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Prophylactic Mastectomy

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https://www.readbyqxmd.com/read/28428099/nipple-sparing-mastectomy-and-its-application-on-brca-gene-mutation-carrier
#1
REVIEW
Michael Co, Rosemarie Chiu, Tung Milly Chiu, Yau Chun Chong, Swan Lau, Yung Ho Lee, Hoi Man To, Ava Kwong
In breast cancer 1 (BRCA) gene mutation carriers, mastectomy is still the mainstay of treatment for breast cancers due to the increased risk of local recurrence. It is performed as a therapeutic, as well as prophylactic procedure. However, mastectomy with removal of nipple areolar complex (NAC) is associated with adverse cosmetic outcome. NAC sparing mastectomy (NSM), which results in better cosmetic outcome, has been performed in non-BRCA mutation carriers. While studies have shown that NSM is a oncologically safe in sporadic breast cancers, its application in BRCA mutation carriers is still controversial...
February 14, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28402085/decision-aids-for-people-facing-health-treatment-or-screening-decisions
#2
REVIEW
Dawn Stacey, France Légaré, Krystina Lewis, Michael J Barry, Carol L Bennett, Karen B Eden, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Anne Lyddiatt, Richard Thomson, Lyndal Trevena
BACKGROUND: Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. OBJECTIVES: To assess the effects of decision aids in people facing treatment or screening decisions. SEARCH METHODS: Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008...
April 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28384687/patient-reactions-to-surgeon-recommendations-about-contralateral-prophylactic-mastectomy-for-treatment-of-breast-cancer
#3
Steven J Katz, Nancy K Janz, Paul Abrahamse, Lauren P Wallner, Sarah T Hawley, Lawrence C An, Kevin C Ward, Ann S Hamilton, Monica Morrow, Reshma Jagsi
Importance: Guidelines assert that contralateral prophylactic mastectomy (CPM) should be discouraged in patients without an elevated risk for a second primary breast cancer. However, little is known about the impact of surgeons discouraging CPM on patient care satisfaction or decisions to seek treatment from another clinician. Objective: To examine the association between patient report of first-surgeon recommendation against CPM and the extent of discussion about it with 3 outcomes: patient satisfaction with surgery decisions, receipt of a second opinion, and receipt of surgery by a second surgeon...
April 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28382503/cost-effectiveness-of-different-strategies-to-prevent-breast-and-ovarian-cancer-in-german-women-with-a-brca-1-or-2-mutation
#4
Dirk Müller, Marion Danner, Kerstin Rhiem, Björn Stollenwerk, Christoph Engel, Linda Rasche, Lisa Borsi, Rita Schmutzler, Stephanie Stock
BACKGROUND: Women with a BRCA1 or BRCA2 mutation are at increased risk of developing breast and/or ovarian cancer. This economic modeling study evaluated different preventive interventions for 30-year-old women with a confirmed BRCA (1 or 2) mutation. METHODS: A Markov model was developed to estimate the costs and benefits [i.e., quality-adjusted life years (QALYs), and life years gained (LYG)] associated with prophylactic bilateral mastectomy (BM), prophylactic bilateral salpingo-oophorectomy (BSO), BM plus BSO, BM plus BSO at age 40, and intensified surveillance...
April 5, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28364165/post-mastectomy-cancer-recurrence-with-and-without-a-continuous-paravertebral-block-in-the-immediate-postoperative-period-a-prospective-multi-year-follow-up-pilot-study-of-a-randomized-triple-masked-placebo-controlled-investigation
#5
Daphna M Finn, Brian M Ilfeld, Jonathan T Unkart, Sarah J Madison, Preetham J Suresh, Nav Parkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, Cindy H Wen, Anya C Morgan, Anne M Wallace
PURPOSE: Retrospective studies have associated perioperative regional anesthesia/analgesia during mastectomy for breast cancer with a decreased incidence of cancer recurrence. However, to date, no prospective data from a randomized controlled trial have been reported. In a previous study we found that extending a single-injection paravertebral block with a multiple-day perineural local anesthetic infusion improves analgesia. This follow-up study investigates the rates of cancer recurrence for the single-injection and multiple-day infusion treatments...
March 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28355431/state-variation-in-the-receipt-of-a-contralateral-prophylactic-mastectomy-among-women-who-received-a-diagnosis-of-invasive-unilateral-early-stage-breast-cancer-in-the-united-states-2004-2012
#6
Rebecca Nash, Michael Goodman, Chun Chieh Lin, Rachel A Freedman, Laura S Dominici, Kevin Ward, Ahmedin Jemal
Importance: The use of contralateral prophylactic mastectomies (CPMs) among patients with invasive unilateral breast cancer has increased substantially during the past decade in the United States despite the lack of evidence for survival benefit. However, whether this trend varies by state or whether it is correlated with changes in proportions of reconstructive surgery among these patients is unclear. Objective: To determine state variation in the temporal trend and in the proportion of CPMs among women with early-stage unilateral breast cancer treated with surgery...
March 29, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28349337/erratum-to-impact-of-an-in-visit-decision-aid-on-patient-knowledge-about-contralateral-prophylactic-mastectomy-a-pilot-study
#7
Katharine Yao, Jeff Belkora, Isabelle Bedrosian, Shoshana Rosenberg, Mark Sisco, Ermilo Barrera, Alexandra Kyrillos, Jon Tilburt, Chihsiung Wang, Sarah Rabbitt, Catherine Pesce, Sandra Simovic, David J Winchester, Karen Sepucha
No abstract text is available yet for this article.
March 27, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28340626/decision-making-for-breast-cancer-prevention-among-women-at-elevated-risk
#8
REVIEW
Tasleem J Padamsee, Celia E Wills, Lisa D Yee, Electra D Paskett
Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women...
March 24, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28335989/sentinel-lymph-node-biopsy-in-low-risk-settings
#9
Marios Konstantinos Tasoulis, Tyler Hughes, Gildy Babiera, Anees B Chagpar
BACKGROUND: Sentinel lymph node biopsy (SLNB) should be performed in patients with ductal carcinoma in situ (DCIS) undergoing mastectomy. Yet, the same logic is controversial in the setting of prophylactic mastectomy. METHODS: Surgeons were surveyed as to their practices. Statistical analyses were performed to identify associated factors. RESULTS: 238 surgeons responded to the survey. 73.1% of respondents stated they would always perform SLNB in the setting of mastectomy for DCIS, but only 6...
March 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#10
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328628/unilateral-versus-bilateral-breast-reconstruction-is-less-really-more
#11
Lauren V Kuykendall, Bugra Tugertimur, Corin Agoris, Sara Bijan, Ambuj Kumar, Deniz Dayicioglu
OBJECTIVE: Over the recent years, there has been an increase in prophylactic mastectomies with an associated increase in bilateral breast reconstruction. We aimed to compare outcomes in terms of patient satisfaction with unilateral versus bilateral breast reconstruction after deep inferior epigastric perforator (DIEP) flap and implant-based reconstruction. METHODS: Patients who underwent breast reconstruction by a single surgeon between July 2011 and July 2015 were surveyed using the independently validated BREAST-Q questionnaire...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28319433/breast-reconstruction-following-nipple-sparing-mastectomy-clinical-outcomes-and-risk-factors-related-complications
#12
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Caterina Patti, Maria Rosaria Mastrangeli, Corrado Rubino, Fabio Santanelli di Pompeo
BACKGROUND: The aim of this study was to investigate clinical outcomes and risk factors related complications in patients who had undergone nipple-sparing mastectomy (NSM) followed by implant-based or autologous reconstruction. METHODS: Between 2004-2014 a single-institution retrospective review was collected on NSMs reconstruction. Patient demographics, comorbidities, breast morphological factors, type and timing of radiotherapy, type of incision, reconstruction type and timing, implant volume and complications were collected...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28293518/the-use-of-a-hyaluronic-acid-carboxymethylcellulose-membrane-as-an-adhesion-barrier-during-nipple-delay-before-nipple-preserving-mastectomy
#13
Andreas M Lamelas, Eric M Jablonka, Marco A Harmaty, Philip J Torina
The desire for nipple-preserving mastectomies has increased over the past decade as studies have proven that the procedure has comparable oncologic risk as a traditional mastectomy in both therapeutic and prophylactic cases. Partial or complete nipple necrosis is a well-known complication of this procedure with rates in the literature ranging between 1% and 9%. In high-risk patients, surgeons are performing a delay procedure before the mastectomy to help improve nipple vascularity and decrease necrosis rates...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28270235/-preventive-contralateral-mastectomy-despite-absence-of-gene-mutation-management-and-treatment-of-women-with-no-medical-indication
#14
L de Jong, T M A L Klem, M Groen, L B Koppert, R A Oldenburg, W W Vrijland
Recently, there has been an increase in the rate of contralateral prophylactic mastectomies (CPM) as a therapy for breast cancer. The CPM is performed to achieve a reduction in the risk of developing asecond breast cancer. However, evidence is lacking for beneficial survival outcomes after a CPM in patients without a gene mutation, and complications of surgery are inevitable. Currently there are no evidence-based clinical practice guidelines available for clinicians to decide upon the right treatment for patients without a gene mutation...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28263160/-reconstructive-breast-surgery-using-implant-and-mesh
#15
Lene Nyhøj Heidemann, Gudjon Leifur Gunnarsson, Camilla Bille, Jens Ahm Sørensen, Jørn Bo Thomsen
The demand for reconstructive surgery after therapeutic and prophylactic mastectomy is increasing. The hammock technique for breast reconstruction was introduced in 2001 and provides support for the implant using either biologically derived or synthetic mesh. The material is formed as a hammock in the lower pole of the reconstructed breast, and due to its supportive capabilities it has been found to shorten the time needed for reconstruction, decrease the risk of capsular contracture and leave a superior aesthetic result...
March 6, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28255494/juvenile-breast-hypertrophy-a-successful-breast-reduction-of-14-9-body-weight-without-recurrence-in-a-5-year-follow-up
#16
Akmal Hisham, Marzida Abd Latib, Normala Basiron
Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28238934/mastectomy-and-immediate-breast-reconstruction-for-cancer-in-the-elderly-a-national-cancer-data-base-study
#17
Waleed O Gibreel, Courtney N Day, Tanya L Hoskin, Judy C Boughey, Elizabeth B Habermann, Tina J Hieken
BACKGROUND: Mastectomy with immediate breast reconstruction (M+IBR) is performed increasingly for breast cancer treatment, but whether this trend extends to the growing number of women diagnosed ≥age 65 is unknown. We studied the effects of age and comorbidities on the use and outcomes of M+IBR. STUDY DESIGN: Patients undergoing mastectomy for breast cancer were ascertained from the National Cancer Database 2004-2012. Performance of M+IBR and outcomes were compared by age group (<65 versus ≥65) and other patient and tumor factors...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28221673/breast-cancer-prevention-strategies-in-lobular-carcinoma-in-situ-a-decision-analysis
#18
Stephanie M Wong, Natasha K Stout, Rinaa S Punglia, Ipshita Prakash, Yasuaki Sagara, Mehra Golshan
BACKGROUND: Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. METHODS: A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies...
February 21, 2017: Cancer
https://www.readbyqxmd.com/read/28169929/growing-use-of-contralateral-prophylactic-mastectomy-despite-no-improvement-in-long-term-survival-for-invasive-breast-cancer
#19
Stephanie M Wong, Rachel A Freedman, Yasuaki Sagara, Fatih Aydogan, William T Barry, Mehra Golshan
OBJECTIVE: To update and examine national temporal trends in contralateral prophylactic mastectomy (CPM) and determine whether survival differed for invasive breast cancer patients based on hormone receptor (HR) status and age. METHODS: We identified women diagnosed with unilateral stage I to III breast cancer between 1998 and 2012 within the Surveillance, Epidemiology, and End Results registry. We compared characteristics and temporal trends between patients undergoing breast-conserving surgery, unilateral mastectomy, and CPM...
March 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28152879/contralateral-prophylactic-mastectomy-decision-making-in-the-population-based-icancare-study-of-early-stage-breast-cancer-patients
#20
Sarah T Hawley, Kent A Griffith, Nancy K Janz, Allison W Kurian, Kevin C Ward, Ann S Hamilton, Steven J Katz, Monica Morrow
177 Background: Contralateral prophylactic mastectomy (CPM) use is increasing in women who are not at increased risk of contralateral cancer development and will experience no survival benefit from the more morbid procedure. Little is known about treatment decision-making or provider interactions. METHODS: We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer who were treated in 2013-14, identified through the population-based SEER registries of Los Angeles and Georgia about 3 months after surgical treatment, and merged with SEER data (N=2632, RR=70%), to determine receipt of diagnostic tests and factors related to the decision about surgery (including knowledge and perceived physician recommendation)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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