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Prophylactic Mastectomy

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https://www.readbyqxmd.com/read/28916957/perspectives-of-women-considering-bilateral-prophylactic-mastectomy-and-their-peers-towards-a-telephone-based-peer-support-intervention
#1
D St-Pierre, K Bouchard, L Gauthier, J Chiquette, Michel Dorval
Prophylactic mastectomy is an effective strategy to reduce the risk of breast cancer for women carrying a BRCA1/2 germline mutation. This decision is complex and may raise various concerns. Women considering this surgery have reported their desire to discuss the implications of this procedure with women who have undergone prophylactic mastectomy. We conducted a qualitative study to describe the topics covered during a telephone-based peer support intervention between women considering prophylactic mastectomy (recipients) and women who had undergone this surgery (peers), and to explore their perspectives regarding the intervention...
September 15, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28903167/oncologic-safety-of-prophylactic-nipple-sparing-mastectomy-in-a-population-with-brca-mutations-a-multi-institutional-study
#2
James W Jakub, Anne Warren Peled, Richard J Gray, Rachel A Greenup, John V Kiluk, Virgilio Sacchini, Sarah A McLaughlin, Julia C Tchou, Robert A Vierkant, Amy C Degnim, Shawna Willey
Importance: Nipple-sparing mastectomy (NSM) offers superior cosmetic outcomes and has been gaining wide acceptance; however, its role among patients with BRCA mutations remains controversial. Objective: To report on the oncologic safety of NSM and provide evidence-based data to patients and health care professionals regarding preservation of the nipple-areolar complex during a risk-reducing mastectomy in a population with BRCA mutations. Design, Setting, and Participants: We retrospectively reviewed the outcomes of 9 institutions' experience with prophylactic NSM from 1968 to 2013 in a cohort of patients with BRCA mutations...
September 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28903158/surgeon-influence-on-variation-in-receipt-of-contralateral-prophylactic-mastectomy-for-women-with-breast-cancer
#3
Steven J Katz, Sarah T Hawley, Ann S Hamilton, Kevin C Ward, Monica Morrow, Reshma Jagsi, Timothy P Hofer
Importance: Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but we know little about the influence of surgeons on variability of the procedure in the community. Objective: To quantify the influence of the attending surgeon on rates of CPM and clinician attitudes that explained it. Design, Setting, and Participants: In this population-based survey study, we identified 7810 women with stages 0 to II breast cancer treated in 2013 to 2015 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County...
September 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28894848/risk-reduction-strategies-in-breast-cancer-prevention
#4
REVIEW
Mauricio Costa, Paula Saldanha
Evaluating the risk of breast cancer makes it possible to identify women with a high risk of developing breast cancer in the future. Adopting a healthier lifestyle, involving diet and exercise, is one way of reducing this risk-but there are other, non-modifiable risk factors, such as family history, genetics and diagnosis of premalignant lesions. In this high-risk population, the tracking must be rigorous and involve the participation of the patient herself, earlier and more frequent clinical assessment, and the use of imaging screening...
July 2017: Eur J Breast Health
https://www.readbyqxmd.com/read/28870441/influences-on-decision-making-for-young-women-undergoing-bilateral-prophylactic-mastectomy
#5
Rachael Glassey, Moira O'Connor, Angela Ives, Christobel Saunders, Sarah J Hardcastle
OBJECTIVE: The objective of this study was to explore the influences on decision-making of younger women (<35) undergoing or considering bilateral prophylactic mastectomy (BPM). METHODS: Qualitative interviews guided by interpretative phenomenological analysis (IPA) were conducted with forty-six women who had a strong family history of breast cancer (BC) who had either undergone (n=26) or were considering (n=20) BPM. Participants were recruited from Australia and New Zealand (NZ) via hospitals, a genetics clinic, a research cohort, a registry and online...
August 24, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28857238/the-diversity-in-the-expression-profile-of-caveolin-ii-transcripts-considering-its-new-transcript-in-breast-cancer
#6
Ariana Mehdi, Nasibeh Arabi, Majid Pornour, Hajar Vaseghi, Shahla Mohammad Ganji, Mohammad Reza Alivand, Maryam Salari, Mohammad Esmaeil Akbari
Most studies have revealed the effects of caveolins in cancer inhibition. However, due to a lack of reports about their new transcripts, their presence and their effects on different cancers are unclear. This study was conducted to evaluate the cavolin-2(cav-2) transcripts expression changes in tumoral and corresponding tissues and in contralateral breast, to investigate their variation associated with the variation of caveolin-1 (cav-1) expression in breast cancer. There were 40 breast-derived tumoral, corresponding and contralateral tissues obtained from the patients with breast cancer...
August 31, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28841601/prophylactic-nipple-sparing-mastectomy-and-direct-to-implant-reconstruction-of-the-large-and-ptotic-breast-is-preshaping-of-the-challenging-breast-a-key-to-success
#7
Gudjon L Gunnarsson, Camilla Bille, Laurens C Reitsma, Peter Wamberg, Jørn Bo Thomsen
BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28831365/comparative-study-of-prepectoral-and-subpectoral-expander-based-breast-reconstruction-and-clavien-iiib-score-outcomes
#8
Lynne N Bettinger, Linda M Waters, Stephen W Reese, Susan E Kutner, Daniel I Jacobs
Prepectoral breast reconstruction is increasingly popular. This study compares complications between 2 subpectoral and 1 prepectoral breast reconstruction technique. METHODS: Between 2008 and 2015, 294 two-staged expander breast reconstructions in 213 patients were performed with 1 of 3 surgical techniques: (1) Prepectoral, (2) subpectoral with acellular dermal matrix (ADM) sling ("Classic"), or (3) subpectoral/subserratus expander placement without ADM ("No ADM"). Demographics, comorbidities, radiation therapy, and chemotherapy were assessed for correlation with Clavien IIIb score outcomes...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28820618/college-women-s-responses-to-a-celebrity-health-disclosure
#9
Julia H Drizin, Vanessa L Malcarne, Melody K Schiaffino, Kristen J Wells
Celebrities can have a powerful influence on people's health-related attitudes and behaviors, often by publicly disclosing their own personal health decisions. In May 2013, Angelina Jolie, an internationally recognized actress, director, and author, wrote an op-ed for the New York Times disclosing her decision to undergo a prophylactic double mastectomy to reduce her risk of breast cancer after learning that she carried the BRCA1 gene mutation. This cross-sectional study examined whether exposure to Angelina Jolie and her mastectomy disclosure and parasocial involvement (PSI) with Angelina Jolie were related to female college students' perceived risk of breast cancer and breast cancer screening intentions...
August 18, 2017: Health Communication
https://www.readbyqxmd.com/read/28811185/the-effect-of-receptor-status-on-mastectomy-and-contralateral-prophylactic-mastectomy-rates-in-early-stage-invasive-breast-carcinoma
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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