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Prophylactic Mastectomy

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https://www.readbyqxmd.com/read/27933411/society-of-surgical-oncology-breast-disease-working-group-statement-on-prophylactic-risk-reducing-mastectomy
#1
Kelly K Hunt, David M Euhus, Judy C Boughey, Anees B Chagpar, Sheldon M Feldman, Nora M Hansen, Swati A Kulkarni, David R McCready, Eleftherios P Mamounas, Lee G Wilke, Kimberly J Van Zee, Monica Morrow
Over the past several years, there has been an increasing rate of bilateral prophylactic mastectomy (BPM) and contralateral prophylactic mastectomy (CPM) surgeries. Since publication of the 2007 SSO position statement on the use of risk-reducing mastectomy, there have been significant advances in the understanding of breast cancer biology and treatment. The purpose of this manuscript is to review the current literature as a resource to facilitate a shared and informed decision-making process regarding the use of risk-reducing mastectomy...
December 8, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27931006/brca-mutation-genetic-testing-implications-in-the-united-states
#2
REVIEW
Soley Bayraktar, Banu Arun
BRCA mutation carriers have a very high risk of breast and ovarian cancer by age 70, in the ranges 47%-66% and 40%-57%, respectively. Additionally, women with BRCA mutation-associated breast cancer also have an elevated risk of other or secondary malignancies. Fortunately, the breast and ovarian cancer outcome for BRCA1/2 mutation carriers is at least as good as for non-carriers with chemoprevention, prophylactic surgeries and appropriate use of therapies. Therefore, identification of those who might have a mutation is important so that genetic counseling, testing, screening and prevention strategies can be applied in a timely manner...
December 5, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27922795/breast-cancer-risk-reduction-decisions-of-the-brca-positive-patient-an-observational-study-at-a-single-institution
#3
Dana Johns, Jay Agarwal, Layla Anderson, Jian Ying, Wendy Kohlmann
BACKGROUND: BRCA1 and BRCA2 gene mutations carry with them a 50%-80% risk of developing breast cancer. The best choice for managing breast cancer risk in patients with a BRCA1/2 mutation is a highly personal decision. Options for risk management include surveillance with multiple modalities or prophylactic surgical intervention. The goal of this study was to gain a better understanding of contributing factors affecting the decision for managing breast cancer risk made by patients who are BRCA mutation positive and cancer free...
December 6, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27893634/comparison-of-different-acellular-dermal-matrix-adm-in-breast-reconstruction-the-50-50-study
#4
Troy A Pittman, Kenneth L Fan, Andrew Knapp, Shelby Frantz, Scott L Spear
BACKGROUND: Acellular Dermal Matrix (ADM) has enjoyed extensive use in primary and secondary alloplastic breast aesthetic and reconstructive surgery. The objective of this study is to examine clinical outcomes between available ADM: DermACELL(LifeNet Health, Virginia Beach, VA) and AlloDerm RTU (LifeCell, Branchburg, New Jersey). METHODS: A retrospective chart review was performed on 58 consecutive patients (100 breasts) reconstructed with either DermACELL(n=30 patients; 50 breasts) or AlloDerm RTU (n=28 patients; 50 breasts)...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27867298/prophylactic-bilateral-nipple-sparing-mastectomy-and-a-staged-breast-reconstruction-technique-preliminary-results
#5
Thierry Tondu, Filip Thiessen, Wiebren A A Tjalma
More high-risk women with breast cancer are identified using genetic testing at a younger age. These young women often opt for prophylactic surgery. Most patients are reluctant for extra donor-site scars besides infections and necrosis. In order to reduce these risks, a two-stage breast reconstruction technique is used for high-risk women with large or ptotic breasts. We presume that this procedure will reduce the risk of skin envelope and nipple-areola complex (NAC) necrosis to less than 1%. In the first stage, an inferior pedicle reduction is performed to obtain large volume reduction with maximal safety for the NAC...
2016: Breast Cancer: Basic and Clinical Research
https://www.readbyqxmd.com/read/27845965/the-necessity-of-the-nipple-redefining-completeness-in-breast-reconstruction
#6
E Hope Weissler, Julie B Schnur, Andreas M Lamelas, Marisa Cornejo, Elan Horesh, Peter J Taub
INTRODUCTION: Satisfaction with breast reconstruction is thought to be greatest among patients who complete nipple and areolar complex (NAC) reconstruction. Anecdotally, many patients are known to decline NAC reconstruction. The authors aimed to characterize the epidemiology of and factors associated with incomplete breast reconstruction. METHODS: Breast reconstruction patients with follow-up in a single institution's electronic medical record system were reviewed...
November 15, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27817227/-evaluation-of-clinicopathological-findings-and-cosmetic-outcome-of-100-immediate-postmastectomy-breast-reconstruction-cases
#7
Dávid Pukancsik, Péter Kelemen, Ákos Sávolt, Mihály Újhelyi, Eszter Kovács, Zoltán Zaka, Miklós Kásler, Zoltán Mátrai
INTRODUCTION: Immediate breast reconstruction provides oncological safety, requires longer operation time. It does not influence the initiation of adjuvant therapy and radiological control, and results in favourable cosmetic outcome. AIM: Assessing the Hungarian data of immediate postmastectomy breast reconstructions, and comparing them to international findings. METHOD: Between May, 2011 and September, 2014 121 therapeutic and prophylactic, postmastectomy immediate breast reconstructions were performed in 100 patients...
November 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27815748/a-model-for-individualized-risk-prediction-of-contralateral-breast-cancer
#8
Marzana Chowdhury, David Euhus, Tracy Onega, Swati Biswas, Pankaj K Choudhary
PURPOSE: Patients diagnosed with invasive breast cancer (BC) or ductal carcinoma in situ are increasingly choosing to undergo contralateral prophylactic mastectomy (CPM) to reduce their risk of contralateral BC (CBC). This is a particularly disturbing trend as a large proportion of these CPMs are believed to be medically unnecessary. Many BC patients tend to substantially overestimate their CBC risk. Thus, there is a pressing need to educate patients effectively on their CBC risk. We develop a CBC risk prediction model to aid physicians in this task...
November 4, 2016: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/27787313/new-advisory-on-contralateral-prophylactic-mastectomy
#9
Joan Zolot
Breast surgeons recommend against the procedure unless cancer risk is increased.
November 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27783164/guidelines-for-guidelines-an-assessment-of-the-american-society-of-breast-surgeons-contralateral-prophylactic-mastectomy-consensus-statement
#10
EDITORIAL
Todd M Tuttle, Andrea V Barrio, V Suzanne Klimberg, Armando E Giuliano, Mariana Chavez-MacGregor, Heather A Thompson Buum, Kelly M McMasters
No abstract text is available yet for this article.
October 25, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27779988/is-sentinel-lymph-node-dissection-necessary-in-all-patients-with-ductal-carcinoma-in-situ-undergoing-total-mastectomy
#11
Valentina Bonev, Carlos Chavez De Paz Villanueva, Naveenraj Solomon, Maheswari Senthil, Mark E Reeves, Carlos Garberoglio, Sharon S Lum
When ductal carcinoma in situ (DCIS) is found on core needle biopsy, rates of upgrade to invasive cancer of 25 per cent and nodal positivity of 10 per cent have been reported. Sentinel lymph node dissection (SLND) is recommended when mastectomy is performed for DCIS. We investigated the role of SLND in DCIS patients undergoing partial and total mastectomy (TM). During the study period 2004 to 2013, 170 patients with DCIS were identified with a median age of 60 years (range 26-84 years). Of these, 58.2 per cent had partial mastectomy (PM) alone, 10...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27776557/mammographically-dense-human-breast-tissue-stimulates-mcf10dcis-com-progression-to-invasive-lesions-and-metastasis
#12
Cecilia W Huo, Mark Waltham, Christine Khoo, Stephen B Fox, Prue Hill, Shou Chen, Grace L Chew, John T Price, Chau H Nguyen, Elizabeth D Williams, Michael Henderson, Erik W Thompson, Kara L Britt
BACKGROUND: High mammographic density (HMD) not only confers a significantly increased risk of breast cancer (BC) but also is associated with BCs of more advanced stages. However, it is unclear whether BC progression and metastasis are stimulated by HMD. We investigated whether patient-derived HMD breast tissue could stimulate the progression of MCF10DCIS.com cells compared with patient-matched low mammographic density (LMD) tissue. METHODS: Sterile breast specimens were obtained immediately after prophylactic mastectomy from high-risk women (n = 10)...
October 25, 2016: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/27737975/identification-and-management-of-women-with-a-family-history-of-breast-cancer-practical-guide-for-clinicians
#13
REVIEW
Ruth Heisey, June C Carroll
OBJECTIVE: To summarize the best evidence on strategies to identify and manage women with a family history of breast cancer. SOURCES OF INFORMATION: A PubMed search was conducted using the search terms breast cancer, guidelines, risk, family history, management, and magnetic resonance imaging screening from 2000 to 2016. Most evidence is level II. MAIN MESSAGE: Taking a good family history is essential when assessing breast cancer risk in order to identify women suitable for referral to a genetic counselor for possible genetic testing...
October 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27674591/contralateral-breast-cancer-risk-and-the-selection-of-contralateral-prophylactic-mastectomy-among-women-with-unilateral-breast-cancer
#14
J V Hegde, J Wang, A Kusske, S A McCloskey
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27668334/users-guide-to-the-surgical-literature-how-to-assess-an-article-about-harm-in-surgery
#15
Achilleas Thoma, Manraj Nirmal Kaur, Forough Farrokhyar, Daniel Waltho, Carolyn Levis, Peter Lovrics, Charlie H Goldsmith
You are a new plastic surgeon in the community and you are referred a patient interested in breast reconstruction. The patient is a 35-year-old female school teacher who had a bilateral prophylactic mastectomy 2 years earlier, as she was a BRCA gene carrier. Since she is of a petite build with very little subcutaneous tissue or extra skin in the lower abdomen, you decide that she is not a suitable candidate for an abdomen-based autologous tissue reconstruction. You recommend the technique of tissue expansion and silicone gel implants...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27650678/outcomes-of-contralateral-prophylactic-mastectomy-in-relation-to-familial-history-a-decision-analysis-brcr-d-16-00033
#16
Kalatu R Davies, Abenaa M Brewster, Isabelle Bedrosian, Patricia A Parker, Melissa A Crosby, Susan K Peterson, Yu Shen, Robert J Volk, Scott B Cantor
BACKGROUND: Family history of breast cancer is associated with an increased risk of contralateral breast cancer (CBC) even in the absence of mutations in the breast cancer susceptibility genes BRCA1/2. We compared quality-adjusted survival after contralateral prophylactic mastectomy (CPM) with surveillance only (no CPM) among women with breast cancer incorporating the degree of family history. METHODS: We created a microsimulation model for women with first-degree, second-degree, and no family history treated for a stage I, II, or III estrogen receptor (ER)-positive or ER-negative breast cancer at the ages of 40, 50, 60, and 70...
2016: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/27649974/risk-reduction-and-survival-benefit-of-prophylactic-surgery-in-brca-mutation-carriers-a-systematic-review
#17
Kandice K Ludwig, Joan Neuner, Annabelle Butler, Jennifer L Geurts, Amanda L Kong
BACKGROUND: Mutations in BRCA1 or BRCA2 genes results in an elevated risk for developing both breast and ovarian cancers over the lifetime of affected carriers. General surgeons may be faced with questions about surgical risk reduction and survival benefit of prophylactic surgery. METHODS: A systematic literature review was performed using the electronic databases PubMed, OVID MEDLINE, and Scopus comparing prophylactic surgery vs observation with respect to breast and ovarian cancer risk reduction and mortality in BRCA mutation carriers...
October 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27624164/subsequent-risk-of-ipsilateral-and-contralateral-invasive-breast-cancer-after-treatment-for-ductal-carcinoma-in-situ-incidence-and-the-effect-of-radiotherapy-in-a-population-based-cohort-of-10-090-women
#18
Lotte E Elshof, Michael Schaapveld, Marjanka K Schmidt, Emiel J Rutgers, Flora E van Leeuwen, Jelle Wesseling
PURPOSE: To assess the effect of different treatment strategies on the risk of subsequent invasive breast cancer (IBC) in women diagnosed with ductal carcinoma in situ (DCIS). METHODS: Up to 15-year cumulative incidences of ipsilateral IBC (iIBC) and contralateral IBC (cIBC) were assessed among a population-based cohort of 10,090 women treated for DCIS in the Netherlands between 1989 and 2004. Multivariable Cox regression analyses were used to evaluate associations of treatment with iIBC risk...
October 2016: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/27601060/bilateral-oophorectomy-and-breast-cancer-risk-in-brca1-and-brca2-mutation-carriers
#19
Joanne Kotsopoulos, Tomasz Huzarski, Jacek Gronwald, Christian F Singer, Pal Moller, Henry T Lynch, Susan Armel, Beth Karlan, William D Foulkes, Susan L Neuhausen, Leigha Senter, Nadine Tung, Jeffrey N Weitzel, Andrea Eisen, Kelly Metcalfe, Charis Eng, Tuya Pal, Gareth Evans, Ping Sun, Jan Lubinski, Steven A Narod
BACKGROUND: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. METHODS: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n = 3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable)...
January 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/27600636/current-trends-and-outcomes-of-breast-reconstruction-following-nipple-sparing-mastectomy-results-from-a-national-multicentric-registry-with-1006-cases-over-a-6-year-period
#20
Donato Casella, Claudio Calabrese, Lorenzo Orzalesi, Ilaria Gaggelli, Lorenzo Cecconi, Caterina Santi, Roberto Murgo, Stefano Rinaldi, Lea Regolo, Claudio Amanti, Manuela Roncella, Margherita Serra, Graziano Meneghini, Massimiliano Bortolini, Vittorio Altomare, Carlo Cabula, Francesca Catalano, Alfredo Cirilli, Francesco Caruso, Maria Grazia Lazzaretti, Icro Meattini, Lorenzo Livi, Luigi Cataliotti, Marco Bernini
BACKGROUND: Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study. METHODS: Data extraction from the National Database was performed restricting cases to the 2009-2014 period...
September 6, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
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