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Contralateral prophylactic mastectomy

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https://www.readbyqxmd.com/read/28903167/oncologic-safety-of-prophylactic-nipple-sparing-mastectomy-in-a-population-with-brca-mutations-a-multi-institutional-study
#1
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
#2
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/28857238/the-diversity-in-the-expression-profile-of-caveolin-ii-transcripts-considering-its-new-transcript-in-breast-cancer
#3
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/28831365/comparative-study-of-prepectoral-and-subpectoral-expander-based-breast-reconstruction-and-clavien-iiib-score-outcomes
#4
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/28811185/the-effect-of-receptor-status-on-mastectomy-and-contralateral-prophylactic-mastectomy-rates-in-early-stage-invasive-breast-carcinoma
#5
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
#6
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/28770017/preoperative-genetic-testing-impacts-surgical-decision-making-in-brca-mutation-carriers-with-breast-cancer-a-retrospective-cohort-analysis
#7
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
#8
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
#9
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
#10
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/28766208/contralateral-breast-cancer-risk-in-women-with-ductal-carcinoma-in-situ-is-it-high-enough-to-justify-bilateral-mastectomy
#11
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
#12
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
#13
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
#14
COMPARATIVE STUDY
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/28690658/influence-of-the-angelina-jolie-announcement-and-insurance-reimbursement-on-practice-patterns-for-hereditary-breast-cancer
#15
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/28666919/age-molecular-subtypes-and-local-therapy-decision-making
#16
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...
August 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
#17
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
#18
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
https://www.readbyqxmd.com/read/28634720/the-financial-impact-and-drivers-of-hospital-charges-in-contralateral-prophylactic-mastectomy-and-reconstruction-a-nationwide-inpatient-sample-hospital-analysis
#19
Alexandra Bucknor, Anmol Chattha, Klaas Ultee, Winona Wu, Parisa Kamali, Patrick Bletsis, Austin Chen, Bernard T Lee, Claire Cronin, Samuel J Lin
PURPOSE: Rates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction. METHODS: Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009-2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group)...
June 20, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28609204/surveillance-of-women-with-the-brca1-or-brca2-mutation-by-using-biannual-automated-breast-us-mr-imaging-and-mammography
#20
Jan C M van Zelst, Roel D M Mus, Gwendolyn Woldringh, Matthieu J C M Rutten, Peter Bult, Suzan Vreemann, Mathijn de Jong, Nico Karssemeijer, Nicoline Hoogerbrugge, Ritse M Mann
Purpose To evaluate a multimodal surveillance regimen including yearly full-field digital (FFD) mammography, dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) imaging, and biannual automated breast (AB) ultrasonography (US) in women with BRCA1 and BRCA2 mutations. Materials and Methods This prospective multicenter trial enrolled 296 carriers of the BRCA mutation (153 BRCA1 and 128 BRCA2 carriers, and 15 women with first-degree untested relatives) between September 2010 and November 2012, with follow-up until November 2015...
June 13, 2017: Radiology
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