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Breast surgery guidelines

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
Hae Jin Park, Do Hoon Oh, Kyung Hwan Shin, Jin Ho Kim, Doo Ho Choi, Won Park, Chang-Ok Suh, Yong Bae Kim, Seung Do Ahn, Su Ssan Kim
Adjuvant radiotherapy (RT) is a well-established treatment for breast cancer. However, there is a large degree of variation and controversy in practice patterns. A nationwide survey on the patterns of practice in breast RT was designed by the Division for Breast Cancer of the Korean Radiation Oncology Group. All board-certified members of the Korean Society for Radiation Oncology were sent a questionnaire comprising 39 questions on six domains: hypofractionated whole breast RT, accelerated partial breast RT, postmastectomy RT (PMRT), regional nodal RT, RT for ductal carcinoma in situ , and RT toxicity...
September 2018: Journal of Breast Cancer
Liang Q Liu, Olivier A Branford, Sinead Mehigan
Background: Since BREAST-Q was developed in 2009, it has been widely used by clinicians and researchers to capture information regarding health-related quality of life (HRQoL) and patient satisfaction related to breast surgery. Yet clinical guidelines regarding the use of BREAST-Q for assessment of success of surgery in women with breast cancer remain limited. To maximize the benefits of using BREAST-Q to inform clinical decision making, this systematic review aimed to identify and appraise current evidence on patient-reported outcomes (PROs) assessed by BREAST-Q associated with breast oncoplastic surgery...
August 2018: Plastic and Reconstructive Surgery. Global Open
Ian Campbell, Chunhuan Lao, Tania Blackmore, Melissa Edwards, Louise Hayes, Alex Ng, Ross Lawrenson
BACKGROUND: The aim of this study was to understand the factors influencing the use of surgical options by New Zealand women with newly diagnosed breast cancer. METHODS: Using data from the Auckland and Waikato breast cancer registers, we included 11 798 women diagnosed with stage I-III breast cancer from June 2000 to May 2013. The characteristics of women receiving different surgical treatments and having immediate breast reconstruction following mastectomy were examined...
September 25, 2018: ANZ Journal of Surgery
Jan-Willem Groen, Andrzej A Piatkowski, John H Sawor, Janneke A Wilschut, Marco J P F Ritt, Rene R J W van der Hulst
OBJECTIVE: The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. BACKGROUND DATA: The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. METHODS: An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries...
September 24, 2018: Surgical Innovation
Mikkel Herly, Mathias Ørholt, Andreas Larsen, Christian B Pipper, Rikke Bredgaard, Christina S Gramkow, Adam J Katz, Krzysztof T Drzewiecki, Peter V Vester-Glowinski
BACKGROUND: Breast reconstruction with fat grafting is a new alternative to prosthetic implants and flaps for women with breast cancer. In this study, we investigate the efficacy of fat grafting for breast reconstruction in a meta-analysis. METHODS: The study followed the PRISMA and MOOSE guidelines for systematic reviews and meta-analyses. Studies were included if the patients underwent complete breast reconstruction with fat grafting as the only treatment modality...
September 4, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Nele Devoogdt, Inge Geraerts, Marijke Van Kampen, Tessa De Vrieze, Lore Vos, Patrick Neven, Ignace Vergote, Marie-Rose Christiaens, Sarah Thomis, An De Groef
QUESTION: What are the short-term and long-term preventive effects of manual lymph drainage (MLD), when used in addition to information and exercise therapy, on the development of lymphoedema after axillary dissection for breast cancer? DESIGN: Randomised controlled trial with concealed allocation, blinded assessors and intention-to-treat analysis. PARTICIPANTS: Adults undergoing unilateral dissection for breast cancer were recruited, with 79 allocated to the experimental group and 81 to the control group...
October 2018: Journal of Physiotherapy
Jay S Lee, Ryan A Howard, Michael P Klueh, Michael J Englesbe, Jennifer F Waljee, Chad M Brummett, Michael S Sabel, Lesly A Dossett
BACKGROUND: Excessive opioid prescribing is common in surgical oncology, with 72% of prescribed opioids going unused after curative-intent surgery. In this study, we sought to reduce opioid prescribing after breast and melanoma procedures by designing and implementing an intervention focused on education and prescribing guidelines, and then evaluating the impact of this intervention. METHODS: In this single-institution study, we designed and implemented an intervention targeting key factors identified in qualitative interviews...
September 20, 2018: Annals of Surgical Oncology
Zhi Wang, Zhangjian Zhou, Wenxing Li, Wei Wang, Xin Xie, Jincheng Liu, Yongchun Song, Chengxue Dang, Hao Zhang
Objective: The prevalence of breast cancer in elderly women (older than 80 years) is expected to rise more dramatically than its incidence. In this study, we evaluated the evidence for treatment guidelines for elderly breast cancer patients. Patients and methods: All included patients were enrolled from 2010 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. The Akaike information criterion (AIC) and Harrell's C statistic were used to perform comparisons...
2018: Cancer Management and Research
Simon Lowes, Fiona MacNeill, Lee Martin, Joe M O'Donoghue, Mandana O Pennick, Alan Redman, Robin Wilson
This is an overview of the guidelines for breast imaging before and after aesthetic (cosmetic) breast surgery, which includes but is not limited to implants, lipomodelling and mammoplasty procedures. The guidelines are based on a review of the literature and consensus of breast imaging and aesthetic breast surgery specialists. 1. Pre-aesthetic surgery 2. Post-aesthetic surgery If breast imaging or breast assessment is required, it should be performed in a designated breast facility with access to specialist breast imaging and a complete breast multidisciplinary team in accordance with national guidelines and recommendations...
August 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Laura Steponavičienė, Daiva Gudavičienė, Rūta Briedienė, Donatas Petroška, Aušra Garnelytė
Background: Encapsulated papillary carcinoma (EPC) is a rare entity of breast cancer accounting for approximately 1-2% of all breast tumours. There are no evidence-based guidelines for the treatment of EPC. Materials and methods: From the database of the National Centre of Pathology (NCP), we obtained pathology reports of 19 patients with histologically confirmed EPC, who were treated at the National Cancer Institute (NCI) in Vilnius, Lithuania, between July 2009 and July 2015...
2018: Acta Medica Lituanica
Anthony M Scott, Matthew C Callier, Madison Lashley, David A Cole, Paul S Dale
Accelerated partial breast irradiation (APBI) using the implanted brachytherapy device MammoSite® was approved for routine use by the Food and Drug Administration in 2002. The American Society of Breast Surgeons MammoSite® Breast Brachytherapy Registry served as a guideline for our institution to begin offering this treatment in 2005. This report reviews our available data to provide an analysis of patient outcomes over 12 years of use at a single institution. A retrospective review was conducted of records of 150 patients who underwent APBI or attempted APBI after breast-sparing surgeries between 2006 and 2017...
August 1, 2018: American Surgeon
Kristin A Theobald, Lisa R Susswein, Megan L Marshall, Maegan E Roberts, Jessica L Mester, Darrow Speyer, Ravin N W Williams, Sara C Knapke, Sheila R Solomon, Patricia D Murphy, Rachel T Klein, Kathleen S Hruska, Benjamin D Solomon
BACKGROUND: Knowledge of a germline pathogenic/likely pathogenic variant (PV) may inform breast cancer management. BRCA1/2 PV often impact surgical decisions, but data for multi-gene panel testing are lacking. Expedited genetic testing reduces turn-around times based on request for treatment-related decision making. This report aims to describe the clinical utility of expedited multi-gene panel testing for patients with newly diagnosed breast cancer. METHODS: Clinical and demographic information were reviewed for patients with newly diagnosed female breast cancer undergoing expedited panel testing between 2013 and 2017...
August 30, 2018: Annals of Surgical Oncology
Bettina Braun, Laura Khil, Joke Tio, Barbara Krause-Bergmann, Andrea Fuhs, Oliver Heidinger, Hans-Werner Hense
BACKGROUND: The goal of the German Mammography Screening Program (MSP) is to enable the early detection and less intensive treatment of breast cancer. We compared tumor characteristics and prognostic markers in breast cancers that were detected by screening in the MSP, in the interval after a negative screening, or among non-participants in screening. METHODS: This retrospective series includes all of the 1531 cases of invasive and in situ breast cancer (DCIS, ductal carcinoma in situ) that were newly diagnosed in two certified breast care centers in Münster in the period 2006-2012 among women in the MSP target population...
August 6, 2018: Deutsches Ärzteblatt International
Joerg Heil, Peter Sinn, Hannah Richter, André Pfob, Benedikt Schaefgen, André Hennigs, Fabian Riedel, Bettina Thomas, Marc Thill, Markus Hahn, Jens-Uwe Blohmer, Sherko Kuemmel, Maria Margarete Karsten, Mattea Reinisch, John Hackmann, Toralf Reimer, Geraldine Rauch, Michael Golatta
BACKGROUND: Neoadjuvant chemotherapy (NACT) is a standard approach of the multidisciplinary treatment of breast cancer. Depending on the biological subtype a pathological complete response in the breast (bpCR) can be achieved in up to 60% of the patients. However, only limited accuracy can be reached when using imaging for prediction of bpCR prior to surgery. Due to this diagnostic uncertainty, surgery after NACT is considered to be obligatory for all patients in order to either completely remove residual disease or to diagnose a bpCR histologically...
August 25, 2018: BMC Cancer
Alison Laws, Kathryn Anderson, Jiani Hu, Kathleen McLean, Lara Novak, Laura S Dominici, Faina Nakhlis, Matthew Carty, Stephanie Caterson, Yoon Chun, Margaret Duggan, William Barry, Nathan Connell, Mehra Golshan, Tari A King
BACKGROUND: Guidelines for venous thromboembolism (VTE) prophylaxis are not well-established for breast surgery patients. An individualized VTE prophylaxis protocol using the Caprini score was adopted at our institution for patients undergoing mastectomy ± implant-based reconstruction. In this study, we report our experience during the first year of implementation. METHODS: In August 2016, we adopted a VTE prophylaxis protocol for patients undergoing mastectomy ± implant-based reconstruction...
August 20, 2018: Annals of Surgical Oncology
Tarek Aridi, Mohamad Fawwaz, Ahmad Kassab, Marwan Bahmad, Faisal Houcheimi, Mohamad Mshiek, Fouad Boulos, Ali Kanj, Ghassan Ramadan, Hisham F Bahmad, Najla Fakhruddin
Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor...
2018: Case Reports in Surgery
Fernanda Barbosa C Rocha, Ana Beatriz Falcone, Antonio Carlos Buzaid, Juliana Martins Pimenta, Gustavo Schvartsman, Antonio Luiz Frasson
PURPOSE: Breast cancer neoadjuvant chemotherapy (NAC) consists of the administration of cytotoxic and targeted drugs prior to breast surgery, with the objective of reducing the tumor burden to allow breast conservation. NAC also aims to improve long-term treatment outcomes such as disease-free and overall survival. To optimize clinical practice with the best available evidence for breast cancer patients in the setting of neoadjuvant treatment, the Brazilian Society of Breast Surgeons (Sociedade Brasileira de Mastologia-SBM) held a consensus conference to develop this guideline...
August 11, 2018: Breast Cancer Research and Treatment
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