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Breast surgery guidelines

Manish Sahni, Ashish Goel, Pankaj Pande, Kapil Kumar
Multiple gastrointestinal cancers in a single patient is a rare entity. In our study, we are showing the clinical presentation and management of these patients. A fifty-nine-year-old asthenic male (already treated case of metachronous colorectal cancer in 2008 and 2011) presented with complaints of generalized weakness and fatigue. Strong family history was present with two of his first-degree relatives having diagnosed with gastrointestinal cancer at the age < 50 years with one of them having stomach carcinoma and another with GEJ tumors...
December 2018: Indian Journal of Surgical Oncology
Pietro G di Summa, Carlo M Oranges, William Wafta, Gianluca Sapino, Nicola Keller, Sherylin K Tay, Ben K Chew, Dirk J Schaefer, Wassim Raffoul
BACKGROUND: Mastopexy is one of the most performed cosmetic surgery procedures in the U.S. Numerous studies on mastopexy techniques have been published in the past decades, including case reports, retrospective reviews, and prospective studies. However, to date, no study has investigated the overall complications or satisfaction rates associated with the wide spectrum of techniques. OBJECTIVES: This review aims to assess the outcomes of the various mastopexy techniques, without the use of implants, thus focusing on associated complications, and to provide a simplified classification system...
November 9, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
William T Tran, Charmaine Childs, Heidi Probst, Golnaz Farhat, Gregory J Czarnota
Guidelines from the American National Comprehensive Cancer Network recommend neoadjuvant chemotherapy to patients with locally advanced breast cancer (LABC) to downstage tumours before surgery. However, only a small fraction (15%-17%) of LABC patients achieve pathological complete response (pCR); that is, no residual tumour in the breast, after treatment. Measuring tumour response during neoadjuvant chemotherapy can potentially help physicians adapt treatment, thus potentially improving the pCR rate. Recently, imaging biomarkers that are used to measure the tumour's functional and biological features have been studied as pretreatment markers for pCR or as an indicator for intratreatment tumour response...
December 2018: Journal of Medical Imaging and Radiation Sciences
Hannah Trøstrup, Steen H Matzen
INTRODUCTION: Verrucous carcinoma is an uncommon variant of low-grade squamous cell malignancy with a low malignant potential but a high risk of recurrence. PRESENTATION OF CASE: We report a case of a Human Papilloma Virus negative local verrucous carcinoma in the perianal area of a 45-year old otherwise healthy female. The tumor presented clinically as a persistent genital wart not responding to usual dermatologic local therapy. The patient was referred to the Department of Plastic Surgery and Breast Surgery after primary excision in a private practice setting of a general surgeon...
November 27, 2018: International Journal of Surgery Case Reports
Kalpalata Tripathy, Aparajita Mishra, Ajit K Singh, Pragnya L Panda, Arup Mahapatra, Anusaya Lenka
Context: Efficacy of immunocytochemistry (ICC) in determining molecular biomarkers like estrogen receptor (ER), progesterone receptors (PRs), and human epidermal growth factor receptor-2 (HER2). Aims: To evaluate biomarkers using ICC in breast cancer as per American Society of Clinical Oncology/College of American Pathology (ASCO/CAP) guidelines. Settings and Design: The study was conducted over a period of 2 years from September 2012 to August 2014 and is the first such study in eastern India...
October 2018: Journal of Cytology
Amelie de Gregorio, Peter Widschwendter, Susanne Albrecht, Nikolaus de Gregorio, Thomas W P Friedl, Jens Huober, Wolfgang Janni, Florian K Ebner
Background Guideline recommendations for axillary surgical approach in breast cancer (BC) treatment changed over the last decade. Methods Data from all invasive BC patients (n = 5344) treated with breast conserving surgery (BCS) at the breast cancer centers of the University Hospital Ulm (U-BCC) and the community hospital Dachau (D-BCC) were included into a retrospective analysis for assessing information on axillary surgery between 2003 and 2016 based on the documented cancer registry data. Results The average annual rate of sentinel node biopsy (SNB) was 85...
November 2018: Geburtshilfe und Frauenheilkunde
F Riedel, J Heil, M Golatta, B Schaefgen, S Hug, S Schott, J Rom, F Schuetz, C Sohn, A Hennigs
PURPOSE: Breast-conserving therapy (BCT) is the standard procedure for most patients with primary breast cancer (BC). By contrast, axillary management is still under transition to find the right balance between avoiding of morbidity, maintaining oncological safety, and performing a staging procedure. The rising rate of primary systemic therapy creates further challenges for surgical management. METHODS: Patients with primary, non-metastatic BC treated between 01...
November 26, 2018: Archives of Gynecology and Obstetrics
Michelle Jacobson, Marcus Bernardini, Mara L Sobel, Raymond H Kim, Jeanna McCuaig, Lisa Allen
OBJECTIVE: This Committee Opinion outlines the gynaecologic management recommendations for women diagnosed with hereditary breast and ovarian cancer syndrome (HBOC) with respect to screening, contraception, chemoprophylaxis, fertility considerations, risk-reducing surgery, and post-oophorectomy care. INTENDED USERS: This Committee Opinion is designed for gynaecologic oncologists, general gynaecologists, family physicians, genetic counsellors, registered nurses, nurse practitioners, residents, and health care providers...
November 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Wei Wang, Rachel Ward, Dan Jia, Simon Ashworth, Edgar Estoesta, Trevor Moodie, Verity Ahern, Kirsty Stuart, Nicholas Ngui, James French, Elisabeth Elder, David Farlow
BACKGROUND: Lymphoedema of the arm following axillary surgery or radiotherapy remains a significant side effect affecting some women after breast cancer treatment. Axillary reverse mapping (ARM) is a technique used to identify the lymph node draining the arm (ARM node). Our study aim was to examine the location of the ARM nodes in relation to target volumes and treatment fields for breast cancer radiotherapy. MATERIALS AND METHODS: Eighteen breast cancer patients underwent lymphoscintigraphy of contralateral arm (left 10, right 8) and SPECT CT scan on a research study...
November 13, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Klaudia Kozłowska, Leszek Kozłowski, Jolanta Małyszko
PURPOSE: Treatment with chemotherapy and targeted drugs may results in elevated risk of cardiac and renal toxicity as well as hypertension. However, data on prevalence of chronic kidney disease and hypertension in subjects with early breast cancer undergoing primary surgery are very limited. PATIENTS AND METHODS: The study aimed to assess the prevalence of chronic kidney disease and hypertension (evaluated as a preoperative assessment and defined according to ESC/ESH guidelines) in a cohort of 100 consecutive female patients with early breast cancer treated with primary surgery with curative intent...
November 9, 2018: Advances in Medical Sciences
Farah F Quyyumi, Jason D Wright, Melissa K Accordino, Donna Buono, Cynthia W Law, Grace C Hillyer, Alfred I Neugut, Dawn L Hershman
PURPOSE: Follow-up guidelines vary widely among national organizations for patients with early-stage breast cancer treated with curative intent. We sought to evaluate the patterns and predictors of provider follow-up care within the first 5 years after diagnosis. METHODS: Using the SEER-Medicare linked data set, we evaluated patients who were diagnosed with stage I and II breast cancer who underwent breast-conserving surgery from 2002 to 2007 with follow-up until 2012...
November 8, 2018: Journal of Oncology Practice
Torfinn S Madssen, Inger Thune, Vidar G Flote, Steinar Lundgren, Gro F Bertheussen, Hanne Frydenberg, Erik Wist, Ellen Schlichting, Hartmut Schäfer, Hans E Fjøsne, Riyas Vettukattil, Jon Lømo, Tone F Bathen, Guro F Giskeødegård
BACKGROUND: Breast cancer treatment has metabolic side effects, potentially affecting risk of cardiovascular disease (CVD) and recurrence. We aimed to compare alterations in serum metabolites and lipoproteins during treatment between recipients and non-recipients of chemotherapy, and describe metabolite profiles associated with treatment-related weight gain. METHODS: This pilot study includes 60 stage I/II breast cancer patients who underwent surgery and were treated according to national guidelines...
October 2018: British Journal of Cancer
Ainslie Lavers, Wai Siong Yip, Bruce Sunderland, Richard Parsons, Sarah Mackenzie, Jason Seet, Petra Czarniak
Background: Surgical site infections (SSIs) are a common complication following breast surgery procedures, despite being considered a clean surgery. The prevalence of SSIs can be minimised with the appropriate use of antibiotic prophylaxis as outlined in the Australian Therapeutic Guidelines (eTG). The aims of this study were to evaluate adherence to the eTG for antibiotic prophylaxis in breast surgery procedures at a Western Australian teaching hospital following an update of the guidelines in 2014 and examine the impact of prophylactic antibiotics on SSI incidence and length of hospital stay...
2018: PeerJ
Benjamin W Maloney, David M McClatchy, Brian W Pogue, Keith D Paulsen, Wendy A Wells, Richard J Barth
Breast conserving surgery (BCS) is an effective treatment for early-stage cancers as long as the margins of the resected tissue are free of disease according to consensus guidelines for patient management. However, 15% to 35% of patients undergo a second surgery since malignant cells are found close to or at the margins of the original resection specimen. This review highlights imaging approaches being investigated to reduce the rate of positive margins, and they are reviewed with the assumption that a new system would need high sensitivity near 95% and specificity near 85%...
October 2018: Journal of Biomedical Optics
Carl DeSelm, T Jonathan Yang, Oren Cahlon, Jamie Tisnado, Atif J Khan, Erin F Gillespie, Chun Ting Siu, Simon N Powell, Alice Y Ho
PURPOSE: The primary goal was to map the anatomic pattern of isolated nodal recurrences (NR) in the supraclavicular (SCV), axillary (Ax), and internal mammary nodes (IMN) in breast cancer patients treated with curative-intent surgery +/- radiation therapy (RT). Secondary objectives were to assess clinical and pathologic factors associated with patterns of NR and survival rates. MATERIALS AND METHODS: Breast cancer patients with NR post-treatment at a single cancer center between 1998-2013 were identified...
October 24, 2018: International Journal of Radiation Oncology, Biology, Physics
Jai Min Ryu, Hee Jun Choi, Isaac Kim, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Doo Ho Choi, Yeon Hee Park, Jong-Won Kim, Jeong-Sun Seo, Jung-Hoon Park, Jeong Eon Lee, Sung-Won Kim
PURPOSE: Triple-negative breast cancer (TNBC) accounts for 10-20% of all diagnosed BCs and it is enriched in BRCA1 mutation. Guidelines for Western countries suggest that BRCA 1/2 genetic testing should be done for patients with TNBC diagnosed less than 60 years, but there is lack of evidence supporting genetic testing in Asian populations. We determined the prevalence of germline BRCA 1/2 mutations among unselected Korean patients with TNBC and analyzed oncologic outcomes. METHODS: From among 1628 women with TNBC who underwent surgery at Samsung Medical Center (SMC) between Jul 2008 and Jan 2016, 999 samples were available in the SMC biobank for testing germline BRCA 1/2 mutations using next-generation DNA sequencing...
October 22, 2018: Breast Cancer Research and Treatment
Ashley O Frois, Patrick O Harbour, Farhad Azimi, Jane Young, Belinda Chan, Cindy Mak, Sanjay Warrier
Background: The usage of antibiotics and antiseptics to washout the breast pocket, or to soak the breast implant during surgery, has come under scrutiny in recent times. Guidelines from the Centers for Disease Control and Prevention give no recommendation for or against the usage of antibiotics in this regard. They do however offer a weak recommendation for washing tissues with iodophor. This systematic review aims to investigate the efficacy and impact of such topical antibiotic or antiseptic usage in reducing infection rates...
September 2018: Plastic and Reconstructive Surgery. Global Open
Kiran S Yemul, Adam M Zysk, Andrea L Richardson, Krishnarao V Tangella, Lisa K Jacobs
PURPOSE: Initial studies have shown that optical coherence tomography (OCT) is an effective margin-evaluation tool for breast-conserving surgery, but methods for the interpretation of breast OCT images have not been directly studied. In this work, breast pathologies were assessed with a handheld OCT probe. OCT images and corresponding histology were used to develop guidelines for the identification of breast tissue features in OCT images. METHODS: Mastectomy and breast-conserving surgery specimens from 26 women were imaged with a handheld OCT probe...
October 7, 2018: Surgical Innovation
(no author information available yet)
INTRODUCTION: Abdominal-based microvascular breast reconstruction constitutes approximately one-fifth of reconstructions following mastectomy for breast cancer. Enhanced recovery after surgery (ERAS) protocols have been implemented to improve patient care. The aim of this project was to identify variation in the perioperative care of women undergoing microvascular breast reconstruction to inform development of an ERAS protocol. METHODS: Surveys were developed for plastic surgeons, anaesthetists and the lead clinician for breast reconstruction at each unit...
August 25, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Astrid Botty Van Den Bruele, Bharti Jasra, Carmen Smotherman, Marie Crandall, Laila Samiian
BACKGROUND: Re-excision rates after breast conservation surgery are reported to be 20%-40%. Inaccuracies with specimen orientation may affect margin assessment. This study examined whether the addition of surgeon performed intraoperative inking of the lumpectomy specimen after adoption of margin guidelines would be cost-effective. METHODS: A retrospective review of a prospective surgical database was performed from 2009 to 2017. Patients with initial lumpectomy and a preoperative diagnosis of invasive breast carcinoma or ductal carcinoma in situ (DCIS) were included...
November 2018: Journal of Surgical Research
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