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Prophylactic Mastectomy

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https://www.readbyqxmd.com/read/28811185/the-effect-of-receptor-status-on-mastectomy-and-contralateral-prophylactic-mastectomy-rates-in-early-stage-invasive-breast-carcinoma
#1
Sunil W Dutta, Daniel M Trifiletti, Surbhi Grover, Kara D Romano, Einsley-Marie Janowski, Shayna L Showalter
BACKGROUND: There is an established relationship between hormone receptor (HR; estrogen and/or progesterone receptors) status, HER2 status, and locoregional recurrence. The purpose of this study was to analyze how HR and HER2 receptor status have influenced the surgical management trends among patients with early stage breast cancer. PATIENTS AND METHODS: The National Cancer Database was queried for patients with cT1 to cT3, cN0, and cM0 breast carcinoma from 2004 to 2012...
June 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28810062/the-association-between-patient-attitudes-and-values-and-the-strength-of-consideration-for-contralateral-prophylactic-mastectomy-in-a-population-based-sample-of-breast-cancer-patients
#2
Sarah T Hawley, Kent A Griffith, Ann S Hamilton, Kevin C Ward, Monica Morrow, Nancy K Janz, Steven J Katz, Reshma Jagsi
BACKGROUND: Little is known about how the individual decision styles and values of breast cancer patients at the time of treatment decision making are associated with the consideration of different treatment options and specifically with the consideration of contralateral prophylactic mastectomy (CPM). METHODS: Newly diagnosed patients with early-stage breast cancer who were treated in 2013-2014 were identified through the Surveillance, Epidemiology, and End Results registries of Los Angeles and Georgia and were surveyed approximately 7 months after surgery (n = 2578; response rate, 71%)...
August 15, 2017: Cancer
https://www.readbyqxmd.com/read/28780755/when-to-consider-risk-reducing-mastectomy-in-brca1-brca2-mutation-carriers-with-advanced-stage-ovarian-cancer-a-case-study-illustrating-the-genetic-counseling-challenges
#3
Beverley Speight, Marc Tischkowitz
Germline mutations in BRCA1/BRCA2 significantly increase the risk of breast and ovarian cancer in women. This case report describes a BRCA1 germline mutation identified in a woman with stage IV epithelial ovarian cancer and the provision of genetic counseling about BRCA1-associated breast cancer risk in the three years following diagnosis. The report centers on the patient's enquiry about risk-reducing breast surgery. We focus on the challenges for health professionals and patients in understanding and balancing the risks and benefits of major prophylactic surgery in the context of a potentially life-limiting cancer diagnosis...
August 5, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28770017/preoperative-genetic-testing-impacts-surgical-decision-making-in-brca-mutation-carriers-with-breast-cancer-a-retrospective-cohort-analysis
#4
Siddhartha Yadav, Ashley Reeves, Sarah Campian, Amy Sufka, Dana Zakalik
BACKGROUND: The impact of timing of genetic testing on surgical decision making in women with breast cancer and BRCA mutation is not well known. METHODS: Women who were found to carry a deleterious BRCA mutation and had been diagnosed with breast cancer were identified from a database at Beaumont Health. Women who had received BRCA positive results at least a day prior to their index surgery were considered to be aware of their mutation status prior to surgery. Baseline characteristics and surgical choices were compared between women who were aware of their mutation status prior to surgery and those who were not...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/28766231/contralateral-prophylactic-mastectomy-with-immediate-breast-reconstruction-increases-healthcare-utilization-and-cost
#5
Judy C Boughey, Stephanie R Schilz, Holly K Van Houten, Lin Zhu, Elizabeth B Habermann, Valerie Lemaine
BACKGROUND: The rates of contralateral prophylactic mastectomy (CPM) in women with unilateral breast cancer continue to rise, especially in women undergoing immediate breast reconstruction (IBR). METHODS: We utilized administrative claims data from a large US commercial insurance database (OptumLabs) to identify women age 18-64 years who underwent IBR between January 2004 and December 2013. We compared 2-year unadjusted utilization rates and total costs of care between unilateral mastectomy (UM) and bilateral mastectomy (BM) for implant-based and autologous reconstruction...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766225/influence-of-distance-to-hospital-and-insurance-status-on-the-rates-of-contralateral-prophylactic-mastectomy-a-national-cancer-data-base-study
#6
Erin P Ward, Jonathan T Unkart, Alex Bryant, James Murphy, Sarah L Blair
INTRODUCTION: We evaluated the impact of travel distance and insurance status on contralateral prophylactic mastectomy (CPM) rates in breast cancer. METHODS: We queried the National Cancer Data Base (NCDB) for women >18 years of age with a nonmetastatic primary breast cancer of ductal, lobular, or mixed histology. Patient- and facility-specific CPM rates were calculated based on insurance, race, and distance to treatment center. Standard univariable and multivariable regression analysis was performed...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766224/clinical-decision-making-in-patients-with-variant-of-uncertain-significance-in-brca1-or-brca2-genes
#7
Jessemae L Welsh, Tanya L Hoskin, Courtney N Day, Abigail S Thomas, Jodie A Cogswell, Fergus J Couch, Judy C Boughey
BACKGROUND: How diagnosis with a variant of uncertain significance (VUS) in a BRCA gene impacts clinical decision-making is not well known. METHODS: We queried for all patients attending Mayo Clinic Rochester from 2004 to 2016 who tested positive for BRCA1 or BRCA2 VUS and reviewed patient management choices. Groups were compared by using Wilcoxon rank-sum and Chi-square tests. RESULTS: We identified 97 patients (95 females, 2 males) with BRCA VUS...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766223/differences-among-a-modern-cohort-of-brca-mutation-carriers-choosing-bilateral-prophylactic-mastectomies-compared-to-breast-surveillance
#8
Elizabeth Gilbert, Emily C Zabor, Michelle Stempel, Debra Mangino, Alexandra Heerdt, Melissa Pilewskie
BACKGROUND: Women with a BRCA mutation have significantly elevated breast cancer risk, which can be reduced by >90% with bilateral prophylactic mastectomy (BPM). We sought to compare a cohort of BRCA mutation carriers choosing BPM versus breast surveillance to better elucidate factors that may impact decision making. METHODS: Women with a BRCA mutation were retrospectively identified from a prospectively maintained database. The surveillance cohort (n = 313) consisted of women seen in a high-risk clinic between 2014 and 2016, while the surgery cohort (n = 142) consisted of women who underwent BPM between 2010 and 2016...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766208/contralateral-breast-cancer-risk-in-women-with-ductal-carcinoma-in-situ-is-it-high-enough-to-justify-bilateral-mastectomy
#9
Megan E Miller, Shirin Muhsen, Cristina Olcese, Sujata Patil, Monica Morrow, Kimberly J Van Zee
BACKGROUND: Women with ductal carcinoma in situ (DCIS) are increasingly choosing bilateral mastectomy. We sought to quantify rates of contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) for DCIS, and to compare risk factors for CBC and IBTR. METHODS: From 1978 to 2011, DCIS patients undergoing BCS with a contralateral breast at risk were identified from a prospectively maintained database. The association of clinicopathologic and treatment factors with CBC and IBTR were evaluated using Kaplan-Meier analysis, multivariable Cox regression, and competing risk regression (CRR)...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766201/selective-use-of-sentinel-lymph-node-surgery-in-patients-undergoing-prophylactic-mastectomy-using-intraoperative-pathology
#10
Brittany L Murphy, Amy E Glasgow, Gary L Keeney, Elizabeth B Habermann, Judy C Boughey
BACKGROUND: Routine sentinel lymph node (SLN) surgery during prophylactic mastectomy (PM) is unnecessary, because most PMs do not contain cancer. Our institution utilizes intraoperative pathology to guide the surgical decision for resection of SLNs in PM. The purpose of this study was to review the effectiveness of this approach. METHODS: We identified all women aged ≥18 years who underwent bilateral PM (BPM) or contralateral PM (CPM) at our institution from January 2008 to July 2016...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28738941/disparities-in-rural-breast-cancer-care-factors-affecting-choice-of-breast-reconstruction-in-a-west-virginia-tertiary-care-hospital
#11
Tyler L Holliday, Patrick D Suggs, Stephanie N Thompson, Bryan K Richmond
The decision to pursue immediate postmastectomy breast reconstruction (IBR) is not uniform across all groups of women in the United States. We sought to investigate if the challenges of caring for a socioeconomically and geographically challenged rural population affected the incidence of IBR and to identify predictive factors of IBR in this population. Using our institution's cancer registry, we conducted a 10-year review of women with early-stage, unilateral breast cancer who received mastectomy. Demographics, insurance status, comorbidities, and surgeon graduation year were compared for patients receiving IBR versus no reconstruction...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738940/factors-affecting-choice-of-treatment-for-early-stage-breast-cancer-in-west-virginia-a-10-year-experience-from-a-rural-tertiary-care-center
#12
Patrick D Suggs, Tyler L Holliday, Stephanie N Thompson, Bryan K Richmond
Recent literature shows changing trends in use of breast conservation surgery (BCS), mastectomy, and contralateral prophylactic mastectomy (CPM) in women with early-stage breast cancer (ESBC). We analyzed factors associated with selection of these treatment modalities in a rural West Virginia tertiary care hospital. We conducted a 10-year analysis of women treated for ESBC at our institution from the institutional cancer registry. Variables were compared between patients choosing BCS versus mastectomy. In women who chose mastectomy, predictors for choice of CPM were also examined...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28712528/breast-cancer-in-the-21st-century-from-early-detection-to-new-therapies
#13
J A Merino Bonilla, M Torres Tabanera, L H Ros Mendoza
The analysis of the causes that have given rise to a change in tendency in the incidence and mortality rates of breast cancer in the last few decades generates important revelations regarding the role of breast screening, the regular application of adjuvant therapies and the change of risk factors. The benefits of early detection have been accompanied by certain adverse effects, even in terms of an excessive number of prophylactic mastectomies. Recently, several updates have been published on the recommendations in breast cancer screening at an international level...
July 13, 2017: Radiología
https://www.readbyqxmd.com/read/28692521/evaluation-intravenous-drip-cephazolin-prophylaxis-of-breast-cancer-surgery-site-infection
#14
Sufang Yang, Guohua Liu, Danling Tang, De Cai
PURPOSE: The efficacy of antibiotic prophylaxis for the prevention of surgical site infection (SSI) after breast cancer surgery remains uncertain. The authors of a recent Cochrane meta-analysis based on 15 randomized trials were unable to draw a definitive conclusion. The purpose of this study was to determine the effectiveness of prophylactic antibiotics for the prevention of SSI after breast cancer surgery and the risk factors for SSI. METHODS: Breast cancer patients who underwent mastectomy at the authors' institution were enrolled in this study...
July 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28691668/correct-information-to-patients-undergoing-breast-conserving-surgery-the-medicolegal-significance
#15
A Sanguinetti, A Polistena, R Luchini, M Monacelli, S Avenia, S Galasse, R Cirocchi, N Avenia
Many of the women newly diagnosed with breast cancer not have access to all the information they need to make the surgical and treatment choices that are most appropriate for them. Research clearly shows that lumpectomy and other breast-conserving surgeries are just as safe as mastectomy for most women with early stage disease, and yet approximately half will undergo the more disfiguring procedures, but many healthy women who have strong family histories of breast cancer consider prophylactic mastectomies, and their decisions are also based on very limited information, because there are few studies showing the effectiveness of that procedure...
March 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28690658/influence-of-the-angelina-jolie-announcement-and-insurance-reimbursement-on-practice-patterns-for-hereditary-breast-cancer
#16
Jihyoun Lee, Sungwon Kim, Eunyoung Kang, Suyeon Park, Zisun Kim, Min Hyuk Lee
Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database...
June 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28669356/prevalence-and-predictors-of-postdischarge-antibiotic-use-following-mastectomy
#17
Margaret A Olsen, Katelin B Nickel, Victoria J Fraser, Anna E Wallace, David K Warren
OBJECTIVE Survey results suggest that prolonged administration of prophylactic antibiotics is common after mastectomy with reconstruction. We determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. DESIGN Retrospective cohort. PATIENTS Commercially insured women aged 18-64 years coded for mastectomy from January 2004 to December 2011 were included in the study. Women with a preexisting wound complication or septicemia were excluded...
July 3, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28666919/age-molecular-subtypes-and-local-therapy-decision-making
#18
Anne Kuijer, Tari A King
The relationship between age and breast cancer subtype is complex: both impact risk of locoregional recurrence (LRR) and survival. Young patients frequently present with aggressive tumors but the increased risk imparted by young age appears to differ among breast cancer subtypes. Dramatic improvements in local control among young women with breast cancer of all tumor subtypes have been observed, likely attributable to improved local therapy strategies, improvements in adjuvant therapies and implementation of subtype-specific targeted therapies...
June 27, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28649642/disparities-in-contralateral-prophylactic-mastectomy-use-among-women-with-early-stage-breast-cancer
#19
Younji Kim, Anne Marie McCarthy, Mirar Bristol, Katrina Armstrong
Contralateral prophylactic mastectomy use has increased over the past decades among women with early-stage breast cancer. Racial differences in contralateral prophylactic mastectomy use are well described, but with unclear causes. This study examined contralateral prophylactic mastectomy use among black and white women and the contribution of differences in perceived risk to differences in use. We surveyed women diagnosed with early-stage unilateral breast cancer between ages 41-64 in Pennsylvania and Florida between 2007-2009 to collect data on breast cancer treatment, family history, education, income, insurance, and perceived risk...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28649032/a-standard-mastectomy-should-not-be-the-only-recommended-breast-surgical-treatment-for-non-metastatic-inflammatory-breast-cancer-a-large-population-based-study-in-the-surveillance-epidemiology-and-end-results-database-18
#20
Hongliang Chen, Kejin Wu, Maoli Wang, Fuwen Wang, Mingdi Zhang, Peng Zhang
BACKGROUND: Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013...
June 22, 2017: Breast: Official Journal of the European Society of Mastology
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