Should unaffected female BRCA2 pathogenic variant carriers be told there is little or no advantage from risk reducing mastectomy?
When William Stewart Halsted described the radical mastectomy in 1894, it was thought that a cure for breast cancer lay in maximally invasive and often morbid surgery. Our understanding of breast cancer has changed immeasurably in the subsequent century in which innumerable preclinical and clinical studies have demonstrated that advanced breast cancer is a systemic disease that requires a multimodality approach that includes both local (surgery and radiation) and systemic therapies (chemotherapy, endocrine therapy, and/or immunotherapy).
AbstractPurposeIncrease in breast cancer survivorship, advancements in diagnostic imaging and standardization of contralateral breast screening before breast cancer surgery have resulted in increased detection of contralateral breast cancer (CBC). The aim of this study was to assess national trends of synchronous bilateral breast cancer (sBBC) and metachronous bilateral breast cancer (mBBC) incidence in newly diagnosed breast cancer patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database (1973 –2014) was used to identify 11,177 women diagnosed with CBC. CBC was classified as sBBC when primary ...
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]
Soon after publication of the results of NSABP-04 and NSABP-06 trials [1,2], an increasing proportion of women with early stage breast cancer received breast conserving therapy (BCT), including breast conserving surgery and adjuvant whole breast irradiation, in lieu of a mastectomy. Subsequent to these trials, BCT became the preferred treatment approach after the National Institutes of Health (NIH) Consensus conference in 1990 . However, recent studies have shown a rising rate of mastectomies in patients who are eligible for BCT.
ConclusionThis study detected significant differences in postoperative complication rates between the diseased and prophylactic breasts following bilateral mastectomy and immediate breast implant reconstruction. Postoperative complications occurred more frequently in the diseased breast compared with low rates of complications in the contralateral prophylactic breast. This information is helpful for preoperative decision making, as surgeons and patients carefully weigh the additional risks of contralateral prophylactic procedure.
ConclusionsBreast conservation may be considered a safe alternative in the surgical treatment of MBC. Future research should focus on better standardization of local therapy for MBC and improved reporting of outcomes.
Peter Botros, 33, a chef from New York City, was diagnosed with stage I breast cancer in August 2012. After undergoing a double mastectomy, he was declared to be cancer-free.
Abstract BACKGROUND: Women who carry a pathogenic mutation in either a BRCA1 DNA repair associated or BRCA2 DNA repair associated (BRCA1 or BRCA2) gene have a high lifetime risk of developing breast and tubo-ovarian cancer. To manage this risk women may choose to undergo risk-reducing surgery to remove breast tissue, ovaries, and fallopian tubes. Surgery should increase survival, but can impact women's lives adversely at the psychological and psychosexual levels. Interventions to facilitate psychological adjustment and improve quality of life post risk-reducing surgery are needed. OBJECTIVES: To examine psych...
Conclusion: Anti-CV2 autoimmune encephalitis can present as Parkinsonism with bilateral leukoencephalopathy on MRI. PET scanning can be useful to reveal an occult cancer. Treatment of the cancer may improve the paraneoplastic neurological syndrome without the need of immunosuppressive therapy.
ConclusionIt is important to maintain a suspicion for GI tract metastasis in breast cancer patients who present with abdominal mass or GI symptoms, as this aids in prompt institution of accurate and appropriate management.