Complications of breast cancer surgery with axillary dissection: An observational study

2019 ◽  
Vol 13 (3) ◽  
pp. 145-147
Author(s):  
Santosh Raghunath Munde ◽  
◽  
Shaikh Junaid Athar Abdul Samad ◽  
Keyword(s):  
Breast Cancer ◽  
Observational Study ◽  
Axillary Dissection ◽  
Cancer Surgery ◽  
Breast Cancer Surgery

scholarly journals Quality of Life for Women with Breast Cancer-Related Lymphedema: The Importance of Collaboration between Physical Medicine and Rehabilitation and General Surgery Clinics

2021 ◽  
pp. 119-126
Author(s):  
Türkan Turgay ◽  
Pınar Günel Karadeniz ◽  
Göktürk Maralcan
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Body Image ◽  
Axillary Dissection ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Physical Medicine ◽  
Significant Difference ◽  
Breast Cancer Related Lymphedema

Background: The aim of this study was to examine the clinical characteristics and quality of life (QOL) of patients with BCRL (breast cancer-related lymphedema).Methods: In this cross-sectional descriptive study, patients' characteristics such as age, body mass index (BMI: kg/m²), history of chemotherapy (CT), radiotherapy (RT), hormone replacement therapy (HRT), neoadjuvant therapy (NT), cancer stages, and types of surgery were recorded. Patients were evaluated using the ‘Disabilities of the Arm, Shoulder and Hand questionnaire’ (DASH), the ‘Lymphedema Quality of Life Questionnaire’ (LYMQOL-ARM), and a visual analogue scale (VAS). Results: A total of 68 women with the mean age of 52.50±9.33 and BMI 29.240 ± 5.05 kg/m² were recruited after breast cancer surgery in this study: thirty-three patients (48.5%) in Stage 0; 24 (35.3%) in Stage 1; 10 (14.7%) in Stage 2; and 1 (1.5%) in Stage 3. No statistically significant difference was found in the QOL according to treatments received after the diagnosis of breast cancer surgery, RT (except the appearance domain of QOL), CT, HRT, or NT. In patients who had received axillary dissection in combination with RT, a statistically significant association was observed between QOL related to body image and symptoms (p=0.009 and p=0.017, respectively). A statistically significant difference was found only in body image and clinical symptom domains according to the lymphedema stage (p=0.027 and p=0.002, respectively). It was observed that as shoulder pain (VAS) and disability (DASH) scores increased, scores of all domains of QOL increased except the overall domain in QOL (p<0.05). Conclusion: It was observed that clinical symptoms and body image parameters in QOL were associated with the lymphedema stage and the number of lymph nodes dissected. It was concluded that axillary dissection with axillary RT and RT alone after breast cancer surgery is associated with body image. Our study revealed that body image perception is related to the quality of life in patients with BCRL. Optimal management of the negative effects of self-reported lymphedema evaluated in the latency phase on quality of life requires coordination between Physical Medicine and Rehabilitation and General Surgery Clinics.

scholarly journals Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy

2005 ◽  
Vol 16 (3) ◽  
pp. 383-388 ◽  
Author(s):  
U. Veronesi ◽  
R. Orecchia ◽  
S. Zurrida ◽  
V. Galimberti ◽  
A. Luini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Axillary Dissection ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Radiotherapy

scholarly journals THE COMBINATION OF ULTRASOUND-GUIDED PECTORAL NERVES II AND PARASTERNAL BLOCKS AS A VALID ALTERNATIVE FOR ANESTHESIA IN BREAST SURGERY: AN OBSERVATIONAL STUDY

2017 ◽  
pp. 175-179
Author(s):  
Erika Basso Ricci
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Observational Study ◽  
Breast Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Thoracic Wall ◽  
Lateral Part ◽  
Ultrasound Guided ◽  
Mastectomy Group

Background: Breast cancer surgery is often associated with severe postoperative pain that may compromise systemic homeostasis, which increases perioperative morbidity, the length of stay in the hospital, and costs. Scientifi c evidence has also shown that an inadequate analgesia could promote the risk of persistent pain development after breast surgery. Objective: Recent literature suggested that the pectoral nerves II (PECS II) block may represent a valid alternative to general anesthesia (GA) and conventional, regional techniques for analgesia in breast surgery. This technique may provide complete anesthesia of the lateral part of the thorax but cannot block, by itself, the anterior cutaneous branches of the intercostal nerves. The combination of a parasternal block (PSB) and a PECS II block has been performed as a single anesthetic technique. Study Design: This is an observational, monocenter, prospective, and cohort study. We obtained the approval of our scientifi c ethic committee and clinical trials registration. Setting: This study enrolled patients undergoing an elective breast surgery. In particular, we enrolled patients who were scheduled for a mastectomy or quadrantectomy of the medial part of the breast. Methods: We recruited 40 patients who were scheduled for breast surgery. A PECS II block was performed with an injection of ropivacaine 0.5% 20 mL + 10 mL. Then, a PSB was performed by 2 separate injections of 3 mL of 0.5% ropivacaine, for each one, at the level of the second and fourth intercostal space. All of the patients received intraoperative sedation and multimodal analgesia. During the intraoperative period, the accessory need of a local anesthetic infi ltration, conversion to GA, and the total amount of propofol required to maintain good comfort of the patients were recorded. In the fi rst 24 postoperative hours, every 6 hours, postoperative pain was assessed by an investigator using a numerical rating scale (NRS). The consumption of analgesic and antiemetic drugs and the incidence of postoperative nausea and vomiting (PONV) were also recorded. Results: Our observational analysis yielded 40 patients in a period of 6 months. The population was subdivided into 2 groups: a mastectomy group or a quadrantectomy group. All of the population reported their pain scores at rest (rNRS < 3) and during activity (iNRS < 5) in the postoperative period. None of the patients required GA. Six patients (27.3%) in the mastectomy group required a supplemental anesthetic infi ltration. Eleven (27.5%) patients required a rescue analgesic drug: 9 (40.9%) in the mastectomy group and 2 (11.1%) in the quadrantectomy group. Two patients reported events of PONV, one for each group (4.54% for the mastectomy group and 5.55% for the quadrantectomy group). No complications occurred. Conclusion: This study indicates the safety and feasibility of the novel ultrasound-guided thoracic wall blocks during inpatient and outpatient breast surgery for the management of intraoperative anesthesia and postoperative analgesia. Limitations: This is an observational study; a randomized control trial is mandatory to confi rm the results. Key words: Breast cancer surgery, pectoralis nerve block, parasternal block, ultrasound-guided anesthesia, regional anesthesia, pain control

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