Homeostatic Agents
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