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Tidsskrift For Den Norske Laegeforening... Jun 2004Breast cancer is the most common cancer in women, many of whom feel less feminine after the loss of a breast. Breast reconstruction can strengthen their self image,... (Review)
Review
BACKGROUND
Breast cancer is the most common cancer in women, many of whom feel less feminine after the loss of a breast. Breast reconstruction can strengthen their self image, hence it is an excellent treatment option for those who have had a mastectomy.
MATERIAL AND METHODS
This review is based on information retrieved from Medline and on clinical experience. We have also asked all departments of plastic surgery in Norway which methods of breast reconstruction they are using.
RESULTS AND INTERPRETATION
Breast reconstruction following mastectomy is performed by plastic surgeons and if necessary in cooperation with breast surgeons. The missing breast can be reconstructed with an implant, autologous tissue or by combining the two methods. Many years of experience have resulted in high standards within reconstructive breast surgery. In Norway breast reconstruction is performed in every department of plastic surgery.
Topics: Breast Implants; Breast Neoplasms; Contraindications; Female; Humans; Mammaplasty; Mastectomy; Patient Selection
PubMed: 15229707
DOI: No ID Found -
JAMA Surgery Aug 2022Rates of lumpectomy for breast cancer management in the United States previously declined in favor of more aggressive surgical options, such as mastectomy and... (Observational Study)
Observational Study
IMPORTANCE
Rates of lumpectomy for breast cancer management in the United States previously declined in favor of more aggressive surgical options, such as mastectomy and contralateral prophylactic mastectomy (CPM).
OBJECTIVE
To evaluate longitudinal trends in the rates of lumpectomy and mastectomy, including unilateral mastectomy vs CPM rates, and to determine characteristics associated with current surgical practice using 3 national data sets.
DESIGN AND SETTING
Data from the National Surgical Quality Improvement Program (NSQIP), Surveillance, Epidemiology, and End Results (SEER) program, and National Cancer Database (NCDB) were examined to evaluate trends in lumpectomy and mastectomy rates from 2005 through 2017. Mastectomy rates were also evaluated with a focus on CPM. Longitudinal trends were analyzed using the Cochran-Armitage test for trend. Multivariate logistic regression models were performed on the NCDB data set to identify predictors of lumpectomy and CPM.
RESULTS
A study sample of 3 467 645 female surgical breast cancer patients was analyzed. Lumpectomy rates reached a nadir between 2010 and 2013, with a significant increase thereafter. Conversely, in comparison with lumpectomy rates, overall mastectomy rates declined significantly starting in 2013. Cochran-Armitage trend tests demonstrated an annual decrease in lumpectomy rates of 1.31% (95% CI, 1.30%-1.32%), 0.07% (95% CI, 0.01%-0.12%), and 0.15% (95% CI, 0.15%-0.16%) for NSQIP, SEER, and NCDB, respectively, from 2005 to 2013 (P < .001, P = .01, and P < .001, respectively). From 2013 to 2017, the annual increase in lumpectomy rates was 0.96% (95% CI, 0.95%-0.98%), 1.60% (95% CI, 1.59%-1.62%), and 1.66% (95% CI, 1.65%-1.67%) for NSQIP, SEER, and NCDB, respectively (all P < .001). Comparisons of specific mastectomy types showed that unilateral mastectomy and CPM rates stabilized after 2013, with unilateral mastectomy rates remaining higher than CPM rates throughout the entire time period.
CONCLUSIONS
This observational longitudinal analysis indicated a trend reversal with an increase in lumpectomy rates since 2013 and an associated decline in mastectomies. The steady increase in CPM rates from 2005 to 2013 has since stabilized. The reasons for the recent reversal in trends are likely multifactorial. Further qualitative and quantitative research is required to understand the factors driving these recent practice changes and their associations with patient-reported outcomes.
Topics: Breast Neoplasms; Female; Humans; Mastectomy; Mastectomy, Segmental; Postoperative Complications; Prophylactic Mastectomy; SEER Program; United States
PubMed: 35675047
DOI: 10.1001/jamasurg.2022.2065 -
Computational and Mathematical Methods... 2022To compare the efficacy and psychology of breast-conserving surgery and modified radical mastectomy in patients with early breast cancer (BC) under graded nursing.
OBJECTIVE
To compare the efficacy and psychology of breast-conserving surgery and modified radical mastectomy in patients with early breast cancer (BC) under graded nursing.
METHODS
Forty-one early breast-conserving surgery BC patients admitted to our hospital from April 2020 to March 2022 were regarded as group A, and 52 with modified radical surgery were seen as group B. The operating time, intraoperative bleeding, postoperative drainage, and hospital stay were compared, and the postoperative adverse effects were counted. In addition, patients' psychology and quality of life were assessed using the HAMD, HAMA, and QLSBC rating scales. At the time of discharge, a treatment satisfaction survey was conducted.
RESULTS
The operative time, intraoperative bleeding, postoperative drainage, and hospital stay of patients in group A were lower than those in group B ( < 0.05). After treatment, the HAMD and HAMA scores were lower in group A than in group B, while the QLSBC scores and treatment satisfaction were higher ( < 0.05).
CONCLUSION
Breast-conserving surgery under graded nursing is less damaging to early BC patients. It can effectively shorten the postoperative recovery process and improve the psychology and quality of life, so it has higher clinical applicability.
Topics: Breast Neoplasms; Female; Humans; Mastectomy; Mastectomy, Modified Radical; Mastectomy, Segmental; Quality of Life
PubMed: 36158135
DOI: 10.1155/2022/4491573 -
Cleveland Clinic Journal of Medicine 1992Immediate breast reconstruction at the time of mastectomy, whether it involves prosthetic implantation or a myocutaneous flap procedure, has become a standard option for... (Review)
Review
Immediate breast reconstruction at the time of mastectomy, whether it involves prosthetic implantation or a myocutaneous flap procedure, has become a standard option for the care of breast cancer patients. The advantages of breast reconstruction are well understood: it helps to eliminate many of the psychological burdens with which mastectomy patients must contend and allows patients to participate in a normal lifestyle. Immediate breast reconstruction eases much of the initial psychological trauma of mastectomy. For patients who require postoperative radiation, reconstruction is often far less complex if done immediately than if delayed, even though radiation increases the chances of capsular contracture. The knowledge that immediate breast reconstruction is available may reduce patient's reluctance to seek medical advice when they find a breast lump.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Mastectomy, Modified Radical; Prostheses and Implants; Surgical Flaps; Time Factors
PubMed: 1468133
DOI: 10.3949/ccjm.59.5.499 -
Cancer Control : Journal of the Moffitt... Oct 2012The history of surgical treatment of breast cancer is rich with contributions from many surgeons over the centuries. Among the recent advances in technique is the... (Review)
Review
BACKGROUND
The history of surgical treatment of breast cancer is rich with contributions from many surgeons over the centuries. Among the recent advances in technique is the nipple-sparing mastectomy, which reflects the emerging focus on cosmetic outcomes.
METHODS
We took a backward glance at the literature illustrating the evolution of surgical management of breast cancer, culminating with nipple-sparing mastectomy. The growing clinical data with nipple-sparing mastectomy are explored.
RESULTS
The demand for nipple-sparing mastectomy has been steadily increasing at many institutions. Based on the clinical data reported, nipple-sparing mastectomy is an oncologically safe procedure for selected women who have or are at high risk for breast cancer.
CONCLUSIONS
For women facing mastectomy and their surgeons, the optimal aesthetic result centers on preservation of the nipple. However, nipple-sparing mastectomy is technically challenging, with long-term safety not yet confirmed. Evidence-based data are needed to document local tumor recurrence, distant metastasis, cosmetic outcomes, patient satisfaction, and procedural complications.
Topics: Breast Neoplasms; Cosmetics; Female; Humans; Mastectomy; Nipples; Patient Satisfaction; Treatment Outcome
PubMed: 23037496
DOI: 10.1177/107327481201900405 -
Journal of Perianesthesia Nursing :... Apr 2023To summarize and analyze available evidence on perioperative accelerated rehabilitation programs for patients diagnosed with breast cancer that have had a radical... (Review)
Review
PURPOSE
To summarize and analyze available evidence on perioperative accelerated rehabilitation programs for patients diagnosed with breast cancer that have had a radical mastectomy.
DESIGN
This article is a systematic review of literature based on evidence-based methodology.
METHODS
The '6S' evidence resource pyramid model was used to systematically search a range of databases.
FINDINGS
A total of 19 articles were extracted from the literature and used in this study, including 9 clinical decisions, 4 systematic evaluations, 4 expert consensuses, and 2 guidelines. We summarized a total of 47 lines of evidence with regard to various aspects, including preoperative, intraoperative, and postoperative nursing measures.
CONCLUSIONS
In this systematic review, an evidence-based methodology was used to summarize and analyze the best suggestions for perioperative accelerated rehabilitation nursing programs for breast cancer inpatients undergoing radical mastectomy. We aimed to provide a good reference value and evidence-based guidelines for the continuous improvement and development of nursing practice for the breast cancer patient population.
Topics: Humans; Female; Breast Neoplasms; Mastectomy; Mastectomy, Radical
PubMed: 36464572
DOI: 10.1016/j.jopan.2022.06.008 -
Frontiers in Endocrinology 2023The frequency of nipple-sparing mastectomy (NSM) surgery is presently increasing. Nonetheless, there is a paucity of long-term prognosis data on NSM. This study compared...
BACKGROUND
The frequency of nipple-sparing mastectomy (NSM) surgery is presently increasing. Nonetheless, there is a paucity of long-term prognosis data on NSM. This study compared the long-standing prognosis of NSM in relation to breast-conserving surgery (BCS).
METHODS
Population-level data for 438,588 female breast cancer patients treated with NSM or BCS and postoperative radiation from 2000 to 2018 were identified in the Surveillance, Epidemiology, and End Results (SEER) database; 321 patients from the Second Xiangya Hospital of Central South University were also included. Propensity score matching (PSM) was performed to reduce the influence of selection bias and confounding variables to make valid comparisons. The Kaplan-Meier analysis, log-rank test, and Cox regression were applied to analyze the data.
RESULTS
There were no significant differences in long-term survival rates between patients who underwent NSM and those who underwent BCS+radiotherapy (BCS+RT), as indicated by the lack of significant differences in overall survival (OS) (p = 0.566) and breast cancer-specific survival (BCSS) (p = 0.431). Cox regression indicated that NSM and BCS+RT had comparable prognostic values (p = 0.286) after adjusting for other clinicopathological characteristics. For OS and BCSS, subgroup analysis showed that the majority of patients achieved an analogous prognosis whether they underwent NSM or BCS. The groups had comparable recurrence-free survival (RFS), with no significant difference found (p = 0.873).
CONCLUSIONS
This study offers valuable insights into the long-term safety and comparative effectiveness of NSM and BCS in the treatment of breast cancer. These findings can assist clinicians in making informed decisions on a case-by-case basis.
Topics: Female; Humans; Breast Neoplasms; Mastectomy, Segmental; Mastectomy; Nipples; Prognosis
PubMed: 38053723
DOI: 10.3389/fendo.2023.1222651 -
Computational Intelligence and... 2022Over the last two generations, there has been a surge of interest in nonmutilating treatment for women with early breast cancer. Neoadjuvant radiation therapy, which is...
Over the last two generations, there has been a surge of interest in nonmutilating treatment for women with early breast cancer. Neoadjuvant radiation therapy, which is progressively being provided to breast cancer patients, could be used to decrease tumor burden while also providing an ability to examine treatment response. This paper aims to explore the effects of the initiation time of radiotherapy after modified adjuvant radical mastectomy on the prognosis of breast cancer. The EMR data can be used to mine hidden rules, which are of great significance for treatment and prognosis analysis. In collaboration with breast cancer, the appropriate prediction model and visualization method are selected and a visual analysis system for breast cancer group and treatment plan based on electronic medical record is constructed. Patients with multiple dimensions are reduced and clustered to form patient groups. The differences of characteristics among patient groups are intuitively displayed by using Nightingale diagram, word cloud, and time axis visualization methods. The support vector machine (SVM) model is used to predict the treatment scheme. The radiotherapy time after modified radical surgery in the two groups was within 15 weeks (observation group) and 15 weeks (routine group), respectively. The incidence of complications, local recurrence rate, progression-free survival, and quality of life scores of patients in the routine group and observation group were compared. The total incidence of complications differed significantly between the observation and routine groups. The physical function, material function, psychological function, and social function of the observation group were significantly higher than the routine group ( < 0.05). Radiotherapy within 15 weeks after modified radical mastectomy for breast cancer can not only reduce the local recurrence rate but also prolong the progression-free survival of patients, and the incidence of complications will not increase, which will greatly help improve the quality of life of patients.
Topics: Breast Neoplasms; Data Mining; Female; Humans; Mastectomy; Mastectomy, Modified Radical; Neoadjuvant Therapy; Quality of Life
PubMed: 35571719
DOI: 10.1155/2022/6257536 -
BMJ Case Reports May 2021Malignant lesions of the vermiform appendix make up a rare subset of colorectal cancer. While colorectal cancer frequently metastasises to the liver, lung, regional...
Malignant lesions of the vermiform appendix make up a rare subset of colorectal cancer. While colorectal cancer frequently metastasises to the liver, lung, regional lymph nodes and peritoneum, metastasis to the breast is extremely rare. Here, we describe the case of an 84-year-old woman who had the incidental finding of appendiceal adenocarcinoma following emergency laparoscopic appendectomy. She declined further operative or adjuvant treatment for her disease. She represented 1 year later with metastatic appendiceal adenocarcinoma disease to her left breast. A simple mastectomy for symptomatic treatment was performed. In this report, we describe the first case of appendiceal adenocarcinoma metastases to the breast. Due to its rarity, there is a paucity of evidence related to the management of this condition. The limited evidence is reviewed and discussed.
Topics: Adenocarcinoma; Aged, 80 and over; Appendectomy; Appendiceal Neoplasms; Breast Neoplasms; Female; Humans; Mastectomy
PubMed: 33990297
DOI: 10.1136/bcr-2020-240808 -
Annals of Surgical Oncology Oct 2018Nipple-sparing mastectomy (NSM) is increasingly used for breast cancer risk reduction and treatment. Prior small studies with variable control for baseline... (Comparative Study)
Comparative Study
INTRODUCTION
Nipple-sparing mastectomy (NSM) is increasingly used for breast cancer risk reduction and treatment. Prior small studies with variable control for baseline characteristics suggest superior satisfaction with NSM. The purpose of this study was to compare patient satisfaction following NSM and total mastectomy (TM) utilizing the BREAST-Q patient-reported outcome measure in a well-characterized patient population.
METHODS
Patients at a single institution undergoing NSM or TM with immediate tissue expander/implant reconstruction who completed a follow-up BREAST-Q from 2007 to 2017 were identified by retrospective review of a prospective database. Baseline characteristics were compared, and linear mixed models were used to analyze associations with BREAST-Q scores over time.
RESULTS
Of 1866 eligible patients, 219 (12%) underwent NSM, and 1647 (88%) underwent TM. Median time from baseline to BREAST-Q was 658 days. Patients with NSM were younger, more likely to be white, and had lower BMI. They more often had prophylactic surgery, bilateral mastectomies, lower-stage disease, and less often received chemotherapy/radiation than patients with TM. On multivariable analysis, after controlling for relevant clinical variables, there was no difference in satisfaction with breasts or satisfaction with outcome overall between NSM and TM patients. Psychosocial well-being and sexual well-being were significantly higher in the NSM group. After additionally controlling for preoperative BREAST-Q score in a subset of patients (72 NSM; 443 TM), only psychosocial well-being remained significantly higher in NSM patients.
CONCLUSIONS
Patient-reported outcomes should be discussed with women weighing the risks and benefits of NSM to provide a better understanding of expected quality of life.
Topics: Adult; Aged; Breast Neoplasms; Female; Follow-Up Studies; Humans; Mammaplasty; Mastectomy; Mastectomy, Subcutaneous; Middle Aged; Nipples; Organ Sparing Treatments; Patient Reported Outcome Measures; Patient Satisfaction; Prognosis; Quality of Life; Retrospective Studies; Tissue Expansion Devices; Young Adult
PubMed: 29968023
DOI: 10.1245/s10434-018-6585-4