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PloS One 2022Seromas frequently develop in patients who undergo total mastectomy with node surgery. We aimed to prospectively explore whether use of oxidized regenerated cellulose... (Randomized Controlled Trial)
Randomized Controlled Trial
The efficacy of oxidized regenerated cellulose (SurgiGuard®) in breast cancer patients who undergo total mastectomy with node surgery: A prospective randomized study in 94 patients.
BACKGROUND
Seromas frequently develop in patients who undergo total mastectomy with node surgery. We aimed to prospectively explore whether use of oxidized regenerated cellulose (ORC, SurgiGuard®) affects seroma formation after total mastectomy with node surgery (sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND)).
MATERIALS AND METHODS
Ninety four breast cancer patients were enrolled in the study who underwent total mastectomy with ALND or SLNB. The patients were randomized into two groups, one treated with ORC plus closed suction drainage and the other with closed suction drainage alone.
RESULTS
Mean drainage volume was slightly lower in the ORC group on postoperative day 1 (123 ± 54 vs 143 ± 104 ml), but was slightly higher at all other time points; however, these differences were not significant. Mean total drainage volume in patients treated with ORC plus drainage did not differ from that of patients treated with drainage alone (1134 ± 507 ml vs 1033 ± 643 ml, P = 0.486).
CONCLUSIONS
Use of ORC (SurgiGuard®) did not significantly alter the risk of seroma formation.
Topics: Axilla; Breast Neoplasms; Cellulose; Cellulose, Oxidized; Female; Humans; Mastectomy; Mastectomy, Simple; Prospective Studies; Seroma
PubMed: 35622779
DOI: 10.1371/journal.pone.0267694 -
Annals of Surgical Oncology Apr 2022Currently, the operation rate of nipple-sparing mastectomy (NSM) is increasing. However, the long-term prognosis of NSM is not well documented. We utilized the...
BACKGROUND
Currently, the operation rate of nipple-sparing mastectomy (NSM) is increasing. However, the long-term prognosis of NSM is not well documented. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to analyze the long-term prognosis of NSM compared with total mastectomy (TM).
METHODS
Population-level data of female breast cancer patients treated with NSM and TM were extracted from 1998 to 2016 from the SEER database. Propensity score matching (PSM) was performed to reduce the influence of selection bias and confounding variables in comparisons. Kaplan-Meier analysis, log-rank test, and Cox proportional hazard regression were performed.
RESULTS
A total of 5765 patients underwent NSM, which increased from 266 in 2004-2009 to 5370 in 2010-2016. A total of 134,528 patients underwent TM, and the number of patients undergoing TM continued to decline. The overall survival (OS) and breast cancer-specific survival (BCSS) were similar between the NSM group and the TM group (P = 0.058 and 0.87, respectively). For OS, subgroup analysis showed that patients with age ≥ 46, White race, median household income ≥ $70,000, hormone receptor-positive, and HER2 negative had a better prognosis for treatment with NSM. There was no significant difference in BCSS between the NSM group and the TM group.
CONCLUSIONS
In recent years, the clinical application of NSM has been increasing. NSM is a proper procedure for breast cancer patients to achieve long-term survival.
Topics: Breast Neoplasms; Case-Control Studies; Female; Humans; Mammaplasty; Mastectomy; Mastectomy, Simple; Nipples; Organ Sparing Treatments; Prognosis; Propensity Score; Retrospective Studies
PubMed: 34802105
DOI: 10.1245/s10434-021-11044-4 -
The Breast Journal 2007Improvement in local control with radiation therapy translates to a survival benefit in patients with breast cancer. The magnitude this benefit is proportional to the... (Review)
Review
Improvement in local control with radiation therapy translates to a survival benefit in patients with breast cancer. The magnitude this benefit is proportional to the magnitude of the improvement in local control. Since the proportional reduction of local recurrence with the addition of radiation is relatively constant, it is important to determine the probability of local recurrence in order to guide therapy. There are a number of factors, including lymph node involvement, lymphovascular invasion, and size of the primary tumor that correlate with risk of local recurrence. There is very little data on the prognostic significance of malignant cells in seroma fluid after mastectomy or axillary dissection. We report a case of a woman with atypical cells in a persistent seroma following mastectomy for node negative infiltrating ductal carcinoma.
Topics: Breast Neoplasms; Carcinoma, Ductal, Breast; Epithelial Cells; Female; Humans; Immunohistochemistry; Mastectomy, Simple; Middle Aged; Neoplasm Invasiveness; Sentinel Lymph Node Biopsy; Seroma
PubMed: 17319864
DOI: 10.1111/j.1524-4741.2007.00399.x -
The New England Journal of Medicine Dec 2002
Topics: Breast Neoplasms; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Mastectomy, Radical; Mastectomy, Simple
PubMed: 12501861
DOI: No ID Found -
Surgery, Gynecology & Obstetrics Oct 1947
Topics: Breast; Humans; Mastectomy; Mastectomy, Simple
PubMed: 20264330
DOI: No ID Found -
The New England Journal of Medicine Dec 2002
Topics: Breast Neoplasms; Female; Humans; Lymphatic Metastasis; Mastectomy, Radical; Mastectomy, Simple; Neoplasm Recurrence, Local; Survival Analysis
PubMed: 12501233
DOI: 10.1056/NEJM200212263472615 -
Cancer Jul 2002Many women who are at an elevated risk of developing breast carcinoma choose prophylactic mastectomy to decrease their risk. We conducted a population-based study to...
BACKGROUND
Many women who are at an elevated risk of developing breast carcinoma choose prophylactic mastectomy to decrease their risk. We conducted a population-based study to review the indications for, and patterns of practice of prophylactic mastectomy in Ontario, Canada, since 1991.
METHODS
A medical chart review was conducted at 33 hospitals that were identified as having conducted at least one prophylactic mastectomy. All bilateral mastectomy patients with no diagnosis of invasive or in situ breast carcinoma were eligible.
RESULTS
The number of prophylactic bilateral mastectomies performed varied from 6 to 19. The mean age of women undergoing prophylactic mastectomy was 43.5 years. Eighty percent of the women had prophylactic mastectomy performed because of a family history of breast carcinoma (89 of 99) or because of a known BRCA1 or BRCA2 mutation (10 of 99). Twenty percent of the women had no family history, but had the surgery for other benign breast conditions. Women with a family history of breast carcinoma were much more likely to have a total mastectomy (89%) than a subcutaneous mastectomy (11%). Sixty percent of the women had reconstructive surgery following mastectomy.
CONCLUSIONS
Prophylactic mastectomy is not performed on a large scale. The introduction of genetic testing for BRCA1 and BRCA2 has the potential to change the patterns of practice for prophylactic mastectomy.
Topics: Adult; Aged; Breast Neoplasms; Female; Genes, BRCA1; Genes, BRCA2; Genetic Predisposition to Disease; Hospitals, Community; Hospitals, Teaching; Humans; Mastectomy; Mastectomy, Simple; Mastectomy, Subcutaneous; Middle Aged; Ontario; Risk Factors
PubMed: 12124821
DOI: 10.1002/cncr.10680 -
Asian Journal of Surgery Feb 2021Sarcopenia is associated with postoperative complications in patients undergoing digestive surgery. In this study, we investigated the impact of preoperative sarcopenia...
BACKGROUND
Sarcopenia is associated with postoperative complications in patients undergoing digestive surgery. In this study, we investigated the impact of preoperative sarcopenia on postoperative complications in breast cancer patients who underwent total mastectomy.
METHODS
Patients with breast cancer who underwent total mastectomy were included in the analysis. The relationship between the presence of sarcopenia and postoperative complications (e.g., skin flap necrosis and seroma) and between the incidence of these complications as well as preoperative and surgical factors was investigated. Moreover, the effects of sarcopenia on recurrence-free survival and overall survival were evaluated. The psoas muscle index calculated using values measured on preoperative computed tomography images was used to diagnose sarcopenia.
RESULTS
In total, 43 (49%) of 88 patients presented with sarcopenia. The number of patients with a Geriatric Nutritional Risk Index score <91 was higher in the sarcopenia group than in the non-sarcopenia group (p = 0.011). Seroma was observed in 32 (36.4%) patients, and no significant difference was observed between the patients with and without sarcopenia (16 [35.6%] in the non-sarcopenia group vs 16 [37.2%] in the sarcopenia group). By contrast, skin flap necrosis was observed in 20 (22.7%) patients, and the number of patients with this complication was higher in the sarcopenia group than in the non-sarcopenia group (15 [34.9%] vs 5 [11.1%]).
CONCLUSION
Sarcopenia is a risk factor for skin flap necrosis and may be an important factor for preoperative evaluation in patients who will undergo total mastectomy.
Topics: Aged; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Mastectomy, Simple; Necrosis; Postoperative Complications; Retrospective Studies; Sarcopenia; Surgical Flaps
PubMed: 33229126
DOI: 10.1016/j.asjsur.2020.11.001 -
Annals of Plastic Surgery Dec 2022The analgesic efficacy of bilateral low thoracic erector spinae blocks for combined major breast and abdominal surgery has not been reported. The aim of this case series...
Feasibility and Efficacy of Low Thoracic Ultrasound-Guided Erector Spinae Plane Blocks in Patients Undergoing Radical Total Mastectomy With Deep Inferior Epigastric Perforator Flap Reconstruction.
The analgesic efficacy of bilateral low thoracic erector spinae blocks for combined major breast and abdominal surgery has not been reported. The aim of this case series was to assess the feasibility and efficacy of T8 thoracic preincisional erector spinae blocks in patients undergoing total radical mastectomies with axillary lymph node dissections in addition to reconstruction with abdominal deep inferior epigastric flaps. The aim was to supply dermatomal coverage to provide analgesia for T2-L1 that formed the basis for an opioid-sparing multimodal technique in the context of our early recovery after breast surgery with deep inferior epigastric flap program.
Topics: Humans; Female; Perforator Flap; Mastectomy, Simple; Mastectomy; Breast Neoplasms; Feasibility Studies; Mastectomy, Radical; Nerve Block; Ultrasonography, Interventional
PubMed: 36416694
DOI: 10.1097/SAP.0000000000003290 -
Anais Da Academia Brasileira de Ciencias 2022The aim of this study was to evaluate the latency, extent of analgesia, and duration of motor block of levobupivacaine alone and combined with methadone or...
Analgesic, cardiorespiratory effects and motor block characteristics of epidural levobupivacaine alone or in combination with methadone or dexmedetomidine in bitches undergoing unilateral total mastectomy.
The aim of this study was to evaluate the latency, extent of analgesia, and duration of motor block of levobupivacaine alone and combined with methadone or dexmedetomidine after epidural administration during and after mastectomy in dogs. Twenty-four mature, mixed-breed female dogs were randomly divided into three experimental groups with eight animals each, according to the agents used in lumbosacral epidural analgesia: levobupivacaine 0.75% alone (1.5mg/kg - control group), levobupivacaine 0.75% (1.5 mg/kg) + methadone 1% (0.3 mg/kg), or levobupivacaine 0.75% (1.5 mg/kg) + dexmedetomidine 0.05% (3 µg/kg). During surgery, cardiorespiratory parameters were evaluated. Rescue analgesia was given when there were signs of nociception and was necessary in all three treatment groups. Since all animals received rescue analgesia during the surgery and immediately post-surgery, the duration of the sensitive block were not evaluated. The extent of sensory block was between the 12º and 13º thoracic vertebrae for the control group, 7º thoracic vertebra to 5º lumbar vertebra (methadone group), and 8º thoracic vertebra to 4º lumbar vertebra for the dexmedetomidine group. Methadone or dexmedetomidine combined with levobupivacaine increased the extent of the sensory block and the duration of the motor block in bitches when administered via the epidural route.
Topics: Female; Animals; Dogs; Methadone; Levobupivacaine; Mastectomy, Simple; Mastectomy
PubMed: 36477226
DOI: 10.1590/0001-3765202220210082