scholarly journals Breast Cancer Surgery: New Issues

2021 ◽  
Vol 28 (5) ◽  
pp. 4053-4066
Author(s):  
Francesca Magnoni ◽  
Sofia Alessandrini ◽  
Luca Alberti ◽  
Andrea Polizzi ◽  
Anna Rotili ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Biology ◽  
Surgical Techniques ◽  
Well Being ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Ancient Times ◽  
Personalized Approach

Since ancient times, breast cancer treatment has crucially relied on surgeons and clinicians making great efforts to find increasingly conservative approaches to cure the tumor. In the Halstedian era (mid-late 19th century), the predominant practice consisted of the radical and disfiguring removal of the breast, much to the detriment of women’s psycho-physical well-being. Thanks to enlightened scientists such as Professor Umberto Veronesi, breast cancer surgery has since impressively progressed and adopted a much more conservative approach. Over the last three decades, a better understanding of tumor biology and of its significant biomarkers has made the assessment of genetic and molecular profiles increasingly important. At the same time, neo-adjuvant treatments have been introduced, and great improvements in genetics, imaging technologies and in both oncological and reconstructive surgical techniques have been made. The future of breast cancer management must now rest on an ever more precise and targeted type of surgery that, through an increasingly multidisciplinary and personalized approach, can ensure oncological radicality while offering the best possible quality of life.

scholarly journals Liver Transplantation Does Not Increase Morbidity or Mortality in Women Undergoing Surgery for Breast Cancer

2021 ◽  
Author(s):  
Gregory Veillette ◽  
Maria Castaldi ◽  
Sacha Roberts ◽  
Afshin Parsikia ◽  
Ankur Choubey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Transplant Recipients ◽  
Cancer Management ◽  
Breast Cancer Management

Abstract Purpose The incidence of breast cancer (BC) in solid organ transplant recipients is comparable to the age-matched general population. The rate of reported de novo breast cancer following liver transplantation (LT) varies. Further, there is limited information on the management and outcomes of breast cancer in liver transplant recipients (LTR). We aim to evaluate the impact of LT on breast cancer surgery outcomes. Further we compare the outcomes after breast cancer surgery in LTR in transplant versus non-transplant centers. Methods National Inpatient Sample (NIS) database was accessed to identify LTR with BC. Mortality, complications, hospital charges and total length of stay (LOS) were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results Ninety-nine women met inclusion criteria for LT + BC and were compared against a cohort of women with BC without LT (n=736,527). LT + BC had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs.10.2%, p < 0001). There were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p=0.012). However, on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery (OR 1.223, p=0.480). Cost associated with breast cancer care was significantly higher in those with LT (2.621, p<0.001). Breast conservation surgery in LT had shorter LOS as compared to BC alone (OR 0.568, p 0.027) in all hospitals. Conclusion LT does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p=0.012), on multivariate analysis, LT was not an independent risk factor for postoperative complications following breast cancer surgery. Additionally, breast cancer treatment is more costly in LTR. Breast cancer management in LTR at non-transplant centers incurred higher charges but no difference in complication rate, nor LOS when compared to breast cancer management in LTR at transplant centers.

scholarly journals Skin-, nipple-, and areola-sparing mastectomy

2008 ◽  
Vol 11 (12) ◽  
Author(s):  
E. M. Umoh ◽  
N. Arora ◽  
R. M. Simmons
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Clinical Outcome ◽  
Surgical Management ◽  
Surgical Techniques ◽  
Oncologic Outcomes ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Feasible Option

AbstractSurgical management of breast carcinoma has evolved to include more breast conserving techniques such as skin-, nipple-, and areola-sparing mastectomies, as improved cosmesis becomes an increasing concern. However, the oncologic risk of these procedures must be strongly considered before such techniques can be widely adopted. Here we review available literature on these techniques and their associated clinical outcome. From our own experience, as well as from that reported, we conclude that nipple-, skin-, and areola-sparing mastectomies in carefully selected patients can have safe oncologic outcomes comparable to more traditional surgical techniques and therefore may be a feasible option for breast cancer management.

scholarly journals Management of Breast Cancer in Nepal

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Yogendra P Singh ◽  
P Sayami
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cancer Education ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
Premenopausal Women ◽  
Clinical Breast Examination ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Clinical Breast

Breast cancer is the second most common malignancy among women in Nepal. It is more commonin young premenopausal women. Breast cancer continues to increase in incidence due to lifestylechanges in Nepalese women despite constant remarkable development in the management of thisdisease over the past three decades. Breast cancer was diagnosed solely clinically and surgery wasthe only treatment option until fi fty years ago. Multidisciplinary approach has been adopted fordiagnosis and treatment of breast cancer in Nepal. Imaging is required for the diagnosis, appropriatetreatment decision and proper follow up. Treatment modality depends upon the extent of thedisease and tumor biology. However, there is a strong need for standard guidelines for the propermanagement of breast cancer in Nepal so that surgeries, chemotherapy, hormone therapy andradiotherapy are standardized in the country. Palliative care has been initiated to provide to somepatients with metastatic breast cancer recently.The breast cancer management in Nepal is a little different when compared with the centers in thedeveloped countries. The reasons are socioeconomic status, lack of education and lack of facilities.Although cancer care is on the rise in Nepal, the optimal facility for centers managing breast cancerhas to be improved signifi cantly.Cancer education, screening and early detection are the keyelements to infl uence the diagnosis, treatment and prognosis of breast cancer in Nepal. Breast cancerawareness and clinical breast examination are important tools for early detection in our resourcelimited context. Breast cancer can be cured in majority of the cases if diagnosed in early stages.This review will focus on relevant patient data along with future recommendation regarding breastcancer treatment in Nepal.Key Words: Breast cancer, cancer education, chemotherapy, imaging, radiotherapy, surgery

scholarly journals Association of Breast Cancer Surgery With Quality of Life and Psychosocial Well-being in Young Breast Cancer Survivors

JAMA Surgery ◽  
2020 ◽  
Vol 155 (11) ◽  
pp. 1035
Author(s):  
Shoshana M. Rosenberg ◽  
Laura S. Dominici ◽  
Shari Gelber ◽  
Philip D. Poorvu ◽  
Kathryn J. Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Young Breast Cancer

scholarly journals Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
B. Shunnmugam ◽  
S. Sinnadurai ◽  
S.H. Chua ◽  
T. Islam ◽  
M.H. See ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Intraclass Correlation ◽  
Well Being ◽  
Cancer Surgery ◽  
Psychometric Validation ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Patient Reported ◽  
The Impact

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

scholarly journals Management of Breast Cancer During the COVID-19 Pandemic: A Stage- and Subtype-Specific Approach

2020 ◽  
pp. OP.20.00364 ◽  
Author(s):  
Jennifer Y. Sheng ◽  
Cesar A. Santa-Maria ◽  
Neha Mangini ◽  
Haval Norman ◽  
Rima Couzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Medical Oncology ◽  
Tumor Biology ◽  
Local Conditions ◽  
Cancer Management ◽  
Neoadjuvant Systemic Therapy ◽  
Breast Cancer Management ◽  
Oncology Treatment ◽  
Hospital Resources ◽  
Balance Treatment

The COVID-19 pandemic has rapidly changed delivery of cancer care. Many nonurgent surgeries are delayed to preserve hospital resources, and patient visits to health care settings are limited to reduce exposure to SARS-CoV-2. Providers must carefully weigh risks and benefits of delivering immunosuppressive therapy during the pandemic. For breast cancer, a key difference is increased use of neoadjuvant systemic therapy due to deferral of many breast surgeries during the pandemic. In some cases, this necessitates increased use of genomic tumor profiling on core biopsy specimens to guide neoadjuvant therapy decisions. Breast cancer treatment during the pandemic requires multidisciplinary input and varies according to stage, tumor biology, comorbidities, age, patient preferences, and available hospital resources. We present here the Johns Hopkins Women’s Malignancies Program approach to breast cancer management during the COVID-19 pandemic. We include algorithms based on tumor biology and extent of disease that guide management decisions during the pandemic. These algorithms emphasize medical oncology treatment decisions and demonstrate how we have operationalized the general treatment recommendations during the pandemic proposed by national groups, such as the COVID-19 Pandemic Breast Cancer Consortium. Our recommendations can be adapted by other institutions and medical oncology practices in accordance with local conditions and resources. Guidelines such as these will be important as we continue to balance treatment of breast cancer against risk of SARS-CoV-2 exposure and infection until approval of a vaccine.

scholarly journals A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial

2011 ◽  
Vol 6 (2) ◽  
pp. 172-181 ◽  
Author(s):  
Roger T. Anderson ◽  
Gretchen G. Kimmick ◽  
Thomas P. McCoy ◽  
Judith Hopkins ◽  
Edward Levine ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Well Being ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
And Function
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