scholarly journals Education and Training in Breast Cancer Surgery in Europe

Breast Care ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 366-372
Author(s):  
Lynda Wyld ◽  
Isabel T. Rubio ◽  
Tibor Kovacs
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Breast Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Specialist Training ◽  
Member States ◽  
The Usa ◽  
The Uk

Background: The substantial increase in the complexity of breast cancer care in the last few decades has resulted in significant improvements in survival rates and also in the quality of life of breast cancer survivors. However, across Europe there are variations in outcomes and access to the latest techniques. Whilst much of this variance is due to differences in health economies between European member states, training variation may also play a part. Training in breast cancer surgery varies greatly across Europe, not only in its basal discipline (general surgery, gynaecology or plastic surgery) but also in the length of training and whether there is any requirement for specialist training. Several countries have been leading the way in training breast specialist surgeons (the USA, the UK, Australia and New Zealand) with dedicated 1- or 2-year fellowships either within or in addition to standard training. Access to such training is limited and consequently many women in Europe are still treated by generalists, potentially denying them access to the best care. This paper reviews the issues surrounding training provision in breast surgery and some of the challenges which need to be addressed to improve the current situation. Summary: Breast surgery training in Europe is of variable quality and duration, which may result in variations in the quality of care received by patients with breast cancer. Specialist training standards are urgently required which should be adopted by all European member states. Excellent models are available in the USA, the UK and Australia and New Zealand on which to base this training. Key Messages: The quality of training in breast surgery needs to be upgraded and harmonised across Europe.

scholarly journals Women’s choices for breast cancer surgery in Italy: quality and equity implications

2019 ◽  
Author(s):  
Francesca Ferre ◽  
Chiara Seghieri ◽  
Sabina Nuti
Keyword(s):  
Breast Cancer ◽  
Breast Surgery ◽  
Hospital Performance ◽  
Cancer Surgery ◽  
Patient Choice ◽  
Breast Cancer Surgery ◽  
Surgical Interventions ◽  
Surgery Patient ◽  
National Quality

Abstract Background Equity and quality in healthcare are key goals embraced by universal healthcare systems; however, inequalities in access and unwarranted variations in quality of care are well documented in the Italian healthcare system. To reduce unwarranted variation and improve equal utilization of services at hospital level, national quality standards have been applied for selected clinical procedures including oncological surgery for which there is evidence of a positive relationship between volumes and clinical outcomes. However, high dispersion of surgical interventions across hospitals still exists highlighting the need to understand the determinants behind women’s choice for hospital for breast surgery. Methods We apply mixed logit regression to investigate the determinants, both at patient and provider level, associated with women’s choice of hospital for breast surgery. Patient level non-emergency hospital data are used to model breast cancer surgical choices in Tuscany region, Italy. We considered hospitalizations occurring during 2016. We focused on the effects of travel time and hospital performance for breast cancer treatments (elective surgery) in different patient groups. Hospital quality indicators include structural variables (volumes), measurement of process (timeliness) and quality of surgical procedures as recommended by clinical guidelines (proportion of breast-conservative surgery and execution of the sentinel lymph node biopsy). Results Results reveal that women prefer hospitals nearby, delivering high volumes of interventions with an appropriate surgical approach. Differences in women choice depend on education and age. Highly educated patients travelled further to seek surgical intervention for breast cancer and were likely to select high performing hospitals. Moreover, older women preferred quicker response compared to younger women when awaiting surgical interventions. Conclusions Differences in patient choice highlight equity concerns in access to elective breast cancer surgery. These results could be used to optimize the allocation of resources toward breast cancer units that meet quality and efficacy standards to increase the efficiency and responsiveness of breast cancer care.

scholarly journals Breast Cancer Surgery During the COVID-19 Pandemic: An Observational Clinical Study of the Breast Surgery Clinic at Ospedale Policlinico San Martino – Genoa, Italy

In Vivo ◽  
2020 ◽  
Vol 34 (3 suppl) ◽  
pp. 1667-1673 ◽  
Author(s):  
PIERO FREGATTI ◽  
MARCO GIPPONI ◽  
MARIA GIACCHINO ◽  
MARCO SPARAVIGNA ◽  
FEDERICA MURELLI ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Study ◽  
Breast Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery

Effect of Rapid Rehabilitation Concepts on Quality of Life and Pain in Patients Undergoing Radical Breast Cancer Surgery in Perioperative Period

2021 ◽  
Vol 7 (5) ◽  
pp. 1538-1544
Author(s):  
Xin Li ◽  
Hai-yan An ◽  
Yi Zhao ◽  
Mingli Ji ◽  
Jing An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Significant Difference

To study the effect of rapid rehabilitation nursing on patients’ quality of life and pain level during the perioperative period of radical breast cancer surgery. Methods: 126 patients who were hospitalized in our hospital from January 2018 to February 2020 and underwent radical breast cancer surgery were divided into control group and rapid rehabilitation group according to the perioperative period intervention method. Routine nursing intervention and rapid rehabilitation nursing intervention were used respectively. The general conditions of the two groups were recorded, and the differences of T cell subsets before operation and 3 days after operation were detected. Visual analogue pain (VAS) score was used to evaluate the changes of pain degree at 1 day, 3 days and 5 days after operation and on the day of discharge. Postoperative complications and satisfaction were compared between the two groups. Quality of life (QOL) was assessed at 1 month and 3 months after operation using the CARES-SF score. Results: Anesthesia waking time (26.12 ± 5.77) min, off-bed activity time (14.25 ± 2.87) h and hospital stay (7.82 ± 2.15) d in the rapid rehabilitation group were shorter than those in the control group (P < 0.05). The operation time (92.02 ± 14.78) min and intraoperative blood loss (57.96 ± 13.96) mL in the rapid rehabilitation group were not significantly different from those in the control group (P > 0.05). In the control group, 3d after operation, T lymphocyte subsets were decreased gradually than that before operation (P < 0.05), CD3+ was decreased 3d after operation than that before operation in the rapid rehabilitation group (P < 0.05), but CD4+, CD8+, CD4+ / CD8 + 3d after operation had no significant difference than that before operation (P > 0.05). In rapid rehabilitation group, T lymphocyte subsets at 3d after operation were higher than those in the control group (P < 0.05). The postoperative complication rate of the rapid rehabilitation group was lower than that of the control group, and the satisfaction degree was higher than that of the control group, with significant difference (P < 0.05). After follow-up, it was found that the scores of qualities of life, such as physiology, psychosocial, marriage, sexual life and relationship with medical staff in the rapid rehabilitation group were lower than those in the control group at 1 month and 3 months after operation (P < 0.05). Conclusion: The concept of rapid rehabilitation nursing can stabilize the immune function of patients after radical breast cancer surgery, promote the postoperative rehabilitation and improve the quality of life after operation.

Changes in depression status during the year after breast cancer surgery and impact on quality of life and functioning

2018 ◽  
Vol 50 ◽  
pp. 33-37 ◽  
Author(s):  
Seon-Young Kim ◽  
Sung-Wan Kim ◽  
Il-Seon Shin ◽  
Min-Ho Park ◽  
Jung-Han Yoon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Depression Status

scholarly journals Myofascial Massage for Chronic Pain and Decreased Upper Extremity Mobility After Breast Cancer Surgery

2018 ◽  
Vol 11 (3) ◽  
pp. 4-9 ◽  
Author(s):  
Jeanne Massingill, LMT, MLD, CST, KT, NMT ◽  
Cara Jorgensen, LMT ◽  
Jacqueline Dolata, MBA ◽  
Ashwini R. Sehgal, MD
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Chronic Pain ◽  
Upper Extremity ◽  
Outcome Measures ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Mobility Limitations ◽  
And Control

Background: Chronic localized pain and decreased upper extremity mobility commonly occur following breast cancer surgery and may persist despite use of pain medication and physical therapy.Purpose: We sought to determine the value of myofascial massage to address these pain and mobility limitations.Setting: The study took place at a clinical massage spa in the U.S. Midwest. The research was overseen by MetroHealth Medical Center’s Institutional Review Board and Case Center for Reducing Health Disparities research staff.Participants: 21 women with persistent pain and mobility limitations 3–18 months following breast surgery.Research Design: We conducted a pilot randomized controlled trial where intervention patients received myofascial massages and control patients received relaxation massages.Intervention: Intervention participants received 16 myofascial massage sessions over eight weeks that focused on the affected breast, chest, and shoulder areas. Control participants received 16 relaxation massage sessions over eight weeks that avoided the affected breast, chest, and shoulder areas. Participants completed a validated questionnaire at the beginning and end of the study that asked about pain, mobility, and quality of life.Main Outcome Measures: Outcome measures include change in self-reported pain, self-reported mobility, and three quality-of-life questions.Results: At baseline, intervention and control participants were similar in demographic and medical characteristics, pain and mobility ratings, and quality of life. Compared to control participants, intervention participants had more favorable changes in pain (-10.7 vs. +0.4, p < .001), mobility (-14.5 vs. -0.8, p < .001), and general health (+29.5 vs. -2.5, p = .002) after eight weeks. All intervention and control participants reported that receiving massage treatments was a positive experience.Conclusions: Myofascial massage is a promising treatment to address chronic pain and mobility limitations following breast cancer surgery. Further work in several areas is needed to confirm and expand on our study findings.

scholarly journals Machine Learning Algorithms to Predict Recurrence within 10 Years after Breast Cancer Surgery: A Prospective Cohort Study

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3817
Author(s):  
Shi-Jer Lou ◽  
Ming-Feng Hou ◽  
Hong-Tai Chang ◽  
Chong-Chi Chiu ◽  
Hao-Hsien Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Machine Learning ◽  
Learning Algorithms ◽  
External Validation ◽  
Model Development ◽  
Cancer Surgery ◽  
Machine Learning Algorithms ◽  
Breast Cancer Surgery ◽  
Training Dataset

No studies have discussed machine learning algorithms to predict recurrence within 10 years after breast cancer surgery. This study purposed to compare the accuracy of forecasting models to predict recurrence within 10 years after breast cancer surgery and to identify significant predictors of recurrence. Registry data for breast cancer surgery patients were allocated to a training dataset (n = 798) for model development, a testing dataset (n = 171) for internal validation, and a validating dataset (n = 171) for external validation. Global sensitivity analysis was then performed to evaluate the significance of the selected predictors. Demographic characteristics, clinical characteristics, quality of care, and preoperative quality of life were significantly associated with recurrence within 10 years after breast cancer surgery (p < 0.05). Artificial neural networks had the highest prediction performance indices. Additionally, the surgeon volume was the best predictor of recurrence within 10 years after breast cancer surgery, followed by hospital volume and tumor stage. Accurate recurrence within 10 years prediction by machine learning algorithms may improve precision in managing patients after breast cancer surgery and improve understanding of risk factors for recurrence within 10 years after breast cancer surgery.

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