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Bilateral mastectomy

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https://www.readbyqxmd.com/read/28429197/axillary-micrometastases-and-isolated-tumor-cells-are-not-an-indication-for-post-mastectomy-radiotherapy-in-stage-1-and-2-breast-cancer
#1
Anita Mamtani, Sujata Patil, Michelle Stempel, Monica Morrow
BACKGROUND: Randomized trials demonstrate equivalent locoregional control with sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) for T1-2 micrometastatic breast cancer, but include few mastectomy patients. Consensus is lacking on indications for post-mastectomy radiotherapy (PMRT) in this population. Herein, we evaluate locoregional recurrence (LRR) in an unselected, modern cohort of T1-2 breast cancer patients with micrometastases or isolated tumor cells (ITCs; N0i+/N1mi) having a mastectomy...
April 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28418342/transsexual-mastectomy-selection-of-appropriate-technique-according-to-breast-characteristics
#2
Hüsamettin Top, Serkan Balta
BACKGROUND: Subcutaneous mastectomy for female- to-male transsexuals is usually the first surgical pro- cedure in sexual reassignment. The main objective of subcutaneous mastectomy is to create an aesthetically pleasing male chest contour by removing all glandular tissue while minimizing chest wall scars. AIMS: In this paper, we present our experience with subcutaneous mastectomy performed in female-to- male transsexual patients. The authors recommend their point of view to aid in selecting the most suitable subcutaneous mastectomy technique depending on breast characteristics...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28417238/bilateral-mastectomy-as-overtreatment-for-breast-cancer-in-women-age-forty-years-and-younger-with-unilateral-operable-invasive-breast-cancer
#3
Cory A Donovan, Jean Bao, Alexandra Gangi, Farin Amersi, Xiao Zhang, Armando E Giuliano, Alice P Chung
BACKGROUND: Young women with breast cancer (BC) have an increased risk of contralateral breast cancer (CBC) compared with older women. This may contribute to the rising rates of bilateral mastectomy (BM), but it is unclear if BM leads to improved outcomes. METHODS: A prospectively maintained database was reviewed. Patient and tumor characteristics, survival, and rate of CBC were compared in women age ≤40 years treated for unilateral Stage 1-3 BC from January 2000 through December 2013...
April 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28407998/a-cost-effectiveness-evaluation-of-germline-brca1-and-brca2-testing-in-uk-women-with-ovarian-cancer
#4
Anthony Eccleston, Anthony Bentley, Matthew Dyer, Ann Strydom, Wim Vereecken, Angela George, Nazneen Rahman
OBJECTIVES: To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 (collectively termed "BRCA") testing in women with epithelial ovarian cancer, and testing for the relevant mutation in first- and second-degree relatives of BRCA mutation-positive individuals, compared with no testing. Female BRCA mutation-positive relatives of patients with ovarian cancer could undergo risk-reducing mastectomy and/or bilateral salpingo-oophorectomy. METHODS: A cost-effectiveness model was developed that included the risks of breast and ovarian cancer; the costs, utilities, and effects of risk-reducing surgery on cancer rates; and the costs, utilities, and mortality rates associated with cancer...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28402748/gaps-in-incorporating-germline-genetic-testing-into-treatment-decision-making-for-early-stage-breast-cancer
#5
Allison W Kurian, Yun Li, Ann S Hamilton, Kevin C Ward, Sarah T Hawley, Monica Morrow, M Chandler McLeod, Reshma Jagsi, Steven J Katz
Purpose Genetic testing for breast cancer risk is evolving rapidly, with growing use of multiple-gene panels that can yield uncertain results. However, little is known about the context of such testing or its impact on treatment. Methods A population-based sample of patients with breast cancer diagnosed in 2014 to 2015 and identified by two SEER registries (Georgia and Los Angeles) were surveyed about genetic testing experiences (N = 3,672; response rate, 68%). Responses were merged with SEER data. A patient subgroup at higher pretest risk of pathogenic mutation carriage was defined according to genetic testing guidelines...
April 12, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28391513/incidental-findings-in-reduction-mammoplasty-specimens-in-patients-with-no-prior-history-of-breast-cancer-an-analysis-of-783-specimens
#6
Pedro Luiz Serrano Usón Junior, Donato Callegaro Filho, Diogo Diniz Gomes Bugano, Felipe Correa Geyer, Marcus Vinicius de Nigro Corpa, Paulo David Scatena Gonçalves, Sergio Daniel Simon, Rafael Aliosha Kaliks
Breast reduction surgery is a common procedure and the rate of incidental findings in the removed specimens varies between 0% and 4.6%. There are no guidelines about pathological evaluation of breast reduction surgery. We reviewed all pathology reports of patients undergoing breast reduction surgery in a single tertiary institution in Brazil from January 2008 to August 2014. Exclusion criteria were a personal history of breast cancer, unclear reason for mastectomy and incomplete data on the pathology report...
April 8, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#7
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
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
#8
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
#9
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/28363948/false-negative-contrast-enhanced-spectral-mammography-use-of-more-than-one-imaging-modality-and-application-of-the-triple-test-avoids-misdiagnosis
#10
Donna Taylor, Susan O'Hanlon, Bruce Latham
A 50-year-old woman presented with chest tenderness. On examination, both breasts were lumpy. Bilateral mammography showed heterogeneously dense parenchyma, with possible stromal distortion laterally on the right at the 0900 position. On ultrasound (US), a corresponding 13×9×10 mm irregular hypoechoic mass with internal vascularity was noted and both breasts had a complex heterogeneous fibroglandular background pattern. US-guided core biopsy with marker clip insertion was performed with the diagnosis of a grade 2 invasive ductal carcinoma (IDC)...
March 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28350658/top-surgery-in-transgender-men-how-far-can-you-push-the-envelope
#11
Rachel Bluebond-Langner, Jens U Berli, Jennifer Sabino, Karan Chopra, Devinder Singh, Beverly Fischer
BACKGROUND: The authors present their grading scale and the outcomes of the largest cohort of top surgery published to date. Application of this grading system can help determine which patients will benefit from a subcutaneous mastectomy with free nipple graft versus a circumareolar technique, with the primary endpoint being need for aesthetic revisions. METHODS: The authors reviewed their database of transgender males who underwent bilateral mastectomy between 2006 and 2015...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#12
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28341315/initial-clinical-experience-of-postmastectomy-intensity-modulated-proton-therapy-in-patients-with-breast-expanders-with-metallic-ports
#13
Robert W Mutter, Nicholas B Remmes, Mohamed Mh Kahila, Kathy A Hoeft, Deanna H Pafundi, Yan Zhang, Kimberly S Corbin, Sean S Park, Elizabeth S Yan, Valerie Lemaine, Judy C Boughey, Chris J Beltran
PURPOSE: The feasibility of proton postmastectomy radiation therapy in patients reconstructed with expanders has not been previously reported, limiting treatment options. We analyzed the dosimetric impact of the metallic port contained within expanders on intensity modulated proton therapy (IMPT) and report our techniques and quality control for treating patients in this setting. METHODS AND MATERIALS: Twelve patients with the same expander model underwent 2-field IMPT as part of a prospective registry...
December 16, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28331739/a-rare-tumor-that-mimicked-metastasis-in-a-patient-with-breast-cancer-epithelioid-hemangioendothelioma
#14
Fatmagül Kuşku Çabuk, Fatma Aktepe, Ahmet Serkan İlgün, Dauren Sarsenov, Filiz Elbüken, Vahit Özmen
A woman aged 50 years was diagnosed as having an invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast and underwent bilateral mastectomy eight years ago. A mass was identified during follow-up in positron-emission tomography (PET) image in the left infraclavicular region, indicating metastasis. Histopathologic examination showed a mass of 1.9 × 1 × 0.7 cm in dimensions characterized by spindle or round nuclei cells that formed island or cords in hyaline and myxoid ground and intracytoplasmic vacuoles containing erythrocytes...
April 2016: Journal of Breast Health (2013)
https://www.readbyqxmd.com/read/28328628/unilateral-versus-bilateral-breast-reconstruction-is-less-really-more
#15
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/28328308/sexual-and-gender-minority-breast-cancer-patients-choosing-bilateral-mastectomy-without-reconstruction-i-now-have-a-body-that-fits-me
#16
Maria Teresa Brown, Jane A McElroy
Sexual and gender minority (SGM) breast cancer patients have begun embracing the choice to "go flat" or opt out of reconstruction after bilateral mastectomy, though little is known about this population. SGM breast cancer survivors were identified through purposive and referral sampling and invited to participate in a web-based survey containing both closed- and open-ended items. Of the sixty-eight SGM breast cancer survivors aged 18-75 years who completed the survey between May 2015 and January 2016, 25 percent reported "going flat" (flattoppers®)...
March 22, 2017: Women & Health
https://www.readbyqxmd.com/read/28319433/breast-reconstruction-following-nipple-sparing-mastectomy-clinical-outcomes-and-risk-factors-related-complications
#17
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/28319327/bilateral-breast-reconstruction-with-deep-inferior-epigastric-perforator-flaps-in-slim-patients
#18
Maria Mani, Samer Saour, Kelvin Ramsey, Kieran Power, Paul Harris, Stuart James
BACKGROUND: Slim women are not always considered candidates for bilateral autologous breast reconstruction. The study aims to assess the volume considerations and complications of deep inferior epigastric perforator (DIEP) flap in bilateral breast reconstruction among slim patients. METHODS: All patients undergoing bilateral DIEP breast reconstruction at the Royal Marsden Hospital, London, September 2007-March 2015, were reviewed. Flap weight was compared to mastectomy weight (weight ratio) and complications were recorded...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28316306/evolving-trends-and-influencing-factors-in-mastectomy-decisions
#19
Sneha Bhat, Amila Orucevic, Caroline Woody, Robert E Heidel, John L Bell
It is known that survival is unaffected by the choice of surgical management for breast cancer (BC) patients. Despite this fact, recent literature reveals that the number of bilateral mastectomies (BMs) in the United States is increasing. In an effort to elucidate potential factors influencing this trend, we investigated socioeconomic and clinicopathologic characteristics of our patient cohort that could have affected a patient's decision between unilateral mastectomy (UM) versus BM. Five-hundred-eight patients with unilateral BC who underwent mastectomy between 2000 and 2009 were analyzed: 397-UM; 111-BM...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28301366/management-of-mastectomy-skin-necrosis-in-implant-based-breast-reconstruction
#20
Gloria R Sue, Chao Long, Gordon K Lee
BACKGROUND: Mastectomy skin necrosis is a significant problem after breast reconstruction. This complication may lead to poor wound healing and need for implant removal, which may delay subsequent oncologic treatment. We sought to characterize factors associated with mastectomy skin necrosis and propose a management algorithm. METHODS: A retrospective review was performed on consecutive patients undergoing implant-based breast reconstruction by the senior author from 2006 through 2015...
May 2017: Annals of Plastic Surgery
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