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1

Prophylactic Mastectomy: Surgery to Reduce Breast Cancer Risk  

MedlinePLUS

... noncommercial use only. Prophylactic mastectomy: Surgery to reduce breast cancer risk By Mayo Clinic staff Original Article: http:// ... address Sign up Prophylactic mastectomy: Surgery to reduce breast cancer risk Prophylactic mastectomy may reduce your risk of ...

2

Mastectomies of healthy, contralateral breasts in patients with breast cancer.  

PubMed

Breast cancer remains the most common malignancy for women in the UK and the leading cause of death for women aged 34-54 years. Since the 1990s, the paradigm shift in surgical treatment has been away from mastec-tomy towards breast conservation. This remains the gold standard in appropriate patients in terms of oncological and aesthetic outcomes. PMID:24022547

Basu, Nn; Littlechild, S; Evans, Dg; Ross, Gl; Barr, L

2013-09-01

3

Role of mastectomy in breast cancer.  

PubMed

The surgical management of breast cancer continues to evolve in an attempt to define the ideal line between therapeutic efficacy and morbidity. It is clear that breast cancer is a biologically heterogeneous group of diseases, and no single hypothesis explains its behavior. The surgical options proposed to the individual patient must draw from the experience of retrospective clinical studies and prospective randomized trials in an attempt to optimize the treatment plan. Most patients without distant disease are eligible to consider mastectomy, which can accomplish excellent local control and significantly improve survival for earlier stages of disease. However, breast conservation remains an appropriate alternative for a carefully defined subset of patients. Today, with early-stage disease, no patient need leave the operating room without a breast. Recent advances in reconstructive surgery make mastectomy with immediate reconstruction or limited resection plus axillary dissection with postoperative radiation therapy the two principal treatment choices available. Future studies will focus on the integration of other treatment modalities. Clinical research into the use of preoperative chemotherapy to downstage the disease to permit less extensive surgery is of interest. Recent application of molecular biologic techniques such as oncogene analysis, cytogenetic studies, proliferative indices, and the highly sensitive detection of distant micrometastases using monoclonal antibodies may assist in the design of innovative approaches to surgery, radiation therapy, and systemic drug treatment. These advances show great promise for improving the quality of life and the cure rate for patients with breast cancer. Today, surgical treatment options have evolved that fulfill some of the objectives outlined by Dr. James Ewing of Memorial Hospital some 50 years ago. His concerns about breast cancer remain as relevant today as they were half a century ago: "I have drawn the impression that in dealing with mammary cancer, surgery meets with more peculiar difficulties and uncertainties than with almost any other form of the disease. The anatomical types are so numerous, the variations in clinical course so wide, the paths of dissemination so free and diverse, the difficulties of determining the actual conditions so complex, and the sacrifice of tissues so great, as to render impossible in the majority of cases a reasonably accurate adjustment of a means to an end." PMID:2218817

Osborne, M P; Borgen, P I

1990-10-01

4

Contralateral mastectomy in patients treated for unilateral breast cancer  

Microsoft Academic Search

Contralateral prophylactic mastectomy has become an increasingly common breast cancer therapy option as many women believe\\u000a it reduces risk for future breast cancers. Many studies address this therapeutic mode, providing special attention to the\\u000a following questions: Why do women choose contralateral prophylactic mastectomy? What are the actual benefits in risk reduction?\\u000a What are the psychosocial and cosmetic outcomes of the

Kandace P. McGuire; M. Catherine Lee; Christine Laronga

2009-01-01

5

Selective Mastectomy in the Management of Locally Advanced Breast Cancer  

SciTech Connect

Purpose: To evaluate local control for patients with locally advanced noninflammatory breast cancer (LABC) managed by selective mastectomy. Methods and Materials: Between 1979 and 1996, 176 patients with LABC were prospectively managed by chemotherapy (CT)-irradiation (RT)-CT without routine mastectomy. All surviving patients were followed for a minimum of 5 years. Results: A total of 132 patients (75%) had a T4 tumor and 22 (12.5%) supraclavicular nodal disease. The clinical complete response rate was 91% (160/176), which included 13 patients who underwent mastectomy and 2 an iridium wire implant. The first site of failure was local for 43 patients (breast {+-} axilla for 38); 27 of these patients underwent salvage mastectomy and 11 did not for an overall mastectomy rate of 23% (40/176). If all 176 patients had undergone routine mastectomy (136 extra mastectomies), 11 additional patients may have avoided an unsalvageable first local relapse. The others would have either have not had a local relapse or would have suffered local relapse after distant disease. No tumor or treatment related factor was found to predict local disease at death. Median disease-free and overall survival for all patients was 26 and 52 months, respectively. Conclusions: Selective mastectomy in LABC may not jeopardize local control or survival.

Ahern, Verity [Department of Radiation Oncology, Westmead Hospital, Sydney (Australia)]. E-mail: verity.ahern@swahs.healthnsw.gov.au; Boyages, John [Department of Radiation Oncology, Westmead Hospital, Sydney (Australia); NSW Breast Cancer Institute, Westmead Hospital, Sydney (Australia); Gebski, Val M. Stat [Department of Radiation Oncology, Westmead Hospital, Sydney (Australia); Department of Medical Oncology, Westmead Hospital, Sydney (Australia); Moon, Dominic [Department of Surgery, Westmead Hospital, Sydney (Australia); Wilcken, Nicholas [NSW Breast Cancer Institute, Westmead Hospital, Sydney (Australia); NHMRC Clinical Trials Centre, University of Sydney, Sydney (Australia)

2007-07-15

6

Breast cancer after prophylactic mastectomy for Lobular Carcinoma-In-Situ (LCIS) - an unusual case  

PubMed Central

Bilateral risk reducing mastectomy results in the greatest breast cancer risk reduction but is an irreversible intervention. Total mastectomy can never remove all breast tissue and there is always a small risk of breast cancer. Regular follow up and surveillance is beneficial. We present the case of a 47-year-old woman who presented with axillary lymph node metastatic breast cancer after risk reducing mastectomy in which only Lobular Carcinoma-in-Situ (LCIS) was present on histopathology.

Gurjar, N; Basit, A; Thomson, C; Kirby, R

2012-01-01

7

Breast Cancer Risk Perception Among Women Who Have Undergone Prophylactic Bilateral Mastectomy  

Microsoft Academic Search

Background: Prophylactic bilateral mastectomy is a preven- tive option for women who are at high risk of developing breast cancer. We compared the perceptions of breast can- cer risk among women who had previously undergone pro- phylactic bilateral mastectomy with objective estimates of their breast cancer risk. Methods: We asked 75 women in the Canadian province of Ontario who had

Kelly A. Metcalfe; Steven A. Narod

2002-01-01

8

Nipple-sparing mastectomy in association with intra operative radiotherapy (ELIOT): a new type of mastectomy for breast cancer treatment  

Microsoft Academic Search

Summary\\u000a Background  Breast-conserving surgery has become the standard approach for about 80% of patients treated for primary breast cancer in\\u000a most centres. However, mastectomy is still required in case of multicentric and\\/or large tumours or where recurrences occur\\u000a after conservative treatment. When a total mastectomy is performed, the removal of the nipple areola complex (NAC) is a strongly\\u000a debated issue. In

Jean Yves Petit; Umberto Veronesi; Roberto Orecchia; Alberto Luini; Piercarlo Rey; Mattia Intra; Florence Didier; Stefano Martella; Mario Rietjens; Cristina Garusi; Francesca De Lorenzi; Giovanna Gatti; Maria Elena Leon; Chiara Casadio

2006-01-01

9

Breast reconstruction after mastectomy  

Microsoft Academic Search

The management of the woman with breast cancer who requires mastectomy should involve a multidisciplinary approach which includes close collaboration between the oncological surgeon, the medical oncologist, the radiation oncologist and the reconstructive surgeon. The reconstructive surgeon can be a useful source of information for the patient with respect to the available options for breast reconstruction as well as appropriate

M. A. Codner; J. Bostwick; F. Nahai

1995-01-01

10

Geographic proximity to treatment for early stage breast cancer and likelihood of mastectomy  

Microsoft Academic Search

PurposeWomen with early stage breast cancer who live far from a radiation therapy facility may be more likely to opt for mastectomy over breast conserving surgery (BCS). The geographic dimensions of this relationship deserve further scrutiny.

Francis P. Boscoe; Christopher J. Johnson; Kevin A. Henry; Daniel W. Goldberg; Kaveh Shahabi; Elena B. Elkin; Leslie K. Ballas; Myles Cockburn

2011-01-01

11

Analysis of the Effects of Breast Reconstruction in Breast Cancer Patients Receiving Radiotherapy after Mastectomy  

PubMed Central

Background Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

Kim, Seong Hwan; Kim, Jeong Min; Park, Sun Hyung

2012-01-01

12

Body Image of Greek Breast Cancer Patients Treated with Mastectomy or Breast Conserving Surgery  

Microsoft Academic Search

The aim of this study was to assess and compare the body image of breast cancer patients (n = 70) whom underwent breast conserving surgery or mastectomy, as well as to compare patients’ scores with that of a sample of healthy control women (n = 70). A secondary objective of this study was to examine the reliability and validity of the 10-item Greek version

Fotios Anagnostopoulos; Spyridoula Myrgianni

2009-01-01

13

Comparison Of Mastectomy With Tamoxifen For Treating Elderly Patients With Operable Breast Cancer  

Microsoft Academic Search

Study objective—Comparison of tamoxifen and mastectomy in treatment of breast cancer in elderly patients. Design—Randomised trial of treatment of operable breast cancer by wedge mastectomy or tamoxifen, with median follow up 24 and 25 months respectively (range 1-63). Setting—University hospital; most patients from primary catchment area. Patients—135 consecutive patients with breast cancer aged over 70 with operable tumours (<5 cm

J. F. R. Robertson; J. H. Todd; I. O. Ellis; C. W. Elston; R. W. Blamey

1988-01-01

14

Predictors and outcomes of contralateral prophylactic mastectomy among breast cancer survivors  

Microsoft Academic Search

Background  Women affected with breast cancer who carry a BRCA1 or BRCA2 (BRCA1\\/2) mutation are at risk of developing contralateral breast\\u000a cancer. To reduce the risk of contralateral breast cancer, some patients opt for prophylactic surgery of the unaffected breast\\u000a (contralateral prophylactic mastectomy, CPM) in addition to mastectomy of the affected breast.\\u000a \\u000a \\u000a \\u000a Methods  We conducted the present study to determine the predictors

Kristi D. Graves; Beth N. Peshkin; Chanita H. Halbert; Tiffani A. DeMarco; Claudine Isaacs; Marc D. Schwartz

2007-01-01

15

"Does that Make Me a Woman?": Breast Cancer, Mastectomy, and Breast Reconstruction Decisions among Sexual Minority Women  

ERIC Educational Resources Information Center

|Feminist scholars and activists writing about breast cancer care among women have highlighted the sexist and heterosexist assumptions often embedded in the medical management of breast cancer, and of mastectomy in particular. Despite these contributions, and some speculation that sexual minority women may be less interested in breast

Rubin, Lisa R.; Tanenbaum, Molly

2011-01-01

16

Penn researchers find contralateral prophylactic mastectomy offers limited gains to life expectancy for breast cancer patients:  

Cancer.gov

Contralateral prophylactic mastectomy (CPM), a procedure that removes the unaffected breast in patients with cancer in one breast, provides only a modest increase in life expectancy, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania.

17

The Incidence of Arm Edema in Women With Breast Cancer Randomized on the National Surgical Adjuvant Breast and Bowel Project Study B04 to Radical Mastectomy Versus Total Mastectomy and Radiotherapy Versus Total Mastectomy Alone  

Microsoft Academic Search

Purpose: To determine the incidence and factors associated with the development of arm edema in women who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-04. Methods and Materials: Between 1971 and 1974, the NSABP protocol B-04 randomized 1,665 eligible patients with resectable breast cancer to either (1) the Halstead-type radical mastectomy; (2) total mastectomy and

Melvin Deutsch; Stephanie Land; Mirsada Begovic; Saima Sharif

2008-01-01

18

Synchronous elective contralateral mastectomy and immediate bilateral breast reconstruction in women with early-stage breast cancer  

Microsoft Academic Search

Background: The role of elective contralateral mastectomy (ECM) in women with early-stage breast cancer who elect or require an ipsilateral\\u000a mastectomy and desire immediate bilateral breast reconstruction (IBR) is an intellectual and emotional dilemma for both patient\\u000a and physician. In an attempt to clarify the rationale for this approach, we reviewed our experience with ECM and IBR and evaluated\\u000a operative

Jeffrey E. Gershenwald; Kelly K. Hunt; Stephen S. Kroll; Merrick I. Ross; Bonnie J. Baldwin; Barry W. Feig; Frederick C. Ames; Mark A. Schusterman; S. Eva Singletary

1998-01-01

19

Survival Implications Associated with Variation in Mastectomy Rates for Early-Staged Breast Cancer  

PubMed Central

Despite a 20-year-old guideline from the National Institutes of Health (NIH) Consensus Development Conference recommending breast conserving surgery with radiation (BCSR) over mastectomy for woman with early-stage breast cancer (ESBC) because it preserves the breast, recent evidence shows mastectomy rates increasing and higher-staged ESBC patients are more likely to receive mastectomy. These observations suggest that some patients and their providers believe that mastectomy has advantages over BCSR and these advantages increase with stage. These beliefs may persist because the randomized controlled trials (RCTs) that served as the basis for the NIH guideline were populated mainly with lower-staged patients. Our objective is to assess the survival implications associated with mastectomy choice by patient alignment with the RCT populations. We used instrumental variable methods to estimate the relationship between surgery choice and survival for ESBC patients based on variation in local area surgery styles. We find results consistent with the RCTs for patients closely aligned to the RCT populations. However, for patients unlike those in the RCTs, our results suggest that higher mastectomy rates are associated with reduced survival. We are careful to interpret our estimates in terms of limitations of our estimation approach.

Brooks, John M.; Chrischilles, Elizabeth A.; Landrum, Mary Beth; Wright, Kara B.; Fang, Gang; Winer, Eric P.; Keating, Nancy L.

2012-01-01

20

Male Breast Cancer: 20-Year Survival Data for Post-Mastectomy Radiotherapy  

PubMed Central

Summary Background The goal of this population-based study was to determine the impact of post-mastectomy radiation therapy on long-term overall survival (OS) of male patients with breast cancer. Patients and Methods We investigated 20-year OS rates of 664 patients diagnosed with primary stage I–III breast cancer in former East Germany between 1970 and 1989. Patients had a radical mastectomy with axillary lymph node dissection without systemic adjuvant therapy. Results Median follow-up time was 26.2 years (range 19–38 years). 52.4% of the patients had post-mastectomy radiotherapy. Radiotherapy showed different effects in each stage group after 20 years. Whereas there was an OS trend for radiotherapy to harm patients with stage I disease (hazard ratio (HR) 1.45; 95% confidence interval (CI) 0.98–2.15; p = 0.065), radiotherapy showed no benefit in patients with stage II disease (HR 0.82; 95% CI 0.62–1.1; p = 0.15). There was a significant survival benefit for patients with stage III disease receiving radiotherapy (HR 0.60; 95% CI 0.41–0.88; p = 0.008). Conclusion Post-mastectomy radiotherapy is associated with longer OS in male patients with stage III breast cancer. Male breast cancer patients at stages I and II do not seem to benefit from radiotherapy, but obsolete irradiation techniques might explain adverse long-term effects in earlier stages.

Eggemann, Holm; Ignatov, Atanas; Stabenow, Roland; von Minckwitz, Gunter; Rohl, Friedrich Wilhelm; Hass, Peter; Costa, Serban-Dan

2013-01-01

21

Determinants of breast conservation rates: reasons for mastectomy at a comprehensive cancer center.  

PubMed

Bias in referral patterns and variations in multi-disciplinary management may impact breast conservation therapy (BCT) rates between hospitals. Retrospective studies of BCT rates are limited by their inability to differentiate indicated mastectomies versus those chosen by the patient. Our prospective breast cancer data base was queried for patients with invasive breast cancer who underwent surgical therapy at the University of Michigan over a 3-year period. Demographics, stage and histology were recorded along with the reason mastectomy was performed, categorized as "by need" (contraindication to BCT) or "by choice." Multivariate analysis was used to identify factors significantly associated with mastectomy by choice. BCT was associated with tumor size, histology and nodal status, but not older age, either by choice or by need. Of the 34% of patients initially felt to be poor candidates for BCT, it was absolutely contraindicated in 44%, while 56% were thought to have a tumor-to-breast size ratio too large for successful BCT. Of this latter group, 80% underwent neo-adjuvant chemotherapy in an attempt to downstage the primary tumor and perform BCT, which was successful in over half the patients. For the patients initially thought to be good candidates for BCT, only 15% chose to undergo mastectomy, while 5% eventually required mastectomy due to failed attempts to achieve negative margins. Overall, the BCT rate was 63%, however without the use of neo-adjuvant chemotherapy, the BCT rate would have been only 53%. At a tertiary referral center, BCT rates are driven more by contraindications than patient choice, and may be heavily skewed towards mastectomy due to referral patterns. In addition to tumor factors such as stage and histology, BCT rate can be dramatically impacted by neo-adjuvant chemotherapy or genetic counseling. Examining BCT rates alone as a measure of quality, therefore, is not an appropriate standard across institutions serving diverse populations. PMID:19141132

Lee, M Catherine; Rogers, Kendra; Griffith, Kent; Diehl, Kathleen A; Breslin, Tara M; Cimmino, Vincent M; Chang, Alfred E; Newman, Lisa A; Sabel, Michael S

22

The prediction of local or regional recurrence after simple mastectomy for operable breast cancer.  

PubMed

Both the histological grade of the primary tumour and lymph node status have been found to contribute significantly towards the development of a local or regional recurrence after simple mastectomy for operable breast cancer. No other factor, from a series of seven studied, has been found to be of independent significance. A small group of patients with grade III tumours, lymph node positive at mastectomy, has been identified in whom more than 40 per cent of all symptomatic local or regional recurrences occurred. The chance a patient in this group has of developing a local or regional recurrence requiring treatment within 4 years approaches 50 per cent. PMID:3899246

Williams, M R; Hinton, C P; Todd, J H; Morgan, D A; Elston, C W; Blamey, R W

1985-09-01

23

CA2-04: Variation in Mastectomy Rate for Invasive Breast Cancer: Results from the Breast Cancer Surgical Outcomes Study  

PubMed Central

Background/Aims In 1999, the National Institutes of Health Consensus Conference recommended breast conserving therapy (BCT) as a viable alternative to mastectomy based on several long-term studies and meta-analyses. Since then BCT has been the procedure of choice for most women with early stage breast cancer. However, several recent studies have reported a shift toward increasing use of total mastectomy (TM). We evaluated patterns of mastectomy use and factors associated with mastectomy rates in the Breast Cancer Surgical Outcomes (BRCASO) study. Methods BRCASO is a collaborative study between University of Vermont, Kaiser Permanente, Colorado; Group Health, Seattle; and Marshfield Clinic, Wisconsin and includes detailed data on 4580 women diagnosed with incident invasive or in situ breast cancer between 2003–2008 obtained from administrative data and medical record abstraction. For this analysis, we included 2384 women with an incident diagnosis of stage 1–3 breast cancer with no history of chest radiation. We excluded cases of inflammatory or multifocal breast cancer. Results We found rates of TM as the initial surgical procedure varied by study site (p<0.0001), age at diagnosis (p=0.0005), and by use of preoperative MRI (p<0.0001). TM frequency ranged from 10.4% – 21.0% across the four institutions. Increased TM use was associated with increasing pre-operatively estimated tumor size (p<0.0001), ER/PR negative status (p=0.0007), high grade (p<0.0001) and lobular (vs. ductal) carcinoma (p=0.001). We did not find TM increasing over time. When we limited our analysis to the 1712 cases with tumor size <20 mm, we continued to observe variability in initial TM frequency across institutions from 5.2% to 14.2% (p<0.0001). Discussion Our TM rates were low compared to those reported in previous studies. Variation in TM rates was associated with several patient, tumor, and facility characteristics and may reflect differences in the patient population presenting with breast cancer, or in patients’ treatment preferences. This variation persisted even when limited to women with small tumors. While TM rates were relatively low, the two-fold variation by study site suggests inconsistent surgical practices across facilities despite several studies showing BCT and mastectomy provide equal survival benefit.

Feigelson, Heather; Onitilo, Adedayo; James, Ted; Bowles, Erin Aiello; Single, Richard; Barney, Tom; Engel, Jessica; McCahill, Laurence

2012-01-01

24

Results in 90 Cases of Breast Cancer (5 Year) Following Combined Treatment with Colchicine Derivatives, Mastectomy and Postoperative Radiotherapy.  

National Technical Information Service (NTIS)

90 cases of breast cancer, 25 Stage I, 29 Stage II and 36 Stage III, were treated with preoperative colchicine preparations (extracted from the Chinese medicinal herb Iphigenia indica A Grey, mastectomy and postoperative irradiation. 54 (60%) had axillary...

1980-01-01

25

Predictors of Mastectomy for Women with Breast Cancer in the Greater Western Region of Sydney.  

PubMed

This population-based study examined predictors of mastectomy for women with breast cancer in the greater western region of Sydney (GWRS) in New South Wales (NSW), Australia in 1992. Patients with a first diagnosis of breast cancer in 1992, the year prior to population-based mammographic screening in the region, were identified through the NSW state cancer registry. Data on stage, treatment, and demographic and health service characteristics were obtained from hospital records for patients treated within the region. The 282 patients who received surgical treatment for operable disease were considered in this analysis. Logistic regression was used to determine the odds ratio (OR) for mastectomy in relation to predictor variables with adjustment for confounding where appropriate. Age was included in all regressions even though it was not statistically significant. The tumor characteristics that were significant predictors (age adjusted) of mastectomy were stage [I (referent); IIA: OR = 1.5 (ns); IIB / IIIA-B: OR = 6.3, p < 0.05] and tumor size [T0-1 (referent); T2: OR = 1.8, p < 0.05; T3: OR = 12.9, p < 0.05]. There was a significant linear trend (p < 0.05) for lower ORs for mastectomy in women treated by surgeons with a higher breast cancer caseload (adjusted for age and stage). Women from municipalities with high socioeconomic status had lower mastectomy rates than others (OR = 0.5, p < 0.05), adjusted for age, stage, and surgeon activity level. Distance of residence from the main referral hospital and radiotherapy unit did not affect mastectomy rates. This study documents factors, in addition to stage at diagnosis, that play an important part in decisions about surgery for women with operable breast cancer. The experience of the surgeon, measured by the number of breast cancer patients, had an effect, as did the socioeconomic status of the woman. The latter may act through educational characteristics and participation of women in decisions concerning surgery. PMID:11348270

Taylor, Richard; Stubbs, Joanne M.; Langlands, Allan O.; Boyages, John

1999-03-01

26

Comparison of Locoregional Recurrence with Mastectomy vs. Breast Conserving Surgery in Pregnancy Associated Breast Cancer (PABC)  

PubMed Central

We have compared outcomes, including the locoregional recurrence, between mastectomy and breast conserving therapy in PABC. Patients were divided into those who were treated with mastectomies (group 1) and those with breast conserving surgery (group 2). The groups were comparable except for lower mean age in group 2 and more patients with stage III disease and higher number of nodes positive in the group 1. Five-year actuarial LRR, distant metastases free survival and overall survival in group 1 vs. 2 were 10% vs. 37%, 73% vs. 81% and 57% vs. 59% respectively. The patients with PABC treated with breast conserving therapy, despite having lower stage disease, have a higher risk of local regional recurrence in comparison with those treated with mastectomy.

Beriwal, Sushil; Rungruang, Bunja; Soran, Atilla; Thull, Darcy; Kelley, Joseph L.; Bhargava, Rohit; Lin, Chyongchiou J.; Sukumvanich, Paniti

2009-01-01

27

Traumatic neuroma in a patient with breast cancer after mastectomy: a case report and review of the literature  

PubMed Central

The incidence of traumatic neuroma is extremely low, especially in those patients with breast cancer after mastectomy. There are only 10 cases reported in the literature. We report a patient who developed a palpable nodular mass near the mastectomy scar. The result of excisional biopsy was traumatic neuroma. Review of the literature reveal 10 cases with breast cancer of traumatic neuromas after mastectomy. Traumatic neuroma is a benign lesion and a reparative response of the nerve to injury, either direct/indirect trauma or chronic inflammation. Benign lesions as traumatic neuromas are more rarely seen after mastectomy. However, in order to manage patients' treatment, the most critical problem is to distinguish it from recurrent breast carcinoma. Although assistant examination methods such as ultrasound and computed tomography are valuable to a certain extent, the final diagnosis can only be confirmed on pathologic examination.

2012-01-01

28

Adjustment issues related to bilateral prophylactic mastectomy in women at elevated risk of developing breast cancer.  

PubMed

Breast cancer is the most common cancer diagnosis for North American and Western European women. Increased knowledge in availability of genetic testing has helped to identify those women at high risk of eventually developing breast cancer. This has resulted in more women considering bilateral prophylactic mastectomy as a viable preventative option. Although the efficacy of the procedure has been established, much less is known about the psychological impact of undergoing this procedure. In order to assess these factors, we reviewed what is currently known about the psychological impact of undergoing bilateral prophylactic mastectomy. Searches were conducted and inclusion criteria revealed articles that focused on the psychological components involved with undergoing a bilateral prophylactic mastectomy. The findings are summarized and fell broadly into one or more of the following three areas: (1) satisfaction or regret following the surgery, (2) psychosocial functioning after the surgery, and (3) predictors of quality of life. Plastic surgery nurses have a unique opportunity to impact important psychological considerations, such as expectations of the early postoperative period, body image concerns, and psychological distress. PMID:16783176

Fuller, Shauna; Anderson, Rebecca Cogwell

29

The Incidence of Arm Edema in Women With Breast Cancer Randomized on the National Surgical Adjuvant Breast and Bowel Project Study B-04 to Radical Mastectomy Versus Total Mastectomy and Radiotherapy Versus Total Mastectomy Alone  

SciTech Connect

Purpose: To determine the incidence and factors associated with the development of arm edema in women who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-04. Methods and Materials: Between 1971 and 1974, the NSABP protocol B-04 randomized 1,665 eligible patients with resectable breast cancer to either (1) the Halstead-type radical mastectomy; (2) total mastectomy and radiotherapy to the chest wall, axilla, supraclavicular region, and internal mammary nodes if by clinical examination axillary nodes were involved by tumor; and (3) for patients with a clinically uninvolved axilla, a third arm, total mastectomy alone. Measurements of the ipsilateral and contralateral arm circumferences were to be performed every 3 months. Results: There was at least one recorded measurement of arm circumferences for 1,457 patients (87.5% of eligible patients). There were 674 women (46.3%) who experienced arm edema at some point during the period of follow-up until February 1976. For radical mastectomy patients, total mastectomy and radiotherapy patients, and total mastectomy patients alone, arm edema was recorded at least once in 58.1%, 38.2%, and 39.1% of patients, respectively (p < .001) and at last recorded measurement in 30.7%, 14.8%, and 15.5%, respectively (p = <.001). Increasing body mass index (BMI) also showed a statistically significant correlation with arm edema at any time (p = .001) and at last assessment (p = .005). Conclusions: Patients who undergo mastectomy, including those whose treatment plans do not include axillary dissection or postoperative radiotherapy, suffer an appreciable incidence of arm edema.

Deutsch, Melvin [National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers, Pittsburgh, PA (United States); University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA (United States)], E-mail: deutschm@upmc.edu; Land, Stephanie; Begovic, Mirsada; Sharif, Saima [National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers, Pittsburgh, PA (United States)

2008-03-15

30

Different Annual Recurrence Pattern Between Lumpectomy and Mastectomy: Implication for Breast Cancer Surveillance After Breast-Conserving Surgery  

PubMed Central

Purpose. To investigate the recurrence pattern and annual recurrence risk after breast-conserving surgery and compare them with those after mastectomy. Methods. This retrospective analysis included 6,135 consecutive unilateral breast cancer patients undergoing surgery in 1998–2008, with 847 lumpectomy patients and 5,288 mastectomy patients. Recurrence patterns were scrutinized and annual recurrence rates were calculated. Furthermore, a literature-based review including seven relevant studies was subsequently performed to confirm our single-institution data-based observations. Results. After lumpectomy, 50.9% of recurrences occurred within 3 years and 30.2% of recurrences were detected at 3–5 years; after mastectomy, 64.9% of recurrences occurred within 3 years and 20.4% occurred at 3–5 years. The major locoregional recurrence pattern after lumpectomy was ipsilateral breast tumor recurrence, which mainly (81.3%) occurred ?5 years postsurgery but with a low incidence of 37.5% ?3 years postsurgery. Annual recurrence curves indicated that the relapse peak after mastectomy emerged in the first 2 years; however, recurrence after lumpectomy increased annually with the highest peak near 5 years. By reviewing relevant studies, we confirmed our finding of different annual recurrence patterns for lumpectomy and mastectomy patients. The hazard ratio of dying for those recurring ?5 years postlumpectomy relative to patients relapsing >5 years postlumpectomy was 4.62 (95% confidence interval, 1.05–20.28; p = .042). Conclusions. Different recurrence patterns between mastectomy and lumpectomy patients imply that scheduling of surveillance visits should be more frequent during the 4–6 years after lumpectomy. Further prospective trials addressing the necessity of frequent and longer surveillance after lumpectomy are warranted.

Yu, Ke-Da; Li, Shuang

2011-01-01

31

Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival  

Microsoft Academic Search

Background  Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients,\\u000a despite growing public health concern over potential long-term adverse health effects.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco-Oakland,\\u000a in Seattle-Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger

Gem M Le; Cynthia D O'Malley; Sally L Glaser; Charles F Lynch; Janet L Stanford; Theresa HM Keegan; Dee W West

2004-01-01

32

Treatment results of breast cancer patients with locoregional recurrence after mastectomy  

PubMed Central

Purpose To analyze the results of locoregional and systemic therapy in the breast cancer patients with locoregional recurrence (LRR) after mastectomy. Materials and Methods Seventy-one patients who received radiotherapy for isolated LRR after mastectomy between January 1999 and December 2009 were retrospectively reviewed. Among the 71 patients, 59 (83.1%) underwent wide excision and radiotherapy and 12 (16.9%) received radiotherapy alone. Adjuvant hormonal therapy was given to 45 patients (63.4%). Oncologic outcomes including locoregional recurrence-free survival, disease-free survival (DFS), and overall survival (OS) and prognostic factors were analyzed. Results Median follow-up time was 49.2 months. Of the 71 patients, 5 (7%) experienced second isolated LRR, and 40 (56%) underwent distant metastasis (DM). The median DFS was 35.6 months, and the 3- and 5-year DFS were 49.1% and 28.6%, respectively. The median OS was 86.7 months, and the 5-year OS was 62.3%. Patients who received hormone therapy together showed better 5-year DFS and OS than the patients treated with locoregional therapy only (31.6% vs. 22.1%, p = 0.036; 66.5% vs. 55.2%, p = 0.022). In multivariate analysis, higher N stage at recurrence was a significant prognostic factor for DFS and OS. Disease free interval (?30 months vs. >30 months) from mastectomy to LRR was also significant for OS. The patients who received hormone therapy showed superior DFS and showed trend to better OS. Conclusion DM was a major pattern of failure after the treatment of LRR after mastectomy. The role of systemic treatment for LRR after mastectomy should be investigated at prospective trials.

Jeong, Yuri; Gong, Gyungyub; Lee, Hee Jin; Ahn, Sei Hyun; Son, Byung Ho; Lee, Jong Won; Choi, Eun Kyung; Lee, Sang-wook; Joo, Ji Hyeon; Ahn, Seung Do

2013-01-01

33

Analysis of selected factors influencing seroma formation in breast cancer patients undergoing mastectomy  

PubMed Central

Introduction The aim of the work was to analyze the impact of selected factors on the incidence of seroma formation in breast cancer patients undergoing mastectomy. Material and methods One hundred and fifty breast cancer patients were prospectively enrolled in the study. All patients had mastectomy performed using the same operative technique with electrocoagulation. The amount of seroma formed after surgery and its duration were correlated with selected demographic, clinical and pathological parameters. Results The cumulative total seroma volume collected by the end of treatment was higher and the overall time of seroma treatment was longer in patients over the age of 60 years (p = 0.001 and p = 0.001 respectively). Duration of seroma was significantly longer in obese patients (p = 0.036). The cumulative total seroma volume collected by the end of treatment was higher and the overall time of seroma treatment was longer in patients who had over 130 ml of lymph drained during the first 24 postoperative hours (p < 0.001 and p = 0.001 respectively). Additionally, longer duration of seroma was observed in patients with pathological stage I and II according to TNM-UICC (p = 0.042) and in patients with ? 1200 g weight resected of mammary gland (p = 0.05). Conclusions Age and obesity are important prognostic factors influencing seroma formation in breast cancer patients undergoing mastectomy. The amount of lymph formed during first postoperative day may have predictive value in assessing cumulative total seroma volume collected during treatment and its overall duration.

Jaworski, Radoslaw; Irga, Ninela; Kruszewski, Janusz Wieslaw; Jaskiewicz, Janusz

2012-01-01

34

Post mastectomy radiation for large node negative breast cancer: time for a second look.  

PubMed

Patients with node negative and large primary tumors ?5cm comprise a rare entity of breast cancer patients for which clear management guidelines are not available. Data about the rates of loco-regional failures (LRF) in this patient population are scarce and reporting widely varying observations. Post Mastectomy Radiation Therapy (PMRT) for this group of patients is controversial. In this review we examined the available literature discussing the LRF rates in this clinical setting and the value of adding PMRT in their management. PMID:21115360

Boutrus, Rimoun; Taghian, Alphonse G

2010-11-05

35

Local Therapy in BRCA1 and BRCA2 Mutation Carriers with Operable Breast Cancer: Comparison of Breast Conservation and Mastectomy  

PubMed Central

Purpose Women with BRCA1 and BRCA2 mutations have an elevated risk of breast cancer and ovarian cancer, but also of developing second primary breast cancer. BRCA1/2 mutation carriers with breast cancer must choose between breast conservation (BCT) and mastectomy (M) yet data on outcomes are limited. The purpose of this study is to compare BCT to M in BRCA1/2 carriers. Methods 655 women with BRCA1/2 mutations diagnosed with breast cancer and treated with BCT (n=302) or M (n=353) were identified and underwent follow up to assess local, regional and systemic recurrence. Results Local failure as first failure was significantly more likely in those treated with BCT compared to M, with a cumulative estimated risk of 23.5% vs. 5.5%, respectively, at 15 years (p<0.0001); 15-year estimates in carriers treated with BCT and chemotherapy was 11.9% (p=0.08 when compared to M). Most events appeared to be second primary cancers rather than failure to control the primary tumor. The risk of contralateral breast cancer was high in all groups, exceeding 40%, but was not statistically significantly different by use of adjuvant radiotherapy (RT) or not, suggesting no added risk from scatter RT at 10 and 15 years. There were no differences seen in regional or systemic recurrences between the BCT and M groups, and no difference in overall survival. Conclusions BRCA1/2 mutation carriers with breast cancer have similar survivals whether treated with M or BCT. However, women undergoing BCT have an elevated risk of a second in-breast event that is significantly reduced in the presence of chemotherapy. Contralateral breast cancer events are very common.

Pierce, Lori J.; Phillips, Kelly-Anne; Griffith, Kent A.; Buys, Saundra; Gaffney, David K.; Moran, Meena S.; Haffty, Bruce G.; Ben-David, Merav; Kaufman, Bella; Garber, Judy E.; Merajver, Sofia D.; Balmana, Judith; Meirovitz, Amichay; Domchek, Susan M.

2010-01-01

36

The use of nipple-sparing mastectomy in patients with breast cancer.  

PubMed

Breast cancer is the most common cancer diagnosed in women. Nipple-sparing mastectomy (NSM) offers the opportunity to preserve the breast envelope and the nipple-areolar complex by removing only breast tissue and avoiding multiple surgical procedures for reconstruction. The objective of this article is to review the oncologic and surgical concerns with NSM, along with the appropriate selection of patients and potential postoperative complications. A review of the literature was conducted through MEDLINE®, PubMed, and Google Scholar, focusing on recent research. The findings revealed that although the oncologic safety of NSM continues to be debated, indications are strong that cancer recurrence rates are low and the aesthetic motivation is high for carefully screened patients. From those findings, considerations for patient education regarding risks and expectations are described. Nurses in a variety of cancer care settings can use this information to address the concerns of patients making decisions regarding surgical options and adjusting to postoperative body image expectations and changes. PMID:23372098

Long, Laura

2013-02-01

37

Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction  

Microsoft Academic Search

The aim of this study was to assess and compare the psychological outcome and satisfaction of patients whom underwent wide local excision, mastectomy alone and mastectomy with breast reconstruction. A total of 577 patients had different types of operations for primary breast cancer (254 (44%) had wide local excision, 202 (35%) had simple mastectomy and 121 (21%) had breast reconstruction).

S. K. Al-Ghazal; L. Fallowfield; R. W. Blamey

2000-01-01

38

Radiation dose escalation for loco-regional recurrence of breast cancer after mastectomy  

PubMed Central

Background Radiation is a standard component of treatment for patients with locoregional recurrence (LRR) of breast cancer following mastectomy. The current study reports the results of a 10% radiation dose escalation in these patients. Methods 159 patients treated at MD Anderson Cancer Center between 1994-2006 with isolated LRR after mastectomy alone were reviewed. Patients in the standard treatment group (65 pts, 40.9%) were treated to 50 Gy comprehensively plus a boost of 10 Gy. The dose escalated group (94 pts, 59.1%) was treated to 54 Gy comprehensively and a minimum 12 Gy boost. Median dose in the standard dose and dose escalated group was 60 Gy (±1 Gy, 95% CI) and 66 Gy (±0.5 Gy, 95% CI) respectively. Median follow up for living patients was 94 months from time of recurrence. Results The actuarial five year locoregional control (LRC) rate was 77% for the entire study population. The five year overall survival and disease-free survival was 55% and 41%, respectively. On multivariate analysis, initial tumor size (p?=?0.03), time to initial LRR (p?=?0.03), absence of gross tumor at the time of radiation (p?=?0.001) and Her2 status (p?=?0.03) were associated with improved LRC. Five year LRC rates were similar in patients with a complete response to chemotherapy without surgery and patients with a complete surgical excision (77% vs 83%, p?=?NS), compared to a 63% LRC rate in patients with gross disease at the time of radiation (p?=?0.024). LRC rates were 80% in the standard dose group and 75% in the dose escalated group (p?=?NS). Conclusions While LRR following mastectomy is potentially curable, distant metastasis and local control rates remain suboptimal. Radiation dose escalation did not appear to improve LRC. Given significant local failure rates, these patients are good candidates for additional strategies to improve their outcomes.

2013-01-01

39

Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer  

Microsoft Academic Search

In 1976 the authors began a randomized trial to evaluate breast conservation by a segmental mastectomy in the treatment of State I and II breast tumors less than or equal to 4 cm in size. The operation removes only sufficient tissue to ensure that margins of resected specimens are free of tumor. Women were randomly assigned to total mastectomy, segmental

Bernard Fisher; Madeline Bauer; Richard Margolese; Roger Poisson; Yosef Pilch; Carol Redmond; Edwin Fisher; Norman Wolmark; Melvin Deutsch; Eleanor Montague; Elizabeth Saffer; Lawrence Wickerham; Harvey Lerner; Andrew Glass; Henry Shibata; Peter Deckers; Alfred Ketcham; Robert Oishi; Ian Russell

1985-01-01

40

Sacramento Area Breast Cancer Epidemiology Study (SABES): Use of Post-Mastectomy Breast Reconstruction Along the Rural to Urban Continuum  

PubMed Central

Background Health care disparities have been documented in rural populations. We hypothesized that breast cancer (BCa) patients in urban counties would have higher rates of post-mastectomy breast reconstruction (BR) relative to patients in surrounding near-metro and rural counties. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with BCa and treated with mastectomy in the greater Sacramento area between 2000 and 2006. Counties were categorized as urban, near-metro or rural. Univariate models evaluated the relationship of rural, near-metro or urban location with use of BR via the chi-square test. Multivariate logistic regression models controlling for patient, tumor, and treatment-related factors predicted use of BR. The likelihood of undergoing BR was reported as odds ratios (OR) with 95% confidence intervals (CI); significance was set at p ? 0.05. Results Complete information was available for 3,552 BCa patients treated with mastectomy. Of these, 718 (20.2%) underwent BR. On univariate analysis, differences in the rates of BR were noted among urban, near-metro and rural areas (p<0.001). On multivariate analysis patients from rural (OR 0.51, CI 0.28-0.93; p<0.03) and near-metro (OR 0.73, CI 0.59-0.89; p=0.002) areas had a decreased likelihood of undergoing BR relative to patients from urban areas. Conclusions Patients from near-metro and rural areas as less likely to receive BR following mastectomy for BCa than their urban counterparts. Differences in use of BR detected at a population level should guide future interventions to increase rates of BR at the local level.

Tseng, Warren H.; Stevenson, Thomas R.; Canter, Robert J.; Chen, Steven L.; Khatri, Vijay P.; Bold, Richard J.; Martinez, Steve R.

2010-01-01

41

Preoperative dexamethasone reduces postoperative pain, nausea and vomiting following mastectomy for breast cancer  

PubMed Central

Background Dexamethasone has been reported to reduce postoperative symptoms after different surgical procedures. We evaluated the efficacy of preoperative dexamethasone in ameliorating postoperative nausea and vomiting (PONV), and pain after mastectomy. Methods In this prospective, double-blind, placebo-controlled study, 70 patients scheduled for mastectomy with axillary lymph node dissection were analyzed after randomization to treatment with 8 mg intravenous dexamethasone (n = 35) or placebo (n = 35). All patients underwent standardized procedures for general anesthesia and surgery. Episodes of PONV and pain score were recorded on a visual analogue scale. Analgesic and antiemetic requirements were also recorded. Results Demographic and medical variables were similar between groups. The incidence of PONV was lower in the dexamethasone group at the early postoperative evaluation (28.6% vs. 60%; p = 0.02) and at 6 h (17.2% vs. 45.8%; p = 0.03). More patients in the placebo group required additional antiemetic medication (21 vs. 8; p = 0.01). Dexamethasone treatment significantly reduced postoperative pain just after surgery (VAS score, 4.54 ± 1.55 vs. 5.83 ± 2.00; p = 0.004), at 6 h (3.03 ± 1.20 vs. 4.17 ± 1.24; p < 0.0005) and at 12 h (2.09 ± 0.85 vs. 2.54 ± 0.98; p = 0.04). Analgesics were required in more patients of the control group (21 vs. 10; p = 0.008). There were no adverse events, morbidity or mortality. Conclusions Preoperative intravenous dexamethasone (8 mg) can significantly reduce the incidence of PONV and pain in patients undergoing mastectomy with axillary dissection for breast cancer. Trial registration number NCT01116713

2010-01-01

42

Treatment choices in breast cancer: a comparative analysis of mastectomy patients and radiation patients  

SciTech Connect

This descriptive-exploratory study identified factors that distinguished women on the basis of the treatment they chose for breast cancer. A semi-structured interview and questionnaire was administered to 30 respondents who received mastectomy and 31 who received lumpectomy with radiation. The variables investigated as potential predictors of treatment choice were (1) participation in treatment planning, (2) knowledge of illness and treatment alternatives, (3) health locus of control, (4) sex-role identification, (5) body image, (6) social support and (7) age. As perceptions of the outcome of treatment influence attitudes about treatment choice, five variables relating to perceived treatment consequences were also examined. These were (1) social support, (2) body image, (3) satisfaction with medical care, (4) satisfaction with treatment and (5) general well-being. The major findings in regard to the predictor variables included a profile of the characteristics of each group. The radiation group had more knowledge, participated in planning to a greater extent, investigated treatment options more often and typically made their own decisions about treatment. The mastectomy group was older, attributed locus of control to chance and demonstrated nonsignificant trends toward locus of control in powerful others and toward a feminine sex-role identification; 50% cited Surgeon's Advice as the basis of their choice.

Williams, J.

1985-01-01

43

Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial.  

PubMed

Music therapy has been used in multiple health care settings to reduce patient pain, anxiety, and stress. However, few available studies have investigated its effect on pain among breast cancer patients after radical mastectomy. The aim of this study was to explore the effects of music therapy on pain reduction in patients with breast cancer after radical mastectomy. This randomized controlled trial was conducted at the Surgical Department of Oncology Center, First Affiliated Hospital of Xi'an Jiaotong University from March to November 2009. A total of 120 breast cancer patients who received Personal Controlled Analgesia (PCA) following surgery (mastectomy) were randomly allocated to two groups, an intervention group and a control group (60 patients in each group). The intervention group accepted music therapy from the first day after radical mastectomy to the third admission to hospital for chemotherapy in addition to the routine nursing care, while the control group received only routine nursing care. Pain scores were measured at baseline and three post-tests using the General Questionnaire and Chinese version of Short-Form of McGill Pain Questionnaire. The primary endpoint was the change in the Pain Rating Index (PRI-total) score from baseline. Music therapy was found to reduce the PRI-total score in the intervention group significantly compared with the control group with a mean difference (95% CI) of -2.38 (-2.80, -1.95), -2.41 (-2.85, -1.96), and -1.87 (-2.33, -1.42) for the 1st, 2nd, and 3rd post-tests, respectively. Similar results were found for Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) scores. The findings of the study provide some evidence that music therapy has both short- and long-term positive effects on alleviating pain in breast cancer patients following radical mastectomy. PMID:21537935

Li, Xiao-Mei; Yan, Hong; Zhou, Kai-Na; Dang, Shao-Nong; Wang, Duo-Lao; Zhang, Yin-Ping

2011-05-03

44

Breast cancer subpopulation with high risk of internal mammary lymph nodes metastasis: analysis of 2,269 Chinese breast cancer patients treated with extended radical mastectomy  

Microsoft Academic Search

Purpose  The selective treatment of internal mammary lymph nodes (IMNs) in breast cancer is controversial. The purpose of this research\\u000a was to determine the subpopulation patients with high risk of internal mammary lymph nodes metastasis who received extended\\u000a radical mastectomy without any preoperative treatment from 1956 to 2003 in China.\\u000a \\u000a \\u000a \\u000a Patients and methods  1,679 Chinese patients were underwent extended radical mastectomy (ERM)

Ou Huang; Liping Wang; Kunwei Shen; Hong Lin; Zhen Hu; Guangyu Liu; Jiong Wu; Jinsong Lu; Zhiming Shao; Qixia Han; Zhenzhou Shen

2008-01-01

45

Breast Reconstruction After Mastectomy  

MedlinePLUS

... breast reconstruction Nipple and areola reconstruction Choosing your plastic surgeon for breast reconstruction Before breast reconstruction surgery After breast reconstruction surgery Can breast reconstruction hide ...

46

Patterns of local breast cancer recurrence after skin-sparing mastectomy and immediate breast reconstruction  

Microsoft Academic Search

BackgroundLocal recurrence rates after skin-sparing mastectomy and immediate reconstruction are similar to recurrence rates after conventional mastectomy. We investigated the pattern of local recurrences and risk factors associated with them.

Aislinn Vaughan; Jill R. Dietz; Rebecca Aft; William E. Gillanders; Timothy J. Eberlein; Phoebe Freer; Julie A. Margenthaler

2007-01-01

47

The impact of breast-conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients: a review.  

PubMed

In recent years, doubt has been shed on the necessity of mastectomy for women with early-stage breast cancer. Apart from purely medical studies comparing (radical) mastectomy to less intruding surgical treatment, a number of studies (N = 18) have been published investigating the impact of breast-conserving treatment versus mastectomy on quality of life. We review these studies with respect to medical issues (treatment modality, stage of disease), methodologic issues (design, measurement moment, sample size), and results (psychologic discomfort, changes in life patterns, fears and concerns). It is concluded that there is no solid proof of a better psychologic adjustment after breast-conserving treatment and that there are no substantial differences between the different treatment modalities in changes of life patterns and fears and concerns. However, the results with respect to body image and sexual functioning favor the use of breast-conserving treatment. PMID:2033420

Kiebert, G M; de Haes, J C; van de Velde, C J

1991-06-01

48

The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009  

Microsoft Academic Search

BACKGROUND: Breast cancer among women is a relatively common with a more favorable expected survival rates than other forms of cancers. This study aimed to determine the improved quality of life for post-mastectomy women through peer education. METHODS: Using pre and post test follow up and control design approach, 99 women with stage I and II of breast cancer diagnosis

Farkhondeh Sharif; Narjes Abshorshori; Sedigheh Tahmasebi; Maryam Hazrati; Najaf Zare; Sarah Masoumi

2010-01-01

49

Clinical practice guidelines for the care and treatment of breast cancer: 16. Locoregional post-mastectomy radiotherapy  

Microsoft Academic Search

Objective: To provide information and recommendations to assist women with breast cancer and their physicians in making de- cisions regarding the use of locoregional post-mastectomy ra- diotherapy (PMRT). Outcomes: Locoregional control, disease-free survival, overall survival and treatment-related toxicities. Evidence: This guideline is based on a review of all meta-analyses, consensus statements and other guidelines published between 1966 and November 2002.

Pauline T. Truong; Ivo A. Olivotto; Timothy J. Whelan; Mark Levine

50

Skin-sparing mastectomy and immediate breast reconstruction by use of implants: An assessment of risk factors for complications and cancer control in 120 patients  

Microsoft Academic Search

Background: Combined skin-sparing mastectomy and immediate reconstruction by use of an implant is increasingly accepted as a therapy for patients with breast cancer or a hereditary risk of breast cancer. Because little and contradictory evidence regarding possible risk factors for postoperative complications is available, the authors retrospectively assessed 13 such factors. They also evaluated the oncological safety of the procedure.

Leonie A. E. Woerdeman; J Joris Hage; Mark J. C. Smeulders; Emiel J. Th. Rutgers; Horst van der C. M. A. M

2006-01-01

51

Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC trial 10801  

Microsoft Academic Search

In 1980 the EORTC-BCCG initiated a multicentre randomised clinical trial comparing modified radical mastectomy (MRM) with breast-conserving therapy (BCT) in stage I and II breast cancer. The main endpoint of the trial was survival. A brief quality of life (QoL) questionnaire consisting of two multi-item scales (body image and fear of recurrence) and two single items (satisfaction with treatment and

D Curran; J. P van Dongen; N. K Aaronson; G Kiebert; I. S Fentiman; F Mignolet; H Bartelink

1998-01-01

52

Long-term follow-up of breast cancer survivors with post-mastectomy pain syndrome  

Microsoft Academic Search

Post-mastectomy pain syndrome (PMPS) is a recognised complication of breast surgery although little is known about the long-term outcome of this chronic pain condition. In 1996, Smith et al identified a prevalence rate of PMPS of 43% among 408 women in the Grampian Region, Northeast Scotland. The aim of this study was to assess long-term outcome at 7–12 years postoperatively

L Macdonald; J Bruce; N W Scott; W C S Smith; W A Chambers

2005-01-01

53

Does it matter where you go for breast surgery?: Attending Surgeon's Influence on Variation in Receipt of Mastectomy for Breast Cancer  

PubMed Central

Background Concerns about the use of mastectomy and breast reconstruction for breast cancer have motivated interest in surgeon’s influence on the variation in receipt of these procedures. Objectives To evaluate the influence of surgeons on variations in the receipt of mastectomy and breast reconstruction for patients recently diagnosed with breast cancer. Methods Attending surgeons (n=419) of a population-based sample of breast cancer patients diagnosed in Detroit and Los Angeles during 6/05 ? 2/07 (n=2290) were surveyed. Respondent surgeons (n=291) and patients (n=1780) were linked. Random-effects models examined the amount of variation due to surgeon for surgical treatment. Covariates included patient clinical and demographic factors and surgeon demographics, breast cancer specialization, patient management process measures, and attitudes about treatment. Results Surgeons explained a modest amount of the variation in receipt of mastectomy (4%) after controlling for patient clinical and sociodemographic factors but a greater amount for reconstruction (16%). Variation in treatment rates across surgeons for a common patient case was much wider for reconstruction (median 29%, 5th–95th percentile 9%–65%) than for mastectomy (median 18%, 5th–95th percentile, 8% and 35%). Surgeon factors did not explain between-surgeon variation in receipt of treatment. For reconstruction, one surgeon factor (tendency to discuss treatment plans with a plastic surgeon prior to surgery) explained a substantial amount of the between-surgeon variation (31%). Conclusion Surgeons have largely adopted a consistent approach to the initial surgery options. By contrast, the wider between-surgeon variation in receipt of breast reconstruction suggests more variation in how these decisions are made in clinical practice.

Katz, Steven J.; Hawley, Sarah T.; Abrahamse, Paul; Morrow, Monica; Friese, C. R.; Alderman, Amy K.; Griggs, Jennifer J.; Hamilton, Ann; Graff, John J.; Hofer, Timothy P.

2011-01-01

54

Treatment of primary breast cancer without mastectomy. The Los Angeles community experience and review of the literature.  

PubMed Central

Between 1977 and 1983, 150 women with primary breast cancer, ranging in age from 26 to 84, were treated with a breast-sparing procedure involving lumpectomy, axillary node dissection, external beam radiotherapy, and 192-iridium implant. Median follow-up to date is 46+ months, with a range of 14 to 96+ months. All surviving patients have been followed for a minimum of 24+ months. Actuarial disease-free survival projected to 8 years is 79% for the entire group, 100% for the five noninfiltrating intraductal cancer patients, 97% for the 71 Stage I patients, and 68% for the 74 Stage II patients. Eighteen of the 150 patients (12%) have developed local recurrences thus far. Five (3%) have developed second, nonbreast, primary tumors. This community-based study, examined together with other published reports of similar procedures and compared to published results following mastectomy, helps confirm lumpectomy-radiotherapy as a legitimate approach to the management of primary breast cancer.

1986-01-01

55

Malignant pleural effusion in breast cancer 12 years after mastectomy that was successfully treated with endocrine therapy  

PubMed Central

Patient: Female, 94 Final Diagnosis: Malignant pleural effusion Symptoms: — Medication: — Clinical Procedure: Cytology Specialty: Oncology Objective: Unusual clinical course Background: The most common site of postoperative breast cancer recurrence is bone, followed by local relapse, lung, and liver. The majority of relapses occur within the first 3 years after surgery. Pleural recurrences more than 10 years after surgery are rare. Case Report: A 94-year-old woman who had undergone modified radical mastectomy for right breast cancer (invasive ductal carcinoma, pT2, pN1, ER+, PgR+) 12 years earlier presented to our hospital with carcinomatous pleuritis and a chief complaint of dyspnea. Endocrine therapy with oral letrozole was started and the pleural effusion had disappeared 3 months later. Conclusions: Oral endocrine therapy may be effective for the treatment of late recurrence of hormon receptor-positive breast cancer in elderly women.

Shinohara, Tsuyoshi; Yamada, Hiroyuki; Fujimori, Yoshiro; Yamagishi, Kiyofumi

2013-01-01

56

Body image issues after bilateral prophylactic mastectomy with breast reconstruction in healthy women at risk for hereditary breast cancer.  

PubMed

The outcome of bilateral prophylactic mastectomy with breast reconstruction (BPM-IBR) in healthy BRCA1/2 mutation carriers can be potentially burdensome for body image and the intimate relationship. Therefore, in the current analysis the impact on body image, sexual and partner relationship satisfaction was prospectively investigated in women opting for BPM-IBR as well as cancer distress and general quality of life. Healthy women undergoing BPM-IBR completed questionnaires preoperatively (T0, n = 48), at 6 months (T1, n = 44) and after finishing breast reconstruction (median 21 months, range 12-35) (T2, n = 36). With multi-level regression analyses the course of outcome variables was investigated and a statistically significant change in body image and/or sexual and partner relationship satisfaction was predicted by baseline covariates. Body image significantly decreased at T1. At T2 sexual relationship satisfaction and body image tended to be lower compared to baseline. The overall partner relationship satisfaction did not significantly change. At T2, 37 % of the women reported that their breasts felt unpleasantly, 29 % was not satisfied with their breast appearance and 21 % felt embarrassed for their naked body. Most body image issues remained unchanged in 30 % of the women. A negative body image was predicted by high preoperative cancer distress. BPM-IBR was associated with adverse impact on body image in a substantial subgroup, but satisfaction with the overall sexual and partner relationship did not significantly change in time. The psychosocial impact of BPM-IBR in unaffected women should not be underestimated. Psychological support should ideally be integrated both before and after BPM-IBR. PMID:23224779

Gopie, Jessica P; Mureau, Marc A M; Seynaeve, Caroline; Ter Kuile, Moniek M; Menke-Pluymers, Marian B E; Timman, Reinier; Tibben, Aad

2013-09-01

57

Factors that Affect Patients' Decision-Making about Mastectomy or Breast Conserving Surgery, and the Psychological Effect of this Choice on Breast Cancer Patients  

PubMed Central

Summary Background Breast cancer is the most common cancer in women. Primary treatment is surgery, with breast conserving surgery (BCS) being widely used for early-stage disease. Due to changes in body image, depressive symptoms can occur after surgery. Here, we evaluate factors that affect patients’ decision on surgery, and investigate differences in the level of depression after mastectomy or BCS in a population of Turkish patients. Patients and Methods One hundred breast cancer patients who had undergone mastectomy or BCS and were followed up at our institution between 2007 and 2008 were included. Patients were questioned about their involvement in surgical decision-making. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria via a Structural Clinical Interview for DSM (SCID). Severity of depression was evaluated by using the Beck Depression Inventory (BDI). Results Patients who were older than 50 years, had more than 1 child, a history of lactation, and a positive family history of breast cancer mostly preferred mastectomy. However, patients who sought a second opinion and further information on BCS preferred BCS (p < 0.005). There was no statistical correlation between marital status, first childbearing age, and educational status and the decision on surgery type (p > 0.005). Mastectomy patients were prone to depression, but this was not statistically significant (p = 0.099). Conclusion Age, parenthood, lactation, and positive familial history, as well as thorough information about the type of surgery were important factors for the patients’ decision. After breast cancer surgery, patients might experience depression affecting treatment and quality of life. Therefore, adequate information and communication are essential.

Gumus, Mahmut; Ustaalioglu, Basak O.; Garip, Meral; Kiziltan, Emre; Bilici, Ahmet; Seker, Mesut; Erkol, Burcak; Salepci, Taflan; Mayadagli, Alpaslan; Turhal, Nazim S.

2010-01-01

58

Prognostic index score and clinical prediction model of local regional recurrence after mastectomy in breast cancer patients  

SciTech Connect

Purpose: To develop clinical prediction models for local regional recurrence (Lr) of breast carcinoma after mastectomy that will be superior to the conventional measures of tumor size and nodal status. Methods and Materials: Clinical information from 1,010 invasive breast cancer patients who had primary modified radical mastectomy formed the database of the training and testing of clinical prognostic and prediction models of LRR. Cox proportional hazards analysis and Bayesian tree analysis were the core methodologies from which these models were built. To generate a prognostic index model, 15 clinical variables were examined for their impact on LRR. Patients were stratified by lymph node involvement (<4 vs. {>=}4) and local regional status (recurrent vs. control) and then, within strata, randomly split into training and test data sets of equal size. To establish prediction tree models, 255 patients were selected by the criteria of having had LRR (53 patients) or no evidence of LRR without postmastectomy radiotherapy (PMRT) (202 patients). Results: With these models, patients can be divided into low-, intermediate-, and high-risk groups on the basis of axillary nodal status, estrogen receptor status, lymphovascular invasion, and age at diagnosis. In the low-risk group, there is no influence of PMRT on either LRR or survival. For intermediate-risk patients, PMRT improves LR control but not metastases-free or overall survival. For the high-risk patients, however, PMRT improves both LR control and metastasis-free and overall survival. Conclusion: The prognostic score and predictive index are useful methods to estimate the risk of LRR in breast cancer patients after mastectomy and for estimating the potential benefits of PMRT. These models provide additional information criteria for selection of patients for PMRT, compared with the traditional selection criteria of nodal status and tumor size.

Cheng, Skye Hongiun [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China) and Department of Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China) and Department of Radiation Oncology, Duke University, Durham, North Carolina (United States)]. E-mail: skye@mail.kfcc.org.tw; Horng, C.-F. [Department of Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Clarke, Jennifer L. [Institute of Statistics and Decision Sciences, Duke University, Durham, North Carolina (United States); Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina (United States); Tsou, M.-H. [Department of Pathology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Tsai, Stella Y. [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Chen, C.-M. [Department of Surgical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Jian, James J. [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Liu, M.-C. [Department of Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); West, Mike [Institute of Statistics and Decision Sciences, Duke University, Durham, North Carolina (United States); Huang, Andrew T. [Department of Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Medicine, Duke University, Durham, North Carolina (United States); Prosnitz, Leonard R. [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States)

2006-04-01

59

A false positive for metastatic lymph nodes in the axillary region of a breast cancer patient following mastectomy.  

PubMed

Recent advanced imaging modalities such as positron emission tomography (PET) detect malignancies using 2-[18F]-fluoro-2-deoxy-D: -glucose (18-FDG) with high accuracy, and they contribute to decisions regarding diagnosis, staging, recurrence, and treatment response. Here, we report a case of false-positive metastatic lymph nodes that were diagnosed by PET/CT and ultrasonography in a 48-year-old breast cancer patient who had undergone mastectomy. The tumors, which were oval shaped and resembled lymph nodes, were detected by ultrasonography. PET/CT revealed high uptake of 18-FDG in the tumors. To investigate the proposed recurrence and to re-evaluate the biology of the recurrent tumors, a tumor was removed from the brachial plexus of the patient. Histological findings revealed it to be a schwannoma. All imaging modalities including PET/CT failed to distinguish benign tumors from metastatic lymph nodes in the brachial plexus. After resection of the schwannomas, the patient complained of a slight motor disorder of the second finger on the right hand. Hence, it is important to consider a false-positive case of lymph node metastasis in a breast cancer patient following mastectomy. PMID:19554397

Fujiuchi, Nobuko; Saeki, Toshiaki; Takeuchi, Hideki; Sano, Hiroshi; Takahashi, Takao; Matsuura, Kazuo; Shigekawa, Takashi; Misumi, Misono; Nakamiya, Noriko; Okubo, Katsuhiko; Osaki, Akihiko; Sakurai, Takaki; Matsuda, Hiroshi

2009-06-24

60

Feasibility study on radiofrequency ablation followed by partial mastectomy for stage I breast cancer patients  

Microsoft Academic Search

To evaluate the safety and reliability of thermal ablation therapy instead of breast-conserving surgery (BCS), we performed radiofrequency ablation (RFA) for clinical stage I breast cancer patients. Subjects were T1N0 breast cancer patients with no extensive intraductal components. Under general anesthesia, sentinel node biopsy was performed, followed by RFA and BCS. Resected specimens were examined at 5-mm intervals by hematoxylin–eosin

Shigeru Imoto; Noriaki Wada; Noriko Sakemura; Takahiro Hasebe; Yukinori Murata

2009-01-01

61

PS1-42: Beyond Risk Reduction: Decision-Making Factors Among Breast Cancer Patients Undergoing Contralateral Prophylactic Mastectomy  

PubMed Central

Background/Aims Women diagnosed with unilateral breast cancer are electing to undergo contralateral prophylactic mastectomy (CPM)—or removal of the healthy breast—at rapidly increasing rates worldwide. CPM significantly reduces the risk of recurrence of contralateral breast cancer; however, it is also believed to be unnecessary for most patients due to the relatively low risk of contralateral breast cancer, and the effectiveness of less invasive treatment options. Additionally, since the risk of systemic metastases often exceeds the risk of contralateral breast cancer, most patients will not receive any survival benefit. As such, there is a growing need to understand why patients are electing to have CPM. Drawing from prospective, in-depth interviews with breast cancer patients, we explore how women are making this decision and investigate what factors beyond risk reduction may be impacting their decision. Methods Participants were recruited from a multispecialty clinic in Northern California. Participants were interviewed at four time points during their treatment journey. Medical records for each participant were reviewed to confirm therapies received. Analysis of interview transcripts used grounded theory to identify emergent decision-making factors across participants. Results Of the 41 patients enrolled in the study, 11 (27%) women elected to have CPM. The majority of these women underwent BCRA testing (9 or 82%), but only two women received a positive result. Influential factors identified across participants were: 1) desire to reduce or avoid breast cancer treatment; 2) having a close relationship with someone who died from breast cancer; 3) wanting to maintain (or improve) breast appearance; and 4) receiving imaging results that showed “suspicious” but ultimately benign changes in their healthy breast. Conclusions The decision to undergo CPM is impacted by a variety of factors including, but not limited to, risk reduction. Moreover, perceptions of risk are entangled with individual experiences prior to and during treatment, which may influence the ways patients understand risk as both a concept and a decision-making factor. Further investigation of the impact of both risk comprehension and perceived benefits of CPM—most notably reconstruction—on decision-making is needed to understand why women are electing to undergo this invasive and potentially medically unnecessary procedure.

Rendle, Katharine; Halley, Meghan; Ventre, Nicole; Frosch, Dominick; May, Suepattra

2013-01-01

62

Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation  

PubMed Central

Background Primary non-Hodgkin lymphoma (NHL) of the breast represents 0.04–0.5% of malignant lesions of the breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults with the breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the breast described in the literature. Eight of these cases occurred in proximity to breast implants, four in relation to silicone breast implant and three in relation to saline filled breast implant with three out of the eight implant related cases having previous history of breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML), the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude sarcomatoid carcinoma, malignant melanoma and pleomorphic sarcoma by an appropriate panel of immunostains to arrive at the correct diagnosis of ALCL.

Bishara, Mona RY; Ross, Cathy; Sur, Monalisa

2009-01-01

63

Effect of Postmastectomy Radiotherapy in Patients <35 Years Old With Stage II-III Breast Cancer Treated With Doxorubicin-Based Neoadjuvant Chemotherapy and Mastectomy  

SciTech Connect

Purpose: Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II-III breast cancer. Patients and Methods: We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA-IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival. Results: Despite more advanced disease stages, the patients who received PMRT (n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT (n = 27). Conclusion: Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy.

Garg, Amit K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oh, Julia L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: joh@mdanderson.org; Oswald, Mary Jane; Huang, Eugene; Strom, Eric A.; Perkins, George H.; Woodward, Wendy A.; Yu, T. Kuan; Tereffe, Welela [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Meric-Bernstam, Funda [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hahn, Karin [Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2007-12-01

64

Radiotherapy for Stage II and Stage III Breast Cancer Patients With Negative Lymph Nodes After Preoperative Chemotherapy and Mastectomy  

SciTech Connect

Purpose: To evaluate the effect of postmastectomy radiotherapy (PMRT) in Stage II-III breast cancer patients with negative lymph nodes (pN0) after neoadjuvant chemotherapy (NAC). Patients and Materials: Of 1,054 breast cancer patients treated with NAC at our institution between 1990 and 2004, 134 had pN0 status after NAC and mastectomy. The demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The effect of PMRT on locoregional recurrence-free survival and overall survival (OS) was evaluated by multivariate analysis, including known prognostic factors. Results: Of the 134 eligible patients, 78 (58.2%) received PMRT and 56 (41.8%) did not. At a median follow-up time of 91.4 months, the 5-year locoregional recurrence-free survival and OS rate was 96.2% and 88.3% with PMRT and 92.5% and 94.3% without PMRT, respectively (p = NS). The corresponding values at 10 years were 96.2% and 77.2% with PMRT and 86.8% and 87.7% without PMRT (p = NS). On multivariate analysis, PMRT had no effect on either locoregional recurrence-free survival (hazard ratio, 0.37; 95% confidence interval, 0.09-1.61; p = .18) or OS (hazard ratio, 2.06; 95% confidence interval, 0.71-6; p = .18). This remained true in the subgroups of patients with clinical Stage II or Stage III disease at diagnosis. A trend was seen toward poorer OS among patients who had not had a pathologic complete in-breast tumor response after NAC (hazard ratio, 6.65; 95% confidence interval, 0.82-54.12; p = .076). Conclusions: The results from the present retrospective study showed no increase in the risk of distant metastasis, locoregional recurrence, or death when PMRT was omitted in breast cancer patients with pN0 status after NAC and mastectomy. Whether the omission of PMRT is acceptable for these patients should be addressed prospectively.

Le Scodan, Romuald, E-mail: lescodan@crh1.org [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Selz, Jessica [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Stevens, Denise [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bollet, Marc A.; Lande, Brigitte de la; Daveau, Caroline [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Lerebours, Florence [Department of Medical Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Labib, Alain [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bruant, Sarah [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France)

2012-01-01

65

The effects of relaxation on reducing depression, anxiety and stress in women who underwent mastectomy for breast cancer  

PubMed Central

Background: Breast cancer is one of the most frequent malignancies among Iranian women. These patients suffer from a wide range of physical and mental (depression, anxiety and stress) signs and symptoms during the diagnostic and therapeutic processes. Despite the improvement in survival rates due to advances in medical care, different types of psychosocial interventions are still growingly needed considering the increasing number of cancer patients with longer survival times. The objective of this study was to determine the effect of relaxation on depression, anxiety and stress in women who underwent mastectomy for breast cancer. Materials and Methods: This clinical trial was conducted during about 4.5 months in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 48 breast cancer patients who were selected by simple random sampling. They were randomly assigned into two groups of control and case. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medical-relaxation therapy. Data collection tools were the validated Depression, Anxiety and Stress Scale (DASS42) and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, repeated measures analysis of variance (ANOVA), chi-square test and paired t-test.. Findings: The baseline mean scores of depression, anxiety and stress were not significantly different between the case and control groups. However, the scores in the case group improved significantly after the treatment (p < 0.05). On the contrary, such improvement was not seen in the control group. Conclusions: Relaxation therapy can be effective in the improvement of depression, anxiety and stress. Therefore, it can be recommended as an effective care program in patients with malignant disorders.

Kashani, Fahimeh; Babaee, Sima; Bahrami, Masoud; Valiani, Mahboobeh

2012-01-01

66

Feasibility study on radiofrequency ablation followed by partial mastectomy for stage I breast cancer patients.  

PubMed

To evaluate the safety and reliability of thermal ablation therapy instead of breast-conserving surgery (BCS), we performed radiofrequency ablation (RFA) for clinical stage I breast cancer patients. Subjects were T1N0 breast cancer patients with no extensive intraductal components. Under general anesthesia, sentinel node biopsy was performed, followed by RFA and BCS. Resected specimens were examined at 5-mm intervals by hematoxylin-eosin (H&E) staining and nicotinamide adenine dinucleotide (NADH) diaphorase staining. Thirty of the 34 eligible patients were enrolled. RFA-related adverse events were observed in nine patients: two with skin burn and seven with muscle burn. Twenty-six patients (87%) showed pathological degenerative changes in tumor specimens with H&E staining. In 24 of the 26 cases (92%) examined by NADH diaphorase staining, tumor cell viability was diagnosed as negative. RFA proved to be reliable and feasible in clinical stage I breast cancer, with no extensive intraductal components. Randomized clinical trials are needed to compare RFA with BCS. PMID:19324550

Imoto, Shigeru; Wada, Noriaki; Sakemura, Noriko; Hasebe, Takahiro; Murata, Yukinori

2009-03-26

67

The burden of breast cancer in Italy: mastectomies and quadrantectomies performed between 2001 and 2008 based on nationwide hospital discharge records  

PubMed Central

Background Where population coverage is limited, the exclusive use of Cancer Registries might limit ascertainment of incident cancer cases. We explored the potentials of Nationwide hospital discharge records (NHDRs) to capture incident breast cancer cases in Italy. Methods We analyzed NHDRs for mastectomies and quadrantectomies performed between 2001 and 2008. The average annual percentage change (AAPC) and related 95% Confidence Interval (CI) in the actual number of mastectomies and quadrantectomies performed during the study period were computed for the full sample and for subgroups defined by age, surgical procedure, macro-area and singular Region. Re-admissions of the same patients were separately presented. Results The overall number of mastectomies decreased, with an AAPC of ?2.1% (?2.3 -1.8). This result was largely driven by the values observed for women in the 45 to 64 and 65 to 74 age subgroups (?3.0%, -3.4 -3.6 and ?3.3%, -3.8 -2.8, respectively). We observed no significant reduction in mastectomies for women in the remaining age groups. Quadrantectomies showed an overall +4.7 AAPC (95%CI:4.5–4.9), with no substantial differences by age. Analyses by geographical area showed a remarkable decrease in mastectomies, with inter-regional discrepancies possibly depending upon variability in mammography screening coverage and adherence. Quadrantectomies significantly increased, with Southern Regions presenting the highest average rates. Data on repeat admissions within a year revealed a total number of 46,610 major breast surgeries between 2001 and 2008, with an overall +3.2% AAPC (95%CI:2.8-3.6). Conclusions In Italy, NHDRs might represent a valuable supplemental data source to integrate Cancer Registries in cancer surveillance.

2012-01-01

68

Development of active myofascial trigger points in neck and shoulder musculature is similar after lumpectomy or mastectomy surgery for breast cancer.  

PubMed

Our aim was to describe the differences in the presence of myofascial trigger points (TrPs) in neck and shoulder muscles after 2 surgery approaches for breast cancer: mastectomy or lumpectomy. Thirty-two women (mean age: 50 ± 7 years) who received lumpectomy, 16 women (mean age: 48 ± 10 years) who had received mastectomy after breast cancer, and 16 women (mean age: 49 ± 9 years) with breast cancer who had not received either surgical treatment, participated. Myofascial TrPs in the upper trapezius, sternocleidomastoid, levator scapulae, scalene, infraspinatus and pectoralis major muscles were bilaterally explored by an assessor blinded to the women's condition. TrPs were considered active when palpation reproduced local and referred pain symptoms recognized by the patient as familiar pain symptoms. The number of active TrPs within mastectomy (mean ± SD: 4.6 ± 1) and lumpectomy (mean ± SD: 4.5 ± 1) groups was significantly higher (P < 0.001) as compared to the control group (mean ± SD: 1.1 ± 1.3), but not significantly different between them (P = 0.641). Women who received either lumpectomy or mastectomy showed similar distribution of active TrPs and a higher prevalence of active TrPs as compared to the control group. Active TrPs in the pectoralis major muscle were the most prevalent in both surgery groups The number of active TrPs was weakly correlated with neck (r(s) = 0.385; P = 0.029) and shoulder/axillary (r(s) = 0.397; P = 0.024) pain intensity within the lumpectomy, but not the mastectomy group. This study found active TrPs in neck and shoulder musculature in women who had received lumpectomy or mastectomy. The induced local and referred pain pattern from active TrPs reproduced neck and shoulder/axillary symptoms and pain patterns in women after breast cancer surgery. Few active TrPs were found in a control group of women with breast cancer who had not received any surgical treatment. PMID:22464115

Fernández-Lao, Carolina; Cantarero-Villanueva, Irene; Fernández-de-Las-Peñas, César; Del-Moral-Ávila, Rosario; Menjón-Beltrán, Salomón; Arroyo-Morales, Manuel

2011-02-26

69

Long-term results of post-operative radiation therapy following mastectomy with or without chemotherapy in Stage I--III breast cancer  

SciTech Connect

The purpose of this work was to determine the risk of local-regional failure following post-mastectomy radiotherapy and the incidence of complications associated with such treatment. The authors retrospectively analyzed the results in 309 patients with Stage I--III invasive breast cancer treated with post-mastectomy radiation therapy between 1975 and 1985. The median radiotherapy dose was 45 Gy in 1.8 to 2.25 Gy fractions. One hundred forty-seven (48%) of the patients received adjuvant systemic chemotherapy with 115 (78%) of these receiving a CMF-based or doxorubicin-containing regime. The median follow-up time of surviving patients was 130 months (range, 28 to 191 months) after mastectomy. Seventeen patients (6%) developed a local-regional failure at an interval of 4 to 87 months after radiotherapy. Moderate or severe complications related to radiotherapy and requiring treatment were uncommon. Symptomatic radiation pneumonitis occurred in four patients (1.3%), arm edema in 18 (5.8%), and brachial plexopathy in 2 (0.6%). The authors conclude that post-operative radiotherapy is a safe and effective means of reducing local-regional failure following mastectomy. The efficacy of post-mastectomy radiotherapy in improving survival should be addressed in new large randomized controlled studies. 33 refs., 1 fig., 3 tabs.

Uematsu, Minoru; Bornstein, B.A.; Recht, A.; Abner, A.; Silver, B. (Harvard Medical School, Boston, MA (United States)); Come, S.E. (Beth Israel Hospital, Boston, MA (United States) Harvard Medical School, Boston, MA (United States)); Shulman, L.N. (Brigham and Women's Hospital, Boston, MA (United States) Harvard Medical School, Boston, MA (United States)); Harris, J.R.

1993-04-02

70

Do breast implants after a mastectomy affect subsequent prognosis and survival?  

Microsoft Academic Search

In a large study, published in this issue of Breast Cancer Research, Le and colleagues report that women receiving implants after mastectomies for early-stage breast cancer experience lower breast cancer mortality than women not receiving implants. Assessment of survival patterns among women receiving reconstructive implants is complex given unique patient characteristics, disease attributes, and treatment patterns. The interpretation of reduced

Louise A Brinton

2005-01-01

71

Association Between Treatment With Brachytherapy vs Whole-Breast Irradiation and Subsequent Mastectomy, Complications, and Survival Among Older Women With Invasive Breast Cancer  

PubMed Central

Context Brachytherapy is a radiation treatment that uses an implanted radioactive source. In recent years, use of breast brachytherapy after lumpectomy for early breast cancer has increased substantially despite a lack of randomized trial data comparing its effectiveness with standard whole-breast irradiation (WBI). Because results of long-term randomized trials will not be reported for years, detailed analysis of clinical outcomes in a nonrandomized setting is warranted. Objective To compare the likelihood of breast preservation, complications, and survival for brachytherapy vs WBI among a nationwide cohort of older women with breast cancer with fee-for-service Medicare. Design Retrospective population-based cohort study of 92 735 women aged 67 years or older with incident invasive breast cancer, diagnosed between 2003 and 2007 and followed up through 2008. After lumpectomy 6952 patients were treated with brachytherapy vs 85 783 with WBI. Main Outcome Measures Cumulative incidence and adjusted risk of subsequent mastectomy (an indicator of failure to preserve the breast) and death were compared using the log-rank test and proportional hazards models. Odds of postoperative infectious and noninfectious complications within 1 year were compared using the ?2 test and logistic models. Cumulative incidences of long-term complications were compared using the log-rank test. Results Five-year incidence of subsequent mastectomy was higher in women treated with brachytherapy (3.95%; 95% CI, 3.19%–4.88%) vs WBI (2.18%; 95% CI, 2.04%–2.33%; P<.001) and persisted after multivariate adjustment (hazard ratio [HR], 2.19; 95% CI, 1.84–2.61, P<.001). Brachytherapy was associated with more frequentinfectious (16.20%; 95% CI, 15.34%–17.08% vs 10.33%; 95% CI, 10.13%–10.53%; P<.001; adjusted odds ratio [OR], 1.76; 1.64–1.88) and noninfectious (16.25%; 95% CI, 15.39%–17.14% vs 9.00%; 95% CI, 8.81%–9.19%; P<.001; adjusted OR, 2.03; 95% CI, 1.89–2.17) postoperative complications; and higher 5-year incidence of breast pain (14.55%, 95% CI, 13.39%–15.80% vs 11.92%; 95% CI, 11.63%–12.21%), fat necrosis (8.26%; 95% CI, 7.27–9.38 vs 4.05%; 95% CI, 3.87%–4.24%), and rib fracture (4.53%; 95% CI, 3.63%–5.64% vs 3.62%; 95% CI, 3.44%–3.82%; P?.01 for all). Five-year overall survival was 87.66% (95% CI, 85.94%–89.18%) in patients treated with brachytherapy vs 87.04% (95% CI, 86.69%–87.39%) in patients treated with WBI (adjusted HR, 0.94; 95% CI, 0.84–1.05; P=.26). Conclusion In a cohort of older women with breast cancer, treatment with brachytherapy compared with WBI was associated with worse long-term breast preservation and increased complications but no difference in survival.

Smith, Grace L.; Xu, Ying; Buchholz, Thomas A.; Giordano, Sharon H.; Jiang, Jing; Shih, Ya-Chen Tina; Smith, Benjamin D.

2012-01-01

72

Locoregional Failure in Early-Stage Breast Cancer Patients Treated With Radical Mastectomy and Adjuvant Systemic Therapy: Which Patients Benefit From Postmastectomy Irradiation?  

SciTech Connect

Purpose: To assess the locoregional failure in patients with Stage I-II breast cancer treated with radical mastectomy and to evaluate whether a subset of these patients might be at sufficiently high risk of locoregional recurrence (LRR) to benefit from postmastectomy irradiation (PMRT). Methods and Materials: Stage I-II breast cancer patients (n = 150) treated with radical mastectomy without adjuvant irradiation between 1999 and 2005 were analyzed. The pattern of LRR was reported. Kaplan-Meier analysis was used to calculate rates of LRR, and Cox proportional hazards methods were used to evaluate potential risk factors. Results: Median follow-up was 75 months. Mean patient age was 56 years. One-hundred forty-three (95%) patients received adjuvant systemic therapy: 85 (57%) hormonal therapy alone, 14 (9%) chemotherapy alone, and 44 (29%) both chemotherapy and hormonal therapy. Statistically significant factors associated with increased risk of LRR were premenopausal status (p = 0.004), estrogen receptor negative cancer (p = 0.02), pathologic grade 3 (p = 0.02), and lymphovascular invasion (p = 0.001). T and N stage were not associated with increased risk of regional recurrence. The 5-year LRR rate for patients with zero or one, two, three, and four risk factors was 1%, 10.3%, 24.2%, and 75%, respectively. Conclusions: A subset of patients with early-stage breast cancer is at high risk of LRR, and therefore PMRT might be beneficial.

Trovo, Marco, E-mail: marcotrovo33@hotmail.com [Department of Radiation Oncology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Durofil, Elena [Department of Radiation Oncology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Polesel, Jerry [Department of Epidemiology and Biostatistics, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Roncadin, Mario [Department of Radiation Oncology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Perin, Tiziana [Department of Pathology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Mileto, Mario; Piccoli, Erica [Department of Surgery, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Quitadamo, Daniela [Scientific Direction, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Massarut, Samuele [Department of Surgery, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Carbone, Antonino [Department of Pathology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy); Trovo, Mauro G. [Department of Radiation Oncology, Centro di Riferimento Oncologico of Aviano, Aviano (Italy)

2012-06-01

73

Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy  

Microsoft Academic Search

This study sought to compare the mood and quality of life (QOL) of breast cancer survivors with those observed in low-risk\\u000a breast cancer screening patients. A group of long-term stage I–III breast cancer survivors (n=60) was compared with low-risk breast cancer screening patients (n=93) on measures of depression, anxiety, and QOL. Patients without a previous psychiatric history were studied. Although

M. A. Weitzner; C. A. Meyers; Karla K. Stuebing; Angele K. Saleeba

1997-01-01

74

MD Anderson study finds side effects, complications, and mastectomy are more likely after partial breast irradiation:  

Cancer.gov

Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation (WBI), according to researchers from The University of Texas MD Anderson Cancer Center.

75

Immediate Breast Reconstruction After Mastectomy Increases Wound Complications However, Initiation of Adjuvant Chemotherapy Is Not Delayed  

Microsoft Academic Search

Background: Immediate breast reconstruction is be- ing increasingly used after mastectomy, although it may increase the incidence of wound complications. The in- dications for chemotherapy in breast cancer are expand- ingandwoundcomplicationsfollowingmastectomymay delay the initiation of adjuvant chemotherapy. Hypothesis:Immediatebreastreconstructionaftermas- tectomy for breast cancer does not lead to an increased incidence of wound complications nor delay the initia- tion of systemic chemotherapy.

Melinda M. Mortenson; Philip D. Schneider; Vijay P. Khatri; Thomas R. Stevenson; Thomas P. Whetzel; Eiler J. Sommerhaug; James E. Goodnight; Richard J. Bold

76

Magnetic Resonance Imaging Facilitates Breast Conservation for Occult Breast Cancer  

Microsoft Academic Search

Introduction: Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor is identified in only two-thirds of mastectomy specimens. Breast magnetic resonance imaging (MRI) can identify occult breast

John A. Olson; Elizabeth A. Morris; Kimberly J. Van Zee; David C. Linehan; Patrick I. Borgen

2000-01-01

77

PATTERNS AND RISK FACTORS OF LOCOREGIONAL RECURRENCE IN T1-T2 NODE NEGATIVE BREAST CANCER PATIENTS TREATED WITH MASTECTOMY: IMPLICATIONS FOR POSTMASTECTOMY RADIOTHERAPY  

PubMed Central

Purpose Postmastectomy radiation therapy (PMRT) can reduce locoregional recurrences (LRR) in high-risk patients, but its role in the treatment of lymph node negative (LN?) breast cancer remains unclear. The aim of this study was to identify a subgroup of T1-T2 breast cancer patients with LN? who might benefit from PMRT. Methods and Materials We retrospectively reviewed 1,136 node-negative T1-T2 breast cancer cases treated with mastectomy without PMRT at the Massachusetts General Hospital between 1980 and 2004. We estimated cumulative incidence rates for LRR overall and in specific subgroups, and used Cox proportional hazards models to identify potential risk factors. Results Median follow-up was 9 years. The 10-year cumulative incidence of LRR was 5.2% (95% CI: 3.9–6.7%). Chest wall was the most common (73%) site of LRR. Tumor size, margin, patient age, systemic therapy, and lymphovascular invasion (LVI) were significantly associated with LRR on multivariate analysis. These five variables were subsequently used as risk factors for stratified analysis. The 10-year cumulative incidence of LRR for patients with no risk factors was 2.0% (95% CI: 0.5–5.2%), whereas the incidence for patients with three or more risk factors was 19.7% (95% CI: 12.2–28.6%). Conclusion It has been suggested that patients with T1-T2N0 breast cancer who undergo mastectomy represent a favorable group for which PMRT renders little benefit. However, this study suggests that select patients with multiple risk factors including LVI, tumor size ?2 cm, close or positive margin, age ?50, and no systemic therapy are at higher risk of LRR and may benefit from PMRT.

Abi-Raad, Rita; Boutrus, Rimoun; Wang, Rui; Niemierko, Andrzej; Macdonald, Shannon; Smith, Barbara; Taghian, Alphonse G.

2013-01-01

78

Patterns and Risk Factors of Locoregional Recurrence in T1-T2 Node Negative Breast Cancer Patients Treated With Mastectomy: Implications for Postmastectomy Radiotherapy  

SciTech Connect

Purpose: Postmastectomy radiation therapy (PMRT) can reduce locoregional recurrences (LRR) in high-risk patients, but its role in the treatment of lymph node negative (LN-) breast cancer remains unclear. The aim of this study was to identify a subgroup of T1-T2 breast cancer patients with LN- who might benefit from PMRT. Methods and Materials: We retrospectively reviewed 1,136 node-negative T1-T2 breast cancer cases treated with mastectomy without PMRT at the Massachusetts General Hospital between 1980 and 2004. We estimated cumulative incidence rates for LRR overall and in specific subgroups, and used Cox proportional hazards models to identify potential risk factors. Results: Median follow-up was 9 years. The 10-year cumulative incidence of LRR was 5.2% (95% CI: 3.9-6.7%). Chest wall was the most common (73%) site of LRR. Tumor size, margin, patient age, systemic therapy, and lymphovascular invasion (LVI) were significantly associated with LRR on multivariate analysis. These five variables were subsequently used as risk factors for stratified analysis. The 10-year cumulative incidence of LRR for patients with no risk factors was 2.0% (95% CI: 0.5-5.2%), whereas the incidence for patients with three or more risk factors was 19.7% (95% CI: 12.2-28.6%). Conclusion: It has been suggested that patients with T1-T2N0 breast cancer who undergo mastectomy represent a favorable group for which PMRT renders little benefit. However, this study suggests that select patients with multiple risk factors including LVI, tumor size {>=}2 cm, close or positive margin, age {<=}50, and no systemic therapy are at higher risk of LRR and may benefit from PMRT.

Abi-Raad, Rita; Boutrus, Rimoun [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Wang Rui [Division of Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Division of Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Macdonald, Shannon [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Smith, Barbara [Department of Surgery, Division of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)

2011-11-01

79

Post-Mastectomy and Phantom Breast Pain: Risk Factors, Natural History, and Impact on Quality of Life.  

National Technical Information Service (NTIS)

Post-mastectomy pain syndrome, post-lumpectomy pain, and phantom breast pain are poorly understood chronic pain syndromes that occur following surgical procedures for breast cancer. The primary aims of this research were to identify risk factors for these...

R. M. Dworkin

2003-01-01

80

Post-Mastectomy and Phantom Breast Pain: Risk Factors, Natural History, and Impact on Quality of Life.  

National Technical Information Service (NTIS)

Post-mastectomy pain syndrome (PMPS), phantom breast pain, and post- lumpectomy pain are poorly understood chronic pain syndromes that occur following surgical procedures for breast cancer. These pain syndromes are not well studied, but there is appreciab...

R. Dworkin

2001-01-01

81

[Personal and psychosocial problems in mastectomy for breast cancer and the possibility of adjustment].  

PubMed

Parts of the results of single interviews of 34 patients with carcinoma of the breast are reported. A team of physician, psychologist, and the patients themselves worked out the interviews. These were then coded and analyzed. 10 patients said that they had found it especially difficult to overcome the problems caused by their illness due to the loss of their jobs because of bureaucratic reasons. 5 patients got into financial troubles. The patients tried to get back to their previous jobs, hobbies, social contacts and holiday habits as soon as possible. In all cases the illness caused a more anxious observation of bodily sensations. 19 patients felt the loss of the breast as a heavy diminution of their female identity. These reactions were strongly influenced by the reactions of their male partners and the loss of their jobs. The loss of the breast and the awareness of the disease partly negatively, partly positively changed the emotional state and family life and in many cases caused a change of sexual behaviour. Overprotection and questions regarding the patients' health were generally felt to be stressful. 17 patients tried to avoid obtaining complete information on the disease. They were afraid of contradictory views presented by the mass media or by fellow patients they met in waiting rooms, in convalescent sanatoriums, or in self-help groups. Although, still aware of their disease, 23 patient regained a fully satisfying life-style, 3 were ambivalent. The most important factors in overcoming the problems were family, friends, and the patients' own ability to adapt. The psychosocial care was entirely insufficient, although the patients showed a great readiness to cooperate. PMID:6752793

Heesen, H; Kolecki, S

1982-08-01

82

Mastectomy With Immediate Expander-Implant Reconstruction, Adjuvant Chemotherapy, and Radiation for Stage II-III Breast Cancer: Treatment Intervals and Clinical Outcomes  

SciTech Connect

Purpose: To determine intervals between surgery and adjuvant chemotherapy and radiation in patients treated with mastectomy with immediate expander-implant reconstruction, and to evaluate locoregional and distant control and overall survival in these patients. Methods and Materials: Between May 1996 and March 2004, 104 patients with Stage II-III breast cancer were routinely treated at our institution under the following algorithm: (1) definitive mastectomy with axillary lymph node dissection and immediate tissue expander placement, (2) tissue expansion during chemotherapy, (3) exchange of tissue expander for permanent implant, (4) radiation. Patient, disease, and treatment characteristics and clinical outcomes were retrospectively evaluated. Results: Median age was 45 years. Twenty-six percent of patients were Stage II and 74% Stage III. All received adjuvant chemotherapy. Estrogen receptor staining was positive in 77%, and 78% received hormone therapy. Radiation was delivered to the chest wall with daily 0.5-cm bolus and to the supraclavicular fossa. Median dose was 5040 cGy. Median interval from surgery to chemotherapy was 5 weeks, from completion of chemotherapy to exchange 4 weeks, and from exchange to radiation 4 weeks. Median interval from completion of chemotherapy to start of radiation was 8 weeks. Median follow-up was 64 months from date of mastectomy. The 5-year rate for locoregional disease control was 100%, for distant metastasis-free survival 90%, and for overall survival 96%. Conclusions: Mastectomy with immediate expander-implant reconstruction, adjuvant chemotherapy, and radiation results in a median interval of 8 weeks from completion of chemotherapy to initiation of radiation and seems to be associated with acceptable 5-year locoregional control, distant metastasis-free survival, and overall survival.

Wright, Jean L. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Cordeiro, Peter G. [Department of Surgery, Plastic and Reconstructive Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Ben-Porat, Leah [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Van Zee, Kimberly J. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hudis, Clifford [Department of Medicine, Solid Tumor Division, Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Beal, Kathryn [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)], E-mail: mccormib@mskcc.org

2008-01-01

83

Triple-Negative or HER2-Positive Status Predicts Higher Rates of Locoregional Recurrence in Node-Positive Breast Cancer Patients After Mastectomy  

SciTech Connect

Purpose: To evaluate the prognostic value of determining estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression in node-positive breast cancer patients treated with mastectomy. Methods and Materials: The records of 835 node-positive breast cancer patients who had undergone mastectomy between January 2000 and December 2004 were analyzed retrospectively. Of these, 764 patients (91.5%) received chemotherapy; 68 of 398 patients (20.9%) with T1-2N1 disease and 352 of 437 patients (80.5%) with T3-4 or N2-3 disease received postoperative radiotherapy. Patients were classified into four subgroups according to hormone receptor (Rec+ or Rec-) and HER2 expression profiles: Rec-/HER2- (triple negative; n = 141), Rec-/HER2+ (n = 99), Rec+/HER2+ (n = 157), and Rec+/HER2- (n = 438). The endpoints were the duration of locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, and overall survival. Results: Patients with triple-negative, Rec-/HER2+, and Rec+/HER2+ expression profiles had a significantly lower 5-year locoregional recurrence-free survival than those with Rec+/HER2- profiles (86.5% vs. 93.6%, p = 0.002). Compared with those with Rec+/HER2+ and Rec+/HER2- profiles, patients with Rec-/HER2- and Rec-/HER2+ profiles had significantly lower 5-year distant metastasis-free survival (69.1% vs. 78.5%, p = 0.000), lower disease-free survival (66.6% vs. 75.6%, p = 0.000), and lower overall survival (71.4% vs. 84.2%, p = 0.000). Triple-negative or Rec-/HER2+ breast cancers had an increased likelihood of relapse and death within the first 3 years after treatment. Conclusions: Triple-negative and HER2-positive profiles are useful markers of prognosis for locoregional recurrence and survival in node-positive breast cancer patients treated with mastectomy.

Wang Shulian [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Li Yexiong, E-mail: yexiong@yahoo.com [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Song Yongwen; Wang Weihu; Jin Jing; Liu Yueping; Liu Xinfan; Yu Zihao [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China)

2011-07-15

84

Immediate Breast Reconstruction with Implants After Skin-Sparing Mastectomy: A Report of 96 Cases  

Microsoft Academic Search

Background  Skin-sparing mastectomy (SSM) with immediate breast reconstruction (IBR) has become increasingly popular as an effective treatment\\u000a for patients with early-stage breast cancer requiring mastectomy. This study aimed to evaluate the clinical outcomes of IBR\\u000a using permanent gel breast implants and Becker expandable breast implants after SSM.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A review of 96 patients undergoing IBR with Beck expandable or permanent gel breast

Fa-Cheng LiHong-Chuan; Hong-Chuan Jiang; Jie Li

2010-01-01

85

Phantom Breast and Other Syndromes After Mastectomy: Eight Breast Cancer Patients Describe Their Experiences Over Time: A 2Year Follow-up Study  

Microsoft Academic Search

Patients often experience hard-to-treat neuropathic pain and other sensations after surgery; consequently, they could develop chronic pain conditions. The phantom limb phenomenon is a well-documented postoperative pain condition. However, phantom phenomena after mastectomies are less documented. The reviews report several views on the prevalence of breast phantoms and coexisting distress. Researchers observed that new methodological approaches might facilitate further research

Berit Björkman; Staffan Arnér; Lars-Christer Hydén

2008-01-01

86

Using the lymph nodal ratio to predict the risk of locoregional recurrence in lymph node-positive breast cancer patients treated with mastectomy without radiation therapy  

PubMed Central

Background To evaluate the prognostic value of axillary lymph node ratio (LNR) as compared to the number of involved nodes (pN stage) in patients with axillary lymph node-positive breast cancer treated with mastectomy without radiation. Methods We performed a retrospective analysis of the clinical data of patients with stage II-III node-positive breast cancer (N=1068) between 1998 and 2007. Locoregional recurrence-free survival (LRFS) and overall survival (OS) were compared based on the LNR and pN staging. Results A total of 780 cases were classified as pN1, 183 as pN2, and 105 as pN3. With respect to LNR, 690 cases had a LNR from 0.01-0.20, 269 cases a LNR from 0.21-0.65, and 109 cases a LNR > 0.65. The median follow-up time was 62 months. Univariate analysis showed that both LNR and pN stage were prognostic factors of LRFS and OS (p<0.05). Multivariate analysis indicated that LNR was an independent prognostic factor of LRFS and OS (p<0.05). pN stage had no significant effect on LRFS or OS (p>0.05). In subgroup analysis, the LNR identified groups of patients with different survival rates based on pN stage. Conclusions LNR is superior to pN staging as a prognostic factor in lymph node-positive breast cancer after mastectomy, and should be used as one of the indications for adjuvant radiation therapy.

2013-01-01

87

Breast reconstruction following mastectomy: I. Social characteristics of patients seeking the procedure.  

PubMed

Information is presented from a clinical study of 65 women and a psychometric study of 85 women having breast reconstruction following mastectomy for breast cancer. The average woman was in her midforties. Less than a third of the women described themselves as fulltime housewives; most were employed outside the home. Almost all had completed high school and most had received additional education. Most of the women were married when they sought breast reconstruction. The time at which women had had their mastectomies was related to their source of information about breast reconstruction. When more than five years had elapsed between mastectomy and reconstruction, a woman most often had obtained her information from the media. Women with more recent mastectomies, though utilizing the media, obtained their information more frequently from medical sources. PMID:7458172

Clifford, E; Clifford, M; Georgiade, N G

1980-11-01

88

Better cosmetic results and comparable quality of life after skin-sparing mastectomy and immediate autologous breast reconstruction compared to breast conservative treatment  

Microsoft Academic Search

Preoperative chemotherapy (PCT) can be used in large primary breast cancer to facilitate breast conservative surgery (BCS). Cosmetic results of BCS are influenced by the size of the residual tumour, relative to the size of the breast. After mastectomy, immediate breast reconstruction (IBR) with autologous tissue provides excellent cosmetic outcome and has proven to be safe in breast cancer patients.

Veronique F Cocquyt; Phillip N Blondeel; Herman T Depypere; Karlien A Van De Sijpe; Kristof K Daems; Stanislas J Monstrey; Simon J. P Van Belle

2003-01-01

89

Pattern of local-regional recurrence in patient with early breast cancer after mastectomy: an analysis of 357 cases at King Chulalongkorn Memorial Hospital.  

PubMed

A retrospective review was performed on 357 patients with early stage I-IIIA operable breast cancer who were treated with mastectomy and referred to the clinic at the Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between Jan 1991 and Dec 2001. Patients characteristics, treatment modalities and pattern of local and regional failure were evaluated. The median and mean age in the present study were 49 and 50.2 years, respectively. Stage I, II and IIIA were 10.9%, 79.6% and 9.5%, respectively. One hundred and ninety-seven patients (55.2%) received postoperative radiation therapy (RT). Adjuvant chemotherapy was given in 247 patients (69.2%) while 122 patients (34.2%) received adjuvant hormonal therapy. Sixty one patients (17.1%) received both adjuvant chemotherapy and hormonal therapy. However, 12.6% (45/357) did not receive any adjuvant treatment. Median follow up time was 42.6 months (range 6-136 months). Ipsilateral supraclavicular node and chest wall were the most common sites of local-regional recurrence. The chest wall recurrence rate was 10.4% (37/357), which was 16.9% (27/160) in the non postoperative radiation (No RT) group and 5.1% (10/197) in the postoperative radiation (RT) group. For ispilateral supraclavicular node, the recurrence rate was 10.6% (38/357), which was 15.6% (25/160) and 6.6% (13/197) for non RT and RT groups, respectively. The incidence of ipsilateral axilla, ipsilateral internal mammary node and ipsilateral infraclavicular node recurrence rate were 4.2%, 3.6% and 0.8%, respectively. Overall, chest wall and ipsilateral supraclavicular node were the most common sites of local-regional recurrence in early stage operable breast cancer who underwent mastectomy Postoperative adjuvant radiation therapy decreased the risk of local-regional recurrence. PMID:16083182

Lertsanguansinchai, Prasert; Lertbutsayanukul, Chawalit; Chatamra, Kris; Shotelersuk, Kanjana; Voravud, Narin; Khorprasert, Chonlakiet

2004-09-01

90

Long-Term Outcomes in Patients With Isolated Supraclavicular Nodal Recurrence After Mastectomy and Doxorubicin-Based Chemotherapy for Breast Cancer  

SciTech Connect

Purpose: To examine the outcome of patients who developed an isolated locoregional recurrence (LRR) involving the supraclavicular fossa (SCV) after initial treatment with modified radical mastectomy and chemotherapy. Methods and Materials: Records from 140 breast cancer patients treated on five prospective trials with mastectomy and doxorubicin-based chemotherapy, with or without radiation, who developed a LRR were reviewed. Kaplan-Meier survival times were calculated using date of LRR as time zero. Results: The median follow-up after LRR was 2.9 years (N = 140; interquartile range, 1.3-6.6 years). In all, 47 of 140 patients (34%) had an SCV component to their LRR. These patients had lower 3-y distant metastasis-free survival (40% vs. 54%, p = 0.003) and overall survival (49% vs. 69%, p = 0.04) than patients without an SCV component. Multivariate analysis revealed that LRR involving an SCV component (hazard ratio, 1.96, p = 0.004) and patients with lymphovascular space invasion in their primary tumors (hazard ratio, 1.65, p = 0.029) were independently associated with a poor distant metastasis-free survival. However, among 23 patients with isolated SCV recurrence, Overall survival was not statistically significantly different between isolated chest wall recurrence and isolated SCV recurrence. Patients with isolated SCV recurrence displayed a median follow-up of 3.3 years (IR, 1.2-5.2). Only 6 LRR of 23 patients were treated with aggressive local therapy, including surgery, chemotherapy, and radiation (alone or in combination). Conclusions: Although breast cancer recurrence with SCV involvement carries a high risk of distant metastasis and death, among women with recurrence limited to the SCV alone, overall survival after isolated SCV recurrence can be long (25% >5 years).

Reddy, Jay P. [Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX (United States); Levy, Larry; Oh, Julia L.; Strom, Eric A.; Perkins, George H.; Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Woodward, Wendy A., E-mail: wwoodward@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

2011-08-01

91

Breast conservation in patients with multiple ipsilateral synchronous cancers  

Microsoft Academic Search

BackgroundBecause breast cancer survival after breast conservation has proved comparable to mastectomy, contraindications to mastectomy are increasingly being challenged. We treated the majority of our patients with multiple synchronous ipsilateral cancers with breast conservation and we compared them with patients who underwent mastectomy for comparable disease during the same interval.

Jess Kaplan; Gladys Giron; Paul Ian Tartter; Ira J Bleiweiss; Alison Estabrook; Sharon Rosenbaum Smith

2003-01-01

92

[Experiences of breast reconstruction following mastectomy in cases of cancer and evaluation of psychological aspects of the patients].  

PubMed

The breasts are one of the symbols of femininity. Even if it is for the treatment of cancer, the loss or deformity of the breast brings a considerable psychological burden in addition to the physical pain. Authors have performed breast reconstruction on 150 cases during the past fifteen years and have obtained largely favorable results, which were already reported in several papers. Authors administered questionnaires to these patients in order to ascertain their candid opinions which are often not expressed in a hospital. The results of the survey are presented in this report. The survey was conducted anonymously and the questions were all multiple-choices. Approximately 82% of the patient responded. About the pain, inconvenience and motives for undergoing reconstruction, there was a wide variety of answers and many of those surprised authors. For instance; hesitant to go to a hot spring, or on a trip with friends (76%), hesitant to go to a clinic or a hospital for physical check-ups and common illness (74%), troublesome to wear special underwear (69%), inconvenient because ordinary clothes cannot be worn (56%), distressed when viewing own body (52%), unable to dress in thin clothes in hot summer season (50%), imbalance of the breasts (49%), inconvenient to participate in sports (47%). The most patients experienced inconveniences in daily life and had mental and emotional problems. Overall, an impression of the results of breast reconstruction was 83% satisfactory or near satisfaction. About the condition after reconstruction: Patients also expressed a wide variety of opinions about the improvements. For instance, they are relieved from the troubles of wearing special clothing and enjoy selecting and shopping for clothes. They are able to walk on the street with dignity. They enjoy hot spring baths, sports, and leisure activities. They can go for physical check-ups without hesitation. They have a sense of liberation, and become free from constant anxiety. They developed again a forward-looking and positive attitude. Some patients say that they forgot that they had breast reconstruction and that they had breast cancer. As for marriage after reconstruction, which seems to be author's ultimate goal, 12 of the 52 single women have married, and another 22 are currently planning to marry. To the question, "If you are consulted by someone who is in a similar situation". 99% said they would recommend the reconstruction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2344193

Bando, M

1990-04-01

93

Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy  

PubMed Central

Summary Background Currently about 70% of women who suffer from breast cancer undergo breast-conserving therapy (BCT) without removing the entire breast. Thus, this surgical approach is the standard therapy for primary breast cancer. If corrections are necessary, the breast surgeon is faced with irritated skin and higher risks of complications in wound healing. After radiation, an implant-based reconstruction is only recommended in selected cases. Correction of a poor BCT outcome is often only solved with an additional extended operation using autologous reconstruction. Material/Methods In our plastic surgery unit, which focuses on breast reconstruction, we offer a skin-sparing or subcutaneous mastectomy, followed by primary breast reconstruction based on free autologous tissue transfer to correct poor BCT outcomes. Between July 2004 and May 2011 we performed 1068 deep inferior epigastric artery perforator (DIEP) flaps for breast reconstruction, including 64 skin-sparing or subcutaneous mastectomies, followed by primary DIEP breast reconstruction procedures after BCT procedures. Results In all free flap-based breast reconstruction procedures, we had a total flap loss in 0.8% (9 cases). Within the group of patients after BCT, we performed 41 DIEP flaps and 23 ms-2 TRAM flaps after skin-sparing or subcutaneous mastectomies to reconstruct the breast. Among this group we had of a total flap loss in 1.6% (1 case). Conclusions In cases of large tumour sizes and/or difficult tumour locations, the initial oncologic breast surgeon should inform the patients of a possibly poor cosmetic result after BCT and radiation. In our opinion a skin-sparing mastectomy with primary breast reconstruction should be discussed as a valid alternative.

Andree, Christoph; Munder, Beatrix; Seidenstuecker, Katrin; Richrath, Philipp; Behrendt, Philipp; Koppe, Tobias; Hagouan, Mazen; Audretsch, Werner; Nestle-Kramling, Carolin; Witzel, Christian

2012-01-01

94

Skin-Sparing Mastectomy with Immediate Breast and Nipple Reconstruction: A New Technique of Nipple Reconstruction  

PubMed Central

Background. Most women with breast cancer today can be managed with breast conservation; however, some women still require mastectomy for treatment of their disease. Skin-sparing mastectomy (SSM) with immediate reconstruction has emerged as a favorable option for many of these patients. The authors combined the SSM technique with the preservation of a small part of the areola with immediate nipple together with with breast reconstruction. Methods. In an 8-year-period 155 female patients (age: 20–52 years old; mean age: 37.5 years) with extensive ductal intraepithelial neoplasia (DIN) or invasive breast cancer were treated with areola skin sparing mastectomy with immediate nipple and breast reconstruction. Patients were followed up prospectively by the breast surgeon, the plastic surgeon, and the oncologist for complications and recurrence. Results. After treatment, only 2 cases (1.29%) had a local recurrence. 8 out of 155 (5.5%) patients developed early complications (infections, seroma, haematoma), and 5 out of 155 patients (3.22%) developed delayed complications (implant rotation, aestethic deterioration) in the post operative time period. The final aesthetic outcome was judged as positive in 150 out of 155 patients (96.78%). Conclusion. In our experience, immediate nipple reconstruction after skin-sparing mastectomy is a technically feasible procedure which can give excellent cosmetic results.

Serra, Raffaele; Miglietta, Anna Maria; Abonante, Sergio; Giordano, Vincent; Buffone, Gianluca; de Franciscis, Stefano

2013-01-01

95

Breast reconstruction and post-mastectomy radiation practice  

PubMed Central

Purpose The goal of this study was to explore the perspectives and practice of radiation oncologists who treat breast cancer patients who have had breast reconstruction. Methods In 2010, an original electronic survey was sent to all physician members of the American Society of Radiation Oncology, National Cancer Research Institute-Breast Cancer Studies Group in the United Kingdom, Thai Society of Therapeutic Radiology and Oncology, Swiss Society of Radiation Oncology, and Turkish Radiation Oncology Society. We identified factors associated with radiation oncologists who treat breast cancer patients with reconstruction performed prior to radiation and obtained information regarding radiation management of the breast reconstruction. Results 358 radiation oncologists responded, and 60% of the physicians were from the United States. While 64% of participants agree or strongly agree that breast image affects a woman’s quality of life during radiation, 57% feel that reconstruction challenges their ability to deliver effective breast radiation. Compared with other countries, treatment within the United States was associated with a high reconstruction rate (>/= 50% of mastectomy patients) prior to radiation (p?breast reconstruction. United States physicians were more likely than physicians from other countries to boost or bolus the reconstruction irrespective of the type of reconstruction seen in their clinic patients (p?breast cancer patients with reconstruction. Further research on the impact and delivery of radiation to a reconstructed breast may validate some of the observed practices, highlight the variability in treatment practice, and help create a treatment consensus.

2013-01-01

96

Factors influencing a woman’s choice to undergo breast-conserving surgery versus modified radical mastectomy  

Microsoft Academic Search

Background: The use of breast-conserving surgery (BCS) rather than modified radical mastectomy (MRM) for the treatment of breast carcinoma is an option for the majority of women (75%) with early stage breast cancer, but only 20% to 50% choose to undergo this procedure nationwide. The objective of this study was to identify factors influencing a woman’s choice between BCS and

R. Joseph Nold; R. Larry Beamer; Stephen D Helmer; Marilee F McBoyle

2000-01-01

97

A geometric analysis of mastectomy incisions: Optimizing intraoperative breast volume  

PubMed Central

INTRODUCTION: The advent of acellular dermis-based tissue expander breast reconstruction has placed an increased emphasis on optimizing intraoperative volume. Because skin preservation is a critical determinant of intraoperative volume expansion, a mathematical model was developed to capture the influence of incision dimension on subsequent tissue expander volumes. METHODS: A mathematical equation was developed to calculate breast volume via integration of a geometrically modelled breast cross-section. The equation calculates volume changes associated with excised skin during the mastectomy incision by reducing the arc length of the cross-section. The degree of volume loss is subsequently calculated based on excision dimensions ranging from 35 mm to 60 mm. RESULTS: A quadratic relationship between breast volume and the vertical dimension of the mastectomy incision exists, such that incrementally larger incisions lead to a disproportionally greater amount of volume loss. The vertical dimension of the mastectomy incision – more so than the horizontal dimension – is of critical importance to maintain breast volume. Moreover, the predicted volume loss is more profound in smaller breasts and primarily occurs in areas that affect breast projection on ptosis. CONCLUSIONS: The present study is the first to model the relationship between the vertical dimensions of the mastectomy incision and subsequent volume loss. These geometric principles will aid in optimizing intra-operative volume expansion during expander-based breast reconstruction.

Chopp, David; Rawlani, Vinay; Ellis, Marco; Johnson, Sarah A; Buck, Donald W; Khan, Seema; Bethke, Kevin; Hansen, Nora; Kim, John YS

2011-01-01

98

External breast prostheses in post-mastectomy care: women's qualitative accounts.  

PubMed

A good-quality external breast prosthesis and prosthesis-fitting service is an integral part of the recovery process post-mastectomy. However, this is an area of care that has minimal information or research available. The aim of this research was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. To ascertain women's own personal and subjective experiences, five focus groups with 47 women recruited through national cancer advocacy/support organizations and four Follow-up Breast Clinics throughout Ireland were conducted. As a result, five main themes emerged: (1) The fitting experience--Fitting? (2) Post-mastectomy products--Having? (3) Cost--Affording? (4) Information--Knowing? and (5) Adaptation--Accepting? The emerging themes pinpointed the impact of the fitting experience, fitting environment and the qualities of a prosthesis fitter on a woman's experience in obtaining a first or replacement breast prosthesis; the importance of the physical characteristics of the prosthesis and mastectomy bras; cost, affordability and entitlements; a lack of and perceived difficulty in getting information; and the myriad of personal and social impacts of a breast prosthesis for the woman. These findings are integral for the development of standards of practice in the fitting and supply of external breast prostheses in post-mastectomy care. PMID:19708927

Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

2009-08-26

99

One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy  

PubMed Central

Background Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Methods Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. Results During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Conclusions Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

Kim, Hye Ri; Lim, Jin Soo; Kim, Sue Min; Jung, Sung No; Rha, Eun Young

2013-01-01

100

Expression of metalloproteases and their inhibitors in primary tumors and in local recurrences after mastectomy for breast cancer  

Microsoft Academic Search

Aims  To investigate the expression of matrix metalloproteases (MMPs) and their inhibitors (TIMPs) in patients who develop local\\u000a recurrence (LR) after mastectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We analyzed the expressions of MMP-1, -2, -7, -9, -11, -13, -14, TIMP-1, -2, and -3, using immunohistochemical techniques,\\u000a in primary tumors from patients without tumoral recurrence (n = 50), patients who developed distant metastasis (n = 50), and from patients who develop

José M. del Casar; Guillermo Carreño; Luis O. González; Sara Junquera; Salomé González-Reyes; José M. González; Miguel Bongera; Antonio M. Merino; Francisco J. Vizoso

2010-01-01

101

Breast Cancer  

MedlinePLUS

... version of this page please turn Javascript on. Breast Cancer What is Breast Cancer? How Tumors Form The body is made up ... tumors form in the breast tissue. Who Gets Breast Cancer? Breast cancer is one of the most common ...

102

Meta-analysis of sentinel lymph node biopsy at the time of prophylactic mastectomy of the breast  

PubMed Central

Background Prophylactic mastectomy is performed to decrease the risk of breast cancer in women at high risk for the disease. The benefit of sentinel lymph node biopsy (SLNB) at the time of prophylactic mastectomy is controversial, and we performed a meta-analysis of the reported data to assess that benefit. Methods We searched MEDLINE, EMBASE and the Cochrane Library databases from January 1993 to December 2009 for studies on patients who underwent SLNB at the time of prophylactic mastectomy. Two reviewers independently evaluated all the identified papers, and only retrospective studies were included. We used a mixed-effect model to combine data. Results We included 6 studies in this review, comprising a total study population of 1251 patients who underwent 1343 prophylactic mastectomies. Of these 1343 pooled prophylactic mastectomies, the rate of occult invasive cancer (21 cases) was 1.7% (95% confidence interval [CI] 1.1%–2.5%), and the rate of positive SLNs (23 cases) was 1.9% (95% CI 1.2%–2.6%). In all, 36 cases (2.8%, 95% CI 2.0%–3.8%) led to a significant change in surgical management as a result of SLNB at the time of prophylactic mastectomy. In 17 cases, patients with negative SLNs were found to have invasive cancer at the time of prophylactic mastectomy and avoided axillary lymph node dissection (ALND). In 19 cases, patients with positive SLNBs were found not to have invasive cancer at the time of prophylactic mastectomy and needed a subsequent ALND. Of the 23 cases with positive SLNs, about half the patients had locally advanced disease in the contralateral breast. Conclusion Sentinel lymph node biopsy is not suitable for all patients undergoing prophylactic mastectomy, but it may be suitable for patients with contralateral, locally advanced breast cancer.

Zhou, Wen-Bin; Liu, Xiao-An; Dai, Jun-Cheng; Wang, Shui

2011-01-01

103

The activity and safety of electrochemotherapy in persistent chest wall recurrence from breast cancer after mastectomy: a phase-II study.  

PubMed

Electrochemotherapy (ECT) represents an attractive locoregional therapy for unresectable chest wall recurrence (CWR) from breast cancer. Thirty-five patients with cutaneous CWR after mastectomy who experienced progression despite re-irradiation and extensive systemic treatments were administered bleomycin-based ECT. Local response, toxicity, and superficial control were evaluated. Out of 516 metastases (median 15/patient, range 1-50), response was assessed on 196 target lesions (median size 20 mm, range 10-220). Patients received a median of 2 ECT courses (range 1-3). Two-month objective response was as follows: 54.3 % complete (19/35 patients), 37.1 % partial (13/35), and 8.6 % no change (3/35). Twenty-three patients (65.7 %) developed new lesions (NL) after a median time of 6.6 months (range 2.3-29.5), therefore 1, 2, or 3 ECT cycles were required in 14, 15, and 6 patients, respectively. Median follow-up was 32 months (range 6-53) and the 3-year local control rate was 81 %. Related morbidity was mild, increased after retreatments and consisted primarily of pain (reported as "moderate"/"severe" by 6, 13, and 17 % of patients 1 month after the first, second, and third application, respectively) and dermatological toxicity (acute G3 skin ulceration in 14, 20, and 33 % of patients, respectively). Less than 10 metastases (P < 0.001), the narrower area of tumor spread on the chest wall (P = 0.022), complete response achievement (P = 0.019), and post-ECT endocrine instead of chemotherapy (P = 0.025) were associated to NL-free survival. Only fewer skin metastases, hazard ratio (HR) 0.122, 95 % confidence interval (CI) 0.037-0.397, P < 0.001, and contained superficial spread, HR 0.234, 95 % CI 0.067-0.818, P = 0.023, were predictors for longer NL-free survival. ECT showed a satisfactory activity in refractory breast cancer CWR, providing sustained local control. Patients with fewer and less scattered skin metastases are less likely to develop NL. Partial responders and NL can be handled with additional ECT albeit increasing local pain and skin toxicity. PMID:22821399

Campana, Luca G; Valpione, Sara; Falci, Cristina; Mocellin, Simone; Basso, Michela; Corti, Luigi; Balestrieri, Nicola; Marchet, Alberto; Rossi, Carlo R

2012-07-24

104

Defining a place for nipple sparing mastectomy in modern breast care: an evidence based review.  

PubMed

Breast cancer is a diverse disease that requires a fully integrated multidisciplinary approach. Breast surgery has undergone a revolutionary change leading us from the conventional radical mastectomy of the Halstedian era to the current motion of nipple sparing mastectomy (NSM). Despite the lack of randomized controlled trials, the technique of NSM continues to gain popularity as a prophylactic procedure in high risk patients. The current indications for NSM, if any, in the treatment of early invasive breast cancer remains uncertain and requires rigorous scientific scrutiny. This article aims to critically review the indications and limitations of NSM, discuss evidence based intra-operative protocols and to discuss ways in which radiation therapy may be incorporated in treatment planning following NSM. A comprehensive search of the scientific literature was carried out using PubMed to access all publications related to nipple sparing mastectomy. The search focused specifically on technique, current management, safety, and complications of these procedures. Keywords searched included "Nipple sparing mastectomy,"breast conserving surgery,"Nipple areola complex preservation" and "skin sparing mastectomy." NSM offers an opportunity to preserve native breast envelope without mutilation of nipple-areola complex (NAC), and avoids multiple surgical procedures required for reconstruction. NSM may be a reasonable alternative for prophylactic and select breast cancer patients without NAC involvement; however, oncological safety of NSM has not yet been fully demonstrated. Best available evidence suggests that patients should be selected based on study of breast duct anatomy by breast Magnetic Resonance Imaging, mammographic distance between tumor and nipple and obligatory intra-operative frozen section from retro-areolar tissue. Additional factors such as tumor size, axillary lymph node status, lymphovascular invasion and degree of intraductal component are also being used to either include or exclude NSM candidates based on institutional protocols. Heterogeneity of patients selected for NSM is great and the lack of standardization of preoperative investigations, intra-operative technique and pathologic sampling of retro-areola tissues mandates a multi-institutional prospective study to define and validate a role for NSM in invasive breast cancer and DCIS. Nipple necrosis or sloughing is an important problem after NSM which can be greatly reduced using alternative skin incisions. Even if the nipple survives, an insensate nipple and lack of sexual function is common and requires preoperative counseling and discussion. Finally the relation and timing of intra-operative versus adjuvant breast radiation and tailoring of dosage and delivery methods has not been fully explored. Although NSM reduces the psychological trauma associated with nipple loss, the oncologic safety as well as functional and aesthetic outcomes needs additional investigation. PMID:22284266

Murthy, Vijayashree; Chamberlain, Ronald S

2012-01-29

105

Disparities in Reconstruction Rates after Mastectomy for Ductal Carcinoma in Situ (DCIS): Patterns of Care and Factors Associated with the Use of Breast Reconstruction for DCIS Compared with Invasive Cancer  

Microsoft Academic Search

Background  Many factors influence whether breast cancer patients undergo reconstruction after mastectomy. This study was undertaken to\\u000a determine the patterns of care and variables associated with the use of reconstruction for ductal carcinoma in situ (DCIS)\\u000a and to compare previous results for invasive carcinoma.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Postmastectomy reconstruction rates were collected from the California Office of Statewide Health Planning and Development\\u000a (OSHPD) for

Laura Kruper; Xinxin Xu; Katherine Henderson; Leslie Bernstein

106

Breast reconstruction after mastectomy in Hong Kong Chinese  

Microsoft Academic Search

Breast reconstruction in Western countries is considered an essential part of the total management of breast cancer. This concept may differ somewhat in oriental patients because of certain psycho-social considerations and notably different breast morphology. Over a six-month period, 52 patients were diagnosed with breast cancer among 331 patients presenting to the breast surgical clinic at the Prince of Wales

A. Zekri; W. King

1996-01-01

107

Women with Breast Cancer May Overestimate Secondary Risks  

MedlinePLUS

... on this page, please enable JavaScript. Women with breast cancer may overestimate secondary risks (*this news item will ... 2013) Monday, September 16, 2013 Related MedlinePlus Pages Breast Cancer Mastectomy By Genevra Pittman NEW YORK (Reuters Health) - ...

108

Mastectomy and breast reconstruction - what to ask your doctor  

MedlinePLUS

... of surgery I have? Will one type of breast surgery work better for my breast cancer? What are ... will take to get better? Can I have breast reconstruction surgery afterward? What are the risks of the type ...

109

Receipt of Delayed Breast Reconstruction after Mastectomy: Do women revisit the decision?  

PubMed Central

Background Post-mastectomy breast reconstruction is an important component of breast cancer care but few receive it at the time of the mastectomy. Virtually nothing is known about receipt of reconstruction after initial cancer therapy and why treatment might be delayed. Methods A five-year follow-up survey was mailed to a population-based cohort of mastectomy-treated breast cancer patients who were initially surveyed at time of diagnosis in 2002 and reported to the Los Angeles and Detroit SEER registries (N = 645, response rate 60%). Outcomes were receipt of reconstruction (immediate (IR), delayed (DR) or none) and patient appraisal of their treatment decisions. Results About one-third (35.9%) had IR; 11.5% had DR; and 52.6% had no reconstruction. One-third delayed reconstruction because they focused more on other cancer interventions; and nearly half was concerned about surgical complications and interference with cancer surveillance. Two-thirds of those with no reconstruction said that the procedure was not important to them. A large proportion of all patients were satisfied with their reconstruction decision-making (89.4% IR, 78.4% DR, 80.4% no reconstruction, p = NS). However, only 59.3% of those with no reconstruction felt that they were adequately informed about their reconstructive options (vs. 82.7% IR and 78.4% DR, p < 0.01). Conclusions There was modest uptake of breast reconstruction after initial cancer treatment. Factors associated with delayed reconstruction were primarily related to uncertainty about the procedure, concern about cancer surveillance, and low priority. Those without reconstruction demonstrated significant informational needs, which should be addressed with future research efforts.

Alderman, Amy K; Hawley, Sarah T.; Morrow, Monica; Salem, Barbara; Hamilton, Ann; Graff, John J.; Katz, Steven

2011-01-01

110

Intercostal nerves block for mastectomy in two patients with advanced breast malignancy.  

PubMed Central

Regional anesthesia is recognized as an alternative to general anesthesia for modern breast cancer surgery. Various techniques of block have been described. Each has its unique problems. Regional anesthesia was chosen for simple mastectomy in two patients with advanced breast malignancy, due to compromised pulmonary status resulting from widespread malignant infiltration of both lungs. We used intercostal nerves block. The block was supplemented with an infraclavicular infiltration to interrupt the branches of the superficial cervical plexus that provide sensation to the upper chest wall and subcutaneous infiltration in the midline to block the nerve supply from the contralateral side. Anesthesia was generally effective and the operations were uneventful. Both patients and surgeons expressed satisfaction. We conclude that where patients have significant comorbidities that make general anesthesia undesirable, the use of intercostal nerves block remains a safe and reliable anesthetic option that allows the patient access to surgery for simple mastectomy. Images Figure 1 Figure 2 Figure 3

Kolawole, Israel K.; Adesina, Michael D.; Olaoye, Iyiade O.

2006-01-01

111

Breast Cancer  

MedlinePLUS

Breast cancer affects one in eight women during their lives. Breast cancer kills more women in the United States than ... cancer. No one knows why some women get breast cancer, but there are a number of risk factors. ...

112

Breast sensibility after bilateral risk-reducing mastectomy and immediate breast reconstruction: A prospective study.  

PubMed

The demand for risk-reducing mastectomy (RRM) to avoid breast cancer has increased over the last several years, and knowledge of the outcome after this prophylactic surgical procedure is important. The primary aim of this study was to prospectively compare breast sensibility before and after RRM in a consecutive series of women. The study also investigated whether the nipples were less numb if the nipple areola complexes (NACs) were spared compared with regrafted nipple tips. Forty-six women who selected bilateral RRM with immediate reconstruction using implants at the Karolinska University Hospital, Solna, Stockholm, Sweden, were included in the study. The median patient age at the time of surgery was 39 years (range 26-58). All patients were evaluated preoperatively and at least 2 years postoperatively (median 29 months). Tactile, thermal and nociceptive cutaneous sensibilities were studied with quantitative techniques. The patients at the postoperative evaluation completed a questionnaire about subjective feelings in both breasts. The results showed that breast sensibility is significantly impaired after RRM. Additionally, the ability to experience sexual sensations in the breast is often lost. An NAC-sparing surgery did not result in better nipple sensibility. PMID:23953096

Gahm, Jessica; Hansson, Per; Brandberg, Yvonne; Wickman, Marie

2013-08-13

113

Radiation therapy for breast cancer.  

PubMed

Over the past five decades, radiotherapy (RT) has become an integral part in the combined modality management of breast cancer. Although its significant effect on local control has been long demonstrated, only recently has adjuvant RT been shown to have a significant effect on breast cancer mortality and overall survival. This article summarizes the adjuvant role of RT after mastectomy and lumpectomy, as well as the rationale and techniques for partial-breast irradiation. PMID:16730294

Bellon, Jennifer R; Katz, Angela; Taghian, Alphonse

2006-04-01

114

Does Immediate Breast Reconstruction after Mastectomy affect the Initiation of Adjuvant Chemotherapy?  

PubMed Central

Purpose The frequency of immediate breast reconstruction (IBR) is increasing, and the types of reconstruction used are diverse. Adjuvant chemotherapy is a life-saving intervention in selected high-risk breast cancer patients. The aim of our study was to determine how IBR and type of reconstruction affect the timing of the initiation of chemotherapy. Methods We obtained data from female breast cancer patients treated by mastectomy with IBR (IBR group) and without IBR (mastectomy only group) who received adjuvant chemotherapy between January 1, 2008, and December 31, 2010. We retrospectively collected data including patient characteristics, disease characteristics, treatment details, and treatment outcomes from our institutional electronic patient database and medical treatment records. The reconstruction types were categorized as deep inferior epigastric perforator (DIEP) flap, latissimus dorsi (LD) flap and tissue expander/implant (TEI). Results In total, 595 patients were included in this study. Of these patients, 43 underwent mastectomy with IBR (IBR group) and 552 patients did not undergo reconstruction (mastectomy only group). There was significant difference in the timing of the initiation of chemotherapy between the two groups (p<0.0001). There were no cases of delays of more than 12 weeks. In the IBR group, 20 patients received TEI, 9 patients were treated by the insertion DIEP flaps, and 14 patients were treated by LD flaps. There were no significant differences in the timing of chemotherapy according to the type of reconstruction (p=0.095). Conclusion IBR delays the initiation of chemotherapy, but does not lead to omission or significant clinical delay in chemotherapy. Further, the type of reconstruction does not affect the timing of chemotherapy.

Lee, Jeonghui; Lee, Se Kyung; Kim, Sangmin; Koo, Min Young; Choi, Min-Young; Bae, Soo Youn; Cho, Dong Hui; Kim, Jiyoung; Jung, Seung Pil; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Yang, Jung-Hyun; Nam, Seok Jin

2011-01-01

115

Fifteen-year results of a randomized prospective trial of hyperfractionated chest wall irradiation versus once-daily chest wall irradiation after chemotherapy and mastectomy for patients with locally advanced noninflammatory breast cancer  

SciTech Connect

Purpose: To analyze the results of a Phase III clinical trial that investigated whether a hyperfractionated radiotherapy (RT) schedule could reduce the risk of locoregional recurrence in patients with locally advanced breast cancer treated with chemotherapy and mastectomy. Methods and Materials: Between 1985 and 1989, 200 patients with clinical Stage III noninflammatory breast cancer were enrolled in a prospective study investigating neoadjuvant and adjuvant chemotherapy. Of the 179 patients treated with mastectomy after neoadjuvant chemotherapy, 108 participated in a randomized component of the trial that compared a dose-escalated, hyperfractionated (twice-daily, b.i.d.) chest wall RT schedule (72 Gy in 1.2-Gy b.i.d. fractions) with a once-daily (q.d.) schedule (60 Gy in 2-Gy q.d. fractions). In both arms of the study, the supraclavicular fossa and axillary apex were treated once daily to 50 Gy. The median follow-up period was 15 years. Results: The 15-year actuarial locoregional recurrence rate was 7% for the q.d. arm and 12% for the b.i.d. arm (p = 0.36). The rates of severe acute toxicity were similar (4% for q.d. vs. 5% for b.i.d.), but moist desquamation developed in 42% of patients in the b.i.d. arm compared with 28% of the patients in the q.d. arm (p = 0.16). The 15-year actuarial rate of severe late RT complications did not differ between the two arms (6% for q.d. vs. 11% for b.i.d., p = 0.54). Conclusion: Although the sample size of this study was small, we found no evidence that this hyperfractionation schedule of postmastectomy RT offered a clinical advantage. Therefore, we have concluded that it should not be further studied in this cohort of patients.

Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: tbuchhol@mdanderson.org; Strom, Eric A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oswald, Mary Jane [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Perkins, George H. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oh, Julia [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Domain, Delora [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Yu, Tse-Kuan [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Woodward, Wendy A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Tereffe, Welela [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Singletary, S. Eva [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Thomas, Eva [Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Buzdar, Aman U. [Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hortobagyi, Gabriel N. [Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); McNeese, Marsha D. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2006-07-15

116

Miscellaneous syndromes and their management: occult breast cancer, breast cancer in pregnancy, male breast cancer, surgery in stage IV disease.  

PubMed

Surgical therapy for occult breast cancer has traditionally centered on mastectomy; however, breast conservation with whole breast radiotherapy followed by axillary lymph node dissection has shown equivalent results. Patients with breast cancer in pregnancy can be safely and effectively treated; given a patient's pregnancy trimester and stage of breast cancer, a clinician must be able to guide therapy accordingly. Male breast cancer risk factors show strong association with BRCA2 mutations, as well as Klinefelter syndrome. Several retrospective trials of surgical therapy in stage IV breast cancer have associated a survival advantage with primary site tumor extirpation. PMID:23464700

Colfry, Alfred John

2013-02-07

117

Breast cancer treatment and chemoprevention.  

PubMed Central

OBJECTIVE: To outline modern principles of surgery, radiation therapy, and systemic treatment of breast cancer, and to review preliminary data on breast cancer prevention. QUALITY OF EVIDENCE: A MEDLINE search was conducted from 1966 to the beginning of 1999; most of the studies reviewed are randomized clinical trials. MAIN MESSAGE: Breast conservation surgery should be offered to all women with early breast cancer because studies demonstrate survival rates equivalent to those with mastectomy. If mastectomy is chosen, breast reconstruction should be offered. Most women with breast cancer are treated systemically with either chemotherapy or tamoxifen, or both, and mortality is substantially reduced. Data indicating that tamoxifen prevents breast cancer are promising; more studies with both tamoxifen and raloxifene are under way. All women should be strongly encouraged to enter clinical trials. CONCLUSIONS: Because many issues face women recently diagnosed with breast cancer, they often seek out family physicians as advisors to help negotiate a complex treatment path. The possibility of preventing breast cancer will undoubtedly raise questions among family members of women with breast cancer that should appropriately be answered and referred, if necessary, by family physicians.

Kotwall, C. A.

1999-01-01

118

Psychological effects of breast conserving therapy in comparison with radical mastectomy  

SciTech Connect

Psychosocial sequelae of breast conserving therapy (BCT) and radical mastectomy (RM) have been compared. Also, in the BCT group, the cosmetic results were judged by the patients themselves and two plastic surgeons. Body image in the BCT group (n = 114) was significantly more positive than in the RM group (n = 58). Patients treated with BCT had even less fear of recurrence of the cancer and would, if necessary, choose the same treatment again. Cosmetic results were good to excellent in 75% of the cases as judged by the two plastic surgeons. Most of the patients with a bad grading by the surgeons were happy with the results.

Bartelink, H.; van Dam, F.; van Dongen, J.

1985-02-01

119

Body image and psychological distress after prophylactic mastectomy and breast reconstruction in genetically predisposed women: A prospective long-term follow-up study  

Microsoft Academic Search

PurposeTo explore the course of psychological distress and body image at long-term follow-up (6–9years) after prophylactic mastectomy and breast reconstruction (PM\\/BR) in women at risk for hereditary breast cancer, and to identify pre-PM risk factors for poor body image on the long-term.

Mariska den Heijer; Caroline Seynaeve; Reinier Timman; Hugo J. Duivenvoorden; Kathleen Vanheusden; Madeleine Tilanus-Linthorst; Marian B. E. Menke-Pluijmers; Aad Tibben

120

Radiotherapy Can Decrease Locoregional Recurrence and Increase Survival in Mastectomy Patients With T1 to T2 Breast Cancer and One to Three Positive Nodes With Negative Estrogen Receptor and Positive Lymphovascular Invasion Status  

SciTech Connect

Purpose: To define a subgroup of patients at high risk of locoregional recurrence (LRR) who might be benefit from postmastectomy radiotherapy in invasive breast cancer and tumor size <5 cm with one to three involved axillary lymph nodes (T1-2 N1). Methods and Materials: Between April 1991 and December 2005, 544 patients with T1-2 N1 invasive breast cancer were treated with modified radical mastectomy. Of the 544 patients, 383 patients (70.4%) had no radiotherapy, and 161 patients (29.6%) received radiotherapy. We retrospectively compared these two patient groups. Results: With a median follow-up of 40.3 months, LRR occurred in 40 (7.4%) of 544 patients. On univariate analysis, high nuclear grade (p = 0.04), negative estrogen receptor (ER) status (p = 0.001), presence of lymphovascular invasion (LVI) (p = 0.003), and no radiotherapy (p = 0.0015) were associated with a significantly higher rate of LRR. Negative ER status (hazard ratio = 5.1) and presence of LVI (hazard ratio = 2.5) were the risk factors for LRR with statistical significance in the multivariate analysis. Radiotherapy reduced the LRR in patients with the following characteristics: age <40 years, T2 stage, high nuclear grade, negative ER status, and presence of LVI. For 41 patients with negative ER and positive LVI status, radiotherapy can reduce LRR from 10 of 25 (40%) to 2 of 16 (12.5%) and increase the 5-year overall survival from 43.7% to 87.1%. Conclusion: Radiotherapy can reduce LRR and increase survival in T1-2 N1 breast cancer patients with negative ER status and presence of LVI.

Yang, P.S., E-mail: psyang@kfsyscc.or [Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Chen, C.M. [Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Liu, M.C. [Department of Medical Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Jian, J.M. [Department of Radiation Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Horng, C.F. [Department of Research, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Liu, M.J. [Department of Radiation Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Yu, B.L. [Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Lee, M.Y. [Department of Pathology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Chi, C.W. [Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan (China)

2010-06-01

121

The increasing efficacy of breast cancer treatment  

Microsoft Academic Search

Breast cancer is the commonest malignancy in women and although identification of this multi-system disease has increased, the survival rates have not dramatically altered over the past four decades. Optimium treatment of patients with breast cancer is a subject of great debate and traditionally may be divided into surgery, radiotherapy, chemotherapy and hormone manipulation.Halsted's radical mastectomy, although initially superseded by

A. Gordon

1997-01-01

122

Ten-Year Recurrence Rates in Young Women With Breast Cancer by Locoregional Treatment Approach  

Microsoft Academic Search

Purpose: Young women with breast cancer have higher locoregional recurrence (LRR) rates than older patients. The goal of this study is to determine the impact of locoregional treatment strategy, breast-conserving therapy (BCT), mastectomy alone (M), or mastectomy with adjuvant radiation (MXRT), on LRR for patients 35 years or younger. Methods and Materials: Data for 668 breast cancers in 652 young

Beth M. Beadle; Wendy A. Woodward; Susan L. Tucker; Elesyia D. Outlaw; Pamela K. Allen; Julia L. Oh; Eric A. Strom; George H. Perkins; Welela Tereffe; Tse-Kuan Yu; Funda Meric-Bernstam; Jennifer K. Litton; Thomas A. Buchholz

2009-01-01

123

Sexuality After Breast Cancer  

MedlinePLUS

... breast cancer treatment Emotional aspects of breast cancer Body image after breast cancer treatment Sexuality after breast cancer ... treatment for breast cancer stops working Previous Topic Body image after breast cancer treatment Next Topic Pregnancy after ...

124

Breast Cancer  

MedlinePLUS

... to get breast cancer. Diet and lifestyle choices: Women who smoke , eat high-fat diets, drink alcohol , and don't get enough exercise may be more at risk for developing breast cancer. What Are the Signs ... lump in her breast. If women examine their breasts monthly, they can help find ...

125

Feasibility of Immediate Breast Reconstruction for Locally Advanced Breast Cancer  

Microsoft Academic Search

Background: Immediate breast reconstruction (IBR) has been considered contraindicated for patients with locally advanced breast cancer (LABC). Our goal was to determine whether IBR resulted in delayed postoperative chemotherapy, increased postoperative complications, or increased risk of recurrent disease.Methods: A prospective database of 540 modified radical mastectomies performed with IBR between 1990 and 1993 identified 50 patients with LABC. Postoperative management

Lisa A. Newman; Henry M. Kuerer; Kelly K. Hunt; Frederick C. Ames; Merrick I. Ross; Richard Theriault; Nancy Fry; Stephen S. Kroll; Geoffrey L. Robb; S. Eva Singletary

1999-01-01

126

Contralateral breast cancer risk.  

PubMed

The use of breast-conserving treatment approaches for breast cancer has now become a standard option for early stage disease. Numerous randomized studies have shown medical equivalence when mastectomy is compared to lumpectomy followed by radiotherapy for the local management of this common problem. With an increased emphasis on patient involvement in the therapeutic decision making process, it is important to identify and quantify any unforeseen risks of the conservation approach. One concern that has been raised is the question of radiation- related contralateral breast cancer after breast radiotherapy. Although most studies do not show statistically significant evidence that patients treated with breast radiotherapy are at increased risk of developing contralateral breast cancer when compared to control groups treated with mastectomy alone, there are clear data showing the amount of scattered radiation absorbed by the contralateral breast during a routine course of breast radiotherapy is considerable (several Gy) and is therefore within the range where one might be concerned about radiogenic contralateral tumors. While radiation related risks of contralateral breast cancer appear to be small enough to be statistically insignificant for the majority of patients, there may exist a smaller subset which, for genetic or environmental reasons, is at special risk for scatter related second tumors. If such a group could be predicted, it would seem appropriate to offer either special counseling or special prevention procedures aimed at mitigating this second tumor risk. The use of genetic testing, detailed analysis of breast cancer family history, and the identification of patients who acquired their first breast cancer at a very early age may all be candidate screening procedures useful in identifying such at- risk groups. Since some risk mitigation strategies are convenient and easy to utilize, it makes sense to follow the classic 'ALARA' (as low as reasonably achievable) principles and to minimize scattered radiation for these special risk groups and perhaps for all patients undergoing breast radiotherapy. This paper reviews the literature on the risk of radiation- related second contralateral breast cancers. PMID:11514003

Unnithan, J; Macklis, R M

2001-09-01

127

Operable breast cancer: A clinical analysis of 6,263 cases  

Microsoft Academic Search

Objective  In Europe and America breast cancer commonly occurs in women of middle and old age, with a median age of about 57 years. Modified\\u000a radical mastectomy now called standard radical mastectomy, has taken the place of traditional radical mastectomy. Patients\\u000a with breast cancer at an early stage commonly receive BCT (breast conservative therapy). The TNM stage (especially the lymph\\u000a node

Mingtian Yang; Tiehua Rong; Zhifan Huang; Changuang Zeng; Hao Long; Jianhua Fu; Peng Lin; Xin Wang; Siyu Wang; Jun Tang

2005-01-01

128

Study Links Walking to Lower Breast Cancer Risk  

MedlinePLUS

... of the cancer. Hormone therapy for breast cancer works by blocking the effects of estrogen or lowering estrogen levels. Estrogen receptor-negative ... Information Cancer Basics Cancer Prevention & Detection Signs & Symptoms of ... Programs & Services Breast Cancer Support TLC Hair Loss & Mastectomy Products ...

129

Comfort, control, or conformity: women who choose breast reconstruction following mastectomy.  

PubMed

Following breast amputation women commonly are presented with two choices: to wear a prosthesis or undergo reconstruction. Breast restoration is assumed to allow a full emotional and physical recovery from a breast cancer crisis. Surgical reconstruction is offered to women as the final step in regaining a sense of complete womanhood, enabling a sense of optimism that both body and self will "get back to normal." This article examines 5 women's accounts of breast reconstruction and asks how breast reconstruction figures in the remaking of self following mastectomy. Issues pertaining to the reasoning behind seeking out the procedure, experiences of finding the right surgeon, and how women feel toward their reconstructed postsurgical body are examined. In conclusion it is argued that a number of contradictory expectations are held by women seeking reconstructions. While women suggest that reconstruction will restore lost femininity, sexuality, and normalcy in most cases it is not the procedure that enables this but the elimination of the hassles of prostheses. In contrast to the complete sense of self they expected to regain through reconstruction they articulate a restoration that is simply pragmatic. It is only once women have undertaken this last bastion of hope that they are forced to renegotiate their sense of themselves as women with or without breasts. PMID:16338741

Crompvoets, Samantha

2006-01-01

130

Better cosmetic results and comparable quality of life after skin-sparing mastectomy and immediate autologous breast reconstruction compared to breast conservative treatment.  

PubMed

Preoperative chemotherapy (PCT) can be used in large primary breast cancer to facilitate breast conservative surgery (BCS). Cosmetic results of BCS are influenced by the size of the residual tumour, relative to the size of the breast. After mastectomy, immediate breast reconstruction (IBR) with autologous tissue provides excellent cosmetic outcome and has proven to be safe in breast cancer patients. Besides improving overall and disease free survival, Quality of Life (QoL), body image and cosmetic outcome are also important issues after treatment for breast cancer. In this study, Health-Related-Quality of Life (HRQL) and body image were evaluated, in patients treated with PCT, followed by BCS, or skin-sparing mastectomy (SSM) and perforator-flap breast reconstruction. Additionally, clinical observers assessed cosmetic outcome. All participants were evaluated by the Medical Outcomes Study (MOS) 36-item Short Form Health Status Survey (SF-36, 36 items) and a study-specific questionnaire. An external panel evaluated standardised photographs of the breasts. For all patients, norm-based scores of physical and mental health state are comparable with the general population, except for vitality (VT) score, which is somewhat lower. No significant differences can be observed between both groups. The majority of the patients were satisfied with the appearance of their breasts. The cosmetic results, assessed by the clinical team, were significantly better for patients having IBR, compared to BCS. The mean score was 7.5/10 for IBR, versus 6.0/10 for BCS (p<0.0001).Breast conserving treatment or mastectomy with reconstruction may yield comparable results of QoL, but cosmetic outcome is better after SSM and perforator-flap reconstruction. Patients must be offered both options, and clinicians should stress that both are equally effective. PMID:12890459

Cocquyt, Veronique F; Blondeel, Phillip N; Depypere, Herman T; Van De Sijpe, Karlien A; Daems, Kristof K; Monstrey, Stanislas J; Van Belle, Simon J P

2003-07-01

131

Decision Making about Surgery for Early Stage Breast Cancer  

PubMed Central

Background Practice variation in breast cancer surgery has raised concerns about the quality of treatment decisions. We sought to evaluate the quality of decisions about surgery for early stage breast cancer by measuring patient knowledge, concordance between goals and treatments, and involvement in decisions. Study Design A mailed survey of Stage I/II breast cancer survivors was conducted at four sites. The Decision Quality Instrument measured knowledge, goals, and involvement in decisions. A multivariable logistic regression model of treatment was developed. The model-predicted probability of mastectomy was compared to treatment received for each patient. Concordance was defined as having mastectomy and predicted probability >=0.5 or partial mastectomy and predicted probability <0.5. Frequency of discussion about partial mastectomy was compared to discussion about mastectomy using chi-squared tests. Results 440 patients participated (59% response rate). Mean overall knowledge was 52.7%. 45.9% knew that local recurrence risk is higher after breast conservation. 55.7% knew that survival is equivalent for the two options. Most participants (89.0%) had treatment concordant with their goals. Participants preferring mastectomy had lower concordance (80.5%) than those preferring partial mastectomy (92.6%, p=0.001). Participants reported more frequent discussion of partial mastectomy and its advantages than of mastectomy. 48.6% reported being asked their preference. Conclusions Breast cancer survivors had major knowledge deficits, and those preferring mastectomy were less likely to have treatment concordant with goals. Patients perceived that discussions focused on partial mastectomy, and many were not asked their preference. Improvements in the quality of decisions about breast cancer surgery are needed.

Lee, Clara N; Chang, Yuchiao; Adimorah, Nesochi; Belkora, Jeff; Moy, Beverly; Partridge, Ann; Ollila, David W.; Sepucha, Karen

2011-01-01

132

Breast conservation therapy for patients with locally advanced breast cancer.  

PubMed

Neoadjuvant chemotherapy achieves high response rates in patients with breast cancer and has been used to reduce tumor size and allow for breast conservation in individuals who initially required mastectomy. The goals of this approach are to achieve optimal locoregional control together with acceptable cosmesis. In the setting of locally advanced disease, breast preservation appears to be feasible for appropriately selected patients whose tumors show adequate downstaging in response to induction chemotherapy. Nevertheless, further prospective randomized trials are warranted to better evaluate the results of this approach as compared with mastectomy. PMID:19732687

Alm El-Din, Mohamed A; Taghian, Alphonse G

2009-10-01

133

The unsatisfactory margin in breast cancer surgery  

Microsoft Academic Search

Background: Surgical margin involvement with breast cancer usually results in obligatory reexcision or mastectomy. While unalterable occult host and pathologic factors may interfere with margin clearance during the initial excision, it is possible that alterations in surgical technique might increase the likelihood of obtaining satisfactory margins.Methods: Two hundred and thirty-five patients who were candidates for breast conservation therapy were identified

Han H Luu; Christopher N Otis; William P Reed; Jane L Garb; James L Frank

1999-01-01

134

The lateral inframammary fold incision for nipple-sparing mastectomy: outcomes from over 50 immediate implant-based breast reconstructions.  

PubMed

Nipple-sparing mastectomy (NSM) as a therapeutic or prophylactic procedure for breast cancer is rapidly gaining popularity as the literature continues to support it safety. The lateral inframammary fold (IMF) approach provides adequate exposure and eliminates visible scars on the anterior surface of the breast, making this incision cosmetically superior to radial or periareolar approaches. We reviewed 55 consecutive NSMs performed through a lateral IMF incision with immediate implant-based reconstruction, with or without tissue expansion, between June 2008 and June 2011. Prior to incision, breasts were lightly infiltrated with dilute anesthetic solution with epinephrine. Sharp dissection, rather than electrocautery, was used as much as possible to minimize thermal injury to the mastectomy flap. When indicated, acellular dermal matrix was placed as an inferolateral sling. Subsequent fat grafting to correct contour deformities was performed in select patients. Three-dimensional (3D) photographs assessed changes in volume, antero-posterior projection, and ptosis. Mean patient age was 46 years, and mean follow-up time was 12 months. Twelve mastectomies (22%) were therapeutic, and the remaining 43 (78%) were prophylactic. Seven of the nine sentinel lymph node biopsies (including one axillary dissection) (78%) were performed through the lateral IMF incision without the need for a counter-incision. Acellular dermal matrix was used in 34 (62%) breasts. Average permanent implant volume was 416 cc (range 176-750 cc), and average fat grafting volume was 86 cc (range 10-177 cc). In one patient a positive intraoperative subareolar biopsy necessitated resection of the nipple-areola complex (NAC), and in two other patients NAC resection was performed at a subsequent procedure based on the final pathology report. Mastectomy flap necrosis, requiring operative debridement, occurred in two breasts (4%), both in the same patient. One of these breasts required a salvage latissimus dorsi myocutaneous flap to complete the reconstruction. Three nipples (6%) required office debridement for partial necrosis and operative reconstruction later. No patient had complete nipple necrosis. No statistically significant differences existed between therapeutic and prophylactic mastectomies for developing partial skin and/or nipple necrosis (p = 0.35). Three episodes (5%) of cellulitis occurred, which responded to antibiotics without the need for explantation. Morphological outcomes using 3D scan measurements showed reconstructed breasts were larger, more projected, and less ptotic than the preoperative breasts (196 versus 248 cc, 80 versus 90 mm, 146 versus 134 mm, p < 0.01 for each parameter). Excellent results can be achieved with immediate implant-based reconstruction of NSM through a lateral IMF incision. NAC survival is reliable, and complication rates are low. PMID:23252505

Blechman, Keith M; Karp, Nolan S; Levovitz, Chaya; Guth, Amber A; Axelrod, Deborah M; Shapiro, Richard L; Choi, Mihye

2012-12-17

135

Body image, self?concept, and self?esteem in women who had a mastectomy and either wore an external breast prosthesis or had breast reconstruction and women who had not experienced mastectomy  

Microsoft Academic Search

The perceptions of three groups of women regarding their body image, self?concept, total self?image, and self?esteem were compared. The groups included 64 women who had mastectomies and wore external breast prostheses, 31 women who had mastectomies and underwent breast reconstruction, and a control group of 78 women who had not experienced mastectomy. The body image, total self?image, and self?esteem mean

Linda L. Reaby; Linda K. Hort; John Vandervord

1994-01-01

136

Multileaf Collimator for Modulated Electron Radiation Therapy for Breast Cancer.  

National Technical Information Service (NTIS)

Results from recent clinical trials have shown that irradiation is an effective adjuvant therapy to lumpectomy, mastectomy, and chemotherapy for breast cancers of different stages. However, the conventional tangential photon beam treatment has two major l...

Y. Song S. B. Jiang

2002-01-01

137

Multileaf Collimator for Modulated Electron Radiation Therapy for Breast Cancer.  

National Technical Information Service (NTIS)

Irradiation is an effective adjuvant therapy to lumpectomy, mastectomy, and chemotherapy for breast cancers of different stages. However, the conventional tangential photon beam treatment has two major limitations. Firstly, part of the lung and heart (in ...

Y. Song

2003-01-01

138

THE MANAGEMENT OF CANCER OF THE BREAST  

PubMed Central

Radical mastectomy is excellent only for cases of operable breast cancer in which the tumor is limited to the breast or to the nodes in the axilla. That there is metastasis to the internal mammary lymph nodes in a high proportion of cases has been “overlooked” for many years. Also it is probable that metastasis occurs to the supraclavicular lymph nodes more often than is suspected. Hence the extended radical mastectomy operation leaves much to be desired. There has been no significant improvement in recent years in the mortality rate of mammary cancer. Simple mastectomy and thorough adequate postoperative radiation therapy have much to offer. Treatment of “operable” breast cancer should be a cooperative effort of surgeon, radiation therapist and pathologist.

Stein, Justin J.

1958-01-01

139

Results of conservative surgery and radiation therapy for breast cancer  

Microsoft Academic Search

For stage I or II breast cancer, conservative surgery and radiation therapy are as effective as modified radical or radical mastectomy. In most cases, cosmetic considerations and the availability of therapy are the primary concerns. The extent of a surgical resection less than a mastectomy has not been a subject of a randomized trial and is controversial. It appears that

R. T. Osteen; B. L. Smith

1990-01-01

140

From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy  

PubMed Central

Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From the point of view of oncological result, there is no difference between mastectomy and BCT in local recurrence rate and survival. Long-term results for OBS are not available. The items assessed in the QOL sound a better score for OBS in comparison with mastectomy or BCT. OBS is also associated with a better cosmetic outcome. Although having low income seems to be associated with lower BCT and OBS utilization, prognosis of breast cancer is worse in these women as well. Thus, health economy is the matter that should be studied seriously. OBS is an innovative, progressive, and complicated subspeciality that lacks published randomized clinical trials comparing surgical techniques and objective measures of outcome, especially from oncologic and health economy points of view.

Kaviani, Ahmad; Sodagari, Nassim; Sheikhbahaei, Sara; Eslami, Vahid; Hafezi-Nejad, Nima; Safavi, Amin; Noparast, Maryam; Fitoussi, Alfred

2013-01-01

141

Implant Reconstruction in Breast Cancer Patients Treated with Radiation Therapy  

Microsoft Academic Search

Background: Implant reconstruction in breast cancer patients treated with radiation therapy is controversial. Prior studies are limited by older prosthetic devices, reconstructive techniques, and radiation therapy protocols. Methods: A retrospective review was performed of patients who underwent tissue expansion and implant breast reconstruction performed by a single sur- geon after mastectomy for breast cancer from 1996 to 2003. Complications and

Jeffrey A. Ascherman; Matthew M. Hanasono; Martin I. Newman; Duncan B. Hughes

2006-01-01

142

Breast-conserving surgery in breast cancer.  

PubMed

The breast cancer treatment is based nowadays on new surgical options: breast-conserving surgery, which applies at least for the first and second stage cancer, with radical intention. We have been practicing breast-conserving surgery for the last 16 years and we have performed 303 breast conserving operations from a total of 673. We recorded 12 local recurrences (3,96%) and 2 deaths due to cancer progression. Our protocol includes removal of the primary tumor with enough surrounding tissue to ensure negative margins of the resectable specimen, associated with axillary lymph-node dissection and postoperative breast irradiation. Our oncologist indicated chemotherapy on different postoperative conditions: tumor size, axillary lymph node involvement, patient's age, etc. The purpose of this paper is to emphasize our modest experience, nevertheless to draw the attention on important results, obtained by long-term monitoring of the patients who underwent breast-conserving surgery, in a two prospective protocols, and demonstrate the importance and applicability of breast conserving therapy. The conclusion of this study is that breast-conserving surgery followed by breast irradiation is reliable, as the results are similar with radical mastectomies; the main objective is to obtain a good cosmetic result, which depends on tumor size / breast size. PMID:23116836

Tenea Cojan, T S; Vidrighin, C D; Ciobanu, M; Paun, I; Teodorescu, M; Mogos, G; Tenovici, M; Florescu, M; Mogos, D

143

What are patients' goals and concerns about breast reconstruction after mastectomy?  

PubMed

Discussions about breast reconstruction should include factual information and consideration of the patient's personal concerns. Providers are familiar with the relevant facts but may not know which personal concerns are important to patients. Experience with breast cancer patients has found that providers frequently do not know their patients' treatment preferences. To help reconstructive surgeons discuss personal preferences with their patients, we sought to identify women's key concerns related to breast reconstruction. We employed a qualitative design and convened a sample of 65 women in 7 focus groups and 15 semi-structured interviews. Women with a recent history of early-stage breast cancer who had a mastectomy with or without reconstruction were included. A variety of backgrounds, including underserved populations, low education levels, and various ages were represented. Qualitative content analysis was performed, and key themes were identified. Five key themes emerged. (1) Magnitude of surgery and recovery. Many women reported that concerns over the number of operations, duration of recovery, and risk of complications strongly affected their decision-making. (2) Using one's own tissue. Several women felt comforted by the notion of using their own tissue for reconstruction. (3) Looking natural in clothing. Many women pointed out the difference between how they look in clothing versus how they look naked. (4) Avoiding an external prosthesis. Several women stressed practical concerns and framed the reconstruction decision in terms of not having to use prosthesis. (5) Considering others' opinions. A few women reported that their partners' opinion strongly influenced their decision. Many women stated that they ultimately followed their doctor's recommendation. Women considering reconstruction have some unmet emotional and physical needs as well as important goals and concerns that can affect their decisions about and experience with reconstruction. In particular, some breast cancer patients are unprepared for the full effect of surgery on their lives and for the recovery process. Discussions about reconstruction would benefit from inclusion of these key concerns. PMID:20354433

Lee, Clara N; Hultman, Charles Scott; Sepucha, Karen

2010-05-01

144

Learning about Breast Cancer  

MedlinePLUS

... for Genetic Risk of Breast . . . 2005 Learning About Breast Cancer What do we know about heredity and breast ... Cancer What do we know about heredity and breast cancer? Breast cancer is a common disease. Each year, ...

145

Endoscopic Breast Surgery in Treating Patients With Breast Cancer  

ClinicalTrials.gov

Male Breast Cancer; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

2012-03-10

146

Variation of Tumor Markers in 277 Breast Cancer Cases  

Microsoft Academic Search

Introduction and purpose: Breast cancer is the most frequently diagnosed cancer in women in the world, Advances in paraclinical methods have resulted in dramatic changes in determining the survival of patients. Serial evaluation of serum levels of tumor markers is one of these methods. Methods: During 1993-2002, 277 cases with breast cancer after mastectomy were included in this cross sectional

Iraj Asvadi Kermani

2004-01-01

147

Post-mastectomy radiation in large node-negative breast tumors: does size really matter?  

PubMed

Treatment decisions regarding local control can be particularly challenging for T3N0 breast tumors because of difficulty in estimating rates of local failure after mastectomy. Reports in the literature detailing the rates of local failure vary widely, likely owing to the uncommon incidence of this clinical situation. The literature regarding this clinical scenario is reviewed, including recent reports that specifically address the issue of local failure rates after mastectomy in the absence of radiation for large node-negative breast tumors. PMID:19201501

Floyd, Scott R; Taghian, Alphonse G

2009-02-07

148

[Indications and techniques of reconstruction after mastectomy].  

PubMed

Reconstructive surgery takes an important place in breast cancer treatment. Immediate breast reconstruction is performed during the same operation as mastectomy. It is contraindicated following radiotherapy. Reconstruction performed after mastectomy is called differed breast reconstruction. It is completed 6 months after chemotherapy and 1 year after radiotherapy. Prosthetic breast reconstruction is indicated when tissues are of good qualities and breast are small. Autologous reconstruction is performed in case of radiotherapy or large breast. After breast reconstruction, imperfections can be corrected with autologous fat injection. PMID:23167073

Koch, Nathalie; Delaloye, Jean-François; Raffoul, Wassim

2012-10-24

149

Surgery Choices for Women With DCIS or Breast Cancer  

Cancer.gov

For women diagnosed with DCIS or breast cancer that can be removed with surgery. This guide explains types of breast surgery, such as breast-sparing surgery and mastectomy, and helps women decide which surgery is the best choice for them.

150

Quality of life of breast cancer patients and types of surgery for breast cancer — Current status and unresolved issues —  

Microsoft Academic Search

Since standard radical mastectomy was established by Halsted for breast cancer, surgical procedures for breast cancer have\\u000a been changed according to the results of randomized controlled trials. Breast-conserving treatment is now regarded as a standard\\u000a local treatment for early breast cancer. More recently, sentinel node biopsy is becoming popular as an alternative procedure\\u000a to axillary node dissection for nodal staging.

Shozo Ohsumi; Kojiro Shimozumai; Katsumasa Kuroi; Michikazu Ono; Hirohisa Imai

2007-01-01

151

Reconstructive surgery in young women with breast cancer  

Microsoft Academic Search

Recovery of body image after mastectomy is essential for physical and mental quality of life. Partial or total mastectomy\\u000a deformities can be reversed by reconstructive surgical procedures. Young women with breast cancer have specific characteristics\\u000a related to the age of onset of the disease, prognosis and reconstructive expectations. Patient individualization is the key\\u000a to a successful breast reconstruction. Autologous and

Martina Marín-Gutzke; Alberto Sánchez-Olaso

2010-01-01

152

Effects of breast conservation on psychological morbidity associated with diagnosis and treatment of early breast cancer  

Microsoft Academic Search

Psychiatric morbidity was assessed in 101 women treated for early breast cancer (T0,1,2,N0,1,M0). Patients had expressed no strong preference for treatment, so were randomised to either mastectomy or breast conservation. The incidence of anxiety states or depressive illness, or both, among women who underwent mastectomy was high (33%) and comparable with that found in other studies. Slightly more of the

L J Fallowfield; M Baum; G P Maguire

1986-01-01

153

Radiation therapy in the management of breast cancer.  

PubMed

Radiation therapy (RT) plays an essential role in the management of breast cancer by eradicating subclinical disease after surgical removal of grossly evident tumor. Radiation reduces local recurrence rates and increases breast cancer-specific survival in patients with early-stage breast cancer after breast-conserving surgery and in node-positive patients who have undergone mastectomy. This article reviews the following topics: (1) the rationale for adjuvant RT and the evidence for its use in noninvasive and invasive breast cancer, (2) RT delivery techniques for breast-conserving therapy such as hypofractionated RT, partial breast irradiation, and prone irradiation, and (3) indications for PMRT. PMID:23464696

Yang, T Jonathan; Ho, Alice Y

2013-04-01

154

Post-mastectomy radiation in large node-negative breast tumors: Does size really matter?  

Microsoft Academic Search

Treatment decisions regarding local control can be particularly challenging for T3N0 breast tumors because of difficulty in estimating rates of local failure after mastectomy. Reports in the literature detailing the rates of local failure vary widely, likely owing to the uncommon incidence of this clinical situation. The literature regarding this clinical scenario is reviewed, including recent reports that specifically address

Scott R. Floyd; Alphonse G. Taghian

2009-01-01

155

Breast cancer  

MedlinePLUS

... given to the women in the 1940s - 1960s. Hormone replacement therapy (HRT) -- You have a higher risk of breast cancer if you have received hormone replacement therapy with estrogen for several years or more. Obesity -- ...

156

Quality of life and satisfaction after breast cancer operation  

Microsoft Academic Search

Purpose  To investigate the quality of life and satisfaction after different operations in patients with breast cancer, which are breast\\u000a conserving therapy (BCT), mastectomy and reconstruction after breast BCT or mastectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  180 patients with breast cancer who were operated from January 2005 to October 2006 were chosen. They presented without local\\u000a or distant metastasis in this period of time

Jing Han; Dirk Grothuesmann; Mechthild Neises; Ursula Hille; Peter Hillemanns

2010-01-01

157

Prophylactic Mastectomy and Reconstruction: Clinical Outcomes and Patient Satisfaction  

Microsoft Academic Search

Washington, D.C. Background: The purpose of this study was to evaluate both clinical outcomes and satisfaction in patients who have undergone prophylactic mastectomy and breast reconstruction. Methods: A 5-year retrospective analysis of the senior author's (S.L.S.) expe- rience with breast reconstruction following prophylactic mastectomy was per- formed. Timing, type of mastectomy and reconstruction, complications, and cancer occurrence\\/recurrence were examined. Patients

Scott L. Spear; Karl A. Schwarz; Mark L. Venturi; Todd Barbosa; Ali Al-Attar

2008-01-01

158

International study finds advanced post-mastectomy breast reconstruction improves women's psychosocial and sexual well-being:  

Cancer.gov

After a mastectomy, women who undergo breast reconstruction with tissue from their own abdomen experience significant gains in psychological, social, and sexual well-being as soon as three weeks after surgery.

159

Breast Reconstruction Using Tissue Engineering.  

National Technical Information Service (NTIS)

The cure for breast cancer is a long-term clinical realization. In the meantime, patients continue to undergo mastectomies as a preventative measure against breast cancer or as a means to surgically resect an existing breast cancer. Conventional procedure...

C. W. Patrick

2002-01-01

160

Breast cancer (non-metastatic)  

PubMed Central

Introduction Breast cancer affects at least 1 in 10 women in the UK, but most present with primary operable disease, which has an 80% 5-year survival rate overall. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions after breast-conserving surgery for ductal carcinoma in situ? What are the effects of treatments for primary operable breast cancer? What are the effects of interventions in locally advanced breast cancer (stage 3B)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 83 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding chemotherapy (cyclophosphamide/methotrexate/fluorouracil and/or anthracycline and/or taxane-based regimens), or hormonal treatment to radiotherapy; adjuvant treatments (aromatase inhibitors, adjuvant anthracycline regimens, tamoxifen); axillary clearance; axillary dissection plus sentinel node dissection; axillary radiotherapy; axillary sampling; combined chemotherapy plus tamoxifen; chemotherapy plus monoclonal antibody (trastuzumab); extensive surgery; high-dose chemotherapy; hormonal treatment; less extensive mastectomy; less than whole-breast radiotherapy plus breast-conserving surgery; multimodal treatment; ovarian ablation; primary chemotherapy; prolonged adjuvant combination chemotherapy; radiotherapy (after breast-conserving surgery, after mastectomy, plus tamoxifen after breast-conserving surgery, to the internal mammary chain, and to the ipsilateral supraclavicular fossa, and total nodal radiotherapy); sentinel node biopsy; and standard chemotherapy regimens.

2011-01-01

161

Dosimetric comparison of conventional and forward-planned intensity-modulated techniques for comprehensive locoregional irradiation of post-mastectomy left breast cancers  

SciTech Connect

Three recently published randomized trials have shown a survival benefit to postoperative radiation therapy when the internal mammary chain (IMC), supraclavicular (SCV), and axillary lymphatics are treated. When treating the IMC, techniques that minimize dose to the heart and lungs may be utilized to prevent excess morbidity and mortality and achieve the survival benefit reported. The purpose of this study was to dosimetrically compare forward-planned intensity-modulated radiation therapy (fIMRT) with conventional techniques for comprehensive irradiation of the chest wall and regional lymphatics. For irradiation of the chest wall and IMC, 3 treatment plans, (1) fIMRT, (2) partially-wide tangent (PWT) fields, and (3) a photon-electron (PE) technique, were compared for 12 patients previously treated at our institution with fIMRT to the left chest wall and regional lymphatics. Additionally, the SCV and infraclavicular lymphatics were irradiated and 4 methods were compared: 2 with anterior fields only (dose prescribed to 3 and 5 cm [SC3cm, SC5cm]) and 2 with anterior and posterior fields (fIMRT, 3DCRT). Each patient was planned to receive 50 Gy in 25 fractions. Regions of interest (ROIs) created for each patient included chest wall (CW) planning target volume (PTV), IMC PTV, and SCV PTV. Additionally, the following organs at risk (OAR) volumes were created: contralateral breast, heart, and lungs. For each plan and ROI, target volume coverage (V{sub 95-107}) and dose homogeneity (D{sub 95-5}) were evaluated. Additionally, the mean OAR dose and normal tissue complication probability (NTCP) were computed. For irradiation of the CW, target volume coverage and dose homogeneity were improved for the fIMRT technique as compared to PE (p < 0.001, p = 0.023, respectively). Similar improvements were seen with respect to IMC PTV (p = 0.012, p = 0.064). These dosimetric parameters were also improved as compared to PWT, but not to the same extent (p = 0.011, p = 0.095 for CW PTV, and p = 0.164, p > 0.2 for IMC PTV). The PE technique resulted in the lowest heart V{sub 30}, although this difference was not significant (p > 0.2). The NTCP values for excess cardiac mortality for fIMRT and PE were equivalent (1.9%) and lower than with PWT (2.8%, p > 0.2). The fIMRT technique was able to reduce heart dose and NTCP for each patient as compared to PWT. When comparing the anterior field techniques of treating SCV PTV, prescribing dose to 5 cm resulted in a improved V50 (p = 0.089). However, when compared to fIMRT, the SC3cm and SC5cm had inferior target volume coverage (p = 0.055, p = 0.014) and significantly greater dose heterogeneity (p = 0.031, p = 0.043). The addition of a posterior field increased the volume of lung receiving 40 and 50 Gy, but not significantly (p > 0.2). For complex breast treatments that irradiate the chest wall, IMC, and SCV, fIMRT resulted in improved dose homogeneity and target volume coverage as compared to conventional techniques. Furthermore, the dosimetric gains in target volume coverage with fIMRT came at no significant increase in dose to OAR. The fIMRT technique demonstrated the ability to maintain the advantage of each of the other 2 techniques: reducing the dose to OARs, as with PE, and providing superior target volume coverage, as with PWT.

Cavey, Matthew L. [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States)]. E-mail: mlcavey@utmb.edu; Bayouth, John E. [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Endres, Eugene J. [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Pena, John M. [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Colman, Martin [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States); Hatch, Sandra [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States)

2005-06-30

162

Selection criteria for breast conservation in breast cancer.  

PubMed

Breast conservation, comprising limited excision of the breast and axillary lymphadenectomy followed by irradiation, yields survival equal to mastectomy with the advantage of preservation of the breast for properly selected patients. When breast conservation therapy is competently done it achieves highly satisfactory cosmetic results and acceptably low rates of local recurrence. However, numerous controversies surround the selection criteria, the relative importance of some of them, and the treatment. Four critical elements in selecting patients for breast conservation therapy are: history and physical examination, careful mammographic evaluation, histological assessment of the resected specimen, and assessment of the patient's needs and expectations. Today, it is estimated that breast conservation can be recommended to 50%-75% of all women with operable breast cancer. However, this treatment is not widely used. In this article we review the generally accepted principles and controversies about the selection of patients for breast conservation. PMID:11097148

Sakorafas, G H; Tsiotou, A G

2000-11-01

163

Breast Cancer -- Inflammatory  

MedlinePLUS

... Editorial Board , 4/2010 Overview Cancer.Net Guide Breast Cancer - Inflammatory Overview Statistics Medical Illustrations Risk Factors Symptoms ... Questions to Ask the Doctor Additional Resources Inflammatory breast cancer is a rare form of breast cancer. The ...

164

Breast Cancer  

Microsoft Academic Search

Over the centuries, the breast cancer literature has contained numerous references to the role of psychological factors in the etiology of the disease. Theories and research findings pertaining to this work are reviewed, with a focus on twentieth century work. The specific hypotheses examined in each historic period can be seen in the context of views held about women in

Janet E. Hiller

1989-01-01

165

Breast cancer therapies weighed  

SciTech Connect

Even as the National Institutes of Health came under fire last week for giving short shrift to women in the institute's basic and clinical research programs, the report of a recent NIH consensus conference points up the need for more research on how to treat early breast cancer. Although the experts were able to agree on the best surgical treatment for women with early breast cancer, they couldn't resolve the more controversial issue of whether the patients should subsequently receive systemic treatment - chemotherapy or hormone therapy - to prevent recurrence of their disease. The panel reaffirmed that the removal of the lump and nearby lymph nodes, followed by irradiation, is just as effective as a mastectomy. But then came the contentious question: should women with early breast cancer, especially those without detectable lymph node metastases, receive drug therapy to prevent recurrence of the disease Currently, 70% of such cancers are successfully treated with surgery and radiation alone. For this reason, about 2 years ago, the National Cancer Institute issued a clinical alert saying that addition treatment with drugs or hormones is a credible therapeutic option worthy of careful attention for all early stage patients. This pronouncement engendered a storm of criticism. A consensus panel concluded that in cases where tumors are 1 centimeter or less in diameter and no lymph nodes are affected, the likelihood of recurrence is so small that the benefits of adjuvant therapy would be insignificant. But for the patients with larger tumors, the panel concluded that the decision is an individual one that depends on personal preferences and a variety of prognostic factors that can help to indicate whether a woman is at high risk of having a recurrence and should therefore have adjuvant therapy.

Holden, C.

1990-06-29

166

Low local recurrence rate without postmastectomy radiation in node-negative breast cancer patients with tumors 5 cm and larger  

Microsoft Academic Search

Purpose: To assess the need for adjuvant radiotherapy following mastectomy for patients with node-negative breast tumors 5 cm or larger. Methods and Materials: Between 1981 and 2002, a total of 70 patients with node-negative breast cancer and tumors 5 cm or larger were treated with mastectomy and adjuvant systemic therapies but without radiotherapy at three institutions. We retrospectively assessed rates

Scott R. Floyd; Thomas A. Buchholz; Bruce G. Haffty; Saveli Goldberg; Andrzej Niemierko; Rita Abi Raad; Mary J. Oswald; Timothy Sullivan; Eric A. Strom; Simon N. Powell; Angela Katz; Alphonse G.. Taghian

2006-01-01

167

Update on one-stage immediate breast reconstruction with definitive prosthesis after sparing mastectomies.  

PubMed

Immediate breast reconstruction after skin and nipple-sparing mastectomies is commonly performed as a two-stage procedure; to overcome the paradox of traditional two-stage tissue expander/implant reconstruction used to create a tight muscular pocket that needs expansion to produce lower pole fullness, while losing the laxity of the mastectomy skin flaps, the authors conceived a subpectoral-subfascial pocket by elevating the major pectoral muscle in continuity with the superficial pectoralis fascia up to the inframammary fold. This alteration allowed for the immediate insertion of the definitive implant. The authors present their experience in 220 cases of immediate one-stage breast reconstructions with definitive prostheses in sparing mastectomies. Immediate and long-term local complications were evaluated. Immediate breast reconstruction with definitive anatomical silicone-filled implants can produce excellent cosmetic results (78.6%) with a low rate of complications (17.7%); these results allow for agreement between oncologic, aesthetic and economic purposes. PMID:21146990

Salgarello, Marzia; Barone-Adesi, Liliana; Terribile, Daniela; Masetti, Riccardo

2010-12-13

168

Herpes Zoster in Breast Cancer Patients after Radiotherapy  

Microsoft Academic Search

Background: We have studied the incidence of herpes zoster in patients with adjuvant radiotherapy for breast cancer with special emphasis on possible correlations with other prognostic factors or survival. Patients and Methods: From 1\\/1985 through 12\\/1993, 1 155 breast cancer patients received postoperative radiotherapy with curative interent in our department. After mastectomy 961 patients were irradiated and after breast-preserving treatment

Jürgen Dunst; Bettina Steil; Steffi Furch; Annette Fach; Gisela Bormann; Wolfgang Marsch

2000-01-01

169

Body image disturbance and surgical decision making in egyptian post menopausal breast cancer patients  

Microsoft Academic Search

BACKGROUND: In most developing countries, as in Egypt; postmenopausal breast cancer cases are offered a radical form of surgery relying on their unawareness of the subsequent body image disturbance. This study aimed at evaluating the effect of breast cancer surgical choice; Breast Conservative Therapy (BCT) versus Modified Radical Mastectomy (MRM); on body image perception among Egyptian postmenopausal cases. METHODS: One

Ashraf M Shoma; Madiha H Mohamed; Nashaat Nouman; Mahmoud Amin; Ibtihal M Ibrahim; Salwa S Tobar; Hanan E Gaffar; Warda F Aboelez; Salwa E Ali; Soheir G William

2009-01-01

170

How breast cancer treatment decisions are made by women in North Dakota  

Microsoft Academic Search

Background: Although equally effective, women in rural midwestern states choose modified radical mastectomy (MRM) over breast conservation surgery for early stage breast cancer. This study assessed treatment decisions by the women of North Dakota.Methods: Surveys were sent to women treated for early stage breast cancer from 1990 through 1992. Separate surveys were sent out to surgeons in the state. The

Douglas Stafford; Robert Szczys; Ricky Becker; Julie Anderson; Susan Bushfield

1998-01-01

171

Nipple-sparing mastectomy: initial experience at the Memorial Sloan-Kettering Cancer Center and a comprehensive review of literature.  

PubMed

Success achieved with skin-sparing mastectomy has led surgeons to reconsider the necessity of nipple-areola complex removal. This study reports our short- and mid-term postoperative outcomes with nipple-sparing mastectomy (NSM) and an updated review of reported literature. Data were retrospectively abstracted from medical records at our institution. Patients underwent NSM based on patient preference, oncologic criteria, and cosmesis. A literature review was undertaken through a PUBMED search and selected based on title and abstract relevance. Twenty-five patients underwent 42 NSMs at our institution from July 2000 to October 2005. Patient mean age was 44 years (29-59 years). Indications for mastectomy were: 34 (81%) for prophylaxis, 5 (12%) for invasive ductal carcinoma, 2 (5%) for ductal carcinoma in situ, and 1 (2%) for a malignant phyllodes tumor. One prophylactic mastectomy specimen showed ductal carcinoma in situ in the retroareolar tissue, and the nipple-areola complex was removed at a second operation. Mean tumor size in cases with invasive carcinoma (n = 5) was 1.9 cm (0.7-2.5 cm). All tumors were peripherally located, and no cases showed occult nipple involvement. The nipple-areola complex was entirely preserved in 39 (93%) mastectomies. One nipple-areola complex was surgically removed, and two (5%) cases had partial loss due to infection or ischemia. Cosmetic result from surgeon's assessment was excellent in 30 mastectomies, good in 7, acceptable in 3, and poor in 2, with slight nipple asymmetry in 8 cases. At a median follow-up of 10.5 months (range, 0.4-56.4 months), the 39 nipple-areola complexes were intact and there were no local or systemic recurrences in cases treated for cancer. NSM represented approximately 1% of all mastectomies performed at our institution during the reported period. It was mostly used for prophylaxis and for the treatment of malignant tumors in few selected cases. NSM can be performed with a high success rate of nipple-areola complex preservation. Conclusions about the oncologic safety of this procedure cannot be drawn from our study due to small size series and short follow-up. However, available published data show that NSM can be safely performed for breast cancer treatment in carefully selected cases. Further studies and longer follow-up are necessary to refine selection criteria for NSM. PMID:19496781

Garcia-Etienne, Carlos A; Cody Iii, Hiram S; Disa, Joseph J; Cordeiro, Peter; Sacchini, Virgilio

2009-05-22

172

Post-Mastectomy and Phantom Pain: Risk Factors, Natural History, and Impact on Quality of Life.  

National Technical Information Service (NTIS)

Post-mastectomy pain syndrome (PMPS), phantom breast pain, and post- lumpectomy pain are poorly understood chronic pain syndromes that occur following surgical procedures for breast cancer. These pain syndromes are not well studied, but there is appreciab...

R. Dworkin

2000-01-01

173

Options in breast cancer local therapy: who gets what?  

PubMed

Today, women with primary breast cancer may consider three surgical options: breast-conserving surgery (BCS), mastectomy (MT), and mastectomy with contralateral prophylactic mastectomy (MT + CPM). In each case, the ipsilateral axilla is generally managed with a sentinel node biopsy and possibly an axillary lymph node dissection. BCS generally requires breast radiotherapy, except in older women having tumors with a favorable prognosis who will receive endocrine therapy. In contrast, women treated with MT generally do not require radiotherapy, except for those with large tumors or metastases to the axillary nodes. Moreover, MT and MT + CPM are usually undertaken with breast reconstruction. Yet, most patients today are suitable candidates for BCS, with a few relative contraindications. Thus, early pregnancy, previous radiotherapy to the breasts, active collagen vascular disease, multicentric breast cancer, large tumors (although neoadjuvant systemic therapy can often reduce tumor size), and the presence of the BRCA mutation are all relative contraindications to BCS. BRCA mutation carriers should consider MT + CPM because their risk of contralateral breast cancer is greatly increased. In the U.S., the use of MT for the treatment of primary breast cancer has declined in recent years, while MT + CPM rates have increased, and BCS rates have remained relatively stable. The underlying reasons for these trends are not fully understood. Local therapy options should be discussed with each patient in considerable detail, and more studies are needed to better elucidate which factors influence a woman's choice of local therapy following a breast cancer diagnosis. PMID:22382769

Jatoi, Ismail

2012-07-01

174

Fibrocystic Breast Changes: Linked to Breast Cancer?  

MedlinePLUS

... noncommercial use only. Fibrocystic breast changes: Linked to breast cancer? By Mayo Clinic staff Original Article: http://www. ... Sign up Question Fibrocystic breast changes: Linked to breast cancer? Do fibrocystic breast changes increase my risk of ...

175

Surgery for inoperable breast cancer.  

PubMed

Neoadjuvant chemotherapy has the potential to convert inoperable breast cancer into operable disease; however, patients may remain inoperable by the classic criteria after neoadjuvant chemotherapy. In such cases, palliative surgical therapy to promote comfort and hygiene and to control wound breakdown may need to be considered. This report documents this clinical scenario in a patient with a large exophytic breast cancer who had a partial response with neoadjuvant chemotherapy and required an extended radical mastectomy with extensive reconstruction for coverage. The decision to undertake such a surgical procedure is complicated when the patient's life expectancy may be extremely limited and both patient and treatment team must carefully weigh the risks and potential benefits of a highly complex but technically feasible operation. PMID:11918881

Kuerer, Henry M; Beahm, Elisabeth K; Swisher, Stephen G; Ross, Merrick I

2002-02-01

176

Does surgery modify growth kinetics of breast cancer micrometastases?  

Microsoft Academic Search

Surgery should be considered as a major perturbing factor for metastasis development in laboratory animals. The different time distribution of mortality for 1173 patients undergoing mastectomy in comparison with 250 untreated patients suggests that primary tumour removal could result in changes of the metastatic process even for breast cancer. © 2001 Cancer Research Campaign http:\\/\\/www.bjcancer.com

R Demicheli; P Valagussa; G Bonadonna

2001-01-01

177

Cosmesis in segmental mastectomy.  

PubMed

The controversy about the best treatment for primary breast cancer will be settled only when properly designed clinical trials are completed. Most surgeons would rather await the results of such trials than participate in them. Prominent among the reasons for this view is the belief that an adequate cancer operation can seldom be performed with appropriate cosmetic preservation of the breast and, therefore, the trial of an unproven operation is not justified, because nothing can be gained. The poor cosmetic result is often owing to lack of experience with segmental mastectomy. From experience with 400 patients in the National Surgical Adjuvant Breast Project (NSABP) protocol has emerged an appreciation of the technical points that permit adequately wide local excision with minimal cosmetic loss. The results should stimulate both patients and surgeons to consider appropriate clinical trials for primary breast cancer surgery. This paper considers the causes of cosmetic failure and suggests the means of overcoming them. PMID:7225976

Margolese, R G

1981-03-01

178

Basic Information about Breast Cancer  

MedlinePLUS

... state or territory Cancer Home Basic Information About Breast Cancer On This Page What Is a Normal Breast? ... can develop in the breast. Common Kinds of Breast Cancer There are different kinds of breast cancer. The ...

179

Technical Advances in Skin Sparing Mastectomy  

PubMed Central

Skin sparing mastectomy has resulted in marked improvement in the aesthetic results of immediate breast reconstruction. Mature data has confirmed its oncological safety in the treatment of breast cancer. The procedure has gained wide acceptance and has undergone numerous technical advances since its introduction over twenty years ago. Careful patient selection and choice of skin incisions are necessary to avoid complications.

Carlson, Grant W.

2011-01-01

180

Management and Outcomes of Male Breast Cancer in Zaria, Nigeria  

PubMed Central

Male breast cancer is an uncommon disease accounting for only 1% of all breast cancers. We present the evaluation, treatment and outcome of male patients seen with breast cancer in our institution. Male patients that had histological diagnosis of breast cancer from 2001 to 2010 were retrospectively evaluated. After evaluation patients were treated with modified radical mastectomy. Combination chemotherapy was given to patients with positive axillary lymph nodes. Radiotherapy and hormonal therapy were also employed. There were 57 male patients with breast cancer which accounted for 9% of all breast cancers seen during the study period. Their mean age was 59 ± 2.3 years. The mean tumor diameter was 13 ± 2.5?cm. Fifty three (93%) patients presented with advanced disease including 15 with distant metastasis. Four patients with stage II disease were treated with modified radical mastectomy, chemotherapy and tamoxifen. Of the 30 patients with sage III disease that had modified radical mastectomy, complete axillary clearance and tumor free margins were achieved in 25. Overall 21 (36.8%) patients were tumor free at one year. Overall 5-year survival was 22.8%. In conclusion, male patients with breast cancer present with advanced disease which is associated with poor outcome of treatment.

Ahmed, Adamu; Ukwenya, Yahaya; Abdullahi, Adamu; Muhammad, Iliyasu

2012-01-01

181

BRCA Mutation Testing in Determining Breast Cancer Therapy  

PubMed Central

BRCA-mutation associated breast cancer differs from sporadic breast cancer with regard to future cancer risks and sensitivity to systemic therapies. Now that rapid genetic testing for BRCA1 and BRCA2 mutations is available at the time of breast cancer diagnosis, BRCA mutation status can be considered when making treatment and prevention decisions for BRCA mutation carriers with breast cancer. This article reviews surgical options for management of affected BRCA mutation carriers with emphasis on the risks of ipsilateral recurrence and contralateral breast cancer. The roles of breast conserving surgery, prophylactic mastectomy and oophorectomy are reviewed. In addition, sensitivity of BRCA mutation-associated breast cancer to endocrine therapy, platinum chemotherapy and poly (ADP-Ribose) polymerase inhibitors is reviewed.

Smith, Karen Lisa; Isaacs, Claudine

2011-01-01

182

Radiotherapy and breast reconstruction: complications and cosmesis with TRAM versus tissue expander\\/implant  

Microsoft Academic Search

Purpose: Radiotherapy (RT) has an important role in breast cancer treatment after modified radical mastectomy. Many of these patients also undergo breast reconstruction. We reviewed our institutions’ experience to determine the outcome of patients treated with breast reconstruction and RT.Methods and Materials: Between 1981 and 1999, 48 breast cancer patients underwent modified radical mastectomy, breast reconstruction, and ipsilateral breast RT

Ashish K Chawla; Lisa A Kachnic; Alphonse G Taghian; Andrzej Niemierko; Daniel T Zapton; Simon N Powell

2002-01-01

183

Breast Cancer and Sexuality  

Microsoft Academic Search

Breast cancer is the most common form of cancer among women today. With early detection and advanced treatment options, survival rates are continuing to improve, but not without some long-term physical and emotional side effects. This article reviews the effects of breast cancer in general and breast cancer treatment specifically on sexuality in cancer survivors. How the cancer and its

Helene K. Henson

2002-01-01

184

Male Breast Cancer  

Microsoft Academic Search

SummaryBreast cancer is a rare disease in men representing nearly 1% of the total breast cancer cases worldwide. Due to the low incidence, there are no randomized clinical studies giving information on the optimal diagnostics and therapy for male breast cancer patients. Therefore, treatment recommendations are derived from established guidelines for breast cancer in women. However, the lack of awareness

Christian Rudlowski

2008-01-01

185

The surgical management of breast cancer.  

PubMed

The management of breast cancer is highly controversial. Various operations have been performed in different hospitals. This controversy may arise from an incomplete knowledge of the biology of breast cancer. At present, surgeons are highly recommended to perform an adequate surgery which gives the ultimate in local control, does not compromise the chance of cure and gives the best cosmetic and aesthetic results. Recently, the choice of conservative surgery with aggressive radiation therapy versus more adequate surgery, total mastectomy and axillary dissection, is a major controversial problem for primary treatment of operable breast cancer. However, to avoid local recurrence with attendant worry for the patient, conservative surgery should only be indicated for a select group of patients with early breast cancer. At present, there is little doubt that mastectomy and regional lymph node dissection are the most beneficial methods of treatment in all other patients. So, adequate surgery and breast reconstruction are more preferably recommended for ensuring local control and for providing a better psychological impact. PMID:2180836

Noguchi, M; Miyazaki, I

186

Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique.  

PubMed

Preoperative assessment of breast volume could contribute significantly to the planning of breast-related procedures. The availability of 3D scanning technology provides us with an innovative method for doing this. We performed this study to compare measurements by this technology with breast volume measurement by water displacement. A total of 30 patients undergoing 39 mastectomies were recruited from our center. The volume of each patient's breast(s) was determined with a preoperative 3D laser scan. The volume of the mastectomy specimen was then measured in the operating theater by water displacement. There was a strong linear association between breast volumes measured using the 2 different methods when using a Pearson correlation (r = 0.95, P < 0.001). The mastectomy mean volume was defined by the equation: mastectomy mean volume = (scan mean volume × 1.03) -70.6. This close correlation validates the Cyberware WBX Scanner as a tool for assessment of breast volume. PMID:21587046

Yip, Jia Miin; Mouratova, Naila; Jeffery, Rebecca M; Veitch, Daisy E; Woodman, Richard J; Dean, Nicola R

2012-02-01

187

Two cases of choroidal metastasis from breast cancer  

Microsoft Academic Search

We report two cases of choroidal metastasis from breast cancer. The first case was a 41-year-old woman with loss of her right\\u000a upper visual area in whom right breast cancer accompanied by lung and choroidal metastases were detected simultaneously. She\\u000a died without having received radiation therapy for the affected eye 6 months after mastectomy and oophorectomy. The second\\u000a case was

Shingo Inoue; Kaoru Nagahori; Haruki Yamada; Jun Itakura; Yoshiro Matsumoto

1996-01-01

188

Breast Cancer Training Program.  

National Technical Information Service (NTIS)

The Breast Cancer Training Program (BCTP) in the Eppley Cancer Institute of the University of Nebraska Medical Center offers predoctoral and postdoctoral trainees a comprehensive training environment in breast cancer by supporting, in part, an outstanding...

K. H. Cowan J. D. Shull

2002-01-01

189

Breast Cancer Training Program.  

National Technical Information Service (NTIS)

The Breast Cancer Training Program (BCTP) in the Eppley Cancer Institute of the University of Nebraska Medical Center offers predoctoral and postdoctoral trainees a comprehensive training environment in breast cancer by supporting, in part, and outstandin...

K. H. Cowan

2003-01-01

190

Breast Cancer Trends  

MedlinePLUS

... Colorectal (Colon) Lung Ovarian Prostate Skin Cancer Home Breast Cancer Trends Note: The word "significantly" below refers to ... to 2009 in the United States, incidence of breast cancer has— Decreased significantly by 0.9% per year ...

191

Oncological outcome and patient satisfaction with skin-sparing mastectomy and immediate breast reconstruction: a prospective observational study  

PubMed Central

Background The management of early breast cancer (BC) with skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) is not based on level-1 evidence. In this study, the oncological outcome, post-operative morbidity and patients' satisfaction with SSM and IBR using the latissimus dorsi (LD) myocutaneous flap and/or breast prosthesis is evaluated. Methods 137 SSMs with IBR (10 bilateral) were undertaken in 127 consecutive women, using the LD flap plus implant (n = 85), LD flap alone (n = 1) or implant alone (n = 51), for early BC (n = 130) or prophylaxis (n = 7). Nipple reconstruction was performed in 69 patients, using the trefoil local flap technique (n = 61), nipple sharing (n = 6), skin graft (n = 1) and Monocryl mesh (n = 1). Thirty patients underwent contra-lateral procedures to enhance symmetry, including 19 augmentations and 11 mastopexy/reduction mammoplasties. A linear visual analogue scale was used to assess patient satisfaction with surgical outcome, ranging from 0 (not satisfied) to 10 (most satisfied). Results After a median follow-up of 36 months (range = 6-101 months) there were no local recurrences. Overall breast cancer specific survival was 99.2%, 8 patients developed distant disease and 1 died of metastatic BC. There were no cases of partial or total LD flap loss. Morbidities included infection, requiring implant removal in 2 patients and 1 patient developed marginal ischaemia of the skin envelope. Chemotherapy was delayed in 1 patient due to infection. Significant capsule formation, requiring capsulotomy, was observed in 85% of patients who had either post-mastectomy radiotherapy (PMR) or prior radiotherapy (RT) compared with 13% for those who had not received RT. The outcome questionnaire was completed by 82 (64.6%) of 127 patients with a median satisfaction score of 9 (range = 5-10). Conclusion SSM with IBR is associated with low morbidity, high levels of patient satisfaction and is oncologically safe for T(is), T1 and T2 tumours without extensive skin involvement.

2010-01-01

192

Factors Predicting the Axillary Lymph Node Metastasis in Breast Cancer: Is Axillary Node Clearance Indicated in Every Breast Cancer Patient?  

Microsoft Academic Search

The study was carried out to find out predictors of axillary lymph node metastasis in breast cancer and to evaluate its significance\\u000a in selecting the group of patients in whom axillary dissection could be avoided. Ninety-five breast cancer patients who underwent\\u000a mastectomy and axillary dissection were included in the study. Factors like patient’s age, tumor size, histopathological type,\\u000a histological grade

Amrut V. Ashturkar; Gayatri S. Pathak; Sanjay D. Deshmukh; Harshal T. Pandave

193

VIP and breast cancer.  

PubMed

VIP1 receptors are present in breast cancer cells. VIP elevates the cAMP and stimulates nuclear oncogene expression in MCF-7 cells. VIPhybrid is a VIP receptor antagonist that inhibits breast cancer proliferation. A VIP analog has been developed for imaging breast tumors. Therefore VIP1 receptors may be utilized for the early detection and treatment of breast cancer. PMID:9928023

Moody, T W; Leyton, J; Gozes, I; Lang, L; Eckelman, W C

1998-12-11

194

A randomized, double-blind, placebo-controlled trial of preemptive analgesia with bupivacaine in patients undergoing mastectomy for carcinoma of the breast  

PubMed Central

Summary Background In this prospective, randomized, placebo-controlled, double-blinded clinical trial we tested the hypothesis that preemptive analgesia with bupivacaine applied in the area of the surgical incision in patients undergoing mastectomy for breast cancer would reduce post-operative acute pain and would reduce the amount of analgesics used during surgery and in the post-operative period. Material/Methods Participants were assigned into 1 of 2 groups – with bupivacaine applied in the area of surgical incision or with placebo. We assessed the intraoperative consumption of fentanyl, the postoperative consumption of morphine delivered using a PCA method, and the subjective pain intensity according to VAS score reported by patients in the early post-operative period. Results Out of 121 consecutive cases qualified for mastectomy, 112 women were allocated randomly to 1 of 2 groups – group A (bupivacaine) and group B (placebo). The final study group comprised 106 breast cancer cases. Between the groups, a statistically significant difference was observed with respect to: lower fentanyl consumption during surgery (p=0.011), lower morphine (delivered by means of a PCA) consumption between the 4–12th postoperative hours (p=0.02) and significantly lower pain intensity assessed according to VAS score at the 4th and 12th hours after surgery (p=0.004 and p=0.02 respectively) for the group A patients. Conclusions Preemptive analgesia application in the form of infiltration of the area of planned surgical incisions with bupivacaine in breast cancer patients undergoing mastectomy decreases post-operative pain sensation, limits the amount of fentanyl used during surgery, and reduces the demand for opiates in the hours soon after surgery.

Zielinski, Jacek; Jaworski, Radoslaw; Smietanska, Irmina; Irga, Ninela; Wujtewicz, Maria; Jaskiewicz, Janusz

2011-01-01

195

Palmar fasciitis with polyarthritis syndrome in a patient with breast cancer  

Microsoft Academic Search

Palmar fasciitis and polyarthritis syndrome (PFPAS) is a rare paraneoplastic syndrome often associated with ovarian and pancreatic\\u000a cancers, and rarely lung and breast cancers. A 39-year-old patient with breast cancer underwent neoadjuvant chemotherapy,\\u000a radical mastectomy, and radiation therapy. Subsequently, the patient developed PFPAS coinciding with progression of the breast\\u000a cancer. The rheumatological symptoms were severe causing significant distress and handicap.

Kavya Krishna; Abdulraheem Yacoub; Laura F. Hutchins; Patrick M. Kortebein

2011-01-01

196

A new option for early breast cancer patients previously irradiated for Hodgkin's disease: intraoperative radiotherapy with electrons (ELIOT)  

Microsoft Academic Search

INTRODUCTION: Patients who have undergone mantle radiotherapy for Hodgkin's disease (HD) are at increased risk of developing breast cancer. In such patients, breast conserving surgery (BCS) followed by breast irradiation is generally considered contraindicated owing to the high cumulative radiation dose. Mastectomy is therefore recommended as the first option treatment in these women. METHODS: Six patients affected by early breast

Mattia Intra; Oreste Gentilini; Paolo Veronesi; Mario Ciocca; Alberto Luini; Roberta Lazzari; Javier Soteldo; Gabriel Farante; Roberto Orecchia; Umberto Veronesi

2005-01-01

197

Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress  

Microsoft Academic Search

Women diagnosed and surgically treated for regional breast cancer (N = 190) were studied to determine the sexual and body change sequelae for women receiving modified radical mastectomy (MRM) with breast reconstruction in comparison with the sequelae for women receiving breast-conserving therapy (BCT) or MRM without breast reconstruction. The sexuality pattern for women receiving reconstructive surgery was one that was

Debora Yurek; William Farrar; Barbara L. Andersen

2000-01-01

198

Complete tissue expander coverage by musculo-fascial flaps in immediate breast mound reconstruction after mastectomy.  

PubMed

Abstract Immediate breast reconstruction with tissue expander has become an increasingly popular procedure. Complete coverage of the expander by a musculofascial layer provides an additional well-vascularised layer, reducing the rate of possible complications of skin necrosis, prosthesis displacement, and the late capsular contracture. Complete expander coverage can be achieved by a combination of pectoralis major muscle and adjacent thoracic fascia in selected patients. Seventy-five breast mounds in 59 patients were reconstructed, in the first stage a temporary tissue expander inserted immediately after mastectomy and a musculofascial layer composed of the pectoralis major muscle, the serratus anterior fascia, and the superficial pectoral fascia were created to cover the expander. The first stage was followed months later by implant insertion. Minor and major complications were reported in a period of follow-up ranging from 24-42 months (mean 31 months). Complete musculofascial coverage of the tissue expander was a simple and easy to learn technique providing that the patient has a well-formed and intact superficial pectoral and serratus anterior fascia. From a total of 75 breast mounds reconstructed, major complications rate was 4% (overall rate of 19.8%), including major seroma (n = 4), haematoma (n = 1), partial skin loss (n = 3), wound dehiscence (n = 1), major infection (n = 2), severe capsule contracture (n = 1), and expander displacement (n = 3). The serratus anterior fascia and the superficial pectoral fascia flaps can be effectively used as an autologous tissue layer to cover the lower and the lateral aspect of tissue expanders in immediate breast reconstruction after mastectomy. PMID:23802185

Alani, Harith A; Balalaa, Nahed

2013-06-26

199

Breast cancer in a male patient with prolactinoma  

Microsoft Academic Search

A 68-year-old manw as diagnosed as having left primary breast cancer. Systemic bone roentgenography showed no evident metastasis, however, skull roentgenography revealed ballooning of the sella turcica, suggesting a pituitary tumor, which was subsequently confirmed by computed tumography. Because there was a high serum prolactin level, the pituitary tumor was diagnosed as a prolactinoma. A modified radical mastectomy was performed

Shunsuke Haga; Osamu Watanabe; Tadao Shimizu; Tomio Iida; Hiroshi Imamura; Tetsuro Kajiwara; Mariko Fujibayashi

1993-01-01

200

Immunological responses of breast cancer patients to behavioral interventions  

Microsoft Academic Search

This article reports the results of an 18-month study of immune system and psychological changes in stage 1 breast cancer patients provided with relaxation, guided imagery, and biofeedback training. Thirteen lymph node negative patients who had recovered from a modified radical mastectomy were randomly assigned to either an immediate treatment or a delayed treatment control group. Multiple pre-post psychological measures

Barry L. Gruber; Stephen P. Hersh; Nicholas R. S. Hall; Lucy R. Waletzky; John F. Kunz; Joann K. Carpenter; Karan S. Kverno; Sharlene M. Weiss

1993-01-01

201

Smoking as a risk factor for wound healing and infection in breast cancer surgery  

Microsoft Academic Search

Aim: Clinical studies suggest that smoking is associated with wound necrosis after breast cancer surgery. However, the significance of smoking as a risk factor for wound infection, skin flap necrosis, and epidermolysis when adjusting for other potential risk factors remains to be studied.Methods: From June 1994 through August 1996, 425 patients underwent breast cancer surgery as simple mastectomy, modified radical

L. T. Sørensen; J. Hørby; E. Friis; B. Pilsgaard; T. Jørgensen

2002-01-01

202

Determining Which Patients Require Irradiation of the Supraclavicular Nodal Area After Surgery for N1 Breast Cancer  

Microsoft Academic Search

Purpose: We designed this study to determine which patients have a high risk of supraclavicular node recurrence in N1 breast cancer previously treated with surgery but not having received supraclavicular radiation therapy (SCRT) and to identify which patients needed SCRT. Methods and Materials: We performed a retrospective review of 448 pathologic N1 breast cancer patients treated with mastectomy or breast-conserving

Jeong Il Yu; Won Park; Seung Jae Huh; Doo Ho Choi; Young Hyuk Lim; Jin Suk Ahn; Jung Hyun Yang; Suk Jin Nam

2010-01-01

203

Ipsilateral breast tumor recurrence after breast conservation therapy: Outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation  

SciTech Connect

Purpose: To compare outcomes of salvage mastectomy (SM) and salvage breast-conserving surgery (SBCS) and study the feasibility of SBCS. Methods and Materials: Of 2,038 patients treated with breast-conserving therapy at Yale-New Haven Hospital before 1999, 166 sustained an ipsilateral breast tumor recurrence (IBTR). Outcomes and prognostic factors of patients treated with SM or SBCS were compared. Patients were considered amenable to SBCS if the recurrence was localized on mammogram and physical examination, and had pathologic size <3 cm, confined to the biopsy site, without skin or lymphovascular invasion, and with {<=}3 positive nodes. Results: Of the 146 patients definitively managed at IBTR, surgery was SM (n = 116) or SBCS (n 30). The median length of follow-up after IBTR was 13.8 years. The SM and SBCS cohorts had no significant differences, except at IBTR the SM cohort had a greater tumor size (p = 0.049). Of the SM cohort, 65.5% were considered appropriate for SBCS, and a localized relapse was predicted by estrogen-receptor positive, diploid, and detection of recurrence by mammogram. Multicentric disease correlated with BRCA1/2 mutation, estrogen-receptor negative, lymph node positive at relapse, and detection of recurrence by physical examination. Survival after IBTR was 64.5% at 10 years, with no significant difference between SM (65.7%) and SBCS (58.0%). Only 2 patients in the SBCS cohort subsequently had a second IBTR, and were salvaged with mastectomy. Conclusions: While mastectomy is considered the standard surgical salvage of IBTR, SBCS is feasible and prognostic factors are related to favorable tumor biology and early detection. Patients with BRCA1/2 germline mutations may be less appropriate for SBCS, as multicentric disease was more prevalent. Patients who underwent SBCS had comparable outcomes as those who underwent SM, but remain at continued risk for IBTR. A prospective trial evaluating repeat lumpectomy and partial breast reirradiation is discussed.

Alpert, Tracy E. [Department of Radiation Oncology, Upstate Medical University, Syracuse, NY (United States); Kuerer, Henry M. [Department of Surgical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, TX (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Lannin, Donald R. [Department of Surgery, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Department of Radiation Oncology, Robert Wood Johnson Medical School-UMDNJ and Cancer Institute of New Jersey, New Brunswick, NJ (United States)]. E-mail: hafftybg@umdnj.edu

2005-11-01

204

Progressive Wound Necrosis Associated With Postoperative Thrombocytosis in Mastectomy and Immediate Breast Reconstruction Surgery: Report of a Case  

PubMed Central

A 37-year-old who underwent splenectomy for motor vehicle accident-related injuries was diagnosed with stage IIA carcinoma of left breast 12 years later. She underwent bilateral mastectomy and bilateral immediate unipedicle TRAM flap reconstruction. Her preoperative platelet counts ranged from 332 to 424 K/cmm. Intraoperative fluorescein confirmed mastectomy flap viability. On postoperative day 1, platelet count was 374 K/cmm and all suture lines appeared benign. The patient was discharged 3 days later with healthy appearing tram flaps and slight epidermolysis in the abdominal region. Over the next 2 weeks, both the mastectomy flaps and the abdominal region underwent progressive necrosis as the platelet count increased to 1390 K/cmm. Aspirin therapy was instituted at this time. The TRAM flaps remained completely viable. Eighteen days later, the patient required wound debridement with secondary closure of the breast wounds. Platelet count peaked at 1689 K/cmm 2 days later (postoperative day 38). The wounds deteriorated again and were managed conservatively. Two months after mastectomy, the first area of spontaneous healing was documented (platelet count 758 K/cmm). Ultimately, wounds healed as platelet count reached its preoperative baseline. We hypothesize that an abnormal secondary thrombocytosis at subdermal plexus level caused problematic healing in this patient's mastectomy and abdominal flaps.

Murphy, Robert X.; Holko, Ginger A.; Khoury, Afifi A.; Bleznak, Aaron D.

2009-01-01

205

Can Anal Cancer Be Found Early?  

MedlinePLUS

... News About Cancer Expert Voices Blog Programs & Services Breast Cancer Support TLC Hair Loss & Mastectomy Products Hope Lodge® ... Support Communities WhatNext ACS Events Making Strides Against Breast Cancer Walks Coaches vs. Cancer Cancer Prevention Study (CPS- ...

206

Living Beyond Breast Cancer  

MedlinePLUS

... Those With MBC Read more Upcoming Events Metastatic Breast Cancer Part Two: Understanding Disability Rights 10/23/2013 ... disability rights. Read more News You Can Use: Breast Cancer Updates for Living Well 10/26/2013 Join ...

207

Breast Cancer Staging  

MedlinePLUS

Breast cancer Basics In-Depth Multimedia Expert Answers Expert Blog Resources What's New Reprints A single copy of ... may be reprinted for personal, noncommercial use only. Breast cancer staging By Mayo Clinic staff Original Article: http:// ...

208

Breast Cancer Information Clearinghouse  

NSDL National Science Digital Library

NYSERNet's Breast Cancer Information Clearinghouse: an Internet accessible resource for breast cancer patients and their families. Current partners represent government health agencies, hospitals, libraries, hospice and non-profit agencies.

209

Breast Cancer Research Program.  

National Technical Information Service (NTIS)

The Office of the Congressionally Directed Medical Research Programs (CDMRP) was born in 1992 from a powerful grassroots effort led by the breast cancer advocacy community that resulted in a congressional appropriation of funds for breast cancer research....

2010-01-01

210

Optimization of image quality in breast tomosynthesis using lumpectomy and mastectomy specimens  

NASA Astrophysics Data System (ADS)

The purpose of this study was to determine how image quality in breast tomosynthesis (BT) is affected when acquisition modes are varied, using human breast specimens containing malignant tumors and/or microcalcifications. Images of thirty-one breast lumpectomy and mastectomy specimens were acquired on a BT prototype based on a Mammomat Novation (Siemens) full-field digital mammography system. BT image acquisitions of the same specimens were performed varying the number of projections, angular range, and detector signal collection mode (binned and nonbinned in the scan direction). An enhanced filtered back projection reconstruction method was applied with constant settings of spectral and slice thickness filters. The quality of these images was evaluated via relative visual grading analysis (VGA) human observer performance experiments using image quality criteria. Results from the relative VGA study indicate that image quality increases with number of projections and angular range. A binned detector collecting mode results in less noise, but reduced resolution of structures. Human breast specimens seem to be suitable for comparing image sets in BT with image quality criteria.

Timberg, Pontus; Ruschin, Mark; Båth, Magnus; Hemdal, Bengt; Andersson, Ingvar; Svahn, Tony; Mattsson, Sören; Tingberg, Anders

2007-03-01

211

Oxygenation-Enhanced Radiation Therapy of Breast Tumors.  

National Technical Information Service (NTIS)

The treatment of locoregional breast cancer has evolved from radical mastectomy to targeted local therapy with breast conservation. The efficacy of conserving treatments of breast cancers is impeded by tumor hypoxia, which affects 50% of locally advanced ...

M. Skliar

2011-01-01

212

Delay of Adjuvant Chemotherapy After Elective Mastectomy and Immediate Reconstruction in Breast-conservation Candidates: A Matched-pair Analysis.  

PubMed

OBJECTIVES:: To analyze factors that influence the timing of adjuvant chemotherapy in patients who are candidates for breast-conservation therapy (BCT) but elect mastectomy with immediate reconstruction (M-IR). METHODS:: We identified 35 consecutively treated patients with stage I or II breast cancer between 2004 and 2009 who underwent M-IR and adjuvant chemotherapy from the University of Louisville Cancer Registry. We matched these patients for age and AJCC stage to 35 controls who underwent BCT and adjuvant chemotherapy. We examined the timing and delay of initiation of chemotherapy using univariate logistic regression and McNemar test for matched pairs. RESULTS:: For the 70 patients evaluated, the median age was 46 years (range, 30 to 65 y), and the distribution for stage I, IIA, and IIB was 22.9%, 65.7%, and 11.4%, respectively. The 2 groups were well balanced in terms of race, rural/urban status, smoking, diabetes, insurance coverage, and histology. For BCT and M-IR, the median time to chemotherapy initiation was 38 days (range, 25 to 103 d) and 55 days (range, 30 to 165 d), respectively. Patients undergoing M-IR were more likely to experience any delay (>45 d; 54.3% vs. 22.9%; P<0.001) and/or significant delay (>90 d; 20.0% vs. 2.9%; P<0.001). On univariate logistic regression analysis, surgery type had a major impact on delay of chemotherapy (odds ratio=8.35; 95% confidence interval, 2.86-24.4; P<0.001). CONCLUSIONS:: The use of M-IR in breast-conservation candidates independently predicts for delay in initiation of adjuvant chemotherapy. Further study is needed to qualify the causes and clinical significance of these delays. PMID:23466579

Barry, Parul N; Riley, Elizabeth C; Pan, Jianmin; Crew, John B; Lee, Kiwhoon; Jain, Dharamvir; Kruse, Barbara; Quillo, Amy R; Rai, Shesh; Dragun, Anthony E

2013-03-01

213

Breast cancer statistics: use and misuse.  

PubMed

Statistics can be manipulated, by using various methods of reporting, to support almost any type of regime in breast cancer. The basis for statistical calculations include: the definition of the population of patients treated, the time used for starting calculations, the exact nature of the treatment used and any adjuvant therapy, the prognostic parameters utilized, the importance of long-term follow-ups, adequate number of cases, therapy standardization and pathological reporting, methods of evaluating survival such as observed or crude, relative and no evidence of disease, methods of calculating observed survival rates such as absolute, actuarial or life-table and Kaplan Meier or product limit, statistical evaluation for planned improvement with acceptable Type I and Type II errors, and the use of arithmetic and logarithmic scales in plotting statistics. Purveyors of innovative methods for the treatment of breast cancer aimed at preserving part or all of the breast as cosmetic alternatives to mastectomy, by limited operations with and without primary radiotherapy, have a most appealing argument to a woman with breast cancer. To determine if such procedures are justifiable alternatives to selective mastectomies and reconstructions, detailed, long-term statistical data on large numbers of cases must be available and end-results comparisons of various therapeutic modalities must be made on the basis of comparable statistical data. PMID:3557849

Leis, H P; Robbins, G F; Greene, F L; Cammarata, A; Hilfer, S E

214

Male Breast Cancer  

Microsoft Academic Search

Summary Male breast cancer represents with 1.5% of male malignancies a rare disease. Compared to the vast amount of data and knowledge in female breast cancer, male breast cancer is less well-researched and explored. Potential risk factors are oestrogen (exogenous or endogenous), gynaecomastia, radiation, exposure to heat and the Klinefelter’s syndrome. Whereas female breast cancer shows a double-peak risk distribution,

M. Schön; M. Zaiac; P. M. Schlag

1995-01-01

215

A Comparison of Surgical Complications Between Immediate Breast Reconstruction and Mastectomy: The Impact on Delivery of Chemotherapy—An Analysis of 391 Procedures  

Microsoft Academic Search

Purpose  To compare the postoperative complications after immediate breast reconstruction (IBR) versus mastectomy alone and to examine\\u000a the impact on the delivery of chemotherapy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In this prospective series, there were 391 consecutive women who underwent mastectomy (243 mastectomy alone and 148 mastectomy\\u000a and IBR). The outcome measures were complications (within 3 months after surgery) and time to adjuvant chemotherapy.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Compared to the

Toni Zhong; Stefan O. P. Hofer; David R. McCready; Lindsay M. Jacks; Francis E. Cook; Nancy Baxter

216

The Evolution of the Locoregional Therapy of Breast Cancer  

PubMed Central

Breast-conserving therapy (BCT) and mastectomy have equal survival outcomes. Rates of local recurrence after BCT have declined steadily, largely as a result of the widespread use of systemic therapy. Sentinel node biopsy has replaced axillary dissection for staging the axilla, and in women undergoing BCT with whole-breast irradiation (WBI), axillary dissection is not needed for local control or survival in those with fewer than three involved sentinel nodes. Alternatives to 6 weeks of WBI have been shown to be safe and effective for subsets of breast cancer patients, and the use of preoperative chemotherapy allows BCT in some women who require mastectomy if surgery is the initial step in treatment. The combination of the smaller cancers detected with screening and the routine use of multimodality therapy has resulted in a decrease in the morbidity of local therapy and improved cancer treatment outcomes.

Ho, Alice

2011-01-01

217

Prophylactic mastectomy: an appraisal.  

PubMed

The main indication of prophylactic mastectomy pertains to BRCA1 or BRCA2 mutation carriers. Prophylactic mastectomy includes the simple method and the subcutaneous method. Both methods can be followed by breast plastic reconstruction either at the same time or later. This review examines key issues regarding prophylactic mastectomy: the selection of patients, its effectiveness, its limitations, convergence/divergence in existing guidelines, and future perspectives. PMID:23336662

Zagouri, Flora; Chrysikos, Dimosthenis T; Sergentanis, Theodoros N; Giannakopoulou, Georgia; Zografos, Constantine G; Papadimitriou, Christos A; Zografos, George C

2013-02-01

218

Phantom breast syndrome: The effect of in situ breast carcinoma  

Microsoft Academic Search

Phantom breast syndrome (PBS) represents the experience of the continued presence of the breast, after mastectomy. Our aim was to assess PBS appearance by means of a structured questionnaire and to look into possible associations to disease and treatment parameters, in 105 women with breast cancer treated by mastectomy. PBS was recorded in 22.9% of the patients. In the majority

Christos J. Markopoulos; Areti C. Spyropoulou; Iannis M. Zervas; George N. Christodoulou; Charalabos Papageorgiou

2010-01-01

219

Breast Cancer and Bone Loss  

MedlinePLUS

... Cancer and Bone Loss Share: Questions and Answers Breast Cancer and Bone Loss July, 2010 Download PDFs English ... JoAnn Pinkerton, MD What is the link between breast cancer and bone loss? Certain treatments for breast cancer ...

220

A comparison of body image, self-esteem and social support in total mastectomy and breast-conserving therapy in Turkish women  

Microsoft Academic Search

As weil as the medical outcomes of two distinct operations, namely total mastectomy and breast-conserving therapy, their impact on the psychic structureing of the patient may differ. A group of 40 woman with who had undergone mastectomy were therefore compared with another 40 with who had received breast-conserving therapy, with regard to the variables of body image, self-esteem and social

Nlhifer Yiimazer; Adnan Aydincr; Sedar Ozkau; Isik Aslay; Nijad Blige

1994-01-01

221

Reasons why women who have mastectomy decide to have or not to have breast reconstruction.  

PubMed

Breast reconstruction after mastectomy is chosen by approximately 10 percent of Australian women. Younger women are more likely to have this surgical procedure. This suggests that there may be many factors determining this choice. Sixty-four women who wore an external postmastectomy breast prosthesis and 31 women who had postmastectomy breast reconstruction participated in the present study. The purpose was to gain a greater understanding through semi-structured interviews of why women who had breast reconstruction chose this alternative and why women who wore the external postmastectomy breast prosthesis elected not to have reconstruction. The study also ascertained how difficult it was for the women in both groups to decide their particular breast restoration alternative. The most frequently endorsed reasons for not having breast reconstruction in the prosthesis group included: (1) not essential for physical well being, (2) not essential for emotional well being, (3) not having enough information about the procedure, and (4) not wanting anything unnatural in the body. When each member of the group was asked to identify a major reason for not having reconstruction, two predominant issues emerged: (1) fearing complications and (2) perceiving themselves as being too old for the procedure. Twelve percent of the prosthesis group experienced difficulty in making the decision not to have reconstruction. Three factors accounted for this difficulty: (1) the lack of family support, (2) the inability to have a specific type of reconstruction, and (3) the perception that friends and acquaintances saw the surgery as cosmetic. The most frequently reported reasons given by the reconstruction group for having reconstruction included: (1) to get rid of the external breast prosthesis, (2) to be able to wear many different types of clothing, (3) to regain femininity, and (4) to feel whole again. The least influential factors were to improve marital and sexual relations. The major reason cited most often by this group was to feel whole again. None of the women in the reconstruction group experienced any difficulty when deciding their method of breast restoration. What factors are taken into consideration by women when they decide either to have or not to have reconstruction need to be understood by physicians. This knowledge will assist them in conveying appropriate information regarding alternatives and will help them deal with the women's concerns and/or misconceptions. PMID:9623821

Reaby, L L

1998-06-01

222

MD Anderson Cancer Center study reports many advanced breast cancer patients do not receive recommended treatment:  

Cancer.gov

Radiation after a mastectomy for women with advanced breast cancer saves lives, but almost half of these patients do not receive it. The study's results indicate that treatments that have proven their life-saving potential in clinical trials may not be available to many patients.

223

Models of Understanding: Historical Constructions of Breast Cancer in Medicine and Public Health  

ERIC Educational Resources Information Center

The era of technical and scientific progress ushered in with the twentieth century brought new medical knowledge such as the Halstead 'radical' mastectomy, which promised a cure for breast cancer. These advances in medical knowledge were premised on an epidemiological model of disease, which shaped the treatment and public understanding of breast

Petersen, Jennifer

2004-01-01

224

Models of Understanding: Historical Constructions of Breast Cancer in Medicine and Public Health  

ERIC Educational Resources Information Center

|The era of technical and scientific progress ushered in with the twentieth century brought new medical knowledge such as the Halstead 'radical' mastectomy, which promised a cure for breast cancer. These advances in medical knowledge were premised on an epidemiological model of disease, which shaped the treatment and public understanding of breast

Petersen, Jennifer

2004-01-01

225

Hereditary breast cancer and family cancer syndromes  

Microsoft Academic Search

Hereditary breast cancer (HBC) shows extant clinical and genetic heterogeneity. Clinically one finds the onset of breast cancer at an early age, an excess of bilaterality, and patterns of multiple primary cancer such as combinations of breast and ovarian carcinoma in the hereditary breast-ovarian cancer (HBOC) syndrome. In addition to HBOC, one sees a variety of putative breast cancer-prone genotypes

Henry T. Lynch; Jane Lynch; Theresa Conway; Patrice Watson; Jean Feunteum; Gilbert Lenoir; Steven Narod; Robert Fitzgibbons

1994-01-01

226

[Assessment of oncologic risk of breast reconstruction simultaneous with surgery for breast cancer].  

PubMed

The report deals with retrospective research in possible induction of relapse by breast reconstruction carried out simultaneously with surgery for breast cancer. The end results were compared between cases of modification of radical mastectomy combined with reconstruction (n=124) and controls who underwent surgery for cancer alone (n=379). Standard radio- and systemic therapy was used. Median follow-up was 64 months. Local and general recurrence as well as relapse-free and overall survival rates were identical. Multivariate analysis failed to establish any correlation between primary breast reconstruction and relapse. Nor did it increase the risk of the development of the latter. PMID:19241846

Portno?, S M; Blokhin, S N; Arslanov, Kh S; Laktionov, K P; Balakireva, G V; Akhmetov, M Sh

2008-01-01

227

Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks?  

Microsoft Academic Search

Breast reconstruction is considered as part of the breast cancer treatment when a mastectomy is required. The techniques available today, allow reconstruction of the breast even in almost all the cases even in poor local conditions. In 60–70% of the cases, the reconstruction can be performed with an implant inserted behind the pectoralis muscle. Special implants called expanders, are inflatable

Jean-Yves Petit; Mario Rietjens; Cristina Garusi

2001-01-01

228

DECISION ANALYSIS — EFFECTS OF PROPHYLACTIC MASTECTOMY AND OOPHORECTOMY ON LIFE EXPECTANCY AMONG WOMEN WITH BRCA1 OR BRCA2 MUTATIONS  

Microsoft Academic Search

Background Women with BRCA1 or BRCA2 muta- tions have an increased risk of breast cancer and ovarian cancer. Prophylactic mastectomy and oopho- rectomy are often considered as ways of reducing these risks, but the effect of the procedures on life expectancy has not been established. Methods In a decision analysis, we compared pro- phylactic mastectomy and prophylactic oophorec- tomy with

DEBORAH SCHRAG; KAREN M. KUNTZ; JUDY E. GARBER

2010-01-01

229

Prophylactic Mastectomy: Is It Worth It?  

Microsoft Academic Search

Background  Breast cancer is the second mortality-related cancer and the leading cause of general mortality in women aged 40–55. Prophylactic\\u000a mastectomy has proved to be effective in several clinical scenarios but is still a somewhat controversial procedure.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We performed a retrospective study by reviewing the records of all patients who underwent prophylactic mastectomy in a 25-year\\u000a period. We evaluated the aesthetic

Jose Abel de la Peña-Salcedo; Miguel Angel Soto-Miranda; Jose Fernando Lopez-Salguero

230

Increasing Breast Cancer Surveillance among African American Breast Cancer Survivors.  

National Technical Information Service (NTIS)

Breast cancer survivors are at elevated risk for developing a new breast cancer compared to healthy women; they also are at considerable risk for breast cancer recurrence. According to the American Society of Clinical Oncology, survivors should undergo ca...

H. Thompson

2005-01-01

231

Challenges in managing breast cancer during pregnancy.  

PubMed

Pregnancy-associated breast cancer (PABC) is defined as breast cancer occurring anytime during gestation, lactation or within one year after delivery. The optimal management of pregnant women with breast cancer is challenging and not well established; the main concern is the effect of the drugs on the developing fetus and long-term complications after in utero exposure to anti-cancer drugs. Surgical resection is the mainstay of treatment for early breast cancer diagnosed during pregnancy. Modified radical mastectomy is standard of care in first trimester, whereas breast-conserving surgery (lumpectomy with lymph node dissection) can be performed preferably in the second and third trimester. Of note, breast-conserving surgery is not contraindicated per se during the first trimester, but owing to the potential impact of delaying radiotherapy. Radiation therapy is not favored during pregnancy. Moreover, tamoxifen is contraindicated during pregnancy; the agent has been associated with birth defects in up to 20% of exposures. Chemotherapy is generally contraindicated during the first trimester because of the possible damage to organogenesis. Anthracyclines-based regimens are the most widely used is breast cancer treatment and were been shown to be associated with favourable safety profile when administered during pregnancy. As for taxanes, more limited data is available. The use of trastuzumab is contraindicated during pregnancy, given the apparent risk of oligo- and/or anhydramnios as well as the unknown long-term sequelae on the fetus. It is obvious that, diagnosis of breast cancer during pregnancy adds complexity to cancer treatment recommendations. In all cases, a multidisciplinary therapeutic approach among obstetricians, gynaecologists, surgical oncologists, radiation oncologists, medical oncologists, pediatricians and hematologists is clearly warranted. PMID:23819029

Zagouri, Flora; Psaltopoulou, Theodora; Dimitrakakis, Constantine; Bartsch, Rupert; Dimopoulos, Meletios-Athanassios

2013-06-01

232

Vasopressin and Breast Cancer.  

National Technical Information Service (NTIS)

Previously we demonstrated expression of vasopressin and oxytocin gene-related products in breast cancer, but not benign fibrocystic breast disease, using the technique of immunohistochemistry. In vitro and in vivo studies suggest that both of these hormo...

M. J. Fay

1997-01-01

233

Identifying Breast Cancer Oncogenes.  

National Technical Information Service (NTIS)

Breast cancer is attributed to genetic alterations, the majority of which are yet to be characterized. Oncogenic alterations that give rise to breast tumors need to be identified to develop targeted treatment options and consequently, improve clinical out...

Y. Shrestha

2009-01-01

234

Identifying Breast Cancer Oncogenes.  

National Technical Information Service (NTIS)

Breast cancer is attributed to genetic alterations, the majority of which are yet to be characterized. Oncogenic alterations that give rise to breast tumors need to be identified in order to drive development of more efficient targeted or personalized can...

Y. Shrestha

2010-01-01

235

Occult breast cancer: A case report and review of the literature  

Microsoft Academic Search

We report a case of a 44-year-old woman with occult breast cancer presenting as an axillary mass in whom sonography was able\\u000a to detect an involved internal mammary node also, thus helping to establish a diagnosis of breast cancer. The patient underwent\\u000a extended radical mastectomy, including internal mammary lymphadenectomy. Microscopy of the removed specimen failed to find\\u000a a primary breast

Noriyuki Tohnosu; Yoshihiro Nabeya; Masato Yamazaki; Hiroshi Iizuka; Mitsuhiro Matsuda; Yasushi Okazaki; Yoshiji Watanabe; Hirotoshi Sato; Taku Kato; Satoru Ishii; Koji Nonoshita

1996-01-01

236

Symptomatic cardiac metastases of breast cancer 27 years after mastectomy: a case report with literature review - pathophysiology of molecular mechanisms and metastatic pathways, clinical aspects, diagnostic procedures and treatment modalities  

PubMed Central

Metastases to the heart and pericardium are rare but more common than primary cardiac tumours and are generally associated with a rather poor prognosis. Most cases are clinically silent and are undiagnosed in vivo until the autopsy. We present a female patient with a 27-year-old history of an operated primary breast cancer who was presented with dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. The clinical signs and symptoms aroused suspicion of congestive heart failure. However, the cardiac metastases were detected during a routine cardiologic evaluation and confirmed with computed tomography imaging. Additionally, this paper outlines the pathophysiology of molecular and clinical mechanisms involved in the metastatic spreading, clinical presentation, diagnostic procedures and treatment of heart metastases. The present case demonstrates that a complete surgical resection and systemic chemotherapy may result in a favourable outcome for many years. However, a lifelong medical follow-up, with the purpose of a detection of metastases, is highly recommended. We strongly call the attention of clinicians to the fact that during the follow-up of all cancer patients, such heart failure may be a harbinger of the secondary heart involvement.

2013-01-01

237

Immediate breast reconstruction with anatomical permanent expandable implants after skin-sparing mastectomy: aesthetic and technical refinements.  

PubMed

Use of anatomic permanent expandable implant after skin-sparing mastectomy (SSM) permits a 1-stage immediate breast reconstruction with an optimum breast shape. Preservation of most of the mammary skin after SSM on 1 side and anatomic prosthesis shape on the other makes breast reconstruction easier and enhances the quality of the esthetic results. The authors describe their experience with 40 immediate breast reconstructions after SSM performed over a period of 2 years explaining some technical details. The implant is placed in a submuscular pocket, or preferably, depending upon the condition of the muscles and skin flaps after mastectomy, in a submuscular-subfascial pocket. In this case, the undermining of the pocket is submuscular in its upper part under the major pectoralis muscle and subfascial in the lower part of the breast undermining the adipo-fascial tissues above the anterior serratus muscle. The submuscular dissection is done in continuity with the subfascial dissection to allow the complete closure of the soft tissues over the implant. In this case, the minor consistency of subfascial tissues compared with muscle in the inferior pole of the breast allows the easier and quicker distention of the soft tissue overlying the prosthesis during the inflation phase and ensures a good shape of the breast soon after surgery. Whenever possible, the mastectomy is performed through a periareolar skin incision that is closed with a purse-string suture. Finally, the authors discuss the indications of 2 different-shaped anatomic permanent expandable implants: full-height and short-height prostheses with different shape and fullness of the upper pole of the implant. PMID:15084878

Salgarello, Marzia; Seccia, Antonio; Eugenio, Farallo

2004-04-01

238

Predictive factors for skin telangiectasia following post-mastectomy electron beam irradiation  

Microsoft Academic Search

This study evaluated the predictive factors associated with skin telangiectasia following post-mastectomy electron beam irradiation of the chest wall and regional lymph nodes in patients with breast cancer. From July 1987 to December 1994, 120 women with stages II and III breast cancer received electron beam irradiation following modified radical mastectomy. Doses of 50-50.4 Gy per 25-28 fractions were given

E Y HUANG; H C CHEN; C J WANG; L M SUN; H C HSU; Niao-Sung Hsiang; Kaohsiung Hsien

239

Changing attitudes in the management of cancer of the breast.  

PubMed

Opportunity to assess changes in the management of cancer of the breast over the past 7 years was afforded by analysis of responses to questionnaires that were part of an annual questionnaire course. Comparison of responses to questionnaires conducted in 1971 and 1977 identified important features of approaches to this disease and indicated the way in which changes have occurred. Diagnostic needle aspiration increased from 24% (1971) to 54% (1977). In both surveys surgeons reported employing mammography infrequently. Use of modified radical mastectomy increased from 15% (1971) to 60% (1977). Employment of classical radical mastectomy decreased from 83% (1971) to 37% (1977). Surgeons considering biopsy of the contralateral breast to be unnecessary decreased from 47% (1971) to 14% (1977). Skin grafting, after a mastectomy, decreased from 40% (1971) to 24% (1977). Though oophorectomy is still the preferred initial treatment for premenopausal patients with advanced disease, preference for chemotherapy in postmenopausal patients increased from 5% (1971) to 23% (1977). Surgeons approving of reconstruction with implants after mastectomy for carcinoma increased from 30% (1971) to 49% (1977). Following mastectomy in patients with positive axillary nodes, 58% of our respondents employ chemotherapy with several drugs and 34% prefer irradiation. PMID:694733

Lazaro, E J; Rush, B F; Swaminathan, A P

1978-10-01

240

The need for lymph node dissection in nonmetastatic breast cancer.  

PubMed

Determining whether cancer has spread to locoregional lymph nodes is a critical step in the initial staging of breast cancer patients. Although axillary dissection reliably identifies nodal metastases and prevents the recurrence of cancer in the axilla, there is a significant incidence of long-term side effects, notably lymphedema, and the procedure is of no therapeutic benefit in women without axillary metastases. With the advent of sentinel lymph node biopsy, the axilla can be accurately staged in patients with T1-T3, clinically node-negative breast cancers while avoiding the morbidity of axillary lymph node dissection if the nodes do not contain cancer. Recent clinical trials suggest that for women with metastases to 1 or 2 sentinel nodes, the radiation and systemic therapy that are part of modern multimodality breast cancer treatment can replace axillary dissection when breast-conserving therapy is undertaken. For those with greater disease burden or those undergoing mastectomy, axillary dissection remains standard management. PMID:23020881

Pesce, Catherine; Morrow, Monica

2012-09-27

241

Genetics Home Reference: Breast cancer  

MedlinePLUS

... PubMed Recent literature OMIM Genetic disorder catalog Conditions > Breast cancer On this page: Description Genetic changes Inheritance Diagnosis ... names Glossary definitions Reviewed August 2007 What is breast cancer? Breast cancer is a disease in which certain ...

242

Breast Cancer - Metaplastic  

MedlinePLUS

... lymph vessels connect to lymph nodes, the tiny, bean-shaped organs that ordinarily help fight infection. About metaplastic breast cancer Metaplastic breast cancer describes a cancer that begins in one type of cell (such as those from the glands of the ...

243

Breast Cancer Prevention  

Microsoft Academic Search

Early detection, combined with targeted and more effective therapies, has led to reductions in breast cancer related deaths.\\u000a Approximately 90% of women diagnosed with breast cancer in the US today are disease free 5 years after diagnosis. Despite\\u000a these successes, breast cancer remains a major cause of death, particularly among young women. In addition, chronic or prolonged\\u000a toxicities associated with

P. A. Thompson; A. T. Stopeck

244

A nationwide epidemiologic study of breast cancer incidence followingbreast reduction surgery in a large cohort of Swedish women  

Microsoft Academic Search

Summary  While it has been demonstrated that prophylactic mastectomy reduces breast cancer incidence among women at high risk, many\\u000a women often consider this disfiguring surgery unacceptable. One alternative approach may be breast reduction surgery. In order\\u000a to evaluate the long-term incidence of breast cancer following surgical removal of breast tissue, we have extended by 9 years\\u000a the follow-up period of our earlier

Jon P. Fryzek; Weimin Ye; Olof Nyrén; Robert E. Tarone; Loren Lipworth; Joseph K. McLaughlin

2006-01-01

245

Immediate breast reconstruction and psychological adjustment in women who have undergone surgery for breast cancer: a preliminary study.  

PubMed

Current debate exists regarding the timing of reconstructive surgery following mastectomy for breast cancer, with research pointing in favour of immediate reconstruction. This cross-sectional study sought to compare the psychological outcome of breast cancer treatment in women who had either received mastectomy and immediate reconstruction using autogenous tissue (n?=?30), or mastectomy alone (n?=?34), and also determine adjustment factors in this population as a whole. Participants completed measures of depression, anxiety, body image, self-esteem, coping and perceived social support at a time point 3?-?15 months after initial surgery. No significant differences were revealed between the two groups on any of the outcome measures. Poor body image, low self-esteem, and a tendency to use coping strategies characterized by helpless/hopelessness and anxious preoccupation, rather than fighting spirit, were highly predictive of distress. Reasons for the lack of differences between the two groups are explored. PMID:21974734

Holly, P; Kennedy, P; Taylor, A; Beedie, A

2003-11-01

246

Clinical studies on the use of radiation therapy as primary treatment of early breast cancer  

SciTech Connect

The treatment of operable breast cancer by primary radiation therapy instead of mastectomy is undergoing evaluation in the United States and Europe. Retrospective studies of patients treated by primary radiation therapy show that local control and survival rates are comparable to those obtained by mastectomy. Detailed analysis of local failure following primary radiation therapy indicates the importance of excisional biopsy of the primary tumor, moderate doses of radiation to the breast and draining lymph node areas, and the use of a boost to the primary tumor area in maximizing local control. Further, the judicious use of local excision combined with meticulous radiotherapy technique yields highly satisfactory results for the majority of treated patients. Preliminary results from prospective trials also indicate that primary radiation therapy provides both local control and survival rates equivalent to mastectomy. Primary radiation therapy is becoming an increasingly important alternative to mastectomy where surgical and radiotherapeutic expertise are available to optimize both local tumor control and the final cosmetic outcome.

Harris, J.R.; Beadle, G.F.; Hellman, S.

1984-02-01

247

Investigation of irradiation conditions for recurrent breast cancer in JRR-4  

Microsoft Academic Search

Clinical trials of boron neutron capture therapy (BNCT) for recurrent breast cancers are considered at Japan Research Reactor No. 4 (JRR-4). In this study, the irradiation technique for a total mastectomy patient with recurrent cancer was optimized by dosimetric calculations using JAEA computational dosimetry system (JCDS). The evaluation was performed using an en face technique and a tangents technique with

H. Horiguchi; T. Nakamura; H. Kumada; H. Yanagie; M. Suzuki; H. Sagawa

2011-01-01

248

Breast cancer statistics, 2011.  

PubMed

In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including trends in incidence, mortality, survival, and screening. Approximately 230,480 new cases of invasive breast cancer and 39,520 breast cancer deaths are expected to occur among US women in 2011. Breast cancer incidence rates were stable among all racial/ethnic groups from 2004 to 2008. Breast cancer death rates have been declining since the early 1990s for all women except American Indians/Alaska Natives, among whom rates have remained stable. Disparities in breast cancer death rates are evident by state, socioeconomic status, and race/ethnicity. While significant declines in mortality rates were observed for 36 states and the District of Columbia over the past 10 years, rates for 14 states remained level. Analyses by county-level poverty rates showed that the decrease in mortality rates began later and was slower among women residing in poor areas. As a result, the highest breast cancer death rates shifted from the affluent areas to the poor areas in the early 1990s. Screening rates continue to be lower in poor women compared with non-poor women, despite much progress in increasing mammography utilization. In 2008, 51.4% of poor women had undergone a screening mammogram in the past 2 years compared with 72.8% of non-poor women. Encouraging patients aged 40 years and older to have annual mammography and a clinical breast examination is the single most important step that clinicians can take to reduce suffering and death from breast cancer. Clinicians should also ensure that patients at high risk of breast cancer are identified and offered appropriate screening and follow-up. Continued progress in the control of breast cancer will require sustained and increased efforts to provide high-quality screening, diagnosis, and treatment to all segments of the population. PMID:21969133

DeSantis, Carol; Siegel, Rebecca; Bandi, Priti; Jemal, Ahmedin

2011-10-03

249

Carboplatin and Eribulin Mesylate in Triple Negative Breast Cancer Patients  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

2013-05-14

250

BREAST CANCER AND EXERCISE  

ClinicalTrials.gov

Prevent Osteoporosis and Osteoporotic Fractures; Improve Quality of Life; Improve Weight Control, and Muscular and Cardiovascular Fitness; Help the Patients to Return to Working Life; Reduce the Risk of Breast Cancer Recurrence; Prevent Other Diseases and Reduce All-Cause Mortality in Patients With Primary Breast Cancer.

2008-03-19

251

Seaweed Prevents Breast Cancer?  

Microsoft Academic Search

To investigate the chemopreventive effects of seaweed on breast cancer, we have been studying the relationship between iodine and breast cancer. We found earlier that the seaweed, wakame, showed a suppressive effect on the proliferation of DMBA (dimethylbenz(a)anthracene)-induced rat mam- mary tumors, possibly via apoptosis induction. In the present study, powdered mekabu was placed in distilled water, and left to

Hiroomi Funahashi; Tsuneo Imai; Takahiro Mase; Masanori Sekiya; Kazuki Yokoi; Hiromichi Hayashi; Arihiro Shibata; Takako Hayashi; Mikiko Nishikawa; Namiko Suda; Yatsuka Hibi; Yutaka Mizuno; Kyosuke Tsukamura; Akemi Hayakawa; Seiichi Tanuma

2001-01-01

252

Effects of breast cancer surgery and surgical side effects on body image over time  

PubMed Central

We examined the impact of surgical treatments (breast-conserving surgery [BCS], mastectomy alone, mastectomy with reconstruction) and surgical side-effects severity on early stage (0–IIA) breast cancer patients' body image over time. We interviewed patients at 4–6 weeks (T1), six (T2), 12 (T3), and 24 months (T4) following definitive surgical treatment. We examined longitudinal relationships among body image problems, surgery type, and surgical side-effects severity using the Generalized Estimating Equation approach, controlling for demographic, clinical, and psychosocial factors. We compared regression coefficients of surgery type from two models, one with and one without surgical side-effects severity. Of 549 patients enrolled (mean age 58; 75% White; 65% BCS, 12% mastectomy, 23% mastectomy with reconstruction), 514 (94%) completed all four interviews. In the model without surgical side-effects severity, patients who underwent mastectomy with reconstruction reported poorer body image than patients who underwent BCS at T1–T3 (each P < 0.02), but not at T4. At T2, patients who underwent mastectomy with reconstruction also reported poorer body image than patients who underwent mastectomy alone (P = 0.0106). Adjusting for surgical side-effects severity, body image scores did not differ significantly between patients with BCS and mastectomy with reconstruction at any interview; however, patients who underwent mastectomy alone had better body image at T2 than patients who underwent mastectomy with reconstruction (P = 0.011). The impact of surgery type on body image within the first year of definitive surgical treatment was explained by surgical side-effects severity. After 2 years, body image problems did not differ significantly by surgery type.

Collins, Karen Kadela; Liu, Ying; Schootman, Mario; Aft, Rebecca; Yan, Yan; Dean, Grace; Eilers, Mark; Jeffe, Donna B.

2011-01-01

253

Benefits versus risks in conservation surgery with irradiation for breast cancer  

SciTech Connect

This report analyzes the survival and complications inherent in the conventional treatment of breast cancer, radical mastectomy, and the more conservative procedure, conservation surgery with irradiation. Both procedures have benefits and risks. The benefits as measured by survivorship appear to be approximately the same. The major benefit of conservation surgery with irradiation is that the breast is left intact. The possible complication of irradiation carcinogenesis is addressed, and the literature analyzed. This review indicates that the absolute risk of breast cancer developing in the second breast is not nearly as great as originally thought. It is concluded that if a woman with breast cancer is a candidate for either mastectomy or the conservative procedure, it is the clinician's obligation to objectively present the evidence regarding the benefits and risks of these procedures.

Levitt, S.H.; Mandel, J.

1984-07-01

254

Adjuvant CMF chemotherapy in operable breast cancer: Ten years later  

Microsoft Academic Search

This article reports the 10-year results of a trial testing radical mastectomy with or without adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) in 386 women with breast cancer and positive axillary lymph nodes. The long-term analysis confirmed that adjuvant chemotherapy was able to produce a significant relapse-free survival improvement (43.4%) versus control (31.4%,p0.001) and a trend in total survival (55.2% versus

Gianni Bonadonna; Anna Rossi; Pinuccia Valagussa

1985-01-01

255

pynk : Breast Cancer Program for Young Women  

PubMed Central

Consider this scenario: A 35-year-old recently married woman is referred to a surgeon because of a growing breast lump. After a core biopsy shows cancer, she undergoes mastectomy for a 6-cm invasive lobular cancer that has spread to 8 axillary nodes. By the time she sees the medical oncologist, she is told that it is too late for a fertility consultation, and she receives a course of chemotherapy. At clinic appointments, she seems depressed and admits that her husband has been less supportive than she had hoped. After tamoxifen is started, treatment-related sexuality problems and the probability of infertility contribute to increasing strain on the couple’s relationship. Their marriage ends two years after the woman’s diagnosis. Six years after her diagnosis, this woman has completed all treatment, is disease-free, and is feeling extremely well physically. However, she is upset about being postmenopausal, and she is having difficulty adopting a child as a single woman with a history of breast cancer. Could this woman and her husband have been offered additional personalized interventions that might have helped them better cope with the breast cancer diagnosis and the effects of treatment? Compared with their older counterparts, young women with breast cancer often have greater and more complex supportive care needs. The present article describes the goals, achievements, and future plans of a specialized interdisciplinary program—the first of its kind in Canada—for women 40 years of age and younger newly diagnosed with breast cancer. The program was created to optimize the complex clinical care and support needs of this population, to promote research specifically targeting issues unique to young women, and to educate the public and health care professionals about early detection of breast cancer in young women and about the special needs of those women after their diagnosis.

Ali, A.; Warner, E.

2013-01-01

256

pynk : Breast Cancer Program for Young Women.  

PubMed

CONSIDER THIS SCENARIO: A 35-year-old recently married woman is referred to a surgeon because of a growing breast lump. After a core biopsy shows cancer, she undergoes mastectomy for a 6-cm invasive lobular cancer that has spread to 8 axillary nodes. By the time she sees the medical oncologist, she is told that it is too late for a fertility consultation, and she receives a course of chemotherapy. At clinic appointments, she seems depressed and admits that her husband has been less supportive than she had hoped. After tamoxifen is started, treatment-related sexuality problems and the probability of infertility contribute to increasing strain on the couple's relationship. Their marriage ends two years after the woman's diagnosis.Six years after her diagnosis, this woman has completed all treatment, is disease-free, and is feeling extremely well physically. However, she is upset about being postmenopausal, and she is having difficulty adopting a child as a single woman with a history of breast cancer. Could this woman and her husband have been offered additional personalized interventions that might have helped them better cope with the breast cancer diagnosis and the effects of treatment?Compared with their older counterparts, young women with breast cancer often have greater and more complex supportive care needs. The present article describes the goals, achievements, and future plans of a specialized interdisciplinary program-the first of its kind in Canada-for women 40 years of age and younger newly diagnosed with breast cancer. The program was created to optimize the complex clinical care and support needs of this population, to promote research specifically targeting issues unique to young women, and to educate the public and health care professionals about early detection of breast cancer in young women and about the special needs of those women after their diagnosis. PMID:23443036

Ali, A; Warner, E

2013-02-01

257

The globalisation of breast cancer  

Microsoft Academic Search

Breast cancer is the commonest form of cancer in women worldwide; there were an estimated 1.4 million cases world wide in 2008 [1] and there is no part of the world where breast cancer is now a rare form of cancer [2]. In all major regions of the world, breast cancer is the commonest, or second commonest, cancer in women

Peter Boyle; Antony Howell

2010-01-01

258

Breast Cancer: The Orphan Disease  

Microsoft Academic Search

The American Cancer Society estimates that 178,000 women will be diagnosed with breast cancer annually. Estimates of between 1% and 5% of these women will be diagnosed with a more aggressive and less well understood form, inflammatory breast cancer (IBC). Women are often unaware that breast cancer can present without a lump, but with a red rash and swollen breast.

Barbara E. Bond

2008-01-01

259

Breast cancer stem cells.  

PubMed

Cancer metastasis, resistance to therapies and disease recurrence are significant hurdles to successful treatment of breast cancer. Identifying mechanisms by which cancer spreads, survives treatment regimes and regenerates more aggressive tumors are critical to improving patient survival. Substantial evidence gathered over the last 10 years suggests that breast cancer progression and recurrence is supported by cancer stem cells (CSCs). Understanding how CSCs form and how they contribute to the pathology of breast cancer will greatly aid the pursuit of novel therapies targeted at eliminating these cells. This review will summarize what is currently known about the origins of breast CSCs, their role in disease progression and ways in which they may be targeted therapeutically. PMID:23986719

Owens, Thomas W; Naylor, Matthew J

2013-08-27

260

Surgical Treatment of Gynecomastia: Mastectomy Compared to Liposuction Technique.  

PubMed

BACKGROUND: Gynecomastia was a benign enlargement of the male breast. Yet, the enlarged breasts caused much anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery. METHODS: Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010. RESULTS: Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group. CONCLUSIONS: The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications. PMID:23644441

Song, Yan-Ni; Wang, Yan-Bo; Huang, Rui; He, Xiao-Guang; Zhang, Jin-Feng; Zhang, Guo-Qiang; Ren, Yan-Lv; Pang, Jian-Hua; Pang, Da

2013-05-01

261

CISNET: Breast Cancer  

Cancer.gov

However, there are very limited data on the population effects of these novel cancer control approaches. Population modeling is a unique comparative effectiveness paradigm to fill this gap by translating advances from the laboratory and clinical trials to understanding their net effects on US breast cancer mortality. The CISNET Breast Working Group has collaborated over the past nine years to apply independent population models to evaluate cancer control practices and use results to inform clinical and public health guidelines.

262

Screening for Breast Cancer  

PubMed Central

Context Breast cancer screening in community practices may be different from that in randomized controlled trials. New screening modalities are becoming available. Objectives To review breast cancer screening, especially in the community and to examine evidence about new screening modalities. Data Sources and Study Selection English-language articles of randomized controlled trials assessing effectiveness of breast cancer screening were reviewed, as well as meta-analyses, systematic reviews, studies of breast cancer screening in the community, and guidelines. Also, studies of newer screening modalities were assessed. Data Synthesis All major US medical organizations recommend screening mammography for women aged 40 years and older. Screening mammography reduces breast cancer mortality by about 20% to 35% in women aged 50 to 69 years and slightly less in women aged 40 to 49 years at 14 years of follow-up. Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer with variability based on such factors as age of the woman and assessment category assigned by the radiologist. Studies comparing full-field digital mammography to screen film have not shown statistically significant differences in cancer detection while the impact on recall rates (percentage of screening mammograms considered to have positive results) was unclear. One study suggested that computer-aided detection increases cancer detection rates and recall rates while a second larger study did not find any significant differences. Screening clinical breast examination detects some cancers missed by mammography, but the sensitivity reported in the community is lower (28% to 36%) than in randomized trials (about 54%). Breast self-examination has not been shown to be effective in reducing breast cancer mortality, but it does increase the number of breast biopsies performed because of false-positives. Magnetic resonance imaging and ultrasound are being studied for screening women at high risk for breast cancer but are not recommended for screening the general population. Sensitivity of magnetic resonance imaging in high-risk women has been found to be much higher than that of mammography but specificity is generally lower. Effect of the magnetic resonance imaging on breast cancer mortality is not known. A balanced discussion of possible benefits and harms of screening should be undertaken with each woman. Conclusions In the community, mammography remains the main screening tool while the effectiveness of clinical breast examination and self-examination are less. New screening modalities are unlikely to replace mammography in the near future for screening the general population.

Elmore, Joann G.; Armstrong, Katrina; Lehman, Constance D.; Fletcher, Suzanne W.

2011-01-01

263

[Surgical treatment of breast cancer after neoadjuvant therapy].  

PubMed

Primary chemotherapy represents a new therapeutic strategy that allows the implementation of conservative surgical treatment in locally advanced breast cancer or in cancers measuring > 3 cm. Of 127 patients with breast cancers measuring > 2.5 cm, 86 were treated with primary chemotherapy. This consisted in the administration of the ADM + TAX protocol in 28 cases and CNF in 58 cases. Three complete responses, 8 cases of stable disease and 75 partial responses were observed. Eleven radical mastectomies and 74 conservative treatments were performed. The chemotherapy protocol enabled us to convert 87% of the patients treated to conservative treatment, thus affording a treatment that offers a better quality of life despite the existence of a voluminous cancer and is of considerable psychological help in patients suffering from cancer of the breast. PMID:12744090

Gioffrè Florio, Maria Antonietta; Famà, Fausto; Giacobbe, Giuseppa; Pollicino, Andrea; Scarfò, Paola

264

Breast cancer and obesity.  

PubMed

Epidemiological evidence links breast cancer, a typical endocrine-related tumor, with western lifestyle, in particular eating habits. Yet, it's necessary to distinguish premenopausal from postmenopausal breast cancer. Visceral obesity and body weight gain are considered responsible for the increased risk of postmenopausal breast cancer. In fact, the mammary gland is sensitive to the level of circulating estrogens, visceral obesity is usually associated with higher levels of free steroid hormones, and the adipose tissue performs important endocrine function (clearance and aromatisation of androgens, regulation of free testoterone/DHEAS molar ratio). Before menopause, ovarian polycystosis is often seen with android obesity, and breast cancer risk could arise; however, as visceral obesity is generally less frequent, genetic factors are more important than nutritional ones. Furthermore, variations have been recorded in the secretion of insulin and insulin-like growth factors, involved in the genesis of the breast cancer. High body weight and male fat distribution negatively influence prognosis of breast cancer, too; this association is linked with the presence of estrogen and progesterone receptors in tumoral cells. Links between diet quality and breast cancer risk are shown: increased use of saturated fats and animal proteins, and a consequently decreased use of vegetables, legumes and fruit, constituting the so-called Mediterranean diet, are considered responsible for the increased risk of breast cancer. Lower fat and alcohol ingestion, the use of dietary fibre and a higher use of complex carbohydrates could reduce breast cancer risk. Finally, starting from the results of our previous animal researches, we suggest using a tryptophan devoid diet for a few days for premenopausal women with male obesity and alterations to the menstrual cycle. PMID:11449184

La Guardia, M; Giammanco, M

2001-06-01

265

Axillary Metastasis as the First Manifestation of Occult Breast Cancer in a Male Patient  

Microsoft Academic Search

SummaryBackground: The aim of this study was to investigate the clinicopathologic features of male breast cancer. Case Report: We present the clinicopathologic data of a 72year-old male patient with occult breast cancer, who was diagnosed and underwent surgery in our hospital. The diagnosis was confirmed by histological examination, and the patient underwent modified radical mastectomy and axillary dissection. The histological

Guo-Li Gu; Shi-Lin Wang; Xue-Ming Wei; Li Ren; Fu-Xian Zou

2009-01-01

266

Pain after Quadrantectomy and Radiotherapy for Early-Stage Breast Cancer: Incidence, Characteristics and Influence on Quality of Life  

Microsoft Academic Search

Purpose: Conservative breast surgery (CBS) is viewed as a surgical technique able to improve the psychophysical outcome of women who underwent surgery for breast cancer (BC). CBS has clearly improved the impact of local treatment on postoperative body image adjustment, but the effect on patients’ quality of life (QL) is similar to that observed after mastectomy. This insufficient adjustment may

Maurizio Amichetti; Orazio Caffo

2003-01-01

267

Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review  

PubMed Central

‘Well leg compartment syndrome’ refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient. A case involving a 56-year-old woman who developed an anterior compartment syndrome of her right lower leg following a bilateral mastectomy with immediate breast reconstruction is presented. A detailed literature review is also included.

Tashakkor, A Yashar; Macadam, Sheina A

2012-01-01

268

Landmark trials affecting the surgical management of invasive breast cancer.  

PubMed

Significant progress has been made in the surgical management of breast cancer. Most women diagnosed with early stage invasive breast cancer can now be managed with breast-conserving therapy to include a segmental mastectomy followed by radiation. Axillary lymph nodes are routinely assessed by sentinel lymph node biopsy. Axillary lymph node dissection is reserved for patients with documented nodal metastasis; however, here too progress has been made because a population of low-risk patients has been identified in whom a complete dissection is not required even in the setting of a positive sentinel lymph node. This article details the landmark clinical trials that have guided the surgical management of breast cancer. PMID:23464699

Black, Dalliah M; Mittendorf, Elizabeth A

2013-01-29

269

Colorectal cancer in hereditary breast cancer kindreds  

Microsoft Academic Search

PURPOSE: This study compared characteristics of colorectal cancer between families with dominant breast cancer inheritance and the general population. The cumulative incidence of colorectal cancer was also studied in genetically determined breast cancer syndrome subjects with BRCA1 and BRCA2 mutations and compared with the general population. METHODS: Subjects included 42 patients with colorectal cancer from 32 clinically determined hereditary breast

Kevin M. Lin; Charles A. Ternent; Dean R. Adams; Alan G. Thorson; Garnet J. Blatchford; Mark A. Christensen; Patrice Watson; Henry T. Lynch

1999-01-01

270

Docosahexaenoic Acid in Preventing Recurrence in Breast Cancer Survivors  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

2013-08-19

271

Clinical outcomes following nipple-areola-sparing mastectomy with immediate implant-based breast reconstruction: a 12-year experience with an analysis of patient and breast-related factors for complications.  

PubMed

Nipple-sparing mastectomy (NSM) is increasingly offered to women for therapeutic and prophylactic indications. Although, clinical series have been described, there are few studies describing risk factors for complications. The objective of this study is to evaluate the incidence of complications in a series of consecutive patients submitted to NSM and differences between clinical risk factors, breast volume, and different incision types. In a cohort-designed study, 158 reconstructed patients (invasive/in situ cancer and high risk for cancer) were stratified into groups based on different types of incision used (hemi-periareolar, double-circle periareolar, and Wise-pattern). They were matched for age, body mass index, associated clinical diseases, smoking, and weight of specimen. Also included were patients treated with adjuvant chemotherapy and postoperative radiotherapy. Mean follow-up was 65.6 months. In 106 (67 %) patients, NSM was performed for breast cancer treatment and in 52 (32.9 %) for cancer prophylaxis. Thirty-nine (24.6 %) patients were submitted to hemi-periareolar technique, 67 (42.4 %) to double-circle periareolar incision, and 52 (33 %) to Wise-pattern incision. The reconstruction was performed with tissue expander and implant-expander. Local recurrence rate was 3.7 % and the incidence of distant metastases was 1.8 %. Obese patients and higher weight of specimen had a higher risk for complications. After adjusting risk factors (BMI, weight of specimen), the complications were higher for patients submitted to hemi-periareolar and Wise-pattern incisions. This follow-up survey demonstrates that NSM facilitates optimal breast reconstruction by preserving the majority of the breast skin. Selected patients can have safe outcomes and therefore this may be a feasible option for breast cancer management. Success depends on coordinated planning with the oncologic surgeon and careful preoperative and intraoperative management. Surgical risk factors include incision type, obesity, and weight of breast specimen. PMID:23897416

Munhoz, Alexandre Mendonça; Aldrighi, Cláudia Maria; Montag, Eduardo; Arruda, Eduardo Gustavo; Aldrighi, José Mendes; Gemperli, Rolf; Filassi, Jose Roberto; Ferreira, Marcus Castro

2013-07-30

272

Psychosocial outcome in a randomized surgical trial for treatment of primary breast cancer.  

PubMed

A study of the differences in the psychosocial effects of mastectomy versus segmentectomy was done on a group of women who were in a prospective randomized protocol for treatment of primary breast cancer. Through questionnaires designed for this study and standardized psychologic tests, women with segmentectomies responded as significantly less anxious, less sad, and more in control of their life events than women with mastectomies. The women with segmentectomies had a statistically more positive sexual and body image than those with mastectomies. The trauma of viewing the surgery was much greater in patients with mastectomies. The concern about cancer recurrence was less in the segmentectomy group. The differences in psychosexual adaptation to mastectomy or segmentectomy and the fears of cancer recurrence were significantly better in the segmentectomy group. The adequacies of cancer therapy was the same for both groups in the national study. This study restresses the importance of the segmentectomy option for women with breast cancer in leading to a better quality of life. PMID:3044575

Kemeny, M M; Wellisch, D K; Schain, W S

1988-09-15

273

Breast cancer screening update.  

PubMed

Breast cancer is the most common non-skin cancer and the second leading cause of cancer death in North American women. Mammography is the only screening test shown to reduce breast cancer-related mortality. There is general agreement that screening should be offered at least biennially to women 50 to 74 years of age. For women 40 to 49 years of age, the risks and benefits of screening should be discussed, and the decision to perform screening should take into consideration the individual patient risk, values, and comfort level of the patient and physician. Information is lacking about the effectiveness of screening in women 75 years and older. The decision to screen women in this age group should be individualized, keeping the patient's life expectancy, functional status, and goals of care in mind. For women with an estimated lifetime breast cancer risk of more than 20 percent or who have a BRCA mutation, screening should begin at 25 years of age or at the age that is five to 10 years younger than the earliest age that breast cancer was diagnosed in the family. Screening with magnetic resonance imaging may be considered in high-risk women, but its impact on breast cancer mortality is uncertain. Clinical breast examination plus mammography seems to be no more effective than mammography alone at reducing breast cancer mortality. Teaching breast self-examination does not improve mortality and is not recommended; however, women should be aware of any changes in their breasts and report them promptly. PMID:23418799

Tria Tirona, Maria

2013-02-15

274

Effects of breast cancer surgery and surgical side effects on body image over time  

Microsoft Academic Search

We examined the impact of surgical treatments (breast-conserving surgery [BCS], mastectomy alone, mastectomy with reconstruction)\\u000a and surgical side-effects severity on early stage (0–IIA) breast cancer patients’ body image over time. We interviewed patients\\u000a at 4–6 weeks (T1), six (T2), 12 (T3), and 24 months (T4) following definitive surgical treatment. We examined longitudinal\\u000a relationships among body image problems, surgery type, and surgical side-effects

Karen Kadela Collins; Ying Liu; Mario Schootman; Rebecca Aft; Yan Yan; Grace Dean; Mark Eilers; Donna B. Jeffe

2011-01-01

275

Problems and prospects of cancer of the breast in India.  

PubMed

Breast cancer accounts for about 5-8% of cancer in India. It is second to cancer of the cervix in order of frequency. Parsee women have a higher incidence of breast cancer than Hindu women. The unmarried, lately married, and nullipara women are at higher risk than early married and multiparous women. Sometimes cancer affects women of the same family. Women with family histories of cancer should not use estrogen. 50-70% of all breast cancers, when detected, are in their later stages when the chances of a cure are practically nonexistent. 20% of breast cancer patients may live up to 5 years with the disease without receiving treatment. Following radical treatment of curable cases, metastases can remain dormant for many years, up to 18-20, before it develops. Management of breast cancer is biologically, immunologically, and histologically heterogeneous in character and requires multidisciplinary treatment: surgery, radiotherapy, hormone, chemotherapy, and immunotherapy. About 20-40% of late stage cases respond to hormones. Metastatic bone pain is alleviated by local radiotherapy. The management of breast cancer is a controversial topic including such questions as the value of postoperative radiotherapy following radical mastectomy; prophylactic versus therapeutic oopherectomy, and the place of adjuvant chemotherapy. PMID:501120

Chandra, A B

1979-01-16

276

Phantom breast sensations and phantom breast pain: A 2-year prospective study and a methodological analysis of literature  

Microsoft Academic Search

The first aim of this study was to assess prospectively the incidence of phantom breast sensations (PB sensations) and phantom breast pain (PB pain) in a sample of patients treated for breast cancer (n=204) by means of a modified radical mastectomy (n=82). Patients were assessed 6 weeks, 6, 12 and 24 months after mastectomy, by means of a questionnaire. After

Pieter U. Dijkstra; Johan S. Rietman; Jan H. B. Geertzen

2007-01-01

277

Phantom breast sensations and phantom breast pain: A 2-year prospective study and a methodological analysis of literature  

Microsoft Academic Search

The first aim of this study was to assess prospectively the incidence of phantom breast sensations (PB sensations) and phantom breast pain (PB pain) in a sample of patients treated for breast cancer (n = 204) by means of a modified radical mastectomy (n = 82). Patients were assessed 6 weeks, 6, 12 and 24 months after mastectomy, by means

Pieter U. Dijkstra; Johan S. Rietman; Jan H. B. Geertzen

2007-01-01

278

Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study  

Microsoft Academic Search

Physicians are still concerned about the oncological safety regarding immediate breast reconstruction (IBR) in breast cancer\\u000a patients. This study aimed to evaluate possible differences between local, regional, and distant recurrences between women\\u000a having implant-based reconstruction versus women operated with mastectomy alone. Secondary aims were to evaluate time to oncological\\u000a treatment as well as disease-free and breast-cancer-specific survival. In a retrospective

C. Eriksen; J. Frisell; M. Wickman; E. Lidbrink; K. Krawiec; K. Sandelin

2011-01-01

279

[Breast cancer screening].  

PubMed

Since 1989, several breast cancer screening mammography programs have been established. The purpose of this chapter is to provide the history and the main results of the previous programs. Furthermore, special attention is given to the new rules established in 2001 with emphasis of the general principles as well as the ethical principles of breast screening. PMID:12075156

Haehnel, P

2002-04-01

280

Inflammatory Breast Cancer  

MedlinePLUS

... cancer include a rapid increase in breast size; sensations of heaviness, burning, or tenderness in the breast; or a nipple that is inverted (facing inward). Swollen lymph nodes may also be present under the arm, near the collarbone, or in both places. It is important to note that these symptoms ...

281

What Is Breast Cancer in Men?  

MedlinePLUS

... statistics about breast cancer in men? What is breast cancer in men? A breast cancer is a malignant ... women but are very rare in men. General breast cancer terms Here are some of the key words ...

282

Intraoperative radiotherapy for breast cancer.  

PubMed

Postoperative radiotherapy, which forms part of breast-conserving therapy, may not need to encompass the whole breast. Apart from the consumption of huge resources and patients' time, postoperative radiotherapy deters many women from receiving the benefits of breast-conserving surgery, forcing them to choose a mastectomy instead. If radiotherapy could be given in the operating theatre immediately after surgery, many of these disadvantages could be overcome. One striking fact about local recurrence after breast-conserving surgery is that most occurs in the area of breast immediately next to the primary tumour; this is despite the finding that two-thirds of mastectomy samples have microscopic tumours distributed throughout the breast, even when radiotherapy is omitted. Thus, only the area adjacent to the tumour may need treatment with radiotherapy. On the basis of this premise, clinical scientists have used new technology to administer radiotherapy to the area at greatest risk of local recurrence, with the aim of completing the whole local treatment in one sitting. In this review, we have elaborated on the rationale and different methods of delivery of intraoperative radiotherapy. If this approach is validated by the results of current randomised trials, it could save time, money, and breasts. PMID:15003199

Vaidya, Jayant S; Tobias, Jeffrey S; Baum, Michael; Keshtgar, Mohammed; Joseph, David; Wenz, Frederik; Houghton, Joan; Saunders, Christobel; Corica, Tammy; D'Souza, Derek; Sainsbury, Richard; Massarut, Samuele; Taylor, Irving; Hilaris, Basil

2004-03-01

283

Breast and Gynecologic Cancer  

Cancer.gov

This group conducts and supports research on the prevention and early detection of breast, cervix, endometrial, and ovarian cancers. Clinical trials and the evaluation of new agents, surrogate biomarkers, and new technologies to identify premalignant

284

Male Breast Cancer  

Microsoft Academic Search

\\u000a The aim of studying the epidemiology of breast cancer is to identify risk factors that could be eliminated or inhibited. Unfortunately,\\u000a the two major risk factors are gender and increasing age, neither of which can be avoided. Nevertheless, the relative rarity\\u000a of male breast cancer (MBC) has prompted investigations in the hope that the disease in men can give clues

Ian S. Fentiman

285

PKC and Breast Cancer  

Microsoft Academic Search

\\u000a PKC expression is intimately associated with breast cancer initiation, progression, and therapy responsiveness, and these\\u000a effects are highly isozyme-specific. PKC isozymes play key roles in proliferation and apoptosis of breast cancer cells and\\u000a exert important modulatory roles in cell cycle progression. A close relationship exists between specific PKC isozymes and\\u000a estrogen signaling.

Sofia D. Merajver; Devin T. Rosenthal; Lauren Van Wassenhove

286

Progestin and breast cancer  

Microsoft Academic Search

\\u000a Abstract\\u000a   The previous assumption that progestin does not promote breast cancer development needs to be re-examined since a growing\\u000a body of evidence indicates the opposite. Data from recent experimental trials and results from clinical and epidemiological\\u000a studies on hormonal contraceptives and hormone replacement therapy (HRT) have been confronted with breast cancer cases known\\u000a from the German database of adverse drug

Cecylia Giersig

2008-01-01

287

Diet and breast cancer  

Microsoft Academic Search

Clarification of the role of diet in breast cancer pathogenesis is important in order to identify modifiable risk factors\\u000a on which to focus prevention efforts. Excess weight and weight gain in adult life are related to higher risk of postmenopausal\\u000a breast cancer, and weight loss after menopause is associated with substantially reduced risk. Even moderate alcohol consumption\\u000a contributes considerably to

Eleni Linos; Michelle D. Holmes; Walter C. Willett

2007-01-01

288

Natural history of human breast cancer: Recent data and clinical implications  

Microsoft Academic Search

Summary This study of the natural history of human breast cancer was based on the analysis of a series of 3000 patients treated by radical mastectomy at a single institution (Institut Gustave Roussy) at a time when adjuvant chemotherapy was not prescribed. The follow-up of the patients ranged from 15 to 30 years; for each patient the tumor size, the

Maurice Tubiana; Serge Koscielny

1991-01-01

289

Treatment Guidelines and Techniques in Delivery of Postmastectomy Radiotherapy in Management of Operable Breast Cancer  

Microsoft Academic Search

Radiation therapy has been shown to statistically signifi- cantly reduce the risk of locoregional recurrence in high-risk patients with operable breast cancer following mastectomy and systemic therapy. Recent trials have also demonstrated a significant survival benefit following radiotherapy in high- risk patients. Therefore, it is important to identify the pa- tients who could potentially derive that survival benefit and to

Lori J. Pierce

290

Body Size and Breast Cancer Prognosis: A Statistical Explanation of the Discrepancies1  

Microsoft Academic Search

A historical cohort of 68 female breast cancer patients from one institution who were enrolled in a multicenter randomized controlled trial between 1971 and 1973 were followed up to the beginning of 1986. Weight and height at the time of mastectomy were transformed into two indices of body size, namely the Quetelet Index and a weight to \\

Samy Suissa; Michael Pollak; Walter O. Spitzer; Richard Margolese

1989-01-01

291

Antiestrogen treatment of postmenopausal breast cancer patients with high risk of recurrence: 72 months of life-table analysis and steroid hormone receptor status  

Microsoft Academic Search

The role of anti-estrogen treatment of postmenopausal breast cancer patients with high risk of recurrent disease is evaluated in a nationwide, prospective, randomized trial conducted by the Danish Breast Cancer Group. After total mastectomy and postoperative radiotherapy, 829 patients were randomized to treatment with tamoxifen (RT + TAM) for 1 year and 821 were randomized to no further therapy (RT).

Carsten Rose; Henning T. Mouridsen; Susan M. Thorpe; Johan Andersen; Mogens Blichert-Toft; Knud W. Andersen

1985-01-01

292

New innovative techniques in radiotherapy for breast cancer.  

PubMed

Breast-conserving surgery (BCS) followed by adjuvant whole breast radiotherapy (WBRT) is an established treatment for early-stage breast cancer. Long-term follow-up has demonstrated equivalent survival to mastectomy. However, standard WBRT to the conserved breast requires daily radiation treatment, 5 days per week, for 5-7 weeks. This schedule imposes a considerable burden on breast cancer patients and healthcare systems alike. For the last decade, there has been considerable interest in lessening the volume of breast treated with radiotherapy and reducing the number of fractions of radiation treatment. Accelerated partial breast irradiation (APBI), including intraoperative radiotherapy (IORT), delivers high-dose radiation immediately surrounding the lumpectomy cavity, with relative sparing of the majority of the ipsilateral breast. Hypofractionated WBRT delivers radiation to the entire ipsilateral breast; however, this is achieved using a smaller number of fractions and total dose of radiotherapy. The attraction of less invasive or demanding radiotherapy schedules has led to the widespread introduction of APBI before its long-term results have been established. In the past 5 years, data from prospective trials of hypofractionated WBRT and IORT compared to standard WBRT have become available. Additionally, a large, prospective randomized study of APBI versus WBRT is nearing accrual. In this review article, we will discuss these new innovative techniques in radiotherapy for breast cancer. We will also discuss the recently completed and ongoing prospective studies that will provide a robust evaluation of the safety and efficacy of these techniques. PMID:23612227

Murphy, J O; Sacchini, V S

2013-04-01

293

Breast cancer prevention strategies.  

PubMed

The ultimate goal of breast cancer prevention strategies is to reduce the incidence of this disease in populations. Greater understanding of recently identified associations of lactation, alcohol, exercise, and diet with breast cancer is necessary to bring these to bear favorably on the behavior of populations. As a hormonally related process, breast cancer incidence is associated with two major physiologic mechanisms: (1) extent of lobular maturation, which is profoundly influenced by the occurrence of a full-term pregnancy, and (2) hormonal exposure of the breast epithelium, which is influenced by a spectrum of lifestyle factors. Manipulation of these processes by technologically simple and practical means is a major goal of research. Modulation of preclinical growth of breast cancers by chemopreventive means poses significant challenges, due to the absence of target-organ specificity and frequent toxicity. With the emergence of well-supported models of breast cancer development, behavioral and social strategies are likely to be key to achieving the ultimate goal. PMID:9057173

Love, R R; Vogel, V G

1997-02-01

294

Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report  

PubMed Central

Introduction Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation We describe the case of a Caucasian woman who was initially treated for pregnancy-associated breast cancer at age 23, three months after the birth of her third child. She underwent a total mastectomy with axillary node dissection, followed by chemotherapy and hormonal therapy. Ten years later, when the patient was 24?weeks pregnant with her fourth child, she presented with an ipsilateral chest wall recurrence of breast cancer. To the best of our knowledge, this represents the first reported case of a pregnancy-associated recurrence in a patient previously treated for pregnancy-associated breast cancer. Conclusion The case described here is the first report of a second occurrence of pregnancy-associated breast cancer. This case raises the possibility that pregnancy may represent a unique trigger for breast malignancy in a specific cohort of women. Although there is data showing no increase in the risk of recurrence for women who become pregnant after breast cancer treatment, pregnancy-associated breast cancer may be a distinct clinical category where subsequent pregnancies after treatment may confer an increased risk of recurrent disease.

2012-01-01

295

Male mastectomy: An oncoplastic solution to improve aesthetic appearance.  

PubMed

Mastectomy for breast cancer in men typically results in an unsatisfactory aesthetic appearance due to loss of the normal male chest contour. In this article we present two case studies and a new oncoplastic surgical technique that has given excellent aesthetic results for this challenging problem. PMID:23642792

Schaverien, M V; Scott, J R; Doughty, J C

2013-05-01

296

Effect of counselling on the psychiatric morbidity associated with mastectomy  

Microsoft Academic Search

A controlled trial was conducted to determine whether counselling by a specialist nurse prevented the psychiatric morbidity associated with mastectomy and breast cancer. Seventy-five patients were counselled by the nurse and monitored during follow-up, while 77 patients received only the care normally given by the surgical unit. Counselling failed to prevent morbidity, but the nurse's regular monitoring of the women's

P Maguire; A Tait; M Brooke; C Thomas; R Sellwood

1980-01-01

297

Aromatase and breast cancer susceptibility  

Microsoft Academic Search

Based on experimental and epidemiological evidence it is hypothesized that estrogen increases breast cancer risk by increasing mitotic activity in breast epithelial cells. Aromatase is crucial to the biosynthesis of estrogens and may therefore play a role in breast cancer development. Supporting data for an etiological role of aromatase in breast tumor biology are several-fold. First, the association between weight

N M Probst-Hensch; S A Ingles; A T Diep; R W Haile; F Z Stanczyk; L N Kolonel; B E Henderson

1999-01-01

298

Sialyltransferase in Breast Cancer.  

National Technical Information Service (NTIS)

Alterations in sialylation are well documented in breast cancer as well as other epithelial cancers. A principal enzyme implicated in this process is the sialyltransferase ST6Gal, which mediates the synthesis of the sialyl a2, 6-anomeric linkage to termin...

J. T. Lau

2002-01-01

299

Sialyltransferase in Breast Cancer.  

National Technical Information Service (NTIS)

Alterations in sialylation are well documented in breast cancer as well as other epithelial cancers. A principal enzyme implicated in this process is the sialyltransferase ST6Gal, which mediates the synthesis of the sialyl a2, 6-anomeric linkage to termin...

J. T. Lau

2001-01-01

300

The utility of hyperthermia for local recurrence of breast cancer  

PubMed Central

Background Hyperthermia has long been used in combination with chemotherapy or radiation therapy for the treatment of superficial malignancies, in part due to its sensitizing capabilities. Patients who suffer from superficial recurrences of breast cancer have poor clinical outcomes. Skin metastases may particularly impair the quality of life due to the physical appearance, odor and bleeding. Case presentation A 66-year-old woman underwent mastectomy and axillary lymph node dissection for breast cancer. Nine years post-operatively, local metastases developed in the left axillary area (measuring 5 cm in diameter). Initially the tumor did not respond to radiation therapy and chemotherapy. Therefore, we added hyperthermia combined with them. Eight weeks later, the tumor became nearly flat and the patient noted improved activity in her daily life. Conclusion Hyperthermia may accelerate the antitumor effects of radiation therapy and chemotherapy. This treatment provides an alternative for unresectable breast cancer skin metastases.

2012-01-01

301

Melatonin, Aging and Breast Cancer.  

National Technical Information Service (NTIS)

An increasing percentage of elderly women, particularly in industrialized countries, are developing breast cancer. Numerous hypotheses have been proposed to explain this dramatic increase in breast cancer incidence in the later stages of life. However, an...

S. M. Hill

2001-01-01

302

Breast Cancer Center Support Contract.  

National Technical Information Service (NTIS)

This document represents the final report for our Breast Cancer Center Support Grant. Our grant consisted of five areas, three projects and two cores. Projects included: Project 1 - Impact of Genetic Testing for Breast Cancer Susceptibility; Project 2 - A...

K. J. Cullen

2001-01-01

303

Computer Aided Breast Cancer Diagnosis.  

National Technical Information Service (NTIS)

The long range goal of this project is to improve the accuracy and consistency of breast cancer diagnosis by developing a Computer Aided Diagnosis (CAD) system for early prediction of breast cancer from the patients' mammographic findings and medical hist...

C. E. Floyd

1996-01-01

304

Epidemiology of breast cancer.  

PubMed

Breast cancer is the commonest cause of cancer death in women worldwide. Rates vary about five-fold around the world, but they are increasing in regions that until recently had low rates of the disease. Many of the established risk factors are linked to oestrogens. Risk is increased by early menarche, late menopause, and obesity in postmenopausal women, and prospective studies have shown that high concentrations of endogenous oestradiol are associated with an increase in risk. Childbearing reduces risk, with greater protection for early first birth and a larger number of births; breastfeeding probably has a protective effect. Both oral contraceptives and hormonal therapy for menopause cause a small increase in breast-cancer risk, which appears to diminish once use stops. Alcohol increases risk, whereas physical activity is probably protective. Mutations in certain genes greatly increase breast-cancer risk, but these account for a minority of cases. PMID:11902563

Key, T J; Verkasalo, P K; Banks, E

2001-03-01

305

Breast reconstruction after mastectomy at an urban community-based program.  

PubMed

Reconstruction after mastectomy is an elective procedure. To date many factors have been associated with the choice of operation in these patients including socioeconomic status, insurance, age, comorbidities, and community factors. In an effort to understand the characteristics of patients who undergo reconstruction at our hospital, we performed a retrospective review of patients who received mastectomy at our institution. A total of 354 patients underwent mastectomy from 2006 to 2010 at our hospital. Data from 332 patients undergoing reconstruction within 1 year of mastectomy were then analyzed and ?(2) analysis was performed to identify factors significant in the choice of reconstruction. Age younger than 50 years (odds ratio [OR], 3.87), age older than 70 years (OR, 0.09), presence of insurance (OR, 2.89), diabetes (OR, 0.401), hypertension (OR, 0.379), and Medicare (0.182) were found to be significant factors associated with a choice of reconstruction among our patients. When age was corrected for, insurance status was no longer a significant factor in choice of reconstruction. Over 90 per cent of patients underwent implant or tissue expanders for reconstruction. This study reflects the reconstruction choices of patients in our community, city-based hospital. PMID:23089449

Miller, Anthony; Chandru Kowdley, Gopal

2012-11-01

306

Azacitidine and Entinostat in Treating Patients With Advanced Breast Cancer  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Recurrent Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Triple-negative Breast Cancer

2013-08-19

307

MD Anderson researchers find that APBI is associated with more mastectomies, toxicities, complications, compared to traditional radiation  

Cancer.gov

Accelerated partial breast irradiation brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation.

308

Hereditary breast cancer in Jews  

Microsoft Academic Search

A family history of breast cancer poses higher risks for Jewish versus non-Jewish women, particularly for early-onset breast cancer. This appears to be due in large part to the high prevalence (2.5%) of three BRCA1 and BRCA2 founder mutations in Ashkenazi Jews. About 4 to 8% of non-Jewish male breast cancer cases versus 19% of Jewish male breast cancer cases

Wendy S. Rubinstein

2004-01-01

309

Factors associated with local recurrence and cause-specific survival in patients with ductal carcinoma in situ of the breast treated with breast-conserving therapy or mastectomy  

SciTech Connect

Purpose: We reviewed our institution's experience treating patients with ductal carcinoma in situ (DCIS) of the breast to determine risk factors for ipsilateral breast tumor recurrence (IBTR) and cause-specific survival (CSS) after breast-conserving therapy (BCT) or mastectomy. Materials and Methods: Between 1981 and 1999, 410 cases of DCIS (405 patients) were treated at our institution; 367 were managed with breast-conserving surgery (54 with lumpectomy alone and 313 with adjuvant radiation therapy (RT) [median dose, 45 Gy]). Of these 313 patients, 298 received also a supplemental boost of RT to the lumpectomy cavity (median dose, 16 Gy). Forty-three patients underwent mastectomy; 2 (5%) received adjuvant RT to the chest wall. A true recurrence/marginal miss (TR/MM) IBTR was defined as failure within or adjacent to the tumor bed in patients undergoing BCT. Median follow-up for all patients was 7 years (mean: 6.1 years). Results: Thirty patients (8.2%) experienced an IBTR after BCT (25 [8%] after RT, 5 [9.3%] after no RT), and 2 patients (4.7%) developed a chest wall recurrence after mastectomy. Of the 32 local failures, 20 (63%) were invasive (18/30 [60%] after BCT and 2/2 [100%] after mastectomy), and 37% were DCIS alone. Twenty-four (80%) of the IBTRs were classified as TR/MM. The 10-year freedom from local failure, CSS, and overall survival after BCT or mastectomy were 89% vs. 90% (p = 0.4), 98% vs. 100% (p = 0.7), and 89% vs. 100% (p = 0.3), respectively. Factors associated with IBTR on Cox multivariate analysis were younger age (p = 0.02, hazard ratio [HR] 1.06 per year), electron boost energy {<=}9 MeV (p = 0.03, HR 1.41), final margins {<=}2 mm (p = 0.007; HR, 3.65), and no breast radiation (p = 0.002, HR 5.56). On Cox univariate analysis for BCT patients, IBTR, TR/MM failures, and predominant nuclear Grade 3 were associated with an increased risk of distant metastases and a reduced CSS. Conclusions: After treatment for DCIS, 10-year rates of local control, CSS, and overall survival were similar after mastectomy and BCT. Young age (<45 years), close/positive margins ({<=}2 mm), no breast radiation, and lower electron boost energies ({<=}9 MeV) were associated with IBTR. Local failure and predominant nuclear Grade 3 were found to have a small (4%-12%) but statistically significantly negative impact on the rates of distant metastasis and CSS. These results suggest that optimizing local therapy (surgery and radiation) is crucial to improve local control and CSS in patients treated with DCIS.

Vargas, Carlos [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Kestin, Larry [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Go, Nel [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Krauss, Daniel [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Chen, Peter [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Goldstein, Neal [Department of Pathology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Martinez, Alvaro [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States); Vicini, Frank A. [Department of Radiation Oncology, William Beaumont Hospital, Beaumont Cancer Institute, Royal Oak, MI (United States)]. E-mail: fvicini@beaumont.edu

2005-12-01

310

HER2, P53 and hormonal receptors protein expression as predictive factors in breast cancer prognosis  

Microsoft Academic Search

Objective  Breast cancer is a heterogeneous disease with variable biological and clinical characteristics. We conducted a study to evaluate\\u000a P53, HER-2\\/neu and hormonal receptor expression as predictors of prognosis in breast cancer.\\u000a \\u000a \\u000a \\u000a Methods  In a prospective study, we recruited 81 consecutive patients with primary operable breast cancer who were treated with mastectomy\\u000a followed by locoregional radiotherapy or chemotherapy and studied the presence

Seyed Mohammad Rabiee Hashemi; Somayeh Rabiee Hashemi

2008-01-01

311

Seaweed prevents breast cancer?  

PubMed

To investigate the chemopreventive effects of seaweed on breast cancer, we have been studying the relationship between iodine and breast cancer. We found earlier that the seaweed, wakame, showed a suppressive effect on the proliferation of DMBA (dimethylbenz(a)anthracene)-induced rat mammary tumors, possibly via apoptosis induction. In the present study, powdered mekabu was placed in distilled water, and left to stand for 24 h at 4 degrees C. The filtered supernatant was used as mekabu solution. It showed an extremely strong suppressive effect on rat mammary carcinogenesis when used in daily drinking water, without toxicity. In vitro, mekabu solution strongly induced apoptosis in 3 kinds of human breast cancer cells. These effects were stronger than those of a chemotherapeutic agent widely used to treat human breast cancer. Furthermore, no apoptosis induction was observed in normal human mammary cells. In Japan, mekabu is widely consumed as a safe, inexpensive food. Our results suggest that mekabu has potential for chemoprevention of human breast cancer. PMID:11376555

Funahashi, H; Imai, T; Mase, T; Sekiya, M; Yokoi, K; Hayashi, H; Shibata, A; Hayashi, T; Nishikawa, M; Suda, N; Hibi, Y; Mizuno, Y; Tsukamura, K; Hayakawa, A; Tanuma, S

2001-05-01

312

CDC Vital Signs: Breast Cancer  

MedlinePLUS

... 2.65 MB] Read the MMWR November 2012 Breast Cancer Black Women Have Higher Death Rates from Breast Cancer Than Other Women On this Page Problem U.S. ... to Top U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

313

Breast cancer in young women  

Microsoft Academic Search

ABSTRACT: Although uncommon, breast cancer in young women is worthy of special attention due to the unique and complex issues that are raised. This article reviews specific challenges associated with the care of younger breast cancer patients, which include fertility preservation, management of inherited breast cancer syndromes, maintenance of bone health, secondary prevention, and attention to psychosocial issues.

Courtney A Gabriel; Susan M Domchek

2010-01-01

314

Clinical proteomics in breast cancer  

Microsoft Academic Search

Breast cancer imposes a significant healthcare burden on women worldwide. Early detection is of paramount importance in reducing mortality, yet the diagnosis of breast cancer is hampered by a lack of adequate detection methods. In addition, better breast cancer prognostication may improve selection of patients eligible for adjuvant therapy. Hence, new markers for diagnosis and prognosis are warranted to improve

M. C. W. Gast

2009-01-01

315

Screening of Breast Cancer  

Microsoft Academic Search

\\u000a In the randomized controlled trials carried out in the late 1970s and the 1980s, mammographic screening was demonstrated to\\u000a have an impact in decreasing mortality from breast cancer. The evaluation of mammographic service screening programmes implemented\\u000a in several Western European countries in the late 1980s and the 1990s demonstrated that these programmes may have an even\\u000a higher effect on breast

Per Skaane

316

Diet and breast cancer.  

PubMed

The preponderance of evidence suggests a role for fat and alcohol as risk factors for breast cancer. The role of milk is more controversial with some studies suggesting that milk is a risk factor and others that consumption of milk is protective against breast cancer. No other major nutrient appears to play a significant role in increasing breast cancer risk. On the other hand, there is increasing evidence that a variety of micronutrients and hormones appear to have significant anticancer activity. These range from steroids such as dehydroepiandrosterone (DHEA) and its analysis to indoles, isothiocyanates, and isoflavone derivatives. These compounds act directly by interfering with cyclins and promoting apoptosis as well as indirectly by altering estrogen metabolism in a favorable direction. These effects are not merely theoretical actions in cell culture and tissue explants; they have been demonstrated in human patients as a range of studies have demonstrated. PMID:12095951

Bradlow, H Leon; Sepkovic, Daniel W

2002-06-01

317

Clinical implications for BRCA gene mutation in breast cancer.  

PubMed

To investigate the mutations of BRCA1 and BRCA2 and determine whether clinic-pathological factors related to BRCA gene mutation. Mastectomy specimens from 360 breast cancers were enrolled and examined in the study. The relationship between BRCA gene mutation and clinic-pathological factors was evaluated. Overall, 280 patients were BRCA negative and 80 got BRCA gene mutation. Triple-negative breast cancers--i.e., breast cancers that do not express estrogen receptors (ER), progesterone receptors (PR) or human epidermal growth factor receptor 2 (HER2/neu)--was observed in 53.85% of the BRCA1 mutation patients, in 28.57% of the BRCA2 mutation cases, while 14.29% of BRCA negative patients. BRCA1 mutation patients got a heavy lymph node metastasis and higher nuclear grade tumors than the others (P = 0.004, 0.007). Furthermore, BRCA mutation was also found to be significantly related to ER, PR and HER2/neu status (P < 0.05). BRCA1 expression was not associated with breast cancer-specific survival in the triple-negative breast cancers (P = 0.742). After Cox regression, BRCA1 mutation was not shown to be an independent prognostic factor for breast cancer. These findings substantiated the possibility of tumors associated with BRCA1 mutations divided into two distinct groups, triple-negative and non-triple-negative groups requires further investigation. PMID:21691706

Xu, Jin; Wang, Baosheng; Zhang, Yanjun; Li, Ruihui; Wang, Yuehua; Zhang, Shaokun

2011-06-21

318

Occult Breast Cancer: A Case Report and Review of the Literature.  

PubMed

We report a case of a 44-yar-old woman with occult breast cancer presenting as an axillary mass in whom sonography was able to detecct an involved internal mammary node also, thus helping to establish a diagnosis of breast cancer. The patient underwent extended radical mastectomy, including internal mammary lymphadenectomy. Microscopy of the removed specimen failed to find a primary breast cancer lesion. Metastatic cancer was seen in the palpable axillary node, another resected axillary node and a removed internal mammary node. The estrogen and progesterone receptor analysis of the axillary node were negative. Since occult breast cancer was found highly potential for metastasizing to the infraclavicular or internal mammary nodes, it is reasonable to treat such patients in the same way as those with palpable breast cancer, with adjuvant chemotherapy. PMID:11091761

Tohnosu; Nabeya; Yamazaki; Iizuka; Matsuda; Okazaki; Watanabe; Sato; Kato; Ishii; Nonoshita

1996-12-20

319

Locoregional recurrence rates and prognostic factors for failure in node-negative patients treated with mastectomy: Implications for postmastectomy radiation  

Microsoft Academic Search

Purpose: Postmastectomy radiation therapy (PMRT) reduces locoregional recurrence (LRR) of breast cancer. Survival appears improved in patients at higher risk for LRR. This study addresses whether subsets of node-negative patients with sufficiently high risk of LRR might benefit from PMRT. Methods: Retrospective analysis of a cohort of 877 cases of node-negative breast cancer treated with mastectomy, without adjuvant radiation, from

Reshma Jagsi; Rita Abi Raad; Saveli Goldberg; Timothy Sullivan; James Michaelson; Simon N. Powell; Alphonse G.. Taghian

2005-01-01

320

MRI and Mammography Before Surgery in Patients With Stage I-II Breast Cancer  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Triple-negative Breast Cancer

2013-09-24

321

[Accepting a mastectomy thanks to socio-aesthetics].  

PubMed

For women of all ages, a mastectomy can affect their body image and femininity. Poor management, both physical and emotional, of a breast removal, can have major consequences on a patient's intimate, family and social life. In the framework of the multi-disciplinary treatment of breast cancer, a team in Lyon carried out a study on the impact of including socio-aesthetic practices in the overall care. PMID:23316588

Arquillière, Agnès; Blanc, Nathalie

2012-12-01

322

Knowledge about breast cancer risk factors and hereditary breast cancer among early-onset breast cancer survivors  

Microsoft Academic Search

Little is known about knowledge levels regarding hereditary breast cancer among breast cancer survivors. This study explored, among women with early-onset breast cancer (<50 years): 1) knowledge regarding breast cancer risk factors and hereditary breast cancer; and 2) differences in knowledge based on risk for hereditary disease. Participants recruited from 34 Virginia hospitals responded to two questionnaires. The Family History

Susan Miesfeldt; Wendy Cohn; Mary Ropka; Susan Jones

2001-01-01

323

Pulmonary metastasis from breast cancer with an 18-year disease-free interval: implication of the role of surgery.  

PubMed

Abstract The appearance of pulmonary metastasis more than 15 years after primary treatment for breast cancer is rare. We herein report the case of a breast cancer patient with solitary pulmonary metastasis, after an 18-year disease-free period, treated with resection. A 66-year-old Japanese woman was found to exhibit an abnormal shadow on a chest X-ray. She had undergone a left mastectomy for breast cancer 18 years previously. The nodule was suspected to be either metastatic or primary lung cancer, and thus thoracoscopic surgery was performed. The histologic diagnosis was metastasis from breast cancer. Pulmonary resection in breast cancer recurrence is an important diagnostic tool that allows for a differential diagnosis with primary lung cancer. The clinical implication of surgery for a solitary pulmonary metastasis from breast cancer is discussed in this report. PMID:23294064

Fujii, Takaaki; Yajima, Reina; Yamaki, Ei; Kohsaka, Takayuki; Yamaguchi, Satoru; Tsutsumi, Soichi; Mogi, Akira; Asao, Takayuki; Kuwano, Hiroyuki

324

Cancer of the male breast.  

PubMed

The purpose of this study was to investigate the biological behavior of male breast cancer. We evaluated 11 cases of male breast cancer with respect to tumor growth, extent of disease, hormone receptor status, and histological grade of the malignancy, in comparison with 241 cases of female breast cancer. The duration of symptoms was 8.6 +/- 9.1 months in males and 8.5 +/- 18.6 months in females. The incidences of stages I, II, and III were 46%, 27%, and 27%, respectively, in male breast cancer, and 38%, 49%, and 13% in female breast cancer. Metastasis to the lymph node was negative in 60% of the male patients and 54% of the female patients. All cases of male breast cancer were histologically grade I according to Bloom's classification; the histological grades were as follows for the female breast cancer cases: grade I in 99 patients, grade II in 87, and grade III in 55. The rates of hormone receptor positively were 89% for ER and 86% for PgR in male breast cancer, and 64% for ER and 44% for PgR in female breast cancer. Therefore, there was no significant difference in the growth of male breast cancer and female breast cancer, but in male breast cancer the rate of hormone receptor positivity was high, endocrine therapy was effective, and the histological grade was low. Accordingly, the result following appropriate treatment of male breast cancer should be at least comparable to the results with female breast cancer. PMID:2370802

Morimoto, T; Komaki, K; Yamakawa, T; Tanaka, T; Oomine, Y; Konishi, Y; Mori, T; Monden, Y

1990-07-01

325

Subareolar breast cancers  

Microsoft Academic Search

Background: Despite the high rate of pathologic involvement of the nipple-areola complex (NAC) with subareolar cancers and the suboptimal cosmetic results when lumpectomy removes the NAC, breast conservation surgery has been extended to include these patients.Methods: Ninety-five patients with subareolar cancers operated on between 1979 and 1998 were identified and the relationships between the pathologic findings, treatment, and outcome were

Csaba Gajdos; Paul Ian Tartter; Ira J Bleiweiss

2000-01-01

326

Breast Cancer Stem Cells  

PubMed Central

Breast cancer stem cells (BCSCs) constitute a subpopulation of tumor cells that express stem cell-associated markers and have a high capacity for tumor generation in vivo. Identification of BCSCs from tumor samples or breast cancer cell lines has been based mainly on CD44+/CD24?/low or ALDH+ phenotypes. BCSCs isolation has allowed the analysis of the molecular mechanisms involved in their origin, self-renewal, differentiation into tumor cells, resistance to radiation therapy and chemotherapy, and invasiveness and metastatic ability. Molecular genetic analysis using knockout animals and inducible transgenics have identified NF-?B, c-Jun, p21CIP1, and Forkhead-like-protein Dach1 in BCSC expansion and fate. Clinical analyses of BCSCs in breast tumors have found a correlation between the proportion of BCSCs and poor prognosis. Therefore, new therapies that specifically target BCSCs are an urgent need. We summarize recent evidence that partially explain the biological characteristics of BCSCs.

Velasco-Velazquez, Marco A.; Homsi, Nora; De La Fuente, Marisol; Pestell, Richard G.

2012-01-01

327

[Possibilities of surgical treatment for disseminated breast cancer].  

PubMed

More than in 10% of breast cancer patients distant metastases are detected at diagnosis. The results of treatment of 191 patients are presented. Removal of the primary tumor in case of newly diagnosed advanced breast cancer (oligometastatic) increases the mean duration of life from 26 months up to 38 months (p < 0.01). 3-year overall survival increases from 49% to 71% (p = 0.001), and a 5-year survival-from 18% to 47% (p = 0.001). 9% of patients with metastatic breast cancer who underwent mastectomy live 10 years and more. The relative risk of death in the presence of distant metastases after resection of primary tumor, on average decreases by 34%. By means of multivariable analysis the best results after mastectomy were obtained in the localization of distant metastases in the bones and soft tissues, high expression of steroid hormone receptors, the absence of overexpression of HER2/neu, luminal A type, positive response to preoperative systemic therapy and attaining free surgical margins. PMID:23909032

Bozhok, A A; Topuzov, É É; Semiglazov, V F; Klimov, N A; Kasianova, M N; Osianikov, A A

2013-01-01

328

Monotherapy with paclitaxel as third-line chemotherapy against anthracycline-pretreated and docetaxel-refractory metastatic breast cancer  

Microsoft Academic Search

We describe a patient with anthracycline-pretreated and docetaxel-refractory metastatic breast cancer who achieved a complete\\u000a response after third-line chemotherapy with paclitaxel. A 59-year-old woman underwent modified radical mastectomy for advanced\\u000a cancer in her left breast after local arterial neoadjuvant chemotherapy with anthracycline. Postoperatively anthracycline-containing\\u000a adjuvant therapy was administered. Pulmonary metastases occurred 15 months after surgery, which did not respond to

Jun Kinoshita; Shunsuke Haga; Tadao Shimizu; Hiroshi Imamura; Osamu Watanabe; Hiroshi Nagumo; Yoshihito Utada; Toshihiko Okabe; Kiyomi Kimura; Akira Hirano; Tetsuro Kajiwara

2002-01-01

329

Long-term monitoring of cell-mediated immunity in disease-free breast cancer patients: a preliminary retrospective study  

Microsoft Academic Search

In 102 N– and 44 N+ disease-free breast cancer patients, lymphocytic populations and skin reaction of delayed hypersensitivity (SRDH) were monitored up to 266 months after mastectomy to find out whether they were similar or different from control values. In two selected groups of 34 N– and 11 N+ breast cancer patients, the whole 10 year follow-up was divided into three subintervals, each of them lasting

A. Nicolini; A. Carpi; P. Ferrari; G. Tartarelli; L. Anselmi; M.-R. Metelli; I. Gorini; C. Spinelli; P. Miccoli; R. Giardino

2002-01-01

330

Recurrent Breast Cancer  

MedlinePLUS

... t usually recommended because of the risk of side effects. Drug therapy (chemotherapy). If your recurrent breast cancer is the ... stamina and your ability to cope with the side effects of treatments. But eating ... includes chemotherapy or radiation therapy. For times when you don' ...

331

Breast Cancer Statistics  

Cancer.gov

The maps show a pattern of elevated mortality rates for female breast cancer extending from the Mid-Atlantic through the Northeastern states has persisted for many years. Established risk factors are believed to be largely responsible, but the remaining reasons are unknown.

332

Sexuality after breast cancer  

Microsoft Academic Search

Breast cancer (BC) may affect three main domains of women's sexuality: sexual identity, sexual function and sexual relationship. Age, lymphedema, side-effects of surgery, radio-, chemo- and hormonotherapy, pregnancy-related problems, infertility, iatrogenic premature menopause, with its cohort of symptoms secondary to the chronic loss of estrogens on the brain, on the sensory organs, on the pathophysiology of sexual response and on

A. Graziottin; V. Rovei

2007-01-01

333

Breast Cancer (PDQ): Screening  

MedlinePLUS

... ongoing clinical trials is available from the NCI Web site . Three tests are used by health care providers to screen ... ongoing clinical trials is available from the NCI Web site . Risks of Breast Cancer Screening Screening tests have risks. Decisions about screening tests can be ...

334

Mucinous breast cancer with solitary metastasis to humeral head: a case report.  

PubMed

Breast cancer is the most common cause of metastatic deposits in the skeleton, and bone is the most common site of recurrence of breast cancer. Breast cancer metastasis most commonly affects the spine, ribs, pelvis, and proximal long bones; however, only 3.5% of breast cancer patients develop long-bone metastases. The humerus is the most common upper-extremity site for bony metastasis, and pathologic fractures can result. The patient in the current study presented with breast cancer and discovered to have humeral head metastasis during initial workup. The dilemma was in investigation the modality to confirm humeral head metastasis as there are many differential diagnoses with similar findings. After staging workup, the patient was treated with neoadjuvant chemotherapy followed by modified radical mastectomy and radiotherapy of the chest wall and the shoulder. The lesion in humerus was well healed. PMID:24044063

Aljarrah, Adil; Al-Hashmi, Maryam; Malik, Kamran Ahmad; Sukhpal, Sawhney; Hussein, Samir; Al-Riyami, Marwa; Al-Moundhri, Mansour

2013-09-01

335

Mucinous Breast Cancer with Solitary Metastasis to Humeral Head: A Case Report  

PubMed Central

Breast cancer is the most common cause of metastatic deposits in the skeleton, and bone is the most common site of recurrence of breast cancer. Breast cancer metastasis most commonly affects the spine, ribs, pelvis, and proximal long bones; however, only 3.5% of breast cancer patients develop long-bone metastases. The humerus is the most common upper-extremity site for bony metastasis, and pathologic fractures can result. The patient in the current study presented with breast cancer and discovered to have humeral head metastasis during initial workup. The dilemma was in investigation the modality to confirm humeral head metastasis as there are many differential diagnoses with similar findings. After staging workup, the patient was treated with neoadjuvant chemotherapy followed by modified radical mastectomy and radiotherapy of the chest wall and the shoulder. The lesion in humerus was well healed.

Aljarrah, Adil; Al-Hashmi, Maryam; Malik, Kamran Ahmad; Sukhpal, Sawhney; Hussein, Samir; Al-Riyami, Marwa; Al-Moundhri, Mansour

2013-01-01

336

Familial breast cancer and genes involved in breast carcinogenesis  

Microsoft Academic Search

Breast cancer has often been reported to run in families, and the most important risk factor for the disease is a family history of breast cancer. Numerous pedigrees and segregation analyses have suggested an autosomal dominant transmitted susceptibility to breast cancer. Familial breast cancer occurs alone or associated with other cancers in clinically distinguishable syndromes. Such cases may be characterized

Annika Lindblom

1995-01-01

337

Radiation-Induced Leiomyosarcoma after Breast Cancer Treatment and TRAM Flap Reconstruction  

PubMed Central

The development of a radiation-induced sarcoma (RIS) in the post mastectomy thoracic treatment volume is an infrequent, but recognized, event. Its frequency is rising in relation with increasing survival of breast cancer patients treated with adjuvant radiation therapy, and is associated with poor prognosis despite treatment. We present a case of leiomyosarcoma in a patient who underwent mastectomy followed by radiotherapy for invasive ductal carcinoma. A delayed TRAM flap reconstruction was performed 10 years after and a rapid growing mass under the reconstructed flap appeared, on routine follow-up, twenty years later. This report analyzes the diagnostic and therapeutic approach of patients with RIS.

Olcina, M.; Merck, B.; Gimenez-Climent, M. J.; Almenar, S.; Sancho-Merle, M. F.; Llopis, F.; Vazquez-Albadalejo, C.

2008-01-01

338

Quality of Life After Breast Cancer Surgery With or Without Reconstruction  

PubMed Central

In the modern era, where breast-conserving surgery is a viable alternative to mastectomy, breast cancer patients and their healthcare providers have to consider the issue of quality of life in regards to the type of surgery. The choice of surgical procedure should consider the perceptions of women diagnosed with breast cancer as well as their functional and emotional well-being. A more holistic approach to the patient should be implemented with proper psychological evaluation before and psychological support after the crisis.

Stavrou, Demetris; Weissman, Oren; Polyniki, Anna; Papageorgiou, Neofytos; Haik, Joseph; Farber, Nimrod; Winkler, Eyal

2009-01-01

339

Loss of Heterozygosity in Bilateral Breast Cancer  

Microsoft Academic Search

Women who develop bilateral breast cancer at an early age are likely to harbour germline mutations in breast cancer susceptibility genes. The aim of this study was to test for concordant genetic changes in left and right breast cancer of young women (age <50) with bilateral breast cancer that may suggest an inherited breast cancer predisposition. Microsatellite markers were used

J. Kollias; S. Man; M. Marafie; K. Carpenter; S. Pinder; I. O. Ellis; R. W. Blamey; G. Cross; J. D. Brook

2000-01-01

340

Lactation and Breast Cancer Risk  

Microsoft Academic Search

Breast cancer is a common disease with few practical preventive measures. The recent evidence that lactation, like other reproductive experiences, is associated with a modest reduction in breast cancer risk is therefore of great interest. Overall, the reduction in risk appears to be about 20% for ever breast feeding and is even greater for women with histories of prolonged lactation,

Polly A. Newcomb

1997-01-01

341

MK2206 in Treating Patients With Stage I, Stage II, or Stage III Breast Cancer  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

2013-06-03

342

Glucocorticoid receptor changes its cellular location with breast cancer development.  

PubMed

Glucocorticoids play a major role in attenuation of the inflammatory response and they are useful in the primary combination chemotherapy of breast cancer, since in vitro studies have demonstrated an antiproliferative effect in human breast cancer cells. In contrast, it was recently shown that glucocorticoids protect against apoptotic signals evoked by cytokines, cAMP, tumour suppressors, and death genes in mammary gland epithelia. Their actions are mediated by intracellular receptor (GR) that functions as a hormone-dependent transcription factor; however, no previous studies have been focused on GR expression in different pathologies of the human breast, and the possible relationship with that of mineralocorticoid receptor (MR) and COX-2. Also, the role of these proteins on tumoral breast epithelial cells remains unclear. Therefore, we examined GR, MR and COX-2 expression by immunohistochemistry and Western blot techniques in 142 samples of human breast obtained by total or partial mastectomy. We found that the percentage of positive patients presenting nuclear immunoreaction to GR decreased with tumor development, while all samples analyzed showed cytoplasmic immunoreactions to MR. All positive samples to COX-2 antibody showed cytoplasmic location, a higher immunoreaction being observed in benign breast diseases than in carcinomatous lesions. Thus, breast cancer progression is associated with the accumulation of GR in the cytoplasm of tumoral cells and the decrease of COX-2 expression. PMID:17952860

Conde, Isabel; Paniagua, Ricardo; Fraile, Benito; Lucio, Javier; Arenas, Maria I

2008-01-01

343

Biomarkers in Tissue Samples From Patients With Newly Diagnosed Breast Cancer Treated With Zoledronic Acid  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer

2013-07-17

344

Heterogeneity in breast cancer.  

PubMed

Breast cancer is a heterogeneous disease. There is a high degree of diversity between and within tumors as well as among cancer-bearing individuals, and all of these factors together determine the risk of disease progression and therapeutic resistance. Advances in technologies such as whole-genome sequencing and functional viability screens now allow us to analyze tumors at unprecedented depths. However, translating this increasing knowledge into clinical practice remains a challenge in part due to tumor evolution driven by the diversity of cancer cell populations and their microenvironment. The articles in this Review series discuss recent advances in our understanding of breast tumor heterogeneity, therapies tailored based on this knowledge, and future ways of assessing and treating heterogeneous tumors. PMID:21965334

Polyak, Kornelia

2011-10-03

345

Surgical treatment of early-stage breast cancer in the department of defense healthcare system 1 1 No competing interests declared  

Microsoft Academic Search

BACKGROUND:The choice between breast-conserving surgery and modified radical mastectomy in the treatment of women with early stage breast cancer in the Department of Defense Healthcare System may be influenced by demographic factors.STUDY DESIGN:The Department of Defense Automated Central Tumor Registry (ACTUR) was queried for women diagnosed with American Joint Committee on Cancer Stage I or II invasive breast carcinoma from

John J Kelemen; Thomas Poulton; Marc T Swartz; Ismail Jatoi

2001-01-01

346

Immediate breast reconstruction: results and satisfaction  

Microsoft Academic Search

Delayed breast reconstruction following mastectomy for cancer is widely accepted because of a high satisfaction rate. Immediate\\u000a breast reconstruction offers an even more satisfactory solution, especially related to recovery and self-esteem. In our study,\\u000a immediate breast reconstruction was performed for three indications: breast cancer, high risk for development of breast cancer\\u000a and chronic cystic breast disease. Forty-eight consecutive patients with

P. H. M. Spauwen; T. Wobbes; R. F. van der Sluis

2000-01-01

347

Inflammatory breast cancer: high risk of contralateral breast cancer compared to comparably staged non-inflammatory breast cancer  

Microsoft Academic Search

Inflammatory breast cancer (IBC), the most lethal form of breast cancer, has characteristics linked to higher risk of contralateral\\u000a breast cancer. However, no large studies have examined risk of contralateral breast cancer following IBC. We calculated absolute\\u000a risk of invasive contralateral breast cancer among 5,631 IBC and 174,634 comparably staged non-IBC first breast cancer cases\\u000a who survived at least 2 months

Catherine SchairerLinda; Linda M. Brown; Phuong L. Mai

2011-01-01

348

Birth weight, breast cancer susceptibility loci, and breast cancer risk  

Microsoft Academic Search

Background  There is considerable evidence that birth weight is positively associated with breast cancer risk, and seven single-nucleotide\\u000a polymorphisms (SNPs) have been conclusively associated with this risk. We have hypothesized that breast cancer susceptibility\\u000a loci may have a greater influence on breast cancer risk among women with higher birth weight, who are expected to have a larger\\u000a pool of mammary stem

Rulla M. Tamimi; Pagona Lagiou; Kamila Czene; Jianjun Liu; Anders Ekbom; Chung-Cheng Hsieh; Hans-Olov Adami; Dimitrios Trichopoulos; Per Hall

2010-01-01

349

Mastalgia and breast cancer: a protective association?  

Microsoft Academic Search

Breast pain (mastalgia) is a common complaint, with a potentially important relationship to breast cancer risk. We have examined the association between mastalgia and breast cancer in the patient population of the Breast Care Center of University Hospital, Syracuse, New York. Of 5463 women with complete breast cancer risk factor information, 1532 (28%) reported breast pain as an incidental complaint

Seema A Khan; A. Vania Apkarian

2002-01-01

350

Mastalgia and breast cancer: a protective association?  

Microsoft Academic Search

Breast pain (mastalgia) is a common complaint, with a potentially important relationship to breast cancer risk. We have examined the association between mastalgia and breast cancer in the patient population of the Breast Care Center of University Hospital, Syracuse, New York. Of 5463 women with complete breast cancer risk factor information, 1532 (28%) reported breast pain as an incidental complaint

Seema A. Khan; A. Vania Apkarian

351

Percutaneous Ablation of Breast Tumors  

Microsoft Academic Search

The surgical management of breast cancer has evolved gradually over the past century from the exclusive use of radical mastectomy\\u000a to the current practice of segmental mastectomy and radiation therapy. This less aggressive surgical approach in the management\\u000a of breast cancer extended to treatment of the axilla. The latter led to the recent introduction and subsequent acceptance\\u000a of lymphatic mapping

Bruno D. Fornage; Beth S. Edeiken

352

Locoregional Recurrence of Breast Conserving Surgery after Preoperative Chemotherapy in Korean Women with Locally Advanced Breast Cancer  

PubMed Central

Purpose Preoperative chemotherapy has been used to increase the rate of breast conserving surgery (BCS) in Caucasian women. However, whether it would also increase the rate of BCS in Korean women has not been verified. The aim of this study was to determine the effectiveness of preoperative chemotherapy to make BCS possible in Korean women who have locally advanced cancer without any increase of locoregional recurrence according to operation methods (BCS vs. mastectomy). Methods From August 2002 to April 2005, 205 patients with stage II or III breast cancer were enrolled in a phase III randomized trial of preoperative chemotherapy. Surgeons decided on the type of surgery (mastectomy or BCS) at initial diagnosis. By randomization, patients received four cycles of either docetaxel/capecitabine or doxorubicin/cyclophosphamide followed by surgery and crossover to the other treatment as postoperative chemotherapy. Results The mean tumor size was 3.29 cm and the mean breast volume was 489 cc at diagnosis. After preoperative chemotherapy, clinical response was shown in 76.0% of the patients. Of the 71 patients planned for a mastectomy at initial diagnosis, 27 patients underwent BCS (38.0%). Clinical T stage after preoperative chemotherapy, pathologic T size and lymphatic invasion were correlated with conversion to BCS. In multivariate analysis, only lymphatic invasion showed statistical significance. Locoregional disease-free survival did not statistically differ between the two operation methods for the patients who were planned for a mastectomy at the initial exam. Conclusion This study showed that preoperative chemotherapy also increased the rate of BCS, while avoiding any increase of locoregional recurrence in Korean women with locally advanced breast cancer.

Lee, Seeyoun; Kim, Seok Won; Kim, Seok-Ki; Lee, Keun Seok; Kim, Eun A; Kwon, Youngmee; Shin, Kyung Hwan; Kang, Han-Sung; Ro, Jungsil

2011-01-01

353

Inappropriate Halsted mastectomy and patient volume in Italian hospitals.  

PubMed Central

To study whether Halsted mastectomy was used only when properly indicated, a prospective survey was undertaken on the process of care of 985 breast cancer patients seen consecutively at 62 general hospitals in Northern and Central Italy. Overall, 79% of Halsted mastectomies were performed inappropriately. The procedure was less likely to be performed on more educated patients and, other factors considered, on those seen at hospitals with larger volume. We conclude that the measurement of utilization of a surgical procedure for which only a few appropriate indications exist may help identify important relationships between hospital characteristics and quality of surgical care.

Grilli, R; Mainini, F; Penna, A; Bertolini, G; Scorpiglione, N; Torri, V; Liberati, A

1993-01-01

354

[Clinical and morphological features of breast cancer in men].  

PubMed

Breast cancer in men is 100 times less common than in women. The main risk factors include: the mutation of genes BRCA 1 and 2, Klinefelter's syndrome, alcohol, liver disease, obesity. Clinical examinations, mammography and ultrasound are informative and highly sensitive for early detection of these tumors, but are rarely implemented due to lack of awareness of general practitioners. Local treatment includes the Patey-Dyson mastectomy and radiation therapy. Adjuvant systemic therapy is determined by pTNM and typically involves tamoxifen. PMID:23909038

Nikolaev, K S

2013-01-01

355

Wrap Up: Innovations in Breast Cancer Workshop  

Center for Drug Evaluation (CDER)

Text Version... breast cancer and metastatic breast cancer are different ... positive breast cancer, where the EFS improvement is already high? ... More results from www.fda.gov/downloads/drugs/newsevents

356

Breast cancer personalized medicine: challenges and opportunities.  

PubMed

This Guest Editorial introduces this month's special Breast Cancer Theme Issue, a series of reviews that highlight the molecular pathogenesis of breast cancer and implications for personalized breast cancer therapy. PMID:23978519

Coleman, William B

2013-08-23

357

Diet, Stem Cells, and Breast Cancer Prevention.  

National Technical Information Service (NTIS)

Breast cancer is the most common malignancy of women in the Western world. Many risk factors are associated with the development and progression of breast cancer; however, diet/nutrition constitutes a highly modifiable risk. Breast cancer is considered to...

R. C. Simmen

2011-01-01

358

You, Your Teenage Daughter and Breast Cancer.  

ERIC Educational Resources Information Center

|Discusses breast cancer and teenagers, focusing on how parents can introduce the subject and encourage breast self-examination. The article provides information on breast cancer statistics, mammography, and American Cancer Society services. (SM)|

Brateman, Libby

1991-01-01

359

You, Your Teenage Daughter and Breast Cancer.  

ERIC Educational Resources Information Center

Discusses breast cancer and teenagers, focusing on how parents can introduce the subject and encourage breast self-examination. The article provides information on breast cancer statistics, mammography, and American Cancer Society services. (SM)

Brateman, Libby

1991-01-01

360

Breast and Ovarian Cancers  

PubMed Central

Tumor markers are widely used in pathology not only for diagnostic purposes but also to assess the prognosis and to predict the treatment of the tumor. Because tumor marker levels may change over time, it is important to get a better understanding of the molecular changes during tumor progression. Occurrence of breast and ovarian cancer is high in older women. Common known risk factors of developing these cancers in addition to age are not having children or having children at a later age, the use of hormone replacement therapy, and mutations in certain genes. In addition, women with a history of breast cancer may also develop ovarian cancer. Here, the authors review the different tumor markers of breast and ovarian carcinoma and discuss the expression, mutations, and possible roles of cell surface heparan sulfate proteoglycans during tumorigenesis of these carcinomas. The focus is on two groups of proteoglycans, the transmembrane syndecans and the lipid-anchored glypicans. Both families of proteoglycans have been implicated in cellular responses to growth factors and morphogens, including many now associated with tumor progression.

Yoneda, Atsuko; Lendorf, Maria E.; Couchman, John R.

2012-01-01

361

A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy  

PubMed Central

The aim of this study was to investigate if non-coplanar intensity-modulated radiation therapy (IMRT) in the post-mastectomy setting can reduce the dose to normal structures and improve target coverage. We compared this IMRT technique with a standard partial wide tangential (PWT) plan and a five-field (5F) photon-electron plan. 10 patients who underwent left-sided mastectomy were planned to 50.4 Gy using either (1) PWT to cover the internal mammary (IM) nodes and supraclavicular fields, (2) 5F comprising standard tangents, supraclavicular fields and an electron field for the IM nodes or (3) IMRT. The planning target volume (PTV) included the left chest wall, supraclavicular, axillary and IM lymph nodes. No beams were directed at the right lung, right breast or heart. Mean dose–volume histograms were constructed by combining the dose–volume histogram data from all 10 patients. The mean PTV to receive 95% of the dose (V95%) was improved with the IMRT plan to 94.2% from 91.4% (p = 0.04) with the PWT plan and from 87.7% (p = 0.012) with the 5F plan. The mean V110% of the PTV was improved to 3.6% for the IMRT plan from 16.8% (p = 0.038) for the PWT plan and from 51.8% (p = 0.001) for the 5F plan. The mean fraction volume receiving 30 Gy (v30Gy) of the heart was improved with the IMRT plan to 2.3% from 7.5% (p = 0.01) for the PWT plan and 4.9% (p = 0.02) for the 5F plan. In conclusion, non-coplanar IMRT results in improved coverage of the PTV and a lower heart dose when compared with a 5F or PWT plan.

Koshy, M; Zhang, B; Naqvi, S; Liu, B; Mohiuddin, M M

2010-01-01

362

Breast cancer and the "materiality of risk": the rise of morphological prediction.  

PubMed

This paper follows the history of "morphological risk" of breast cancer. In the early twentieth century, surgeons and pathologists arrived at the conclusion that specific anatomical and cytological changes in the breast are related to a heightened risk of developing a malignancy in the future. This conclusion was directly related to a shift from macroscopic to microscopic diagnosis of malignancies, and to the integration of the frozen section into routine surgery for breast cancer. In the interwar era, conditions such as "chronic mastitis" and "cystic disease of the breast" were defined as precancerous, and women diagnosed with these conditions were advised to undergo mastectomy. In the post-World War II era, these entities were replaced by "carcinoma in situ." The recent development of tests for hereditary predisposition to breast cancer is a continuation of attempts to detect an "embodied risk" of cancer and to eliminate this risk by cutting it out. PMID:17369670

Löwy, Ilana

2007-01-01

363

Breast-Conserving Surgery Followed by Radiation Therapy With MRI-Detected Stage I or Stage II Breast Cancer  

ClinicalTrials.gov

Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Tubular Ductal Breast Carcinoma

2011-12-07

364

Proteomic Approach to Breast Cancer  

Microsoft Academic Search

Background: Breast cancer is the most common cancer affecting women worldwide. Despite tremendous advances in screening, diagnosis, and treatment, the causes of this disease remain elusive and complex. Proteomics is a rapidly developing field that can explore the heterogeneity of breast cancer and supplement the wealth of information gained from genomics. Methods: This article serves as an overview of the

Christine Laronga; Richard R. Drake

2007-01-01

365

Breast cancer susceptibility loci and mammographic density  

Microsoft Academic Search

INTRODUCTION: Recently, the Breast Cancer Association Consortium (BCAC) conducted a multi-stage genome-wide association study and identified 11 single nucleotide polymorphisms (SNPs) associated with breast cancer risk. Given the high degree of heritability of mammographic density and its strong association with breast cancer, it was hypothesised that breast cancer susceptibility loci may also be associated with breast density and provide insight

Rulla M. Tamimi; David Cox; Peter Kraft; Graham A. Colditz; Susan E. Hankinson; David J. Hunter

2008-01-01

366

Knowledge, attitude and practice of prophylactic mastectomy among patients and relations attending a surgical outpatient clinic  

PubMed Central

Introduction Prophylactic mastectomy (PM) is uncommon in our practice. This study documents the knowledge and attitude of patients and relation to prophylactic mastectomy. Methods Adults attending surgical outpatient unit were interviewed. Biodata, awareness of breast cancer, and attitude towards prophylactic mastectomy were inquired about and documented. Results Two hundred and forty eight (99 men and 149 women) were involved. Most, 75.6%, were age bracket 20-29 years and 77.2% had tertiary education. Only 26 (10.4%) of the respondents had previous history of breast diseases. 96.4% were aware of cancer of the breast while 113 (45.2%) of them were aware that breast cancer gene can be inherited from parents and 60 (24.2%) believe cancer of the breast can affect women with strong positive family history. Only 64 (25.6%) of them would agree to prophylactic mastectomy if found necessary. Reasons given for possible refusal to consent to PM include effect on beauty, (40%), psychological effect, (22.8%), non-curing of disease, (18%), possible surgical complications, (7.2%), and financial cost, (1.2%). Presence of unilateral breast cancer and high risk status constituted about 71% of suggested possible indications for PM while presence of any breast disease was suggested by only 7.3% of respondents. The profession or education of respondents did not have significance on their acceptance or rejection of PM. Conclusion Awareness of prophylactic mastectomy is low among patients in this study. Education about breast cancer and methods of prevention need to be improved.

Oguntola, Adetunji Saliu; Olaitan, Peter Babatunde; Omotoso, Olutayo; Oseni, Ganiyu Oyediran

2012-01-01

367

Exercise and breast cancer prevention  

Microsoft Academic Search

Epidemiologic research continues to confirm a strong inverse association between physical activity and breast cancer risk.\\u000a New studies suggest that activity during adolescence is most important for premenopausal breast cancer. Long-term activity\\u000a patterns are clearly important for postmenopausal breast cancer, although recent activity often highly correlates with long-term\\u000a activity, accounting for its influence on risk. Whether physical activity has greater

Leslie Bernstein

2009-01-01

368

Mammographic Screening for Breast Cancer  

PubMed Central

A 44-year-old woman who is a new patient has no known current health problems and no family history of breast or ovarian cancer. Eighteen months ago, she had a normal screening mammogram. She recently read that mammograms may not help to prevent death from breast cancer and that “the patient should decide.” But she does not think she knows enough. She worries that there is a breast-cancer epidemic. What should her physician advise?

Fletcher, Suzanne W.; Elmore, Joann G.

2011-01-01

369

[Scintimammography in breast cancer imaging].  

PubMed

Scintimammography is a rarely used method of breast cancer imaging. The aim of the study was to find its place among other radiological methods. Routine methods of breast cancer detection were compared considering their advantages and disadvantages. Scintimammography seems to be a promising complementary method. Indications for scintimammography are considered and suggestion of a diagnostic algorithm in breast cancer, including of this method is proposed. PMID:12666455

Pilecki, Stanis?aw; Bandurski, Tomasz; Lasek, W?adys?aw; Purzycka-Jazdon, Anna; Lass, Piotr

2002-12-01

370

Global Burden of Breast Cancer  

Microsoft Academic Search

\\u000a Breast cancer in women is a major public health problem throughout the world. It is the most common cancer among women both\\u000a in developed and developing countries. One in ten of all new cancers diagnosed worldwide each year is a cancer of the female\\u000a breast. It is also the principal cause of death from cancer among women globally. More than

Jacques Ferlay; Clarisse Héry; Philippe Autier; Rengaswamy Sankaranarayanan

371

Surgical Treatment Differences Among Latina and African American Breast Cancer Survivors  

PubMed Central

Purpose/Objectives To describe breast cancer treatment choices from the perspectives of Latina and African American breast cancer survivors. Design An interdisciplinary team conducted a mixed-methods study of women treated for stages I–IV breast cancer. Setting Participants’ homes in metropolitan areas. Sample 39 participants in three groups: monolingual Spanish-speaking Latinas (n = 15), English-speaking Latinas (n = 15), and African American women (n = 9). Methods Individual participant interviews were conducted by racially and linguistically matched nurse researchers, and sociodemographic data were collected. Content and matrix analysis methods were used. Main Research Variables Perceptions of breast cancer care. Findings High rates of mastectomy were noted for early-stage treatment (stage I or II). Among the participants diagnosed with early-stage breast cancer, the majority of English-speaking Latinas (n = 9) and African American women (n = 4) received a mastectomy. However, the majority of the Spanish-speaking Latina group (n = 5) received breast-conserving surgery. Four factors influenced the choice of mastectomy over lumpectomy across the three groups: clinical indicators, fear of recurrence, avoidance of adjuvant side effects, and perceived favorable survival outcomes. Spanish-speaking Latinas were more likely to rely on physician treatment recommendations, and the other two groups used a shared decision-making style. Conclusions Additional study is needed to understand how women select and integrate treatment information with the recommendations they receive from healthcare providers. Among the Spanish-speaking Latina group, limited English proficiency, the use of translators in explaining treatment options, and a lack of available educational materials in Spanish are factors that influenced reliance on physician recommendations. Implications for Nursing Oncology nurses were notably absent in supporting the women’s treatment decision making. Advanced practice oncology nurses, coupled with language-appropriate educational resources, may provide essential guidance in clarifying surgical treatment choices for breast cancer among culturally and linguistically diverse populations.

Campesino, Maureen; Koithan, Mary; Ruiz, Ester; Glover, Johanna Uriri; Juarez, Gloria; Choi, Myunghan; Krouse, Robert S.

2012-01-01

372

Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery  

PubMed Central

Women diagnosed with or at high risk for breast cancer increasingly choose prophylactic mastectomy. It is unknown if adding sentinel lymph node biopsy (SLNB) to prophylactic mastectomy increases the risk of lymphedema. We sought to determine the risk of lymphedema after mastectomy with and without nodal evaluation. 117 patients who underwent bilateral mastectomy were prospectively screened for lymphedema. Perometer arm measurements were used to calculate weight-adjusted arm volume change at each follow-up. Of 234 mastectomies performed, 15.8 % (37/234) had no axillary surgery, 63.7 % (149/234) had SLNB, and 20.5 % (48/234) had axillary lymph node dissection (ALND). 88.0 % (103/117) of patients completed the LEFT-BC questionnaire evaluating symptoms associated with lymphedema. Multivariate analysis was used to assess clinical characteristics associated with increased weight-adjusted arm volume and patient-reported lymphedema symptoms. SLNB at the time of mastectomy did not result in an increased mean weight-adjusted arm volume compared to mastectomy without axillary surgery (p = 0.76). Mastectomy with ALND was associated with a significantly greater mean weight-adjusted arm volume change compared to mastectomy with SLNB (p < 0.0001) and without axillary surgery (p = 0.0028). Patients who underwent mastectomy with ALND more commonly reported symptoms associated with lymphedema compared to those with SLNB or no axillary surgery (p < 0.0001). Patients who underwent mastectomy with SLNB or no axillary surgery reported similar lymphedema symptoms. Addition of SLNB to mastectomy is not associated with a significant increase in measured or self-reported lymphedema rates. Therefore, SLNB may be performed at the time of prophylactic mastectomy without an increased risk of lymphedema.

Miller, Cynthia L.; Skolny, Melissa N.; Jammallo, Lauren S.; Horick, Nora; O'Toole, Jean; Coopey, Suzanne B.; Hughes, Kevin; Gadd, Michele; Smith, Barbara L.; Taghian, Alphonse G.

2013-01-01

373

Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery.  

PubMed

Women diagnosed with or at high risk for breast cancer increasingly choose prophylactic mastectomy. It is unknown if adding sentinel lymph node biopsy (SLNB) to prophylactic mastectomy increases the risk of lymphedema. We sought to determine the risk of lymphedema after mastectomy with and without nodal evaluation. 117 patients who underwent bilateral mastectomy were prospectively screened for lymphedema. Perometer arm measurements were used to calculate weight-adjusted arm volume change at each follow-up. Of 234 mastectomies performed, 15.8 % (37/234) had no axillary surgery, 63.7 % (149/234) had SLNB, and 20.5 % (48/234) had axillary lymph node dissection (ALND). 88.0 % (103/117) of patients completed the LEFT-BC questionnaire evaluating symptoms associated with lymphedema. Multivariate analysis was used to assess clinical characteristics associated with increased weight-adjusted arm volume and patient-reported lymphedema symptoms. SLNB at the time of mastectomy did not result in an increased mean weight-adjusted arm volume compared to mastectomy without axillary surgery (p = 0.76). Mastectomy with ALND was associated with a significantly greater mean weight-adjusted arm volume change compared to mastectomy with SLNB (p < 0.0001) and without axillary surgery (p = 0.0028). Patients who underwent mastectomy with ALND more commonly reported symptoms associated with lymphedema compared to those with SLNB or no axillary surgery (p < 0.0001). Patients who underwent mastectomy with SLNB or no axillary surgery reported similar lymphedema symptoms. Addition of SLNB to mastectomy is not associated with a significant increase in measured or self-reported lymphedema rates. Therefore, SLNB may be performed at the time of prophylactic mastectomy without an increased risk of lymphedema. PMID:22941538

Miller, Cynthia L; Specht, Michelle C; Skolny, Melissa N; Jammallo, Lauren S; Horick, Nora; O'Toole, Jean; Coopey, Suzanne B; Hughes, Kevin; Gadd, Michele; Smith, Barbara L; Taghian, Alphonse G

2012-09-01

374

Regional Breast Cancer Treatment  

Microsoft Academic Search

Advances in technology and the increase in screening for breast cancer that identifies tumors at earlier stages have made\\u000a it possible to destroy tumors in situ without surgery. This can also be used to treat locally advanced tumors. These locoregional\\u000a ablative techniques include minimally invasive surgical as well as noninvasive ablative modalities, new radiation technologies,\\u000a and regional chemotherapy. New developments

Moshe Z. Papa; Siegal Sadetzki

375

Screening for breast cancer.  

PubMed Central

The feasibility of mass population screening for breast cancer by clinical examination and x-ray mammography was studied. The results indicate that such a programme could be conducted effectively by non-medical staff and be safe from the dangers of irradiation. The response rate of women invited for screening suggests that such a service is acceptable to the general public. The additional work load produced by screening would not overburden the existing surgical services.

George, W D; Gleave, E N; England, P C; Wilson, M C; Sellwood, R A; Asbury, D; Hartley, G; Barker, P G; Hobbs, P; Wakefield, J

1976-01-01

376

Improving quality of breast cancer surgery through development of a national breast cancer surgical outcomes (BRCASO) research database  

PubMed Central

Background Common measures of surgical quality are 30-day morbidity and mortality, which poorly describe breast cancer surgical quality with extremely low morbidity and mortality rates. Several national quality programs have collected additional surgical quality measures; however, program participation is voluntary and results may not be generalizable to all surgeons. We developed the Breast Cancer Surgical Outcomes (BRCASO) database to capture meaningful breast cancer surgical quality measures among a non-voluntary sample, and study variation in these measures across providers, facilities, and health plans. This paper describes our study protocol, data collection methods, and summarizes the strengths and limitations of these data. Methods We included 4524 women ?18 years diagnosed with breast cancer between 2003-2008. All women with initial breast cancer surgery performed by a surgeon employed at the University of Vermont or three Cancer Research Network (CRN) health plans were eligible for inclusion. From the CRN institutions, we collected electronic administrative data including tumor registry information, Current Procedure Terminology codes for breast cancer surgeries, surgeons, surgical facilities, and patient demographics. We supplemented electronic data with medical record abstraction to collect additional pathology and surgery detail. All data were manually abstracted at the University of Vermont. Results The CRN institutions pre-filled 30% (22 out of 72) of elements using electronic data. The remaining elements, including detailed pathology margin status and breast and lymph node surgeries, required chart abstraction. The mean age was 61 years (range 20-98 years); 70% of women were diagnosed with invasive ductal carcinoma, 20% with ductal carcinoma in situ, and 10% with invasive lobular carcinoma. Conclusions The BRCASO database is one of the largest, multi-site research resources of meaningful breast cancer surgical quality data in the United States. Assembling data from electronic administrative databases and manual chart review balanced efficiency with high-quality, unbiased data collection. Using the BRCASO database, we will evaluate surgical quality measures including mastectomy rates, positive margin rates, and partial mastectomy re-excision rates among a diverse, non-voluntary population of patients, providers, and facilities.

2012-01-01

377

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study  

Microsoft Academic Search

Feasibility and oncological safety of post-adjuvant skin-sparing mastectomy (SSM) plus immediate breast reconstruction (IBR)\\u000a cannot be evaluated by randomized trials. However, comparative study could modify guidelines for the oncosurgical treatment\\u000a of invasive breast cancer. Our study compared the feasibility, oncological safety and esthetic outcome of SSM plus latissimus\\u000a dorsi (LD) flap IBR after chemotherapy (CT) and radiotherapy (RT) with the

Pierre Ludovic Giacalone; Gauthier Rathat; Jean Pierre Daures; Paul Benos; David Azria; Caroline Rouleau

2010-01-01

378

Breast cancer risk reduction: strategies for women at increased risk.  

PubMed

Breast cancer risk reduction now represents an achievable medical objective. Current interventions include selective estrogen receptor modulators (SERMs), prophylactic surgery, and lifestyle change. For SERMs, current evidence supports tamoxifen use for breast cancer risk reduction whereas raloxifene requires further study. Prophylactic mastectomy and prophylactic oophorectomy, effective in retrospective clinical experiences, should be considered only for women at substantial risk willing to accept the irreversible consequences of these procedures. Although dietary fat intake is under clinical trial evaluation, lifestyle change, including weight loss, dietary change, and increased physical activity, can be recommended based on other health considerations. Use of any intervention requires careful breast cancer risk assessment, risk-benefit calculations, and informed decision making with full patient participation. Future breast cancer risk assessment may incorporate additional biologic measures of estrogen exposure and/or analyses of collected breast cells. Under active evaluation are novel SERMs, aromatase inhibitors/inactivators, gonadotrophin-releasing hormone agonists, retinoids, statins, and tyrosine kinase and cyclooxygenase-2 inhibitors. PMID:11818488

Chlebowski, Rowan T

2002-01-01

379

‘Fiona Farewells Her Breasts’: A popular magazine account of breast cancer prevention  

Microsoft Academic Search

In this paper, the authors examine a popular media account of prophylactic mastectomy—the surgical removal of ‘healthy’ breasts for preventive purposes—focusing on the ways in which the account works to normalize what might alternatively be considered extreme preventive health behaviour. Although the procedure remains controversial, prophylactic mastectomy is increasingly presented as a treatment option for women considered to be at

Shona Crabb; Amanda LeCouteur

2006-01-01

380

[Cancer of the breast and the receptor status].  

PubMed

Correlation between survival and hormonal receptor status in patients with breast cancer is still controversial. The results of a study carried out, from 1973 to 1988, on 55 patients (average age 56.7) affected with breast cancer and submitted to radical (Halsted) mastectomy, are reported. Estradiol receptors (ER) and progesterone receptors (PR) were determined using the dextran-coated charcoal (DCC) method and the enzymatic immuno assay (EIA). The threshold value for defining the ER positivity was 10 f/mole/mg of cytosol protein and 50 f/mole/mg for PR positivity. Forty-one patients resulted as ER+, 31 were also PR+. Moreover, 41 patients were treated with tamoxifen (10 mg x 2 die per os). In a 15-year follow-up, no significant difference in survival rate between patients with receptor-positive tumors or treated with tamoxifen and patients with receptor-negative tumors was recorded. PMID:1911078

Buonomo, O; Serao, A; Muggianu, A; Guglielmelli, E; Davoli, E; Amori, A

1991-04-01

381

Breast Cancer: Screening for a Cure  

Microsoft Academic Search

In 2006, an estimated 275,000 women in the United States were diagnosed with breast cancer and 41,000 patients died of this disease. 1 Because breast cancer is a common disease and early stage cancers detected by mammography are more successfully treated, mam- mogram screening programs have been instrumental in reducing breast cancer mortality. The morbidity of breast cancer treatment has

Linda S. Haigh

2007-01-01

382

Imaging techniques in breast cancer  

Microsoft Academic Search

Radiology, along with clinical examination and the pathological results, is a fundamental aspect of the triple assessment of patients with breast disease, particularly those with breast cancer. In addition to long established imaging techniques such as mammography and breast ultrasound in the symptomatic patient, there are now many developing technologies which assist in making and confirming the diagnosis (eg digital

Gaurav Jyoti Bansal; Kate Gower Thomas

2010-01-01

383

Undertreated Breast Cancer in the Elderly  

PubMed Central

The effect of undertreatment with adjuvant hormonal therapy, chemotherapy, or radiation was studied in elderly women with breast cancer. A prospectively maintained database was used to identify women undergoing potentially curative surgery between 1978 and 2012. The presentation, pathologic findings, treatment, and outcomes of 382 women over 70 were compared to the findings in 2065 younger patients. Subsequently, conventionally treated and undertreated elderly patients were identified and their characteristics and outcomes were compared. Both young and old patients presented most frequently with mammographic findings, but older patients presented more frequently with mammographic masses while younger patients presented more frequently with mammographic calcifications. Cancers of older patients were significantly more favorable than cancers in younger patients: smaller, with more infiltrating lobular, fewer ductal carcinoma in situ, and more frequently estrogen receptor positive and fewer were poorly differentiated. Elderly patients had less axillary sampling, fewer mastectomies, less adjuvant radiation therapy, and more hormonal therapy. Fifty-one percent of the 382 elderly patients were undertreated by conventional criteria. Undertreated patients were more frequently in situ, better differentiated, smaller, and more often estrogen receptor positive. Forty-four percent of the undertreated patients died during followup without disease recurrence. Despite undertreatment, local and distant disease-free survival was comparable to patients who were not undertreated.

Malik, Manmeet Kaur; Tartter, Paul Ian; Belfer, Rachel

2013-01-01

384

Vascular and Cognitive Assessments in Patients With Breast Cancer Undergoing Chemotherapy After Surgery  

ClinicalTrials.gov

Cognitive/Functional Effects; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

2013-07-29

385

Rosuvastatin in Treating Women With Cardiovascular Complications Who Are Undergoing Chemotherapy For Breast Cancer  

ClinicalTrials.gov

Cardiovascular Complications; Recurrent Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

2013-03-21

386

Trametinib and Akt Inhibitor GSK2141795 in Treating Patients With Metastatic Triple-Negative Breast Cancer  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Recurrent Breast Cancer; Stage IV Breast Cancer; Triple-negative Breast Cancer

2013-10-15

387

Aesthetic results following partial mastectomy and radiation therapy  

SciTech Connect

This study was undertaken to determine the aesthetic changes inherent in partial mastectomy followed by radiation therapy in the treatment of stage I and stage II breast cancer. A retrospective analysis of breast cancer patients treated according to the National Surgical Adjuvant Breast Project Protocol B-06 was undertaken in 57 patients from 1984 to the present. The size of mastectomy varied between 2 x 1 cm and 15 x 8 cm. Objective aesthetic outcome, as determined by physical and photographic examination, was influenced primarily by surgical technique as opposed to the effects of radiation. These technical factors included orientation of resections, breast size relative to size of resection, location of tumor, and extent and orientation of axillary dissection. Regarding cosmesis, 80 percent of patients treated in this study judged their result to be excellent or good, in comparison to 50 percent excellent or good as judged by the plastic surgeon. Only 10 percent would consider mastectomy with reconstruction for contralateral disease. Asymmetry and contour abnormalities are far more common than noted in the radiation therapy literature. Patients satisfaction with lumpectomy and radiation, however, is very high. This satisfaction is not necessarily based on objective criteria defining aesthetic parameters, but is strongly influenced by retainment of the breast as an original body part.

Matory, W.E. Jr.; Wertheimer, M.; Fitzgerald, T.J.; Walton, R.L.; Love, S.; Matory, W.E.

1990-05-01

388

Intraoperative Radiotherapy in the Treatment of Breast Cancer: A Review of the Evidence  

PubMed Central

The surgical treatment of early breast cancer has evolved from the removal of the entire breast and surrounding tissues (mastectomy) to the removal of the tumour together with a margin of healthy tissue (lumpectomy). Adjuvant radiotherapy, however, is still mainly given to the whole breast. Furthermore, external beam radiotherapy is often given several months after initial surgery and requires the patient to attend the radiotherapy centre daily for several weeks. A single fraction of radiotherapy given during surgery directly to the tumour bed (intraoperative radiotherapy) avoids these problems. The rationale and level-1 evidence for the safety and efficacy of the technique are reviewed.

Williams, Norman R.; Pigott, Katharine H.; Keshtgar, Mohammed R. S.

2011-01-01

389

Genetics of Hereditary Breast Cancer  

Microsoft Academic Search

\\u000a The identification and clinical management of patients at inherited risk for breast cancer has become an integral part of\\u000a the practice of preventative medicine and oncology. Although only about 5–10% of all cases of breast cancer are attributable\\u000a to a highly penetrant cancer predisposition gene, individuals who carry a cancer susceptibility gene mutation have a significantly\\u000a higher risk of developing

Paula D. Ryan

390

The impact of the sentinel node concept on the aesthetic outcome of breast cancer conservative surgery.  

PubMed

BACKGROUND: The sentinel node (SN) concept has brought numerous advantages to women with breast cancer. Sparing axillary node anatomy and physiology may enhance the cosmetic results of breast cancer conservative surgery, either owing to less breast edema or to a better tolerance to the effects of surgery and radiotherapy. Our aim was to compare the cosmetic outcome of two randomized groups of patients, on a subjective and objective basis. METHODS: A consecutive series of breast cancer patients (n = 60) submitted to partial mastectomy plus axillary dissection or partial mastectomy plus SN biopsy (included in a randomized trial) was photographed. Photos were analysed in three ways: by seven different observers according to seven features from poor to excellent; two observers estimated the percentage of breast retraction assessment (pBRA); or by the BCCT.core 1.0(®) software. RESULTS: The panel subjective analysis showed a benefit in terms of the skin colour for the patients submitted to SN biopsy only. This group of patients did not show any advantage in terms of pBRA estimates even after the complex BCCT.core appraisal. CONCLUSIONS: The sentinel node concept is not associated with improvements in the aesthetic outcome of breast cancer conservative treatment. PMID:22467404

Fougo, José Luis; Reis, Paulo; Giesteira, Laurinda; Dias, Teresa; Araújo, Cláudia; Dinis-Ribeiro, Mário

2012-03-31

391

Adjuvant Bisphosphonates for Breast Cancer  

Cancer.gov

Drugs called bisphosphonates may be able to prevent bone metastases in women with early breast cancer. With this trial, researchers are comparing a bisphosphonate called clodronate with two newer, more-potent bisphosphonates--zoledronate and ibandronate--in women with stage I-III breast cancer.

392

Immunological enhancement of breast cancer.  

PubMed

Breast cancer is a complex disease. Its aetiology is multifactorial, its period of development can span decades, and its clinical course is highly variable. Evaluation of the role of the immune response in either the development or control of breast cancer is also complex. Nevertheless, there is substantial information that in this disease, the immune response is not a host defence reaction and may even serve to facilitate cancer development. This evidence comes from a variety of sources including clinical-pathological investigations in women that show a correlation between the intensity of lymphocytic infiltration into the tumour mass with poor prognosis, studies in breast cancer patients that demonstrate a similar correlation between delayed hypersensitivity reactivity or in vitro assays of immune reactivity to tumour cell membranes or non-specific antigens and poor prognosis, and analyses of cancer incidence in chronically immunosuppressed, kidney transplant recipients who develop an unexpectedly low incidence of breast cancer. The overall conclusions from these human studies are corroborated by observations in mouse mammary tumour models that also demonstrate immune enhancement of breast cell proliferation in vitro and of breast cancer development in vivo. Potential mechanisms for these effects include production, by inflammatory cell infiltrates, of direct or indirect modulators of breast cell growth, e.g. cytokines, peptide or steroid hormones, enzymes involved in steroid metabolism, as well as of antibodies to growth factors or their receptors. These immune facilitatory mechanisms must be overcome if immune-based therapies are to be applied successfully in breast cancer. PMID:9571699

Stewart, T H; Heppner, G H

1997-01-01

393

Fulvestrant and/or Anastrozole in Treating Postmenopausal Patients With Stage II-III Breast Cancer Undergoing Surgery  

ClinicalTrials.gov

Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

2013-10-08

394

Nipple Discharge: An Early Warning Sign of Breast Cancer  

PubMed Central

Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create “breast awareness.” Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest.

Parthasarathy, Veda; Rathnam, Usharani

2012-01-01

395

Radiation-induced breast cancer  

SciTech Connect

Between 1975 and 1983, sixteen patients with a history of irradiation at an early age to the head, neck, or chest areas for a variety of conditions in whom breast cancer subsequently developed were seen at out institute. The median latent period between the irradiation and the development of breast cancer was 420 months. The distribution of patients by stage of the disease and the median age at diagnosis of this subgroup was similar to the breast cancer observed in the general population. The subsequent course of this disease was also similar to the breast cancer observed in the general population. A substantial number of women have been exposed to irradiation at a young age, and these women are at a higher risk of having breast cancer develop. These women should be closely observed to discover the disease in an early curable stage.

Finnerty, N.A.; Buzdar, A.U.; Blumenschein, G.R.

1984-06-01

396

Twelve years' experience with irradiation as the primary treatment for breast cancer  

SciTech Connect

Ninety patients received comprehensive, high-dose, supervoltage teletherapy as the primary treatment for carcinoma of the breast, following a biopsy or a segmental resection. The tumor doses delivered to the breast ranged between 5600 and 7000 rad in six to nine weeks; the draining lymph nodes received tumor doses of 5000 to 7000 rad in six to eight weeks. In five cases, Iridium-192 implants were employed to boost the radiation dose to the breast, and in seven instances a toilette mastectomy was performed for residual cancer. Satisfactory local control and cosmetic results were achieved in 86 patients. The patients were followed for 2 1/2 to 12 1/2 years. The local control rates were: Stage I, 100%, Stage II, 95%; Stage III, 100%; Stave IV (M-0), 89%; Stave IV (M-1), 100%. The overall disease-free survival figures were: Stage I, 85%; Stage II, 48%; Stage III, 50%; and Stage IV (M-0), 29%. We feel that this approach to the initial management of breast cancer is a practical, useful, and successful substitute for mastectomy when medical or surgical contraindications exist, or when the patient refuses a mastectomy.

Nobler, M.P. (Mount Sinai School of Medicine, New York, NY); Venet, L.

1981-01-01

397

Micro-computed tomography (Micro-CT): a novel approach for intraoperative breast cancer specimen imaging.  

PubMed

Intraoperative radiographic examination of breast specimens is commonly performed to confirm excision of image-detected breast lesions, but it is not reliable for assessing margin status. A more accurate method of intraoperative breast specimen imaging is needed. Micro-CT provides quantitative imaging parameters, image rotation, and virtual "slicing" of intact breast specimens. We explored the use of micro-CT for assessment of a variety of clinical breast specimens. Specimens were evaluated with a table top micro-CT scanner, Skyscan 1173 (Skyscan, Belgium), with a 40-130 kV, 8 W X-ray source. Skyscan software for 3D image analysis (Dataviewer and CTVox) was employed to review 3D graphics of specimens. Scanning for 7 min and another 7 min for image reconstruction provided the desired resolution for breast specimens. Breast lumpectomy specimens, shaved cavity margins, mastectomy specimens, and axillary lymph nodes were imaged by micro-CT. The micro-CT images could be rotated in all directions and cross sections of internal portions of specimens could be visualized from any angle. This provided information about spatial orientation of masses and calcifications relative to margins in intact lumpectomy specimens. Micro-CT is a potentially useful tool for assessment of breast cancer specimens, allowing real-time analysis of tumor location in breast lumpectomy specimens or shaved cavity margins. Micro-CT may also be useful for assessing sentinel lymph nodes and mastectomy specimens. PMID:23670129

Tang, Rong; Buckley, Julliette M; Fernandez, Leopoldo; Coopey, Suzanne; Aftreth, Owen; Michaelson, James; Saksena, Mansi; Lei, Lan; Specht, Michelle; Gadd, Michele; Yagi, Yukako; Rafferty, Elizabeth; Brachtel, Elena; Smith, Barbara L

2013-05-14

398

Assessment of the Current Medicare Reimbursement System for Breast Cancer Operations  

Microsoft Academic Search

Background: Medicare determines procedural reimbursement by means of formulas considering physician work, practice, and liability expenses.\\u000a Since no mechanism exists to consider outcomes in calculating reimbursements, we hypothesized that Medicare reimbursements\\u000a do not correlate with outcomes for different breast cancer operations.\\u000a \\u000a \\u000a Methods: We prospectively studied 240 patients with T1, 2N0M0 breast cancer in three surgical treatment arms: segmental mastectomy\\u000a with

Anthony Lucci; Angela Shoher; Marc O. Sherman; Ali Azzizadeh

2004-01-01

399

An unusual presentation of breast cancer in a very young woman  

Microsoft Academic Search

A healthy 27-year-old woman presented to an outside institution with unilateral nipple pruritus and a slight brown discolouration. When her symptoms failed to respond to topical therapy, nipple biopsy revealed Paget’s disease of the nipple. The patient sought further evaluation and care at our institution. Further investigation revealed multifocal breast cancer and the patient underwent bilateral mastectomies with sentinel lymph

Nicole P Sandhu; Harry J Long; Kiley J Johnson; Amy C Degnim

2011-01-01

400

Contributions of radiology to the diagnosis, management, and cure of breast cancer  

SciTech Connect

The role of radiology in the diagnosis and treatment of breast cancer is reviewed and placed in the context of advances in diagnostic radiology and radiation oncology in the overall care of patients with this disease. The author discusses the early history of mammography, the results of large-scale screening studies, improvements in the understanding of the biology of tumors, and the principles underlying the movement away from radical or modified radical mastectomy for tumor control.

Lester, R.G.

1984-04-01

401

The Feasibility of Irreversible Electroporation for the Treatment of Breast Cancer and Other Heterogeneous Systems  

Microsoft Academic Search

Developments in breast cancer therapies show potential for replacing simple and radical mastectomies with less invasive techniques.\\u000a Localized thermal techniques encounter difficulties, preventing their widespread acceptance as replacements for surgical resection.\\u000a Irreversible electroporation (IRE) is a non-thermal, minimally invasive focal ablation technique capable of killing tissue\\u000a using electric pulses to create irrecoverable nano-scale pores in the cell membrane. Its unique

Robert E. Neal; Rafael V. Davalos

2009-01-01

402

``In vivo'' Dosimetry in Tangential and Axilosupraclavicular Radiation Fields for Breast Cancer Postmastectomy''  

NASA Astrophysics Data System (ADS)

This work is an ``in vivo'' dosimetry study for breast cancer patients, treated with external radiotherapy. Patients who have suffered a modified radical mastectomy have been included in the study. Measurements will be made with thermoluminescent dosimeters and with radiochromic films. Such dosimetry will let us know the dose distribution in the zone which the applied beams overlap and compare the measureddose with that calculated one using the Eclipse 6.5 (Varian) planning system.

García, Heredia A.; Ruiz, Trejo C. G.; Gamboa de Buen, I.; Poitevin, Chacón M. A.; Flores, J. M. Castro; Rodríguez, M. Ponce; Ángeles, Zaragoza S. O.; Buenfil, Burgos A. E.

2008-08-01

403

Breast cancer, colorectal cancer, and esophageal cancer.  

PubMed

This is the second of a six-part series on metastatic spread and natural history of 18 common tumors. Part one summarized symptom/problem anticipation, cancer metastasis, and the 18 tumors that each cause more than 6,000 deaths per year in the United States. Bladder and brain cancer were discussed, with information given on tumor types, metastatic spread and invasion, and common symptoms. Part two charts the natural histories of breast, colorectal, and esophageal cancers. Each of these cancers is presented separately, with information given on mortality rates, the most common tumor types, sites of metastases, common problems, and common oncologic emergencies. Sites of spread, resulting problems (including site-specific symptoms), and assessment parameters are presented as tables. Material is presented so that clinicians will be able to anticipate the spread of these cancers and thus identify problems early in their development so that the problems are more easily managed. PMID:10085798

Kemp, C

404

Male breast cancer: is the scenario changing  

Microsoft Academic Search

BACKGROUND: The overall incidence of male breast cancer is around 1% of all breast cancers and is on the rise. In this review we aim to present various aspects of male breast cancer with particular emphasis on incidence, risk factors, patho-physiology, treatment, prognostic factors, and outcome. METHODS: Information on all aspects of male breast cancer was gathered from available relevant

Kaiyumars B Contractor; Kanchan Kaur; Gabriel S Rodrigues; Dhananjay M Kulkarni; Hemant Singhal

2008-01-01

405

Bilateral Synchronous Breast Cancer in a Male  

Microsoft Academic Search

Breast cancer in males is rare, accounting for less than 1% of all cases. Bilateral male breast cancer is reported to occur in fewer than 2% of all the diagnosed cases of male breast cancer, and synchronous tumors are exceedingly rare. The authors report a case of male breast cancer that is bilateral and syn- chronous, and review the literature

PETER B. KAHLA; SEBASTIANO CASSARO; FELIX G. VLADIMIR; MICHAEL G. WAYNE; ANGELO CAMMARATA

406

Plasmatic hypercoagulation in patients with breast cancer: role of heme oxygenase-1.  

PubMed

Breast cancer is an important health threat to women worldwide, and is associated with a 9-14% incidence of thrombophilia. Of interest, patients with breast cancer have been noted to have an increase in endogenous carbon monoxide production via upregulation of heme oxygenase-1 activity. Given that it has been demonstrated that carbon monoxide enhances plasmatic coagulation in vitro and in vivo, we sought to determine whether patients with breast cancer had an increase in endogenous carbon monoxide and concurrent plasmatic hypercoagulability. Breast cancer patients who were not smokers scheduled to undergo partial or complete mastectomy (n?=?18) had 15?ml of whole blood collected via an indwelling intravenous catheter and anticoagulated with sodium citrate. Whole blood was centrifuged and citrated plasma assessed with a thromboelastometric method to measure coagulation kinetics and the formation of carboxyhemefibrinogen. Breast cancer patients were determined to have an abnormally increased carboxyhemoglobin concentration of 2.5?±?1.3%, indicative of heme oxygenase-1 upregulation. Breast cancer patient plasma on average clotted 73% more quickly and had 32% stronger thrombus strength than normal individual (n?=?30) plasma. Further, 44% of breast cancer patients had plasma clot strength that exceeded the 95% confidence interval value observed in normal individuals, and 75% of this hypercoagulable subgroup had carboxyhemefibrinogen formation. Future investigation of the role played by heme oxygenase-1-derived carbon monoxide in the pathogenesis of breast cancer-related thrombophilia is warranted. PMID:24145726

Nielsen, Vance G; Ley, Michele L B; Waer, Amy L; Alger, Patrick W; Matika, Ryan W; Steinbrenner, Evangelina B

2013-12-01

407

[Sulodexide in the prevention of post-mastectomy lymphedema].  

PubMed

Post-mastectomy lymphedema of the upper limb, that can be noticed by 10 to 20 percent of patients with breast cancer, is usually related to some risk factors: use of radiotherapy on the axilla, obesity, venous outflow obstruction, delayed wound healing or infection. The most important contributing factor to postsurgical edema is the development of lymphangitis in the upper limb. Although literature contains numerous accounts on the use of pharmacological agents for the treatment of postmastectomy lymphedema, the results are not satisfactory in term of clinical response and side effects. In the present study we investigate tolerability and feasibility of the use of suledexide in patients, submitted to mastectomy for breast cancer, with an initial lymphedema of the limb omolateral to surgery or other risk factors for the development of a clinical remarkable lymphedema. Our results show that sulodexide is a very satisfactory therapy in term of lack of side effects and good compliance. PMID:7675295

Dini, D; Gozza, A; Silvestro, S; Cavallari, M; Forno, G

1995-04-01

408

Carboplatin and Combination Chemotherapy With or Without Veliparib in Treating Patients With Stage IIB-IIIC Breast Cancer  

ClinicalTrials.gov

Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

2013-06-20

409

Retinoids and breast cancer prevention.  

PubMed

Preclinical models suggest that retinoids inhibit mammary carcinogenesis. Induction of apoptosis is a unique feature of fenretinide, the most studied retinoid in clinical trials of breast cancer chemoprevention due to its selective accumulation in breast tissue and its favorable toxicological profile. In a phase III breast cancer prevention trial, fenretinide showed a very strong trend of reduction of incidence of second breast malignancies in premenopausal women, which was confirmed by the 15-year follow-up. Interestingly, ovarian cancer incidence appeared reduced during treatment in the same trial. This warrants further research on fenretinide mechanisms of action and potential efficacy and provides the rationale for a phase III primary prevention trial in young women at high risk for breast cancer. PMID:19213560

Bonanni, Bernardo; Lazzeroni, Matteo

2009-01-01

410

Epigenetic Therapy in Breast Cancer  

PubMed Central

Breast carcinogenesis is a multistep process involving both genetic and epigenetic changes. Epigenetics is defined as reversible changes in gene expression, not accompanied by alteration in gene sequence. DNA methylation, histone modification, and nucleosome remodeling are the major epigenetic changes that are dysregulated in breast cancer. Several genes involved in proliferation, anti-apoptosis, invasion, and metastasis have been shown to undergo epigenetic changes in breast cancer. Because epigenetic changes are potentially reversible processes, much effort has been directed toward understanding this mechanism with the goal of finding effective therapies that target these changes. Both demethylating agents and the histone deacetylase inhibitors (HDACi) are under investigation as single agents or in combination with other systemic therapies in the treatment of breast cancer. In this review, we discuss the role of epigenetic regulation in breast cancer, in particular focusing on the clinical trials using therapies that modulate epigenetic mechanisms.

Lustberg, Maryam B.

2012-01-01

411

Adjuvant chemotherapy in breast cancer  

Microsoft Academic Search

Summary  Breast cancer is the most common malignancy in women in Western Europe and the U.S. Adjuvant chemotherapy reduces the rate\\u000a of cancer recurrence, thereby contributing to the recent decline of breast cancer mortality. Notably, a number of important\\u000a developments occurred over the past decades. Starting with first generation regimens like CMF, the next step was the introduction\\u000a of anthracyclines into

R. Bartsch; G. G. Steger

2008-01-01

412

Pathology of hereditary breast cancer  

Microsoft Academic Search

Patients with germline mutations in BRCA1 or BRCA2 genes are predisposed to breast cancer. The BRCA1-associated breast cancers have distinct morphology, being more often medullary-like, triple negative and showing a ‘basal’ phenotype. On the other hand, BRCA2 and BRCAX cancers are a heterogeneous group without a specific phenotype. When incorporated into risk assessment models, pathology data improves prediction of carrier

Leonard Da Silva; Sunil R Lakhani

2010-01-01

413

Management of Adenoid Cystic Carcinoma of the Breast: A Rare Cancer Network Study  

SciTech Connect

Background: Mammary adenoid cystic carcinoma (ACC) is a rare breast cancer. The aim of this retrospective study was to assess prognostic factors and patterns of failure, as well as the role of radiation therapy (RT), in ACC. Methods: Between January 1980 and December 2007, 61 women with breast ACC were treated at participating centers of the Rare Cancer Network. Surgery consisted of lumpectomy in 41 patients and mastectomy in 20 patients. There were 51(84%) stage pN0 and 10 stage cN0 (16%) patients. Postoperative RT was administered to 40 patients (35 after lumpectomy, 5 after mastectomy). Results: With a median follow-up of 79 months (range, 6-285), 5-year overall and disease-free survival rates were 94% (95% confidence interval [CI], 88%-100%) and 82% (95% CI, 71%-93%), respectively. The 5-year locoregional control (LRC) rate was 95% (95% CI, 89%-100%). Axillary lymph node dissection or sentinel node biopsy was performed in 84% of cases. All patients had stage pN0 disease. In univariate analysis, survival was not influenced by the type of surgery or the use of postoperative RT. The 5-year LRC rate was 100% in the mastectomy group versus 93% (95% CI, 83%-100%) in the breast-conserving surgery group, respectively (p = 0.16). For the breast-conserving surgery group, the use of RT significantly correlated with LRC (p = 0.03); the 5-year LRC rates were 95% (95% CI, 86%-100%) for the RT group versus 83% (95% CI, 54%-100%) for the group receiving no RT. No local failures occurred in patients with positive margins, all of whom received postoperative RT. Conclusion: Breast-conserving surgery is the treatment of choice for patients with ACC breast cancer. Axillary lymph node dissection or sentinel node biopsy might not be recommended. Postoperative RT should be proposed in the case of breast-conserving surgery.

Khanfir, Kaouthar, E-mail: kaouthar.khanfir@rsv-gnw.ch [Hopital de Sion, CHCVs, Sion (Switzerland); Kallel, Adel [Institut Gustave Roussy, Villejuif (France); Villette, Sylviane [Centre Rene Huguenin, Paris (France); Belkacemi, Yazid [CHU Henri Mondor, Centre Oscar Lambret, Lille (France); Vautravers, Claire [Centre George Francois Leclerc, Dijon (France); Nguyen, TanDat [Institut Jean Gaudinot, Reims (France); Miller, Robert [Mayo Clinic, Rochester, Minnesota (United States); Li Yexiong [Peking Union Medical College, Beijing (China); Taghian, Alphonse G. [Massachusetts General Hospital, Boston, Massachusetts (United States); Boersma, Liesbeth [Maastricht University Medical Center (MAASTRO clinic), Maastricht (Netherlands); Poortmans, Philip [Dr. Bernard Verbeeten Institute, Tilburg (Netherlands); Goldberg, Hadassah [Western Galilee Hospital-Nahariya, Nahariya (Israel); Vees, Hansjorg [Hopitaux Universitaires de Geneve, Geneva (Switzerland); Senkus, Elzbieta [Medical University of Gdansk, Gdansk (Poland); Igdem, Sefik; Ozsahin, Mahmut [Istanbul Bilim University, Istanbul (Turkey); Jeanneret Sozzi, Wendy [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)

2012-04-01

414

The aluminium content of breast tissue taken from women with breast cancer.  

PubMed

The aetiology of breast cancer is multifactorial. While there are known genetic predispositions to the disease it is probable that environmental factors are also involved. Recent research has demonstrated a regionally specific distribution of aluminium in breast tissue mastectomies while other work has suggested mechanisms whereby breast tissue aluminium might contribute towards the aetiology of breast cancer. We have looked to develop microwave digestion combined with a new form of graphite furnace atomic absorption spectrometry as a precise, accurate and reproducible method for the measurement of aluminium in breast tissue biopsies. We have used this method to test the thesis that there is a regional distribution of aluminium across the breast in women with breast cancer. Microwave digestion of whole breast tissue samples resulted in clear homogenous digests perfectly suitable for the determination of aluminium by graphite furnace atomic absorption spectrometry. The instrument detection limit for the method was 0.48?g/L. Method blanks were used to estimate background levels of contamination of 14.80?g/L. The mean concentration of aluminium across all tissues was 0.39?g Al/g tissue dry wt. There were no statistically significant regionally specific differences in the content of aluminium. We have developed a robust method for the precise and accurate measurement of aluminium in human breast tissue. There are very few such data currently available in the scientific literature and they will add substantially to our understanding of any putative role of aluminium in breast cancer. While we did not observe any statistically significant differences in aluminium content across the breast it has to be emphasised that herein we measured whole breast tissue and not defatted tissue where such a distribution was previously noted. We are very confident that the method developed herein could now be used to provide accurate and reproducible data on the aluminium content in defatted tissue and oil from such tissues and thereby contribute towards our knowledge on aluminium and any role in breast cancer. PMID:23870171

House, Emily; Polwart, Anthony; Darbre, Philippa; Barr, Lester; Metaxas, George; Exley, Christopher

2013-06-01

415

Breast cancer local recurrence after breast reconstruction.  

PubMed

The primary aim of surgery in breast cancer is to achieve local control of disease. Secondly, improving quality of life and patient satisfaction is of utmost importance. While the positive effect of postmastectomy reconstruction on the psychological well-being of women with breast cancer has been demonstrated, evidence-based data on its oncological safety remain sparse. There is concern that the presence of autologous tissue or an implant may mask locoregional recurrence. Furthermore, there is little agreement on the appropriateness of routine radiological surveillance of these patients as well as on the surgical treatment of locoregional recurrence. We attempt to review the impact of breast reconstruction on the incidence and detection of locoregional recurrence and discuss treatment options. PMID:18716989

Kropf, N; McCarthy, C M; Disa, J J

2008-08-20

416

Breast cancer surgery and diagnosis-related groups (DRGs): Patient classification and hospital reimbursement in 11 European countries.  

PubMed

Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. PMID:23218742

Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard

2012-12-06

417

Résultats oncologiques de la reconstruction immédiate après mastectomie pour cancer du sein: à propos de 38 cas  

Microsoft Academic Search

Résumé\\u000a Objectifs  Analyser les résultats oncologiques de la reconstruction mammaire immédiate (RMI) par lambeau abdominal avancé (LAA) associé\\u000a à une prothèse et l’impact des traitements adjuvants sur les résultats esthétiques.\\u000a \\u000a \\u000a \\u000a \\u000a Matériel et méthodes  Étude rétrospective colligeant 38 patientes ayant eu une RMI après mastectomie pour cancer du sein, utilisant le LAA associé\\u000a à une prothèse mammaire, réalisée par un même opérateur au

M. Fekih; N. Mansouri-Hattab; M. Bibi; T. Fekry; S. Ben Ahmed; N. Bouaouina; H. Khairi

2010-01-01

418

Hedgehog signalling in breast cancer  

PubMed Central

Breast cancer is the most common cause of cancer death among women worldwide. In order to improve the treatment of this disease, a more complete understanding of its biological basis is necessary. Since the Hedgehog (Hh) pathway was recently found to be required for growth and propagation of a number of different cancers, we discuss here the possible involvement of this pathway in the normal biology and development of cancer in the mammary gland. The use of mouse mammary cancer models has assisted the process of dissecting the mechanisms behind Hh-driven mammary tumour formation and growth. Based on recent studies, we conclude that the inhibition of Hh signalling in breast tumours may interfere with the maintenance of a putative cancer stem cell compartment and the abnormal stimulation of tumour stroma. Therefore, the components of the Hh signalling cascade may provide a set of drug targets, which could be implemented into novel combinatorial strategies for the treatment of breast cancer.

Kasper, Maria; Jaks, Viljar; Fiaschi, Marie; Toftgard, Rune

2009-01-01

419

New Models of Breast Cancer Risk Focus on Breast Density  

Cancer.gov

Two new models for assessing a patient's risk of developing breast