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contralateral 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/28894666/optimizing-aesthetic-outcomes-in-delayed-breast-reconstruction
#3
Wojciech Dec
BACKGROUND: The need to restore both the missing breast volume and breast surface area makes achieving excellent aesthetic outcomes in delayed breast reconstruction especially challenging. Autologous breast reconstruction can be used to achieve both goals. The aim of this study was to identify surgical maneuvers that can optimize aesthetic outcomes in delayed breast reconstruction. METHODS: This is a retrospective review of operative and clinical records of all patients who underwent unilateral or bilateral delayed breast reconstruction with autologous tissue between April 2014 and January 2017...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28890746/a-new-criterion-for-the-application-of-2-stage-implant-only-breast-reconstruction-using-a-classification-based-on-the-rostrocaudal-distance-along-the-chest-wall-between-the-lowest-point-of-the-breast-and-inframammary-fold
#4
Naohiro Ishii, Jiro Ando, Michiko Harao, Masaru Takemae, Kazuo Kishi
Objective: It is generally difficult to achieve symmetry in implant-only breast reconstruction with ptosis, and it remains unclear what quantitative criterion may be applied in cases of breast ptosis regarding the application of this modality. Our study aimed to suggest a criterion for obtaining good aesthetic outcomes and a symmetrical inframammary fold that is well-fitting for the brassiere in implant-only breast reconstruction after simple mastectomy. Methods: We classified into 3 groups 50 consecutive patients who underwent implant-only breast reconstruction that created an inframammary fold using a modified internal method after simple mastectomy...
2017: Eplasty
https://www.readbyqxmd.com/read/28876589/reconstruction-in-locally-advance-breast-cancer-who-what-and-when
#5
L Van Schalkwyk, C Benn, K Bergstrom
BACKGROUND: Locally advanced breast cancer (LABC) is defined as the most advanced stage of non-metastatic breast cancer. While breast reconstruction is not contraindicated in this subset of patients, the decision-making process is influenced by several considerations, including recurrence risk and the need for and timing of adjuvant therapy such as radiotherapy. This retrospective analysis investigates the reconstructive procedures performed on women presenting with locally advanced breast cancer at the Netcare Breast Care Centre (NCBC) in Johannesburg...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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/28831365/comparative-study-of-prepectoral-and-subpectoral-expander-based-breast-reconstruction-and-clavien-iiib-score-outcomes
#7
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/28819836/management-of-contralateral-breast-following-mastectomy-and-breast-reconstruction-using-a-mirror-adjustment-with-crescent-mastopexy-technique
#8
A Cogliandro, B Brunetti, Mauro Barone, G Favia, P Persichetti
INTRODUCTION: Heterologous breast reconstruction after mastectomy sometimes requires the management of the contralateral breast to achieve symmetric long lasting aesthetic results. Some techniques could be used for the symmetrization of contralateral breast with or without implants as breast augmentation, reduction mammoplasty, mastopexy, with T inverted, J, vertical, periareolar, semi-circular, or axillary scars. The aim of this study is to present the use of crescent mastopexy technique with implants in contralateral adjustment following monolateral breast reconstruction compared with a control group in which patients underwent other contralateral procedures...
August 17, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28811185/the-effect-of-receptor-status-on-mastectomy-and-contralateral-prophylactic-mastectomy-rates-in-early-stage-invasive-breast-carcinoma
#9
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
#10
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/28781102/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy
#11
Eileen Rakovitch, Sharon Nofech-Mozes, Wedad Hanna, Rinku Sutradhar, Sumei Gu, Cindy Fong, Alan Tuck, Bruce Youngson, Naomi Miller, Susan J Done, Martin C Chang, Sandip Sengupta, Leela Elavathil, Prashant A Jani, Michel Bonin, Nafisha Lalani, Lawrence Paszat
PURPOSE: Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence (LR). The omission of RT is often supported by the paradigm that patients who develop LR can be salvaged with further breast-conserving therapy leading to higher rates of breast preservation and improved quality of life. However, population-based, long-term rates of breast preservation in women treated by upfront BCS ± RT are unknown. METHODS AND MATERIALS: Women diagnosed with pure DCIS from 1994 to 2003 treated with BCS ± RT in Ontario were identified...
August 3, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28770017/preoperative-genetic-testing-impacts-surgical-decision-making-in-brca-mutation-carriers-with-breast-cancer-a-retrospective-cohort-analysis
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/28758229/time-dependent-factors-in-diep-flap-breast-reconstruction
#18
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Vittoria Amorosi, Fabio Santanelli di Pompeo
BACKGROUND: The process of harvesting and performing microsurgical anastomosis may lengthen deep inferior epigastric artery perforator (DIEP) flap breast reconstruction affecting results and patient safety. The aim of the study was to investigate the associations between predictors and operative time (OT). METHODS: Between 2004 and 2016, 336 immediate and 68 delayed unilateral reconstructions were performed in 404 patients. Age, weight, height, body mass index (BMI), nulliparity, or pluriparity condition were collected to determine the impact of patient characteristics on OT...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28740779/using-the-venous-pectoral-branch-from-the-thoracoacromial-system-as-a-lifeboat-in-autologous-breast-reconstruction
#19
Michael Tarakji, Matthew J Bartow, Charles Dupin, Oren Tessler
The most common recipient vessels for autologous free flap breast reconstruction are the internal mammary vessels. At times, there are problems with the exposed internal mammary vein (IMV) that require other options such as using the contralateral IMV, superior rib resection to access proximal IMV, retrograde IMV use, and thoracodorsal vein access with or without a vein graft. This case demonstrates using the pectoral branch of the thoracoacromial venous system without a vein graft as a lifeboat option when the IMV is not suitable for anastomosis...
June 2017: Plastic and Reconstructive Surgery. Global Open
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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