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Breast surgery guidelines

Alex Monaghan, Núria Chapinal, Lauren Hughes, Christopher Baliski
BACKGROUND: Re-operation rates following breast-conserving surgery (BCS) for early invasive breast cancer are highly variable, largely due to uncertainty regarding adequate margins. The 2014 SSO-ASTRO guidelines recommended "no ink on tumor" as adequate margins. We evaluated the effect of guideline implementation on re-operation following BCS at our regional cancer center. METHODS: Retrospective chart review was performed on records for patients with early invasive breast carcinoma undergoing BCS between February 2011 and May 2017...
January 17, 2019: American Journal of Surgery
Ko Un Park, Kristin Kyrish, John Terrell, Min Yi, Abigail S Caudle, Kelly K Hunt, Henry M Kuerer, Isabelle Bedrosian, Alastair Thompson, Sarah M DeSnyder
BACKGROUND: Few guidelines exist for an opioid prescription after breast surgical oncology (BSO) procedures. We sought to characterize opioid prescribing and use patterns by surgery type. METHODS: Patients (n = 332) undergoing BSO procedure were surveyed one week postoperatively for opioid use. The surgeons were surveyed about pain management preferences surgery type. CPT codes were collected for 2017 to calculate the amount of opioids used by surgery type relative to surgeon preference...
February 8, 2019: Journal of Surgical Oncology
Hiroko Kinoe, Kosho Yamanouchi, Sayaka Kuba, Michi Morita, Chika Sakimura, Kengo Kanetaka, Mitsuhisa Takatsuki, Kuniko Abe, Hiroshi Yano, Megumi Matsumoto, Ryota Otsubo, Naomi Hayashida, Takeshi Nagayasu, Susumu Eguchi
PURPOSE: We herein report the discordance rate between primary breast cancer and synchronous axillary node metastasis, its characteristics and its prognostic impact. METHODS: One hundred and four patients with invasive breast cancer with synchronous axillary node metastasis who underwent surgery were included. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor-2 (HER2), and Ki-67 were stained by immunohistochemistry in both primary and node metastasis...
December 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Samira Tabrizi, Vinod Malhotra, Zachary A Turnbull, Victoria Goode
PURPOSE: Postoperative nausea and vomiting (PONV) is one of the most common complications after anesthesia. This evidence-based quality improvement (QI) project describes the implementation of a PONV guideline and the impact on providers' compliance with PONV risk assessment using the Apfel PONV score. DESIGN: A retrospective preimplementation and postimplementation QI project. METHODS: This evidence-based QI project sample included 294 adult female patients scheduled for gynecologic or breast surgery in the ambulatory setting...
February 1, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Byung-Chul Son, Joong-Seok Kim, Woo-Chan Park, Hak-Cheol Ko
Although deep brain stimulation (DBS) has been used for > 25 years in the treatment of movement disorders, no report has been published on the management of DBS pulse generators implanted in the anterior chest in patients with breast cancer who require mastectomy, radiotherapy, and future imaging studies.We describe a 62-year-old female patient with advanced Parkinson's disease (PD) who was dependent on bilateral subthalamic nucleus (STN) DBS. She was diagnosed with cancer in her left breast. To avoid difficulties in imaging studies, surgery, and radiotherapy related to the breast cancer, bilateral pulse generators for STN DBS previously implanted in the anterior chest wall were repositioned to the anterior abdominal wall with replacement of long extension cables...
February 1, 2019: Journal of Neurological Surgery. Part A, Central European Neurosurgery
J M Ye, L Xin, Y Wang, S Guan, Y H Liu
In recent years, with the improvement of screening and early diagnosis, the overall prognosis of breast cancer patients has been greatly improved in China. Breast reconstruction is an option to improve cosmetic outcomes and quality of life for the patients received mastectomy, this procedure has attracted a lot of attention. The breast reconstruction surgery is recommended by the 2018 NCCN Clinical Practice Guidelines in Oncology for Breast Cancer in patients with appropriate indications. Despite the high proportion of breast reconstruction after mastectomy in western countries, Chinese breast surgeon should objectively understand the differences in breast structure and cultural backgrounds between Chinese and foreign women, and conduct rigorous clinical practice on the basis of calm thinking...
February 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
(no author information available yet)
To facilitate the progress of the standardization of performing breast-conserving therapy in China, the Chinese Association of Breast Surgery organized the Chinese experts to discuss the latest domestic and international breast surgical treatment guidelines and reached a consensus about breast-conserving surgery of early-stage breast cancer based on the actual clinical situation of China. The contents include recommendations about the indication and contraindications of breast-conserving surgery, preoperative imaging examinations, and standardized techniques of breast-conserving surgery...
February 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Katerina Kaczmarski, Peiqi Wang, Richard Gilmore, Heidi N Overton, David M Euhus, Lisa K Jacobs, Mehran Habibi, Melissa Camp, Matthew J Weiss, Martin A Makary
BACKGROUND: To better understand re-excision practice patterns following breast-conserving therapy (BCT), we evaluated variation in surgeon-specific re-excision rates and associated factors. STUDY DESIGN: We performed a retrospective analysis using Medicare claims from 2012-2018 to identify patients undergoing BCT and subsequent breast resection procedures within 12 months. We compared rates before and after the 2014 "no tumor on ink" consensus guideline...
January 28, 2019: Journal of the American College of Surgeons
Alexander Y Yoon, Laura Bozzuto, Andrew J Seto, Carla S Fisher, Abhishek Chatterjee
BACKGROUND: Surgery for breast cancer can have significant impact on patient quality-of-life. Cost-utility analysis provides a way to analyze the economic impact of a surgical procedure with the change in a patient's quality of life. Utility scores are used in these analyses to quantify the impact on quality of life. We undertook a systematic review of the literature on breast cancer surgical procedures to compile a repository of utility scores and to assess gaps in the current literature...
January 23, 2019: Annals of Surgical Oncology
Anna M Catania, Clarissa Sammut Scerri, Gottfried J Catania
AIMS AND OBJECTIVES: The purpose of this study was to investigate the experiences of male partners of female breast cancer patients who had undergone surgery and oncological treatment and who were still raising children. BACKGROUND: Research on the psychological effects of breast cancer has focused primarily on the patients undergoing treatment, neglecting the effect of such a condition on their closest family members. This study addresses this gap by focusing on understanding the effects of this disease on male partners of these patients...
January 22, 2019: Journal of Clinical Nursing
Stefano Triberti, Lucrezia Savioni, Valeria Sebri, Gabriella Pravettoni
Breast cancer patients (and survivors) use to deal with important challenges daily, such as coping with stress and depression, and adopting healthy lifestyles in order to improve treatment effectiveness; moreover, some experiential issues are quite specific of this disease, such as sexuality and fertility disfunctions after hormonal therapy, and distortions in body image after breast surgery. Recent literature highlighted the utility of eHealth or the use of new technologies to promote health management and quality of life in chronic diseases generally...
January 10, 2019: Cancer Treatment Reviews
Soo Youn Bae, Ku Sang Kim, Jeong-Soo Kim, Sae Byul Lee, Byeong-Woo Park, Seok Won Lee, Hyouk Jin Lee, Hong Kyu Kim, Ji-Young You, Seung Pil Jung
Purpose: Pregnancy-associated breast cancer (PABC) is rare, and its cause and prognosis are not well known. Additionally, treatment is limited with respect to the risk to the fetus. The purpose of this study was to investigate the characteristics and treatment trends of PABC and the survival rate according to the treatment. Methods: In the Korean Breast Cancer Society Registry database, women younger than 50 years and who were diagnosed with breast cancer from 1996 to 2015 were included...
December 2018: Journal of Breast Cancer
Z Dahbi, A Sbai, L Mezouar
PURPOSE: We aimed to evaluate the impact on the thyroid function of hypofractionated adjuvant radiotherapy of localized breast cancer. MATERIAL AND METHOD: This was a prospective study, including 50 patients with breast cancer treated by hypofractionated adjuvant radiation, only half of whom received radiotherapy on the supraclavicular region. The analysis focused on clinical, dosimetric and biological data collected through periodic dosing of thyroid hormones...
December 27, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Achim Wöckel, Jasmin Festl, Tanja Stüber, Katharina Brust, Mathias Krockenberger, Peter U Heuschmann, Steffi Jírů-Hillmann, Ute-Susann Albert, Wilfried Budach, Markus Follmann, Wolfgang Janni, Ina Kopp, Rolf Kreienberg, Thorsten Kühn, Thomas Langer, Monika Nothacker, Anton Scharl, Ingrid Schreer, Hartmut Link, Jutta Engel, Tanja Fehm, Joachim Weis, Anja Welt, Anke Steckelberg, Petra Feyer, Klaus König, Andrea Hahne, Traudl Baumgartner, Hans H Kreipe, Wolfram Trudo Knoefel, Michael Denkinger, Sara Brucker, Diana Lüftner, Christian Kubisch, Christina Gerlach, Annette Lebeau, Friederike Siedentopf, Cordula Petersen, Hans Helge Bartsch, Rüdiger Schulz-Wendtland, Markus Hahn, Volker Hanf, Markus Müller-Schimpfle, Ulla Henscher, Renza Roncarati, Alexander Katalinic, Christoph Heitmann, Christoph Honegger, Kerstin Paradies, Vesna Bjelic-Radisic, Friedrich Degenhardt, Frederik Wenz, Oliver Rick, Dieter Hölzel, Matthias Zaiss, Gudrun Kemper, Volker Budach, Carsten Denkert, Bernd Gerber, Hans Tesch, Susanne Hirsmüller, Hans-Peter Sinn, Jürgen Dunst, Karsten Münstedt, Ulrich Bick, Eva Fallenberg, Reina Tholen, Roswita Hung, Freerk Baumann, Matthias W Beckmann, Jens Blohmer, Peter Fasching, Michael P Lux, Nadia Harbeck, Peyman Hadji, Hans Hauner, Sylvia Heywang-Köbrunner, Jens Huober, Jutta Hübner, Christian Jackisch, Sibylle Loibl, Hans-Jürgen Lück, Gunter von Minckwitz, Volker Möbus, Volkmar Müller, Ute Nöthlings, Marcus Schmidt, Rita Schmutzler, Andreas Schneeweiss, Florian Schütz, Elmar Stickeler, Christoph Thomssen, Michael Untch, Simone Wesselmann, Arno Bücker, Andreas Buck, Stephanie Stangl
Purpose The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Method The process of updating the S3 guideline published in 2012 was based on the adaptation of identified source guidelines. They were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and with the results of a systematic search of literature databases followed by the selection and evaluation of the identified literature...
November 2018: Geburtshilfe und Frauenheilkunde
Mavis Machirori, Christine Patch, Alison Metcalfe
Within the field of breast cancer care, women concerned about their family history are offered genetic testing and subsequent treatment options based on several factors which include but are not limited to personal and family cancer disease histories and clinical guidelines. Discussions around decision-making in genetics in Black and Minority Ethnic (BME) groups are rarely documented in literature, and information regarding interactions with genetics services is usually discussed and linked to lack of scientific knowledge...
December 11, 2018: European Journal of Medical Genetics
Manish Sahni, Ashish Goel, Pankaj Pande, Kapil Kumar
Multiple gastrointestinal cancers in a single patient is a rare entity. In our study, we are showing the clinical presentation and management of these patients. A fifty-nine-year-old asthenic male (already treated case of metachronous colorectal cancer in 2008 and 2011) presented with complaints of generalized weakness and fatigue. Strong family history was present with two of his first-degree relatives having diagnosed with gastrointestinal cancer at the age < 50 years with one of them having stomach carcinoma and another with GEJ tumors...
December 2018: Indian Journal of Surgical Oncology
Pietro G di Summa, Carlo M Oranges, William Wafta, Gianluca Sapino, Nicola Keller, Sherylin K Tay, Ben K Chew, Dirk J Schaefer, Wassim Raffoul
BACKGROUND: Mastopexy is one of the most performed cosmetic surgery procedures in the U.S. Numerous studies on mastopexy techniques have been published in the past decades, including case reports, retrospective reviews, and prospective studies. However, to date, no study has investigated the overall complications or satisfaction rates associated with the wide spectrum of techniques. OBJECTIVES: This review aims to assess the outcomes of the various mastopexy techniques, without the use of implants, thus focusing on associated complications, and to provide a simplified classification system...
February 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
William T Tran, Charmaine Childs, Heidi Probst, Golnaz Farhat, Gregory J Czarnota
Guidelines from the American National Comprehensive Cancer Network recommend neoadjuvant chemotherapy to patients with locally advanced breast cancer (LABC) to downstage tumours before surgery. However, only a small fraction (15%-17%) of LABC patients achieve pathological complete response (pCR); that is, no residual tumour in the breast, after treatment. Measuring tumour response during neoadjuvant chemotherapy can potentially help physicians adapt treatment, thus potentially improving the pCR rate. Recently, imaging biomarkers that are used to measure the tumour's functional and biological features have been studied as pretreatment markers for pCR or as an indicator for intratreatment tumour response...
December 2018: Journal of Medical Imaging and Radiation Sciences
Hannah Trøstrup, Steen H Matzen
INTRODUCTION: Verrucous carcinoma is an uncommon variant of low-grade squamous cell malignancy with a low malignant potential but a high risk of recurrence. PRESENTATION OF CASE: We report a case of a Human Papilloma Virus negative local verrucous carcinoma in the perianal area of a 45-year old otherwise healthy female. The tumor presented clinically as a persistent genital wart not responding to usual dermatologic local therapy. The patient was referred to the Department of Plastic Surgery and Breast Surgery after primary excision in a private practice setting of a general surgeon...
November 27, 2018: International Journal of Surgery Case Reports
Kalpalata Tripathy, Aparajita Mishra, Ajit K Singh, Pragnya L Panda, Arup Mahapatra, Anusaya Lenka
Context: Efficacy of immunocytochemistry (ICC) in determining molecular biomarkers like estrogen receptor (ER), progesterone receptors (PRs), and human epidermal growth factor receptor-2 (HER2). Aims: To evaluate biomarkers using ICC in breast cancer as per American Society of Clinical Oncology/College of American Pathology (ASCO/CAP) guidelines. Settings and Design: The study was conducted over a period of 2 years from September 2012 to August 2014 and is the first such study in eastern India...
October 2018: Journal of Cytology
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