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Long-term Survival After Diverse Therapeutic Modalities in Malignant Phyllodes Tumors of the Breast.Technology in Cancer Research &... 2022Malignant phyllodes tumor of the breast (MPTB) is a rare tumor for which surgery or surgery combined with radiotherapy (RT) is the primary treatment method. However,...
Malignant phyllodes tumor of the breast (MPTB) is a rare tumor for which surgery or surgery combined with radiotherapy (RT) is the primary treatment method. However, recently, the therapeutic effect of RT on MPTB has been controversial. We aimed to explore the role of RT, chemotherapy (CT), and surgical modalities in patients with MPTB. The Surveillance, Epidemiology, and End Results (SEER) database was used to select patients with MPTB who met the criteria between 2010 and 2018. Kaplan-Meier curves and Cox proportional risk regression models were used to analyze the effects of RT on MPTB patients. Based on this, we compared the effects of breast-conserving surgery (BSC) and mastectomy on the postoperative survival of MPTB. A total of 298 patients with MPTB were included in this study. RT was received by 22.1% (n = 66) of the patients while 77.9% (n = 232) did not receive RT. CT was received by 4.7% (n = 14) patients while 95.3% (n = 284) did not receive CT. According to Kaplan-Meier curves, RT and CT combined resulted in a decrease in breast cancer-specific survival (BCSS) and overall survival (OS) compared to patients who did not receive RT. Mastectomy improved the OS and BCSS of the patients more than BCS). The findings of univariate and multivariate Cox regression analyses suggested that "distant metastasis", "tumor grade" and "number of positive lymph node biopsies" affected OS of breast cancer, while "distant metastasis", "tumor grade", "surgery combined with radiotherapy/surgery", and "radiotherapy/chemotherapy or not", had a significant effect on BCSS. RT and CT did not significantly improve the long-term survival of MPTB patients. Mastectomy improved OS and BCSS of the patient more than BCS. RT in an early stage improved early prognosis moderately in MPTB patients with tumor diameter less than 50 mm.
Topics: Breast; Breast Neoplasms; Female; Humans; Mastectomy; Mastectomy, Segmental; Radiotherapy, Adjuvant; SEER Program
PubMed: 36000314
DOI: 10.1177/15330338221121086 -
European Journal of Surgical Oncology :... Jul 2016Skin-sparing mastectomy (SSM) facilitates immediate breast reconstruction. We investigated locoregional recurrence rates after SSM compared with simple mastectomy and...
UNLABELLED
Skin-sparing mastectomy (SSM) facilitates immediate breast reconstruction. We investigated locoregional recurrence rates after SSM compared with simple mastectomy and the factors predicting oncological failure.
METHODS
Patients with early breast cancer that underwent mastectomy between 2000 and 2005 at a single institution were studied to ascertain local and systemic recurrence rates between groups. Kaplan-Meier curves and log-rank test were used to evaluate disease-free survival.
RESULTS
Patients (n = 577) underwent simple mastectomy (80%) or SSM (20%). Median follow up was 80 months. Patients undergoing SSM were of younger average age, less often had involved lymph nodes (22% vs 44%, p < 0.001), more often had DCIS present (79% vs 53%, p < 0.001) and involved margins (29% vs 15%, p = 0.001). Involved surgical margins were associated with large size (p = 0.001). The 8-year local recurrence (LR) rates were 7.9% for SSM and 5% for simple mastectomy respectively (p = 0.35). Predictors of locoregional recurrence were lymph node involvement (HR 8.0, for >4 nodes, p < 0.001) and involved surgical margins (HR 3.3, p = 0.002). In node negative patients, SSM was a predictor of locoregional recurrence (HR 4.8 [1.1, 19.9], p = 0.033).
CONCLUSION(S)
Delayed reconstruction is more appropriate for node positive early breast cancer after post-mastectomy radiotherapy. Re-excision of involved margins is essential to prevent local recurrence after mastectomy.
Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Chemotherapy, Adjuvant; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Margins of Excision; Mastectomy, Simple; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Organ Sparing Treatments; Predictive Value of Tests; Radiotherapy, Adjuvant; Retrospective Studies; Risk Factors; Skin
PubMed: 27256869
DOI: 10.1016/j.ejso.2016.04.055 -
Same-day mastectomy and axillary lymph node dissection is safe for most patients with breast cancer.Journal of Surgical Oncology Apr 2022The aim of this study was to evaluate the safety of same-day mastectomy, with or without a sentinel node biopsy (SNB) and/or axillary lymph node dissection (ALND).
BACKGROUND AND OBJECTIVE
The aim of this study was to evaluate the safety of same-day mastectomy, with or without a sentinel node biopsy (SNB) and/or axillary lymph node dissection (ALND).
METHODS
In this retrospective study, we reviewed 913 consecutive women who underwent a simple mastectomy for breast cancer between the years 2014 and 2019 and were treated either with same-day surgery (SDS) or an overnight stay (OS) regime. We reviewed all surgical complications, any unplanned return to care (RTC) and the rehospitalization rate for 30 postoperative days.
RESULTS
A total of 259 patients (28%) were treated with SDS and 654 patients (72%) with an OS regime. There was no difference in RTC (odds ratio: 0.79 [95% confidence interval: 0.53-1.18], p = 0.26) or any major complications between the groups. None of the investigated subgroups, such as patients with previous neoadjuvant therapy, diabetes, obesity (up to a body mass index of 40 kg/m ), the American Society of Anaesthesiologist Class of 3, or elderly patients aged 75-84 years, showed an increased complication rate when treated with the SDS regime.
CONCLUSION
A same-day simple mastectomy is safe with SNB and/or ALND. It can be performed safely for most patients with stable co-morbidities.
Topics: Aged; Aged, 80 and over; Axilla; Breast Neoplasms; Female; Humans; Lymph Node Excision; Mastectomy; Neoplasm Staging; Retrospective Studies; United States
PubMed: 35050499
DOI: 10.1002/jso.26799 -
Revue Medicale de Liege 2011Oncoplastic surgery combines large lumpectomy and defect remodeling by different plastic surgery methods. These procedures improve the cosmetic result after partial...
Oncoplastic surgery combines large lumpectomy and defect remodeling by different plastic surgery methods. These procedures improve the cosmetic result after partial mastectomy and widens the possibilities for conservative treatment. Different techniques are used from simple glandular remodeling to more difficult techniques for breast plasties with or without simultaneous controlateral symetrisation procedure. The surgical option depends especially on the ratio between the volume of the tumor and the volume of the breast and the position of the tumor. This more effective conservative treatment facilitates also postoperative radiotherapy, reduces the sequellae and the psychological impact of breast cancer treatment.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy, Segmental
PubMed: 21826974
DOI: No ID Found -
Journal of Plastic, Reconstructive &... Jun 2022Women with an increased hereditary risk of breast cancer can undergo risk-reducing prophylactic mastectomy. However, there is a balance between how much subcutaneous...
BACKGROUND
Women with an increased hereditary risk of breast cancer can undergo risk-reducing prophylactic mastectomy. However, there is a balance between how much subcutaneous tissue should be resected to achieve maximal reduction of glandular tissue, while leaving viable skin flaps.
METHODS
Forty-five women previously operated with prophylactic mastectomy underwent magnetic resonance tomography (MRT) and ultrasound (US) to investigate the correlation between skin flap thickness and residual glandular tissue. Residual glandular tissue was documented as being present or not present, but not quantified, as the amount of residual glandular tissue in many cases was considered too small to make reliable volume quantifications with available tools. Since a mastectomy skin flap thickness of 5 mm is discussed as an oncologically safe thickness in the literature, this was used as a cut-off.
RESULTS
Following prophylactic mastectomy, residual glandular tissue was detected in 39.3% of all breasts and 27.9% of all the breast quadrants examined by MRT, and 44.1% of all breasts and 21.7% of all the breast quadrants examined by US. Residual glandular tissue was detected in 6.9% of the quadrants in skin flaps ≤ 5 mm and in 37.5% of the quadrants in skin flaps > 5 mm (OR 3.07; CI = 1.41-6.67; p = 0.005). Furthermore, residual glandular tissue increased significantly already when the skin flap thickness exceeded 7 mm.
CONCLUSIONS
This study highlights that complete removal of glandular breast tissue during a mastectomy is difficult and suggests that this is an unattainable goal. We demonstrate that residual glandular tissue is significantly higher in skin flaps > 5 mm in comparison to skin flaps ≤ 5 mm, and that residual glandular tissue increases significantly already when the flap thickness exceeds 7 mm.
Topics: Breast Neoplasms; Female; Humans; Magnetic Resonance Imaging; Mammaplasty; Mastectomy; Prophylactic Mastectomy; Surgical Flaps
PubMed: 35177362
DOI: 10.1016/j.bjps.2022.01.031 -
European Review For Medical and... Jul 2015The origin of the muscolocutaneous latissimus dorsi flap dates back to 1906 when Igino Tansini, an Italian surgeon, described a procedure to reconstruct the mastectomy...
The origin of the muscolocutaneous latissimus dorsi flap dates back to 1906 when Igino Tansini, an Italian surgeon, described a procedure to reconstruct the mastectomy defect. After a detailed study of Tansini's original description and drawings, new insights about the pedicle of its compound flap have been found, showing that it has the same pedicle of the scapular flap. In the end, Tansini's flap should be more correctly considered as a compound musculocutaneous scapular flap.
Topics: History, 19th Century; History, 20th Century; Humans; Male; Mastectomy; Myocutaneous Flap; Surgeons; Surgical Flaps
PubMed: 26214785
DOI: No ID Found -
Asian Pacific Journal of Cancer... May 2021There are limited data concerning the use of mastectomy and associated factors in China in recent years. This study aimed to investigate the uptake of mastectomy and... (Observational Study)
Observational Study
OBJECTIVE
There are limited data concerning the use of mastectomy and associated factors in China in recent years. This study aimed to investigate the uptake of mastectomy and determine the associations between patients' characteristics and mastectomy among Chinese women with breast cancer.
METHODS
A retrospective analysis of female breast cancer cases from 1st January 2015 to 31st December 2019 from a tertiary hospital was conducted. Socio-demographic data, clinical data, and surgery types were collected by reviewing the medical record system. Chi-squared test, Fisher's exact test and multivariate logistic regression analysis were used to determine any correlations of patients' characteristics with mastectomy.
RESULTS
A total of 1,171 women with breast cancer were identified, and 76.60% of them underwent a mastectomy. The mastectomy rates showed an increase from 70.62% in 2015 to 86.87% in 2017 and then dropped to 71.91% in 2019. Women undergoing mastectomy were older and were more likely to be married and have at least one child. They had an advanced cancer stage, larger tumour size, and more lymph node invasion and were positive for HER-2 overexpression. Older age, larger tumour size (2-5 cm), higher cancer stages (stage 2- stage 3) and being positive for HER-2 were the four independent variables that significantly predicted the uptake of mastectomy.
CONCLUSIONS
Our results showed a wide application of mastectomy in China and uncovered the factors associated with mastectomy uptake from a single-centre experience. Findings suggested the potential overuse of mastectomy among women with early-stage breast cancer, and highlighted the significance of promoting cancer screening in China. Findings could be also used to develop relevant provisions and interventions to facilitate breast cancer treatment decision-making and screening planning.
.Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Mastectomy; Middle Aged; Prognosis; Retrospective Studies; Young Adult
PubMed: 34048191
DOI: 10.31557/APJCP.2021.22.5.1599 -
Minerva Chirurgica Jun 2018
Topics: Breast Neoplasms; Female; Humans; Mastectomy; Procedures and Techniques Utilization
PubMed: 29589677
DOI: 10.23736/S0026-4733.18.07726-X -
Current Oncology (Toronto, Ont.) Mar 2024Breast cancer is diagnosed in nearly 3 million people worldwide. Radiation therapy is an integral component of disease management for patients with breast cancer, and is... (Review)
Review
Breast cancer is diagnosed in nearly 3 million people worldwide. Radiation therapy is an integral component of disease management for patients with breast cancer, and is used after breast-conserving surgery or a mastectomy to reduce the risk of a local recurrence. The following review describes the methods used to personalize radiation therapy by optimizing patient selection, using advanced treatment techniques to lessen the radiation dose to normal organs, and using hypofractionation in order to shorten the duration of radiation treatment.
Topics: Humans; Female; Breast Neoplasms; Mastectomy; Mastectomy, Segmental
PubMed: 38534954
DOI: 10.3390/curroncol31030121 -
Plastic and Reconstructive Surgery Sep 2017Although transgender surgery constitutes a growing field within plastic surgery, prospective studies on masculinizing mastectomies are lacking. The objectives of the...
BACKGROUND
Although transgender surgery constitutes a growing field within plastic surgery, prospective studies on masculinizing mastectomies are lacking. The objectives of the present study were to prospectively follow a cohort of transmen undergoing mastectomy to assess technical and self-reported outcomes and to evaluate surgical decision-making.
METHODS
Fifty-four transmen were recruited during a 10-month period at the Department of Plastic Surgery of the Centre of Expertise on Gender Dysphoria. Preoperative assessment included standardized chest examination. Six months postoperatively, participants rated their satisfaction with surgery, and 12-month postoperative surgical outcomes were reviewed independently. Surgical decision-making was evaluated by comparing indications and outcomes per technique, and assessing the clinical validity of the most-used decision aid (using the Cohen's kappa statistic).
RESULTS
One periareolar mastectomy, 26 concentric circular mastectomies, and 22 inframammary skin resections with free nipple graft were performed in the authors' cohort. Five participants were still to be operated on. Concentric circular mastectomy was performed in smaller or medium-size breasts with low ptosis grade and good elasticity, whereas the inframammary skin resection group showed a wider range of physical characteristics. Despite being performed in better quality breasts, concentric circular mastectomy was associated with more secondary corrections (38.5 percent), dehiscence, seroma, and lower postoperative satisfaction compared with inframammary skin resections. Clinical decision-making was generally in line with the published decision aid.
CONCLUSIONS
Compared with inframammary skin resections, concentric circular mastectomy-despite being performed in favorable breast types-appears to produce poorer technical and self-reported outcomes. Surgical indications and preoperative counseling regarding secondary corrections may therefore be subject to improvement.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Topics: Adolescent; Adult; Female; Humans; Male; Mastectomy; Middle Aged; Patient Satisfaction; Prospective Studies; Sex Reassignment Surgery; Transsexualism; Young Adult
PubMed: 28841608
DOI: 10.1097/PRS.0000000000003607