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Prophylactic Mastectomy

Jessica Keim-Malpass, Aubrey Doede, Fabian Camacho, Christine Kennedy, Shayna L Showalter
Little is known about the role of low health literacy (LHL) among breast surgical oncology patients. We initiated a prospective health literacy assessment to determine the relationship between health literacy and surgical treatment. Among 512 patients, univariate analysis revealed no statistical significance in the relationship of health literacy to breast surgery type, contralateral prophylactic mastectomy, or reconstruction following mastectomy. In a multivariate analysis, women with LHL were less likely to undergo reconstruction (aOR 0...
March 14, 2018: Breast Journal
Julius C Mwita, Sajini Souda, Mgaywa Gmd Magafu, Amos Massele, Brian Godman, Michael Mwandri
OBJECTIVES: Antibiotic prophylaxis in surgery is known to reduce the rate of surgical site infections (SSI) as well as shorten hospital stay. However, there is currently a scarcity of data on antibiotic prophylaxis and SSIs among African countries including Botswana. Consequently, this study aimed to address this. METHODS: A prospective study involving 400 patients was carried out at a leading tertiary hospital in Botswana from 2014-2015. Patients' demographic information, type of surgery performed and peri-operative use of antibiotics were documented...
March 9, 2018: Hospital Practice (Minneapolis)
Sara Câmara, Daniela Pereira, Saudade André, Beatriz Mira, Fátima Vaz, Rodrigo Oom, José Carlos Marques, João Leal de Faria, Catarina Rodrigues Dos Santos
Introduction: Sentinel lymph node biopsy in prophylactic mastectomy is controversial. It avoids lymphadenectomy in occult carcinoma but is associated with increased morbidity. Women with BRCA mutations have a higher incidence of occult carcinoma and our objective was to assess the clinical utility of sentinel lymph node biopsy when these women undergo prophylactic mastectomy. Materials and Methods: Seven-year retrospective consecutive case-series study of women, with a BRCA deleterious mutation, admitted to prophylactic mastectomy, at our center...
2018: International Journal of Breast Cancer
Patrick Bletsis, Alexandra Bucknor, Anmol Chattha, Parisa Kamali, Austin Chen, Renata Flecha-Hirsch, Berend van der Lei, Bernard T Lee, Samuel J Lin
BACKGROUND: Over the last decade, there has been a 12% increase in prophylactic mastectomy (PM) per year. The aim of the study was to analyze complication rates and associated risk factors in patients undergoing PM and reconstruction. METHODS: We reviewed patients undergoing PM (contralateral and bilateral) from 2010 to 2015 at a single academic institution. Data on patient characteristics and postoperative outcomes were obtained. Postoperative complications were categorized into minor and major groups...
February 23, 2018: Annals of Plastic Surgery
Shoshana M Rosenberg, Mary L Greaney, Andrea F Patenaude, Karen R Sepucha, Meghan E Meyer, Ann H Partridge
OBJECTIVE: Young women with unilateral breast cancer are increasingly choosing contralateral prophylactic mastectomy (CPM), despite its limited medical benefit for most women. The purpose of this study was to better understand this choice through a qualitative exploration of surgical decision-making in young survivors, including how issues particular to younger women affected their decision and the post-surgical experience. METHODS: Women age ≤40 years with stage 0-III breast cancer, 1-3 years from diagnosis who had undergone breast cancer surgery were recruited to participate...
February 24, 2018: Psycho-oncology
Christine Mau, Michael Untch
Risk-reducing surgery has proved to be a reasonable procedure in healthy women with a definitely elevated risk of developing cancer. Here we consider the elevated risk of breast and ovarian cancer. There is a clear indication for such surgery in healthy women with a pathogenic BRCA1/2 mutation. For these patients, a risk-reducing bilateral mastectomy leads to a verifiable reduction in mortality from breast cancer, particularly for young patients. In most cases, surgery is combined with breast reconstruction...
December 2017: Breast Care
D Casella, G Di Taranto, M Marcasciano, S Sordi, A Kothari, T Kovacs, F Lo Torto, E Cigna, D Ribuffo, C Calabrese
BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our institutions. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop® )...
February 15, 2018: Breast: Official Journal of the European Society of Mastology
Alessandro Fancellu, Valeria Sanna, Pietrina Cottu, Cladio F Feo, Antonio M Scanu, Giulia Farina, Antonio Bulla, Angela Spanu, Panagiotis Paliogiannis, Alberto Porcu
BACKGROUND: Recent literature reports that rates of mastectomy are increasing in early breast cancer. However, data from European institutions are limited and revealed conflicting results. We report on 15-year trends of mastectomy, mastectomy plus immediate reconstruction and contralateral prophylactic mastectomy (CPM) at an academic institution. METHODS: We identified women diagnosed with unilateral early breast cancer at stage 0-IIa, with tumour size ≤ 4 cm, between 2002 and 2016...
February 14, 2018: Breast: Official Journal of the European Society of Mastology
Mary Ann Sanders, Jane E Brock, Beth T Harrison, Tad J Wieczorek, Xuefei Hong, Anthony J Guidi, Deborah A Dillon, Leslie Max, Susan C Lester
CONTEXT: - Patients choosing to retain the nipple when undergoing therapeutic or prophylactic mastectomy are at risk for cancers arising at that site. OBJECTIVE: - To identify cases of invasive carcinoma arising within the nipple and to investigate their clinical, imaging, biologic, and staging features. DESIGN: - Carcinomas were identified by prospective review of surgical and consult cases at 4 hospitals. RESULTS: - The 24 patients identified presented with symptoms related to the nipple...
February 12, 2018: Archives of Pathology & Laboratory Medicine
Monique C Tourell, Tonima S Ali, Honor J Hugo, Chris Pyke, Samuel Yang, Thomas Lloyd, Erik W Thompson, Konstantin I Momot
PURPOSE: A single-sided NMR instrument was used to investigate the ability of the T1 relaxation constant to distinguish between regions of low and high mammographic density in human breast tissue. METHODS: Measurements were performed on 5 breast slices obtained from 3 women undergoing breast reduction surgery or prophylactic mastectomy. RESULTS: T1 values measured in regions of high mammographic density in both the full breast slices (T1  = 170 ± 30 ms) and excised regions (T1  = 160 ± 30 ms) were found to be significantly different (P < ...
February 4, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
F W Wang, S M Fu, Y C Jin, X H Gong, H D Cheng, K J Wu
Objective: To investigate the principles of diagnosis and treatment of breast cancer during pregnancy. Methods: Clinical data of patients with breast cancer during pregnancy admitted to Obstetrics and Gynecology Hospital of Fudan University between January 2012 to July 2017 were analyzed retrospectively. A total of 17 patients were diagnosed with breast cancer in pregnancy, the median age was 32 years (range from 25 to 45 years old), pathological staging revealed 2 patient with stage 0, 1 with stage Ⅱa, 7 with stage Ⅱb, 1 with stage Ⅲa, 2 with stage Ⅲc, 4 with stage Ⅳ...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Evan Matros, Joseph J Disa
No abstract text is available yet for this article.
January 25, 2018: Plastic and Reconstructive Surgery
S Vreemann, A Gubern-Merida, S Lardenoije, P Bult, N Karssemeijer, K Pinker, R M Mann
PURPOSE: To evaluate the frequency of missed cancers on breast MRI in women participating in a high-risk screening program. METHODS: Patient files from women who participated in an increased risk mammography and MRI screening program (2003-2014) were coupled to the Dutch National Cancer Registry. For each cancer detected, we determined whether an MRI scan was available (0-24 months before cancer detection), which was reported to be negative. These negative MRI scans were in consensus re-evaluated by two dedicated breast radiologists, with knowledge of the cancer location...
January 31, 2018: Breast Cancer Research and Treatment
Holly J Pederson, Dharmesh Gopalakrishnan, Ryan Noss, Courtney Yanda, Charis Eng, Stephen R Grobmyer
BACKGROUND: With the advent of multi-gene panel testing for breast cancer patients, germline mutations with unknown association with cancer risk, known as variants of uncertain significance (VUS), are being increasingly identified. Some studies have shown higher rates of contralateral prophylactic mastectomies (CPM) in these patients despite lack of evidence to support this intervention. We analyzed surgical choices in patients who were identified to have VUS. METHODS: A retrospective review was performed of patients with TNBC treated at a single institution after multi-gene panel tests became available (09/01/2013- 02/28/2017)...
January 19, 2018: Journal of the American College of Surgeons
Marc A M Mureau
Treatment of breast cancer is complex and multidisciplinary by nature, with protocols that are updated continuously. During preoperative multidisciplinary team meetings, regularly there is discussion between team members regarding optimal timing and type of breast reconstruction, due to conflicting interests of oncological and reconstructive treatments. Therefore, a multidisciplinary, evidence-based guideline for breast reconstruction in women undergoing breast conserving therapy or mastectomy for breast cancer, or following prophylactic mastectomy was developed by a multidisciplinary working group...
December 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Lara Petelin, Alison H Trainer, Gillian Mitchell, Danny Liew, Paul A James
PurposeTo review the evidence for the effectiveness and cost-effectiveness of cancer risk management interventions for BRCA carriers.MethodsComparative effectiveness and cost-effectiveness analyses were identified by searching scientific and health economic databases. Eligible studies modeled the impact of a cancer risk management intervention in BRCA carriers on life expectancy (LE), cancer incidence, or quality-adjusted life years (QALYs), with or without costs.ResultsTwenty-six economic evaluations and eight comparative effectiveness analyses were included...
January 11, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Joanne Kotsopoulos, Steven A Narod
No abstract text is available yet for this article.
January 8, 2018: Expert Review of Anticancer Therapy
John Shuck, Neil O'Kelly, Matthew Endara, Maurice Y Nahabedian
Background: Nipple preservation provides superior aesthetic results as well as patient satisfaction in patients treated with both therapeutic and prophylactic mastectomy. Post-operative nipple ischemia and necrosis presents a unique clinical challenge that may be treated with hyperbaric oxygen therapy or conservative measures alone. To date, the efficacy of hyperbaric oxygen on post-operative nipple ischemia has yet to be evaluated. Methods: A retrospective review of patients treated with either hyperbaric oxygen or conservative management was performed...
December 2017: Gland Surgery
R Kenny, M Reed, A Subramanian
BACKGROUND: Prophylactic or 'risk-reducing' mastectomy refers to the procedure of completely removing a healthy breast in order to reduce the risk of developing breast cancer. This may be bilateral or may be performed to the contralateral breast as part of the treatment of a proven breast cancer. The rate of this procedure being performed has been shown to be increasing over the last two decades. Recent guidance for Breast clinicians has been issued over the last 12 months by both The Association of Breast Surgery of Great Britain and Ireland (ABSGBI) and the American Society of Breast Surgeons (ASBrS)...
December 26, 2017: International Journal of Surgery
Ayong Cao, Liang Huang, Zhimin Shao
Approximately 5-10% of breast cancer is considered to be hereditary. Familial breast cancers exhibit a dominant hereditary pattern, which typically have an early age of onset and are accompanied by symptoms of ovarian cancer, bilateral breast cancer, or male breast cancer. BRCA gene mutation carriers should be regarded as high-risk groups for breast cancer, which necessitates early examination of breast cancer. Studies have built up kinds of predictive models and recommended that female BRCA mutation carriers should receive breast self-test training and take monthly breast self-examination...
2017: Advances in Experimental Medicine and Biology
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