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https://www.readbyqxmd.com/read/27869081/long-term-update-of-nrg-oncology-rtog-0319-a-phase-1-and-2%C3%A2-trial-to-evaluate-3-dimensional-conformal-radiation-therapy-confined-to-the-region-of%C3%A2-the%C3%A2-lumpectomy-cavity-for-stage-i-and-ii-breast%C3%A2-carcinoma
#1
Rachel Rabinovitch, Jennifer Moughan, Frank Vicini, Helen Pass, John Wong, Susan Chafe, Ivy Petersen, Douglas W Arthur, Julia White
PURPOSE: NRG Oncology RTOG 0319 was the first cooperative group trial in the United States to evaluate 3-dimensional conformal radiation therapy (3D-CRT) accelerated partial breast irradiation (APBI). This report updates secondary endpoints of toxicity and efficacy. METHODS AND MATERIALS: Patients with stage I or II invasive breast cancer (tumor size ≤3 cm, ≤3 positive lymph nodes, negative margins) were eligible for 3D-CRT APBI: 38.5 Gy in 10 twice-daily fractions...
December 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#2
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843872/an-unusual-presentation-of-metastatic-bone-disease-in-a-subject-with-paget-s-disease-of-bone
#3
Shrinath Shetty, Sahana Shetty, Annie Jennifer Prabhu, Nitin Kapoor, Julie Hepzibah, Thomas Vizhalil Paul
Solid organ malignancies involving breast, prostate, and lung frequently metastasize to the skeleton. However, the occurrence of Paget's disease and metastatic bone disease in the same patient is uncommon. We report a case of a 63-year-old man who presented with back pain and a lump in the right breast. He was earlier diagnosed to have Paget's disease of bone based on characteristic skeletal radiological features,(99m)Tc methylene diphosphonate bone scan and elevated alkaline phosphatase, and treated with bisphosphonates, and his disease was in remission...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27829018/paravertebral-block-plus-thoracic-wall-block-versus-paravertebral-block-alone-for-analgesia-of-modified-radical-mastectomy-a-retrospective-cohort-study
#4
Nai-Liang Li, Ben-Long Yu, Chen-Fang Hung
BACKGROUND AND OBJECTIVES: Paravertebral block placement was the main anesthetic technique for modified radical mastectomy in our hospital until February 2014, when its combination with blocks targeting the pectoral musculature was initiated. We compared the analgesic effects of paravertebral blocks with or without blocks targeting the pectoral musculature for modified radical mastectomy. METHODS: We retrospectively collected data from a single surgeon and anesthesiologist from June 1, 2012, to May 31, 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27785098/single-shot-lamina-thoracic-paravertebral-block-with-ketofol-for-modified-radical-mastectomy
#5
Ambrose Rukewe, Oludolapo O Afuwape, Austin Ugheoke, Akinola A Fatiregun
We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27785049/preventive-effect-of-zoledronic-acid-on-aromatase-inhibitor-associated-bone-loss-for-postmenopausal-breast-cancer-patients-receiving-adjuvant-letrozole
#6
Shengliang Sun, Fuchao Wang, Honglei Dou, Longqiang Zhang, Jiwen Li
BACKGROUND: This study aims to compare the efficacy and safety between zoledronic acid combined with calcium and calcium alone to prevent aromatase inhibitor-associated bone loss for postmenopausal breast cancer patients receiving adjuvant letrozole. METHODS: One hundred twenty patients were randomly divided into two groups, A and B. Patients in group A (n=60) received modified radical mastectomy or breast-conserving surgery + four cycles of AC followed by T regimen (optional) + radiotherapy (optional) + letrozole 2...
2016: OncoTargets and Therapy
https://www.readbyqxmd.com/read/27768139/assessing-the-impact-of-acupuncture-on-pain-nausea-anxiety-and-coping-in-women-undergoing-a-mastectomy
#7
Jessica Quinlan-Woodward, Autumn Gode, Jeffery A Dusek, Adam S Reinstein, Jill R Johnson, Sue Sendelbach
PURPOSE/OBJECTIVES: To compare the effect of acupuncture to a standard-of-care (control) group on pain, nausea, anxiety, and ability to cope. 
. DESIGN: Pilot randomized, controlled trial. 
. SETTING: Abbott Northwestern Hospital, a large, urban, tertiary care hospital in Minneapolis, Minnesota.
. SAMPLE: 30 adult women undergoing surgery for breast cancer.
. METHODS: Women were randomly assigned to two hospital-based acupuncture treatments versus usual care after breast cancer surgery...
November 1, 2016: Oncology Nursing Forum
https://www.readbyqxmd.com/read/27755490/effect-of-topical-morphine-on-acute-and-chronic-postmastectomy-pain-what-is-the-optimum-dose
#8
Sahar Abdel-Baky Mohamed, Hala Saad Abdel-Ghaffar, Shereen Mamdouh Kamal, Khaled Mohamed Fares, Hesham Mahmoud Hamza
BACKGROUND AND OBJECTIVES: Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. METHODS: In this registered clinical trial (ClinicalTrials.gov identifier: NCT02462577), 90 patients were allocated to receive 10 mL plain bupivacaine 0.5% plus either 5, 10, or 15 mg morphine (designated by the group names Morphine5, Morphine10, and Morphine15, respectively)...
October 11, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27747114/intracystic-primary-squamous-cell-carcinoma-of-the-breast-a-challenging-diagnosis
#9
Vera Ramos, João Fraga, Teresa Simões, Margarida Figueiredo Dias
We report a case of a 36-year-old woman that presented with a painful mass in the outer quadrants of the left breast that had grown rapidly. Physical examination revealed a well circumscribed elastic mass and breast ultrasound showed a cyst measuring 26 mm with vegetation growing on the inner wall. Microscopic evaluation, after fine needle aspiration cytology (FNAC), suggested benign lesion. Tumorectomy was performed and the final diagnosis was a pure squamous cell carcinoma (SCC) of the breast. A simple mastectomy with sentinel node biopsy was performed...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27746568/comparisons-of-single-injection-thoracic-paravertebral-block-with-ropivacaine-and-bupivacaine-in-breast-cancer-surgery-a-prospective-randomized-double-blinded-study
#10
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27721719/malignant-phyllodes-tumor-including-aneurysmal-bone-cyst-like-areas-in-pregnancy-a-case-report-and-review-of-the-literature
#11
Canan Kelten, Ceren Boyaci, Cem Leblebici, Kemal Behzatoglu, Didem C Trabulus, Serkan Sari, Mehmet A Nazli, Erol R Bozkurt
BACKGROUND: Malignant phyllodes tumors of the breast are rare biphasic neoplasms. Only few cases related to pregnancy have been reported. CASE REPORT: A 37-year-old woman presented with swelling and pain in her left breast as well as hyperemia on the breast skin, 4 weeks after labor. In her family history, her aunt and maternal cousin had had a breast cancer diagnosis. Clinical evaluation of the patient was consistent with a breast abscess. Therefore, abscess drainage and biopsy from the cavity wall were performed...
August 2016: Breast Care
https://www.readbyqxmd.com/read/27687427/the-effect-of-serratus-plane-block-performed-under-direct-vision-on-postoperative-pain-in-breast-surgery
#12
Marcus Hards, Arisa Harada, Isobel Neville, Sheelagh Harwell, Mahwash Babar, Abdulsatar Ravalia, Giles Davies
STUDY OBJECTIVES: To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. DESIGN: We performed a retrospective study of elective breast surgery patients undergoing mastectomy over 6 months. We collected data on the outcomes for the pain score and use of analgesia in recovery, the use of analgesia and antiemetics overnight, and the pain score and mobilization status of the patient 1 day after the operation...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687397/analgesic-efficacy-of-pregabalin-in-acute-postmastectomy-pain-placebo-controlled-dose-ranging-study
#13
Diab Fuad Hetta, Montaser A Mohamed, Mohammad Farouk Mohammad
STUDY OBJECTIVE: We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption. DESIGN: Prospective randomized controlled clinical trial. SETTING: Postanesthesia care unit. PATIENTS: One hundred twenty adult women scheduled for unilateral (MRM) with axillary evacuation. INTERVENTIONS: Patients were randomized to receive either, placebo capsule, pregabalin 75 mg, pregabalin 150 mg, or pregabalin 300 mg...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687353/pectoralis-serratus-interfascial-plane-block-vs-thoracic-paravertebral-block-for-unilateral-radical-mastectomy-with-axillary-evacuation
#14
Diab Fuad Hetta, Khalid Mohammed Rezk
STUDY OBJECTIVE: The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain. DESIGN: A prospective randomized controlled study. SETTING: Tertiary center, university hospital. PATIENTS: Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and III, scheduled for unilateral modified radical mastectomy with axillary evacuation...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27677113/synchronous-male-breast-and-colon-cancer-presenting-with-ileus-a-case-report
#15
Aziz Ari, Cihad Tatar, Kenan Buyukasik, Ozgur Segmen, Coskun Cakir, Soykan Arikan
INTRODUCTION: Cancer developing from more than one origin is called multiple primary cancer (MPC) and is a rare situation. In this article, we report a case presenting to the Emergency Clinic with symptoms of ileus who was diagnosed with synchronous colon and breast cancer. PRESENTATION OF CASE: A 57year old male patient presented to the Emergency Clinic with abdominal pain, vomiting, constipation and lack of flatulence. The patient was taken to the operating room for emergency surgery with the diagnosis of intestinal obstruction...
September 22, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27676665/efficacy-and-safety-of-ketamine-added-to-local-anesthetic-in-modified-pectoral-block-for-management-of-postoperative-pain-in-patients-undergoing-modified-radical-mastectomy
#16
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27673545/systematic-review-of-liposomal-bupivacaine-exparel-for-postoperative-analgesia
#17
Krishna S Vyas, Sibi Rajendran, Shane D Morrison, Afaaf Shakir, Samir Mardini, Valerie Lemaine, Maurice Y Nahabedian, Stephen B Baker, Brian D Rinker, Henry C Vasconez
BACKGROUND: Management of postoperative pain often requires multimodal approaches. Suboptimal dosages of current therapies can leave patients experiencing periods of insufficient analgesia, often requiring rescue therapy. With absence of a validated and standardized approach to pain management, further refinement of treatment protocols and targeted therapeutics is needed. Liposomal bupivacaine (Exparel) is a longer acting form of traditional bupivacaine that delivers the drug by means of a multivesicular liposomal system...
October 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27672340/use-of-preoperative-gabapentin-significantly-reduces-postoperative-opioid-consumption-a-meta-analysis
#18
Sudha Arumugam, Christine Sm Lau, Ronald S Chamberlain
OBJECTIVES: Effective postoperative pain management is crucial in the care of surgical patients. Opioids, which are commonly used in managing postoperative pain, have a potential for tolerance and addiction, along with sedating side effects. Gabapentin's use as a multimodal analgesic regimen to treat neuropathic pain has been documented as having favorable side effects. This meta-analysis examined the use of preoperative gabapentin and its impact on postoperative opioid consumption. MATERIALS AND METHODS: A comprehensive literature search was conducted to identify randomized control trials that evaluated preoperative gabapentin on postoperative opioid consumption...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27668333/post-breast-surgery-pain-syndrome-establishing-a-consensus-for-the-definition-of-post-mastectomy-pain-syndrome-to-provide-a-standardized-clinical-and-research-approach-a-review-of-the-literature-and-discussion
#19
Daniel Waltho, Gloria Rockwell
BACKGROUND: Post-mastectomy pain syndrome (PMPS) is a frequent complication of breast surgery. There is currently no standard definition for this chronic pain syndrome. The purpose of this review was to establish a consensus for defining PMPS by identifying the various elements included in the definitions and how they vary across the literature, determining how these definitions affect the methodological components therein, and proposing a definition that appropriately encompasses all of the appropriate elements...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27668326/a-review-of-the-literature-and-discussion-establishing-a-consensus-for-the-definition-of-post-mastectomy-pain-syndrome-to-provide-a-standardized-clinical-and-research-approach
#20
Murial Brackstone
Chronic pain presents a management challenge for physicians and patients alike, and post-mastectomy pain is no exception. In this issue, Waltho and Rockwell present a review of post-mastectomy pain syndrome (PMPS) and propose a standard definition that should allow future studies to be comparable. The proposed definition of "post-breast surgery pain syndrome" includes pain after any type of breast surgery that is of at least moderate intensity and comprises neuropathic qualities, that is present in the ipsilateral breast/chest/arm, that lasts longer than 6 months and is present at least half the time...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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