Factors limiting outpatient management in breast surgery.
CONCLUSION: Because of social, medical or psychological constraints, the rate of outpatient breast surgery remains in our practice, stable in recent years at 56%. Some ways of improvement can be envisaged, but it is likely that this rate will only increase in a very gradual manner in the years to come. PMID: 31627904 [PubMed - as supplied by publisher]
Authors: Montagna G, Morrow M Abstract IntroductionThe contralateral prophylactic mastectomy (CPM) rate in the U.S. has been steadily increasing. This is of particular concern because many women who undergo this procedure are candidates for breast-conserving surgery.Areas covered: CPM's medical benefit is related to the risk of contralateral cancer development and whether CPM provides a survival benefit. Contralateral cancer rates have decreased, and CPM does not provide a survival benefit. Other potential benefits of the procedure may be improved quality of life; these data are reviewed. Research efforts have been...
ConclusionOverall, these guidelines provide consistent recommendations on who should receive breast reconstruction education, who is a candidate for postmastectomy breast reconstruction, and the appropriate timing of reconstruction and extent of mastectomy. Future updates from all should focus on expanding to include alloplastic and autologous forms of reconstruction and should include a broad scope of relevant questions.
Conclusions: Robotic-assisted surgery can successfully and reproducibly perform a nipple-sparing mastectomy with breast reconstruction. It can minimize the size of scarring and is superior to the laparoscopic technique, with improved 3-dimensional visualization, dexterity, and range of motion able to guide around the curvature of the breast. The main limiting factors are the lack of the US Food and Drug Administration approval, cost of the robot, and specialized skills required.
Breast carcinoma is the most common malignancy in females. The estimated age-adjusted annual incidence of breast cancer in 40 European countries was 94.2 out of 100,000 in 2012 . Adjuvant breast radiation therapy is a standard of care after both mastectomy and conservative breast surgery aiming to improve local control and survival [2,3]. The benefit of lymph node irradiation (mammary chain (MC), supra and infra clavicular nodes) in patients with axillary lymph nodes involvement or at high risk of relapse has been shown to improve survival in various clinical trials .
CONCLUSIONS.—: Our study demonstrates that we handle transmasculine mastectomy specimens by examining 2.8 times more slides on average than for RMs, with a 2.5 times lower rate of significant pathologic findings. Prior family history of breast cancer or the use of androgen therapy before surgery in gender-affirming individuals did not increase the risk of identifying significant breast lesions. We recommend submitting 4 tissue blocks per mastectomy for individuals undergoing gender-affirming breast surgery. PMID: 31816268 [PubMed - as supplied by publisher]
CONCLUSIONS: Preoperative evaluation in breast cancer patients provides correct assessment of the effect of surgical treatment on patient satisfaction and quality of life. This information is useful for communicating with patients about their expectations and postoperative results. PMID: 31806233 [PubMed - as supplied by publisher]
AbstractPurpose of ReviewContralateral prophylactic mastectomy (CPM) at the time of unilateral breast cancer surgery is increasing, though still controversial in BRCA( −) patients. We review the relevant literature regarding CPM and specifically abnormal imaging/biopsies in patients following unilateral mastectomy (UM) versus CPM and present results from our own retrospective chart review.Recent FindingsA large cohort study by van la Parra et al. examined the incidence/risk of breast biopsy at follow-up, finding the 5-year estimated biopsy rate to be the lowest for UM compared to breast-conserving surgery. Our retros...
This study aims to determine if a disparity in BR utilization exists in women from Appalachia Kentucky. Methods A retrospective, population-based cohort study was conducted from January 1, 2006, to December 31, 2015. The Kentucky Cancer Registry was queried to identify population-level data for female patients diagnosed with breast cancer and treated with mastectomy. A multivariate logistic regression model controlling for patient, disease, and treatment characteristics was constructed to predict the likelihood of BR. Results Bivariate testing showed differences (P
The aim of this study was to assess the effect of preoperative sleep quality on acute postoperative pain in breast cancer patients. The Pittsburgh Sleep Quality Index questionnaire (PSQI) was used to assess the overall sleep status of women scheduled for unilateral modified radical mastectomy in the past month. Based on the responses, patients were allocated to good sleep group or poor sleep group. Postoperatively, acute pain was assessed using the numerical rating score in the first 24â€Šhours; in addition, the requirement of analgesics and the incidence of postoperative complications were recorded. A total of 108 breas...
ConclusionsPecs2 blocks can significantly reduce post-operative pain, nausea and vomiting in patients undergoing mastectomy. Their use can enable units to achieve high day-case mastectomy rates.