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Journal of Surgical Oncology Mar 2022Skin- and nipple-sparing mastectomies (SSMs/NSMs) present as an alternative for patients requiring mastectomy, with better aesthetic results. We aimed to evaluate the...
BACKGROUND
Skin- and nipple-sparing mastectomies (SSMs/NSMs) present as an alternative for patients requiring mastectomy, with better aesthetic results. We aimed to evaluate the locoregional recurrence (LRR) rate and its predictive factors.
METHODS
Retrospective analysis of all consecutive cases of SSM and NSM for a primary diagnosis of in situ or invasive breast cancer, at a national cancer center, from January 1st, 2013 to May 31st, 2019. The primary outcome was LRR. Secondary outcomes included LRR predictive factors, overall survival (OS), and disease-free survival (DFS).
RESULTS
There were included 461 patients; 402 (87%) with invasive carcinoma. The median age was 46 (interquartile range [IQR]: 40-53) years. Ninety (20%) patients had locally advanced disease. LRR rate was 3.0%, with a median follow-up time of 39 (IQR: 21-59) months. The median time to recurrence was 22 (IQR: 10-45) months. Factors independently associated with LRR were high histological grade, negative estrogen receptor status, and high Ki67 (p < 0.05). OS was 94.8% and DFS was 92.8%. LRR was associated with decreased OS.
DISCUSSION
SSM and NSM present as a safe approach to breast cancer requiring mastectomy, including selected patients with a locally advanced tumor. The associated LRR rate is 3.0%, with risk factors being high grade, negative estrogen receptor status, and high Ki67.
Topics: Adult; Breast Neoplasms; Carcinoma; Disease-Free Survival; Female; Humans; Mastectomy, Simple; Mastectomy, Subcutaneous; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Retrospective Studies; Survival Rate; Treatment Outcome
PubMed: 34687468
DOI: 10.1002/jso.26725 -
The British Journal of Surgery Mar 1994A retrospective study was carried out to determine the clinical significance of local recurrence after simple mastectomy and node biopsy for primary operable breast...
A retrospective study was carried out to determine the clinical significance of local recurrence after simple mastectomy and node biopsy for primary operable breast cancer, without postoperative irradiation or systemic adjuvant therapy. Local recurrence was defined as a histologically proven lesion in or deep to the mastectomy skin flaps. A total of 966 patients with a median follow-up of 7 years were reviewed. Of these, 223 (23 per cent) developed local recurrence but half the tumours were small single lesions; 70 women had multiple discrete lesions and 21 diffuse carcinomatous dermal infiltration. Local recurrence showed significant associations with tumour grade, nodal status and the presence of lymphovascular invasion in the primary tumour. A predictive index containing these three variables was constructed. Adjuvant irradiation of the flaps is recommended for patients with high scores; such women would otherwise have a 39 per cent chance of developing local recurrence by 5 years. Different types of local recurrence have different chances of responding to local therapy: 13 per cent of single local recurrences, 32 per cent of multiple spot recurrences and 70 per cent of the diffuse type failed to respond to local therapy. Local recurrence predicts reduced patient survival.
Topics: Aged; Breast Neoplasms; Female; Humans; Lymph Nodes; Mastectomy, Simple; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Time Factors
PubMed: 8173907
DOI: 10.1002/bjs.1800810321 -
The British Journal of Radiology Mar 1955
Topics: Breast Neoplasms; Humans; Mastectomy, Simple; Radiotherapy
PubMed: 14351717
DOI: 10.1259/0007-1285-28-327-128 -
Plastic and Reconstructive Surgery Jul 1999The final appearance of the reconstructed breast is greatly dependent on the relative amounts of skin and breast tissue excised at the time of the mastectomy and on the...
The final appearance of the reconstructed breast is greatly dependent on the relative amounts of skin and breast tissue excised at the time of the mastectomy and on the exact location of the skin incision. A complete mastectomy may be performed using modified skin incisions to avoid the sacrifice of unnecessary breast skin. The type of skin-sparing incision used varies based on the exact location of the tumor and the size of the breast, but it always includes the nipple-areola complex and the biopsy site. The presence of local recurrence, distant disease, or death was determined in 50 consecutive patients who had skin-sparing mastectomies and immediate breast reconstruction between 1985 and 1991 to ascertain the safety of the procedure. The period of follow-up ranged from 23 to 121 months, with a mean of 57 months and a median of 51.5 months. There was no local recurrence, active distant disease was present in five patients, two patients died of distant disease, and there were two unrelated deaths.
Topics: Breast Neoplasms; Female; Follow-Up Studies; Humans; Mammaplasty; Mastectomy, Modified Radical; Mastectomy, Segmental; Mastectomy, Simple; Middle Aged; Retrospective Studies; Safety; Surgical Flaps; Time Factors; Treatment Outcome
PubMed: 10597677
DOI: No ID Found -
American Journal of Surgery Apr 1991A study of 5 patients and 10 mastectomy specimens was performed to identify the extent of surgery necessary to completely remove all breast tissue in patients having...
A study of 5 patients and 10 mastectomy specimens was performed to identify the extent of surgery necessary to completely remove all breast tissue in patients having prophylactic mastectomies. A standard total mastectomy performed for breast cancer was shown to frequently leave breast tissue within the superficial pectoralis major muscle and the lower skin flap. Frozen section analysis of margins was found to be essential to clear the axillary extension of the breast and lower skin flap in particular. The value of more extensive surgery to remove all glandular elements of the breast in the high-risk patient remains to be demonstrated.
Topics: Adult; Axilla; Breast; Breast Neoplasms; Fascia; Fasciotomy; Female; Follow-Up Studies; Humans; Mastectomy, Simple; Pectoralis Muscles; Prospective Studies; Prostheses and Implants; Risk Factors; Tissue Expansion
PubMed: 2035758
DOI: 10.1016/0002-9610(91)91100-w -
Annals of Plastic Surgery May 2011Breast cancer in women under 40 years of age is rare, accounting for approximately 5% of cases. The disease tends to be more aggressive in younger women. Younger age has... (Comparative Study)
Comparative Study
INTRODUCTION
Breast cancer in women under 40 years of age is rare, accounting for approximately 5% of cases. The disease tends to be more aggressive in younger women. Younger age has been shown to be an independent predictive of breast reconstruction after total mastectomy. Treatment by total mastectomy and reconstruction is examined in relation to patient age.
METHODS
A retrospective review of all breast cancer patients treated by total mastectomy and reconstruction between 2005 and 2009 was performed by querying a prospective database.
RESULTS
A total of 671 patients underwent total mastectomy and reconstruction; of them, 106 (16%) aged <40 and 565 (84%) aged ≥40 years. Compared with older patients, the age <40 group was more likely to present with advanced breast cancer (P < 0.001), receive radiation (P = 0.006), undergo contralateral prophylactic mastectomy (P < 0.001) and bilateral reconstruction (P = 0.005), and undergo delayed reconstruction (P = 0.02). Transverse rectus abdominis musculocutaneous flap reconstruction was more common in the age ≥40 years (P = 0.03). Bilateral reconstruction was most commonly performed with tissue expansion regardless of patient age.
CONCLUSIONS
Breast reconstruction in women less than 40 years of age is influenced by advanced tumor stage and the necessity for adjuvant radiation therapy as well as an increased use of contralateral prophylactic mastectomy.
Topics: Adult; Age Factors; Breast Neoplasms; Cohort Studies; Combined Modality Therapy; Disease-Free Survival; Female; Follow-Up Studies; Humans; Mammaplasty; Mastectomy, Simple; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Survival Analysis; Treatment Outcome
PubMed: 21451370
DOI: 10.1097/SAP.0b013e318216b648 -
Clinical Breast Cancer Apr 2013
Simple mastectomy and axillary lymph node biopsy performed under paravertebral block and light sedation in a patient with severe cardiorespiratory comorbidities: proposed management of choice in high-risk breast surgery patients.
Topics: Anesthesia, Local; Axilla; Breast Neoplasms; Carcinoma, Ductal, Breast; Cardiovascular Diseases; Comorbidity; Female; Humans; Mastectomy, Simple; Middle Aged; Neoplasm Grading; Prognosis; Respiratory Tract Diseases; Risk Factors; Sentinel Lymph Node Biopsy
PubMed: 23290077
DOI: 10.1016/j.clbc.2012.12.003 -
Acta Oncologica (Stockholm, Sweden) 1988Total mastectomy and partial axillary dissection as advised in the DBCG (Danish Breast Cancer Cooperative Group) protocols was performed in 104 consecutive females with...
Total mastectomy and partial axillary dissection as advised in the DBCG (Danish Breast Cancer Cooperative Group) protocols was performed in 104 consecutive females with operable primary invasive breast cancer, aged 34-82 years, median 47 years. The glandular removal was complete as assessed by microscopic examination of side resection planes and deep fascia of the surgical specimen. The number of removed axillary lymph nodes ranged from 1 to 28, median 8. The mortality was zero. There were no general complications. Wound complications comprised seroma (47.1%), flap margin necrosis (5.8%) and infection (1.9%). The pitfalls in securing total mastectomy are discussed as is the extent of axillary dissection for staging purposes. Furthermore, the problem of axillary dissection and axillary irradiation in node positive patients is considered.
Topics: Adult; Aged; Aged, 80 and over; Axilla; Breast Neoplasms; Female; Humans; Lymph Node Excision; Mastectomy, Simple; Middle Aged; Postoperative Complications
PubMed: 3219219
DOI: 10.3109/02841868809091765 -
Annales de Pathologie Jun 2013The breast angiosarcoma is an endothelial malign tumor. Its prevalence is about 0.04% of all breast malignant tumors. The characteristics of angiosarcoma are its... (Review)
Review
The breast angiosarcoma is an endothelial malign tumor. Its prevalence is about 0.04% of all breast malignant tumors. The characteristics of angiosarcoma are its malignancy and its clinical and radiologic polymorphism. The breast angiocarcinoma has a bad prognostic because of the frequency of metastases and recurrence. The purpose of this paper is to report the clinical, imaging and pathological features of breast angiosarcoma, a rare but aggressive tumor, based on a review of one case.
Topics: Adult; Age Factors; Biomarkers, Tumor; Biopsy; Breast Neoplasms; Cell Differentiation; Diagnosis, Differential; Fatal Outcome; Female; Hemangioma; Hemangiosarcoma; Humans; Mammography; Mastectomy, Simple; Neoplasm Grading; Neoplasm Invasiveness; Neoplasms, Radiation-Induced; Prognosis
PubMed: 23790666
DOI: 10.1016/j.annpat.2010.07.007 -
Plastic and Reconstructive Surgery Apr 2011
Topics: Breast; Female; Humans; Hypertrophy; Mammaplasty; Mastectomy, Simple
PubMed: 21460686
DOI: 10.1097/PRS.0b013e31820a66b8