A 12-Year Single-Institution Experience with Accelerated Partial Breast Irradiation.
This report reviews our available data to provide an analysis of patient outcomes over 12 years of use at a single institution. A retrospective review was conducted of records of 150 patients who underwent APBI or attempted APBI after breast-sparing surgeries between 2006 and 2017. These charts were analyzed for documentation of patient age, cancer stage, incidence of recurrence, and posttreatment complications. Of the patients evaluated, 99 per cent (149/150) completed treatment. The median time since treatment completion is now 8.9 years. One hundred eleven patients (74% ) are now greater than five years posttreatment. Ipsilateral breast recurrence was found in 2.7 per cent of patients (4/149), and 1.3 per cent of patients (2/149) developed new primary breast tumors. Acute complications, mostly skin erythema (21%), were uncommon and self-limited. Subacute effects were generally fibrosis (13%) and mild local pain (9.4%). APBI for breast cancer after breast-conserving surgery continues to be used at our institution for select patients with good outcomes. Local control and toxicity are similar to that reported in the literature. Five-year local recurrence rates compare favorably with national trials. Occasional complications included fibrosis, persistent pain, and skin irritation. PMID: 30185296 [PubMed - in process]
Conclusion: To enhance the recovery of shoulder mobility, early rehabilitation with a shorter immobilization period should be recommended to patients with breast cancer undergoing reconstruction surgery with TEI. Trial Registration: ClinicalTrials.gov Identifier: NCT03541161. PMID: 31598346 [PubMed]
ConclusionFor women who had BC surgery with ALND, our progressive resistance training intervention conferred no benefit over usual care in reducing pain. Importantly, it did not increase the risk of pain both in the short and long term rehabilitative phase.
Conclusion: This RCT shows that perioperative pregabalin may not have a role in the prevention of chronic pain after breast surgeries.
Women with breast cancer treated with aromatase inhibitor (AI) therapy experience multiple concurrent symptoms or symptom clusters. Understanding of the symptom experience and identifying symptom clusters before and during AI therapy are important for the development of interventions to improve clinical outcomes.
We appreciate the response of Kako et al. to our article, ‘Patient-reported symptom severity among 22,650 cancer outpatients in the last 6 months of life’. Kako and colleagues highlighted that breast cancer, the most common type of cancer among women, was excluded from our study and were concerned this may bias our results. We chose to exclude sex-spec ific cancers, such as breast cancer and prostate cancer, to better understand symptom severity differences between men and women diagnosed with the same cancer, where symptom presentation and disease trajectory are more homogenous.
To measure mammography-related pain in two groups of women undergoing regular surveillance as a baseline for future care.
CONCLUSION(S): QoL deterioration persisted at 2 years after diagnosis with different trajectories by treatment received. ET, but not CT, had a major detrimental impact on C30-SumSc, especially in postmenopausal women. These findings highlight the need to properly select patients for adjuvant ET escalation. PMID: 31591636 [PubMed - as supplied by publisher]
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Can we reduce the persistent, unbearable pain of losing a loved one to 15-20 voxels of brain activity in the nucleus accumbens (O'Connor et al., 2008)? No? Then what if I told you that unrelenting grief — and associated feelings of sheer panic, fear, terminal aloneness, and existential crisis — isn't “suffering”. It's actually rewarding!Well I'm here to tell you that it isn't.Looking back on apost from 2011, you never realize it's going to be you.1The top figure shows that activity in thenucleus accumbens was greater in response to grief-related words vs. neutral words in a group of 11 women with &l...
ConclusionThe list of common frames described in this paper identifies important cancer-related information extracted by existing NLP techniques and serves as a useful resource for future researchers requiring cancer information extracted from EHR notes. We also argue, due to the heavy duplication of cancer NLP systems, that a general purpose resource of annotated cancer frames and corresponding NLP tools would be valuable.Graphical abstract