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Patient reported outcomes breast surgery

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https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#1
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327055/comparing-neoadjuvant-nab-paclitaxel-vs-paclitaxel-both-followed-by-anthracycline-regimens-in-women-with-erbb2-her2-negative-breast-cancer-the-evaluating-treatment-with-neoadjuvant-abraxane-etna-trial-a-randomized-phase-3-clinical-trial
#2
Luca Gianni, Mauro Mansutti, Antonio Anton, Lourdes Calvo, Giancarlo Bisagni, Begoña Bermejo, Vladimir Semiglazov, Marc Thill, Jose Ignacio Chacon, Arlene Chan, Serafin Morales, Isabel Alvarez, Arrate Plazaola, Milvia Zambetti, Andrew D Redfern, Christian Dittrich, Rebecca Alexandra Dent, Domenico Magazzù, Raffaella De Fato, Pinuccia Valagussa, Ignacio Tusquets
Importance: Studies of neoadjuvant chemotherapy regimens using anthracyclines followed by taxanes have reported a doubling of pathological complete remission (pCR) rates compared with anthracycline-based regimens alone. A reverse sequence did not reduce activity. Nab-paclitaxel is an albumin-bound nanoparticle of paclitaxel that allows for safe infusion without premedication, and its use led to a significantly higher rate of pCR in the GeparSepto trial. Objective: To determine whether nab-paclitaxel improves the outcomes of early and locally advanced human epidermal growth factor receptor 2 (ERBB2/HER2)-negative breast cancer compared with paclitaxel when delivered in a neoadjuvant setting...
January 11, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29318171/mobile-web-based-follow-up-for-postoperative-acl-reconstruction-a-single-center-experience
#3
James Higgins, John Semple, Lucas Murnaghan, Sarah Sharpe, John Theodoropoulos
Background: The initial 6 weeks after surgery has been identified as an area for improvement in patient care. During this period, the persistence of symptoms that go unchecked can lead to unscheduled emergency room and clinic visits, calls to surgeons' offices, and readmissions. Purpose: To analyze postoperative data from a previous study examining postoperative outcomes in 2 patient populations following breast reconstruction and anterior cruciate ligament (ACL) reconstruction with use of a patient-centered mobile application...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29312836/malignant-epithelial-transformation-in-phyllodes-tumor-a-population-based-case-series
#4
Ralph L Widya, Myra F Rodrigues, Pauline T Truong, Peter H Watson, Lorna M Weir, Margaret A Knowling, Elaine S Wai
Background Phyllodes tumor (PT) of the breast is an uncommon fibroepithelial neoplasm. Malignant epithelial transformation in PT is rare. This study reports clinicopathologic characteristics and outcomes of patients with malignant epithelial transformation in PT. Methods From an institutional database of 183 patients with newly diagnosed PT referred to a Canadian provincial cancer institution between 1999 and 2014, 11 cases of PT with concomitant in situ or invasive carcinoma were identified. Descriptive analysis was performed to document the characteristics, treatment and outcomes of this cohort...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29304773/breast-carcinoma-with-21-gene-recurrence-score-lower-than-18-rate-of-locoregional-recurrence-in-a-large-series-with-clinical-follow-up
#5
Gulisa Turashvili, Edi Brogi, Monica Morrow, Maura Dickler, Larry Norton, Clifford Hudis, Hannah Y Wen
BACKGROUND: The 21-gene recurrence score (RS) assay determines the benefit of adding chemotherapy to endocrine therapy for patients with early stage, estrogen receptor (ER)-positive, HER2-negative breast cancer. The RS risk groups predict the likelihood of distant recurrence and have recently been associated with an increased risk of locoregional recurrence (LRR). This study analyzed clinicopathologic features of patients with low RS and LRR. METHODS: In our institutional database, we identified 1396 consecutive female patients with lymph node negative, ER+/HER2- invasive breast carcinoma and low RS (<18) results, treated at our center from 2008 to 2013...
January 6, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29302488/oncoplastic-breast-conserving-surgery-with-tailored-needle-guided-excision
#6
Fernando Hernanz, Mónica González-Noriega, Sonia Sánchez, Lucia Paz, Pedro Muñoz, Sandra Hermana
Background: Breast conserving surgery (BCS) administered with oncoplastic approach (OBCS), when it is required, is currently the gold standard for the treatment of early breast cancer. Wire-guided localization (WL) is the most popular technique used to help surgeon in breast cancer excision. Currently, a universal and undeniable goal is to minimize the rate of positive margins and re-excision operation after BCS improving cosmetic outcome and decreasing health care costs. This study is aimed to report our experience combining OBCS and tailored WL as surgical approach for early breast cancers...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29299726/observation-versus-excision-of-lobular-neoplasia-on-core-needle-biopsy-of-the-breast
#7
Hank Schmidt, Brittany Arditi, Margaux Wooster, Christina Weltz, Laurie Margolies, Ira Bleiweiss, Elisa Port, Shabnam Jaffer
PURPOSE: Controversy surrounds management of lobular neoplasia (LN), [atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS)], diagnosed on core needle biopsy (CNB). Retrospective series of pure ALH and LCIS reported "upgrade" rate to DCIS or invasive cancer in 0-40%. Few reports document radiologic/pathologic correlation to exclude cases of discordance that are the likely source of most upgrades, and there is minimal data on outcomes with follow-up imaging and clinical surveillance...
January 3, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29286605/treatment-related-quality-of-life-in-nepalese-women-with-breast-cancer
#8
Saraswati Bhandari, Aurawamon Sriyuktasuth, Kanaungnit Pongthavornkamol
Objective: To identify the level of quality of life and its predictors in Nepalese women with breast cancer while receiving chemotherapy. Methods: This cross-sectional study with a predictive design was conducted for a conveniently selected sample of 85 Nepalese women with primary breast cancer receiving chemotherapy at outpatient clinics of three cancer hospitals of Kathmandu, Nepal. Data were collected during December 2016 and February 2017 using demographic sheets, the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire and the modified Medical Outcomes Study Social Support Survey...
December 29, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29260419/comparative-effectiveness-of-preoperative-paravertebral-block-for-post-mastectomy-reconstruction-a-systematic-review-of-the-literature
#9
Anaeze C Offodile, Mario A Aycart, Jodi B Segal
INTRODUCTION: Paravertebral block (PVB) has emerged as a viable strategy for improving postoperative outcomes in breast surgery; however, it is unclear whether these benefits extend to recipients of post-mastectomy reconstruction (PMR). METHODS: A systematic search of the PubMed, EMBASE, Web of Science and Cochrane Library electronic databases was conducted for all studies matching the a priori inclusion criteria (inception to 1 March 2017). Independent assessment by two reviewers, in stages, of the title/abstract and full text was performed...
December 19, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29251382/robotic-da-vinci-xi-assisted-nipple-sparing-mastectomy-first-clinical-report
#10
Benjamin Sarfati, Jean-Francois Honart, Nicolas Leymarie, Francoise Rimareix, Heba Al Khashnam, Frederic Kolb
Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and esthetic outcomes are important patient-related cosmetic considerations. Today, the concept of minimally invasive surgery has become popular, especially using robotic surgery. The authors report the first case of NSM using the latest version of the da Vinci Xi surgical system (Xi). The final incision used to remove the entire mammary gland was located behind the axillary line...
December 18, 2017: Breast Journal
https://www.readbyqxmd.com/read/29238824/effect-of-perioperative-gabapentin-on-postoperative-pain-resolution-and-opioid-cessation-in-a-mixed-surgical-cohort-a-randomized-clinical-trial
#11
Jennifer Hah, Sean C Mackey, Peter Schmidt, Rebecca McCue, Keith Humphreys, Jodie Trafton, Bradley Efron, Debra Clay, Yasamin Sharifzadeh, Gabriela Ruchelli, Stuart Goodman, James Huddleston, William J Maloney, Frederick M Dirbas, Joseph Shrager, John Costouros, Catherine Curtin, Ian Carroll
Importance: Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. Objective: To determine the effect of perioperative gabapentin on remote postoperative time to pain resolution and opioid cessation. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of perioperative gabapentin was conducted at a single-center, tertiary referral teaching hospital...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29214416/breast-conserving-surgery-following-neoadjuvant-therapy-a-systematic-review-on-surgical-outcomes
#12
REVIEW
José H Volders, Vera L Negenborn, Pauline E Spronk, Nicole M A Krekel, Linda J Schoonmade, Sybren Meijer, Isabel T Rubio, M Petrousjka van den Tol
PURPOSE: Neoadjuvant chemotherapy (NACT) is increasingly used in breast cancer treatment. One of the main goals of NACT is to reduce the extent of local surgery of the breast and axilla. The aim of this study was to determine surgical outcomes for patients receiving breast-conserving therapy (BCT) after NACT, including margin status plus secondary surgeries, excision volumes, and cosmetic outcomes. METHODS: A systematic review was performed in accordance with PRISMA principles...
December 6, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29213346/safe-plastic-surgery-of-the-breast-ii-saving-nipple-sensation
#13
Steven Schulz, Matthew R Zeiderman, J Stephen Gunn, Charles A Riccio, Saeed Chowdhry, Ronald Brooks, Joshua H Choo, Bradon J Wilhelmi
Background: Since its inception, reduction mammoplasty has matured considerably. Primary evolution in clinical research and practice initially focused on developing techniques to preserve tissue viability; breast parenchyma, skin, and nipple tissue that has expanded to include sensation and erectile function play a large role in the physical intimacy of women. Studies regarding primary innervation to the nipple are few and often contradictory. Our past anatomical study demonstrated that primary innervation to the nipple to come from the lateral branch of the fourth intercostal nerve...
2017: Eplasty
https://www.readbyqxmd.com/read/29207864/long-term-cosmesis-following-a-novel-schedule-of-accelerated-partial-breast-radiation-in-selected-early-stage-breast-cancer-result-of-a-prospective-clinical-trial
#14
Mutlay Sayan, Daphne Hard, Karen Wilson, Carl Nelson, Havaleh Gagne, Deborah Rubin, Ruth Heimann
Purpose: There is controversy regarding the cosmetic outcome after accelerated partial breast radiation (APBR). We report the cosmetic outcome from a single-arm prospective clinical trial of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I breast cancer (BC), using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ≥65, with Stage I BC who underwent breast-conserving surgery were enrolled in a phase I/II study evaluating a 2-week course of APBR...
December 15, 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/29191356/a-novel-modality-for-intraoperative-margin-assessment-and-its-impact-on-re-excision-rates-in-breast-conserving-surgery
#15
Amanda Kupstas, Warda Ibrar, R David Hayward, David Ockner, Cheryl Wesen, Jeffrey Falk
BACKGROUND: A single center retrospective chart review was performed examining the ability of a novel radiofrequency probe (Margin Probe; Dune Medical Devices, Caesarea, Israel) for intraoperative margin assessment to reduce the number of reexcisions in breast-conserving surgery. METHODS: Reexcision rates were evaluated in one-hundred and twenty consecutive patients before and after the institution of the device. Utility of the device was evaluated by comparing intraoperative feedback with postoperative pathology reports...
November 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29189967/evaluation-of-a-specialized-oncology-nursing-supportive-care-intervention-in-newly-diagnosed-breast-and-colorectal-cancer-patients-following-surgery-a-cluster-randomized-trial
#16
Jonathan Sussman, Daryl Bainbridge, Timothy J Whelan, Kevin Brazil, Sameer Parpia, Jennifer Wiernikowski, Susan Schiff, Gary Rodin, Myles Sergeant, Doris Howell
BACKGROUND: Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. METHODS: Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services...
November 30, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29184728/diep-flap-breast-reconstruction-in-patients-with-breast-ptosis-2-stage-reconstruction-using-3-dimensional-surface-imaging-and-a-printed-mold
#17
Koichi Tomita, Kenji Yano, Mifue Taminato, Michiko Nomori, Ko Hosokawa
Background: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29180210/survival-outcomes-of-neoadjuvant-chemotherapy-with-zoledronic-acid-for-her2-negative-breast-cancer
#18
Takashi Ishikawa, Kouhei Akazawa, Yoshie Hasegawa, Hirokazu Tanino, Jun Horiguchi, Daishu Miura, Mitsuhiro Hayashi, Norio Kohno
BACKGROUND: A randomized phase 2 trial in women with HER2-negative breast cancer has shown that adding zoledronic acid (ZOL) to neoadjuvant chemotherapy (CT) has potential anticancer benefits in postmenopausal and triple-negative (TN) breast cancer patients. We report the data for the secondary end point of disease-free survival (DFS). METHODS: Patients were randomly assigned to receive CT or CT + ZOL (CT-Z). All patients received four cycles of FEC100 followed by 12 cycles of paclitaxel weekly...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29176411/evidence-based-performance-measures-quality-metrics-for-the-care-of-patients-undergoing-breast-reconstruction
#19
Michele A Manahan, William A Wooden, Stephen M Becker, Jason R Cacioppo, Stephen B Edge, Amanda C Grandinetti, Diedra D Gray, Susan O Holley, Nolan S Karp, Ergun Kocak, Roshni Rao, Gedge D Rosson, Jaime S Schwartz, Thomas J Sitzman, Hooman T Soltanian, Sarvam P TerKonda, Anne M Wallace
The American Society of Plastic Surgeons commissioned the Breast Reconstruction Performance Measure Development Work Group to identify and draft quality measures for the care of patients undergoing breast reconstruction surgery. Two outcome measures were identified. The first desired outcome was to reduce the number of returns to the operating room following reconstruction within 60 days of the initial reconstructive procedure. The second desired outcome was to reduce flap loss within 30 days of the initial reconstructive procedure...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29175149/neoadjuvant-trastuzumab-pertuzumab-and-chemotherapy-versus-trastuzumab-emtansine-plus-pertuzumab-in-patients-with-her2-positive-breast-cancer-kristine-a-randomised-open-label-multicentre-phase-3-trial
#20
Sara A Hurvitz, Miguel Martin, W Fraser Symmans, Kyung Hae Jung, Chiun-Sheng Huang, Alastair M Thompson, Nadia Harbeck, Vicente Valero, Daniil Stroyakovskiy, Hans Wildiers, Mario Campone, Jean-François Boileau, Matthias W Beckmann, Karen Afenjar, Rodrigo Fresco, Hans-Joachim Helms, Jin Xu, Yvonne G Lin, Joseph Sparano, Dennis Slamon
BACKGROUND: HER2-targeted treatments have improved outcomes in patients with HER2-positive breast cancer in the neoadjuvant, adjuvant, and metastatic settings; however, some patients remain at risk of relapse or death for many years after treatment of early-stage disease. Therefore, new strategies are needed. We did a phase 3 trial to assess a neoadjuvant regimen for HER2-positive breast cancer that replaces traditional systemic chemotherapy with targeted treatment. METHODS: We did a randomised, open-label phase 3 KRISTINE trial in 68 Translational Research In Oncology centres (hospitals and specialty cancer centres in Asia, Europe, USA, and Canada)...
November 23, 2017: Lancet Oncology
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