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partial mastectomy

Anees B Chagpar, Theodore N Tsangaris, Donald R Lannin
BACKGROUND: Positive margins have been reported in 20-40% of patients undergoing a partial mastectomy (PM), often resulting in re-excision. How often the re-excision yields further cancer and whether there are predictors of residual disease remains unknown. STUDY DESIGN: Patients who had a positive margin (defined as tumor at ink for patients with invasive disease or within 1 mm for patients with DCIS) in the SHAVE trial prior to randomization were evaluated to determine the rate of additional disease either in cavity shave margins (CSM) or at re-excision...
March 7, 2018: Journal of the American College of Surgeons
Sukru Yazar, E Cigdem Karadag, Altug Altinkaya, Halil Kara, Cihan Uras
BACKGROUND: Breast reconstruction with a Becker-type expander is a common technique following mastectomy. However, inconsistency remains in the literature regarding risk factors for the survival of a Becker-type expander following immediate breast reconstruction. This study's purpose is to investigate possible risk factors for the Becker-type expander survival and to evaluate the complications related to expander removal following immediate breast reconstruction. METHODS: We performed a retrospective chart review of consecutive women who underwent a mastectomy followed by immediate breast reconstruction with a Becker-type expander from November 2010 to November 2016...
March 9, 2018: Aesthetic Plastic Surgery
Kazuyuki Kubo, Hiroyuki Takei, Atsumori Hamahata, Hiroshi Matsumoto, Hiroyuki Sakurai
PURPOSE: To prevent tissue expander (TE) exposure following mastectomy flap necrosis in immediate breast reconstruction, the TE is usually covered completely or partially with a musculofascial (MF) flap. This study compares the complications of the two coverage methods. METHODS: We reviewed, retrospectively, 106 cases of immediate TE-based breast reconstruction. The patients were divided into two groups according to whether complete or partial TE coverage was done...
March 5, 2018: Surgery Today
Siddhartha Yadav, Sruthi Jinna, Otavio Pereira-Rodrigues, Ashley Reeves, Sarah Campian, Amy Sufka, Dana Zakalik
The utility and benefit of integrating germ-line genetic testing into the management of newly diagnosed breast cancer is not fully understood. This study evaluates the impact of preoperative genetic testing on surgical decision making in patients with newly diagnosed breast cancer. Women with newly diagnosed breast cancer were classified into preoperative or postoperative genetic testing group, depending on whether they received their genetic testing results prior to or after their first surgery. Demographics, tumor characteristics, surgical treatment, and results of genetic testing were retrospectively collected...
March 2, 2018: Breast Journal
Maurice Y Nahabedian
Prosthetic breast reconstruction has evolved over the years to provide results that now mimic that of a natural breast. This is due to a variety of innovations and advancements related to mastectomy techniques, acellular dermal matrices, autologous fat grafting, and improved breast implants. The evolution of prosthetic breast reconstruction has gone full-circle and included prepectoral placement in the 1970s and 80s, partial or total subpectoral placement from 1985 to 2015, and now gradually trending back to prepectoral...
March 2, 2018: Breast Journal
Troy A Pittman, Olivia A Abbate, James M Economides
BACKGROUND: Prepectoral prosthetic-based breast reconstruction has become increasingly popular as an alternative to the partial or total submuscular approach. Potential issues with the prepectoral approach include a noticeable superior implant edge and implant rippling. These concerns are particularly apparent in thin patients. We introduce a novel muscle-sparing technique in which a partial-thickness slip of pectoralis muscle is created in an otherwise prepectoral plane to mask these upper pole defects, mask superior implant rippling, and provide greater implant support (The P1 Method)...
February 27, 2018: Annals of Plastic Surgery
Jing Ma, Jin Song, Hai Chen, Cibo Fan, Jiaqi Xie, Xiaodong Qi
The aim of the present study was to evaluate the safety and efficacy of intra-arterial interventional therapy (IAIT) in the treatment of inoperable local advanced breast cancer (LABC). A total of 7 patients with pathologically proven inoperable LABC were included in the present study. Patients received 1-4 cycles of IAIT prior to mastectomy and postoperative adjuvant therapy. The safety and clinical outcomes of IAIT were retrospectively analyzed. Between February 2009 to September 2016, 7 patients received IAIT...
February 2018: Oncology Letters
Neal Bhutiani, Megan K Mercer, Katelynn C Bachman, Samantha R Heidrich, Robert C G Martin, Charles R Scoggins, Kelly M McMasters, Nicolás Ajkay
BACKGROUND: This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and healthcare costs before and after publication of 2014 Society of Surgical Oncology/American Society of Radiation Oncology consensus guideline on margins for breast conserving operation with whole-breast irradiation for stage I and II breast cancer at an academic institution. STUDY DESIGN: Patients with stage I and II invasive carcinomas who underwent partial mastectomy were divided into 2 groups based on whether they were treated before (PRE) or after (POST) guideline publication in March 2014...
February 9, 2018: Journal of the American College of Surgeons
Takashi Katsumori, Hisami Ohshima, Hiromitsu Hamaguchi, Shinichi Yamamoto, Yukika Tsukamoto, Tomohiro Iwanaga, Susumu Ohkawara
A 50s-year-old woman underwent left partial mastectomy with axillary lymphadenectomy for breast cancer. Histological examination indicated invasive ductal carcinoma, pT1c, pN0, Stage I , ly(+), ER(+), PgR(+). She received adjuvant therapy with tamoxifen and 50 Gy of irradiation to the residual breast. Four years after mastectomy, she was found to have left Rotter lymph node metastasis; then, anastrozole was administered instead of tamoxifen. Nine months later, she was found to have liver metastasis. Immunohistostaining revealed that the breast cancer was HER2-positive; she received AC followed by paclitaxel(PTX)with trastuzumab(T), and achieved complete response(CR)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yoshihito Nakayama, Nobukazu Watanabe, Harue Akasaka
We report a rare case of intractable bile leakage after liver resection due to stenosis of the anastomosis of a choledochojejunostomy after pancreaticoduodenectomy. A 65-year-old woman was diagnosed with pancreatic and right breast cancer, and underwent pancreaticoduodenectomy and right mastectomy with simultaneous axillary lymph node dissection. Adjuvant chemotherapy and follow-up were performed in our department. After 18 months, computed tomography revealed a liver metastasis of 2.5 cm in segment 8. Because the primary nest of liver metastasis was unknown and performing a biopsy was difficult due to the location, partial resection of the liver was performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Takahiro Sawatsubashi, Hideki Nakatsuka, Kouei Nihei
We report a case of angiosarcoma of the breast following breast-conserving surgerywith radiotherapyfor breast cancer. The patient was 82-year-old woman, developed induration and eruption in the bilateral breast more than 8 years after the initial operation for breast cancer. The induration was diagnosed as angiosarcoma based on skin-biopsyand vacuum-assisted biopsy. The patient received simple mastectomy, and has been become recurrent condition about one month after simple mastectomy. We operated partial excision for recurrence tumor...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hirotoshi Takahashi, Maya Uno, Kazuya Miyoshi
While skull base metastases from breast cancer are not uncommon, there are relatively few reported cases in the literature. We report a case of skull base metastasis of breast cancer that resulted in dysphasia, odynophagia, and dysarthria. The case involved a woman in her 50 s who was diagnosed with cancer of the right breast(cT4N1M0, cStage III B)at another medical institution 9 years previously and who underwent a partial mastectomy and an axillary lymph node dissection following neoadjuvant chemotherapy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Gen Tsujio, Shinichiro Kashiwagi, Yuka Asano, Wataru Goto, Koji Takada, Tamami Morisaki, Satoru Noda, Tsutomu Takashima, Naoyoshi Onoda, Masahiko Ohsawa, Kosei Hirakawa, Masaichi Ohira
A breast cancer with tumors smaller than or equal to 5mm in diameter is treated as a microscopic lesion and axially lymph node metastasis is considered to be rare. A 52-year-old female was found to have an abnormal shadow on mammography. An ultrasonography revealed a poorly defined and irregular shaped mass with calcification, 4mm in diameter, in the AC area of her left breast. We performed vacuum-assisted biopsy and diagnosed with invasive ductal carcinoma. Under a preoperative diagnosis of left breast cancer with cT1aN0M0, stage I , Luminal A like, we underwent partial mastectomy with sentinel lymph node biopsy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Gen Tsujio, Shinichiro Kashiwagi, Takaharu Hatano, Yuka Asano, Wataru Goto, Koji Takada, Satoru Noda, Tsutomu Takashima, Naoyoshi Onoda, Hisashi Motomura, Kosei Hirakawa, Masaichi Ohira
The rate of local recurrence after mastectomy is reportedly similar to that of one-stage reconstruction. Most recurrences are in the skin or chest wall, while recurrence in the reconstructed breast is rare and the causes are uncertain. We report a case of a 42-year-old female who underwent partial mastectomy for left breast cancer with cT4aN0M1(PUL), cStage IV after endocrine therapy 3 years ago. Histopathological diagnosis was solid-tubular carcinoma. She had been treated with only endocrine therapy but diagnosed with local recurrence in the left breast...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Nigel P Murray
The presence of micrometastatic disease will ultimately determine the breast cancer-specific mortality of patients treated according to current guidelines. Minimal residual disease (i.e., occult tumor, not detected by conventional tests) may exist in two forms: a dormant form of only micrometastasis and a more aggressive "awakened" form where CTCs (circulating tumor cells) are actively disseminating. The hypothesis is that patients with CTCs have a more advanced or aggressive disease (that the cancer has "awoken" and there is active dissemination), whereas those patients with only micrometastasis have "dormant" disease and, although at risk of future relapse, may not do so for many years...
July 27, 2017: Curēus
Emi Ishigami, Masahiro Sakakibara, Junta Sakakibara, Toshiaki Iwase, Shoko Hayama, Takahito Masuda, Ayako Nakagawa, Takeshi Nagashima, Takafumi Sangai, Hiroshi Fujimoto, Masayuki Otsuka
Neoadjuvant chemotherapy (NAC) with anthracyclines followed by taxane chemotherapy has become the standard treatment for patients with locally advanced, operable breast cancer. Recently, the efficacy of nanoparticle albumin-bound paclitaxel (nab-PTX) for metastatic breast cancer was reported. However, there are still few studies of a neoadjuvant regimen including nab-PTX. Thus, the present phase II study evaluated the efficacy and safety of 5-fluorouracil, epirubicin and cyclophosphamide (FEC regimen) followed by nab-PTX as neoadjuvant treatment for operable human epidermal growth factor receptor 2 (HER2)-negative breast cancer...
December 2017: Molecular and Clinical Oncology
Melissa P Mitchell, Jamie Wagner, James Butterworth
PURPOSE: A growing trend in breast reconstruction has been placement of tissue expanders in the pre pectoral space. This is a change from the practice of placement under the pectoralis major with or without an acellular dermal matrix (ADM) sling. The move toward pre pectoral placement with an ADM wrap has the intent of decreasing post-operative pain and decreasing animation deformities. The cosmesis of pre pectoral reconstructions in the setting of post mastectomy radiation has also appeared improved in our early experience, when compared to submuscular reconstructions...
September 8, 2017: Practical Radiation Oncology
Eleftherios Spartalis, Diamantis I Tsilimigras, Petros Charalampoudis, Georgia-Sofia Karachaliou, Demetrios Moris, Antonios Athanasiou, Michael Spartalis, Vasileios Bolkas, Dimitrios Dimitroulis, Nikolaos Nikiteas
Surgery remains the mainstay of treatment for breast cancer, including complete or partial mastectomy and lumpectomy. Breast reconstruction has gained popularity mainly due to its tremendous impact on the psychological status of the patients. Autologous fat grafting is a well-established method used in cosmetic surgery; however, fat re-absoprtion, fat necrosis, calcifications and oil-cyst formation are some usually encountered complications limiting the efficacy of this approach. Platelet-rich plasma (PRP) has recently been postulated as a promising method for tissue regeneration since it contains high levels of diverse human growth factors...
December 2017: Anticancer Research
Aman Saini, Robert Kuske, Coral Quiet, Cheri Pantoja, Daniel Reed, Victor Zannis
PURPOSE: Tumor biology is being recognized as an important indicator of prognosis and risk of locoregional recurrence. Here, we determine actuarial recurrence rates by approximated molecular subtype for women treated with single-entry catheter accelerated partial breast irradiation (sAPBI). METHODS AND MATERIALS: One thousand four hundred eighty-six women with invasive cancer having known ER, PR, and Her2 status and at least 1-year of followup were treated using MammoSite, Contura, or SAVI sAPBI from 2002 to 2014 at our institution...
November 13, 2017: Brachytherapy
Mehran Habibi, Kristen P Broderick, Mohamad E Sebai, Lisa K Jacobs
Oncoplastic surgery of the tissue defect from partial mastectomy should be considered for all patients. It can result in in significant asymmetries from scar contraction, skin tethering, and alterations in the nipple areolar complex location. Indications, risks, and benefits are discussed. Optimal procedures are described, considering resected specimen volume, primary tumor location, tumor to breast size ratio, and the impact on the nipple areolar complex. Indications for plastic surgery consultation and joint surgery are discussed...
January 2018: Surgical Oncology Clinics of North America
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