scholarly journals Risk factors for implant failure following revision surgery in breast cancer patients with a previous immediate implant-based breast reconstruction

2020 ◽  
Vol 184 (3) ◽  
pp. 977-984
Author(s):  
A. Frisell ◽  
J. Lagergren ◽  
M. Halle ◽  
J. de Boniface
Keyword(s):  
Risk Factors ◽  
Breast Reconstruction ◽  
Revision Surgery ◽  
Implant Failure ◽  
Breast Cancer Patients ◽  
Axillary Clearance ◽  
Medical Chart Review ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Immediate Implant

Abstract Purpose The aim of the current study was to evaluate risk factors and timing of revision surgery following immediate implant-based breast reconstruction (IBR). Methods This retrospective cohort included women with a previous therapeutic mastectomy and implant-based IBR who had undergone implant revision surgery between 2005 and 2015. Data were collected by medical chart review and registered in the Stockholm Breast Reconstruction Database. The primary endpoint was implant removal due to surgical complications, i.e. implant failure. Results The cohort consisted of 475 women with 707 revisions in 542 breasts. Overall, 33 implants were removed due to complications. The implant failure rate (4.7%) was lower without RT (2.4%) compared to RT administered after mastectomy (7.5%) and prior to IBR (6.5%) (p = 0.007). While post-mastectomy RT (OR 3.39, 95% CI 1.53–7.53), smoking (OR 3.90, 95% CI 1.76–8.65) and diabetes (OR 5.40, 95% CI 1.05–27.85) were confirmed as risk factors, time from completion of RT (> 9 months, 6–9 months, < 6 months) was not (OR 3.17, 95% CI 0.78–12.80, and OR 0.74, 95% CI 0.20–2.71). Additional risk factors were a previous axillary clearance (OR 4.91, 95% CI 2.09–11.53) and a history of a post-IBR infection (OR 15.52, 95% CI 4.15–58.01, and OR 12.93, 95% CI 3.04–55.12, for oral and intravenous antibiotics, respectively). Conclusions Previous axillary clearance and a history of post-IBR infection emerged as novel risk factors for implant failure after revision surgery. While known risk factors were confirmed, time elapsed from RT completion to revision surgery did not influence the outcome in this analysis.

A Nationwide Analysis of Early and Late Readmissions following Free Tissue Transfer for Breast Reconstruction

2020 ◽  
Vol 36 (06) ◽  
pp. 450-457 ◽  
Author(s):  
David Alejandro Magno-Padron ◽  
Willem Collier ◽  
Jaewhan Kim ◽  
Jayant P. Agarwal ◽  
Alvin C. Kwok
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Readmission Rate ◽  
Free Tissue Transfer ◽  
Breast Cancer Patients ◽  
Tissue Transfer ◽  
History Of

Abstract Background Traditionally, surgical quality outcomes are assessed using a 30-day postoperative window. For breast cancer patients undergoing free tissue transfer for breast reconstruction, we sought to describe the distribution of and specific risk factors for early and late readmissions within a 0- to 90-day postoperative period. Patients and Methods The Nationwide Readmissions Database was used to conduct a retrospective cohort study. Breast cancer patients undergoing free tissue transfer for breast reconstruction were identified using International Classification of Diseases -9 diagnosis and procedure codes. Ninety-day readmissions related to infection or wound complications were identified. Univariable and multivariable logistic regression models were used to identify patient risk factors for readmissions that occurred early (0–30 days) and late (31–90 days) after their index procedure. Results In the weighted sample, we identified approximately 7,305 free flap breast reconstructions and a surgical wound-related readmission rate of 4.3% (n = 312): 65.4% of the readmissions occurred early while 34.6% occurred late after surgery. The mean days to readmission was 26, and 75% of all readmissions occurred within the first 36 days after surgery. Variables independently associated with readmissions during the 0- to 90-day postoperative period included: history of chronic obstructive pulmonary disease (p = 0.036), hypertension (p = 0.03), obesity (p ≤ 0.001), and history of smoking (p = 0.004). The variables independently associated with the early readmission period were the same as those identified for the 0- to 90-day postoperative period. The variables independently associated with late readmissions were different: history of depression (p = 0.001) and history of smoking (p = 0.001). Conclusion The conventional 30-day hospital readmission rate classically used as a quality metric is overlooking a significant portion of admissions after free flap-based breast reconstruction. Different variables were found to be associated with readmission in the early versus late cohorts. Interventions targeting these variables could decrease readmissions and their associated costs.

Outcomes of Breast Reconstruction in Breast Cancer Patients With a History of Mantle Radiation for Hodgkin Lymphoma

2014 ◽  
Vol 72 ◽  
pp. S46-S50 ◽  
Author(s):  
Ryan K. Wong ◽  
Shane D. Morrison ◽  
Arash Momeni ◽  
Matthew Nykiel ◽  
Gordon K. Lee
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Hodgkin Lymphoma ◽  
Breast Cancer Patients ◽  
History Of

scholarly journals Assessment of Breast Cancer Risk Based on Mammary Gland Volume Measured with CT

2010 ◽  
Vol 4 ◽  
pp. BCBCR.S5248 ◽  
Author(s):  
Megumi Kuchiki ◽  
Takaaki Hosoya ◽  
Akira Fukao
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Premenopausal Women ◽  
Breast Cancer Patients ◽  
History Of ◽  
The Relationship

We investigated the relationship between mammary gland volume (MGV) of the breast as measured with three-dimensional chest computed tomography (CT) and breast cancer risk. Univariate analysis was used to assess the relationship between MGV and known risk factors in 427 healthy women. A case control study (97 cases and 194 controls) was conducted to assess breast cancer risk. MGV was significantly smaller for postmenopausal women than for premenopausal women, and was significantly larger for women with a family history of breast cancer than for women without. MGV, body mass index (BMI), and rate of family history of breast cancer were significantly higher among breast cancer patients than among healthy women, and number of deliveries was significantly lower among breast cancer patients. In postmenopausal women, age at menarche was significantly younger for breast cancer patients. MGV correlated well with breast cancer risk factors. The highest odds ratio was 4.9 for premenopausal women with the largest MGV. Regardless of menopausal status, the greater the MGV, the higher the odds ratio. Our results constitute the first reliable data on the relationship between MGV and breast cancer obtained through exact volume analysis.

scholarly journals BREAST CANCER;

2014 ◽  
Vol 21 (06) ◽  
pp. 1128-1132
Author(s):  
Abeer Nisar ◽  
M Naim Siddiqi ◽  
Naveed ur Rehman ◽  
Raza ur Rahman
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Family History ◽  
Menopausal Status ◽  
Positive Family History ◽  
American Woman ◽  
Breast Cancer Patients ◽  
Civil Hospital ◽  
Early Menarche ◽  
History Of

Objective: To assess the risk factors for breast cancer in patients attending oncology OPD of civil hospital Karachi, Pakistan. Introduction: Breast cancer is the single largest cause of death among women1,2. The probability of American woman developing breast cancer in their life is 7 in 11. Studies from subcontinent show that the incidence of breast cancer is increasing, with an estimated 80,000 new cases diagnosed annually. Breast cancer is the second most common type of cancer after lung cancer in Pakistan and ranked first in women. Only 10% women are diagnosed, out of them, 75% women do not get treatment and die within 5 years6. Data from Pakistan about the risk factors or association is not only scanty but also does not comment on the use of fatty diet in breast cancer patients. Method: A cross-sectional descriptive study conducted at Oncology OPD of civil hospital Karachi (CHK) from October 2009 -April 2011. One Hundred and Fifty consecutive patients having histopathalogical diagnosis of breast cancer were assessed for different risk factors that included marital status, parity, age, menopausal status, family history of breast cancer, prolong use of oral contraceptives, breast feeding, , early menarche, trauma to the breast and fatty diet. Result: Mean age of patients was 48 years. Three fourth (73%) of these female were above the age of 40 years. Consumption of fatty diet was found in 62.67% while positive family history of breast cancer was present in 34% of the cases. Early menarche and being nulliparous were not as strong risk factors as in previous studies. Conclusions: Our study has highlighted the need of further exploration in this area that would not only help this population but also enhance our understanding of different risk factors. This will have important implications for the overall management of breast cancer.

Immediate Implant-Based Breast Reconstruction following Total Skin-Sparing Mastectomy in Women with a History of Augmentation Mammaplasty

2014 ◽  
Vol 134 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Hani Sbitany ◽  
Frederick Wang ◽  
Lina Saeed ◽  
Michael Alvarado ◽  
Cheryl A. Ewing ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Augmentation Mammaplasty ◽  
History Of ◽  
Immediate Implant

Bisphosphonate-Related Osteonecrosis of the Jaws: A Case-Control Study of Risk Factors in Breast Cancer Patients

2008 ◽  
Vol 26 (28) ◽  
pp. 4634-4638 ◽  
Author(s):  
Athanassios Kyrgidis ◽  
Konstantinos Vahtsevanos ◽  
Georgios Koloutsos ◽  
Charalampos Andreadis ◽  
Ioannis Boukovinas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Tooth Extraction ◽  
Breast Cancer Patients ◽  
Level Of Evidence ◽  
Osteonecrosis Of The Jaws ◽  
Dental Procedures ◽  
History Of ◽  
Group B

Purpose Osteonecrosis of the jaws (ONJ) was initially described in 2001 in patients receiving intravenous bisphosphonate (BP) treatment. The objective of the present study was to determine whether routine dental procedures can be considered as possible risk factors for the development of ONJ in breast cancer patients receiving BP. Patients and Methods Twenty breast cancer patients who developed ONJ receiving BP treatment were included in group A, whereas group B consisted of 40 matched controls (breast cancer patients who did not progress to ONJ receiving BP treatment). Routine dental care, smoking habits, history of tooth extraction, use of dentures, and root canal therapy were recorded. Results Our results indicate that history of tooth extraction during zoledronic acid treatment (adjusted odds ratio [OR] = 16.4; 95% CI, 3.4 to 79.6) and the use of dentures (adjusted OR = 4.9; 95% CI, 1.2 to 20.1) increase the risk of developing ONJ. Conclusion The outcome of the present study suggests early referral by oncologists for dental evaluation for every patient to be treated with BP. These results raise the current American Society of Clinical Oncology Level of Evidence linking certain dental procedures with ONJ from V to III. Further studies are needed to assess other possible risk factors and also to highlight the etiopathogenesis mechanism of ONJ.

scholarly journals Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Yamashita ◽  
H Tanaka ◽  
K Hatazawa ◽  
Y Tanaka ◽  
K Sumimoto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Previous History ◽  
Left Ventricular ◽  
Clinical Risk Factors ◽  
Lv Function ◽  
Breast Cancer Patients ◽  
Clinical Risk ◽  
History Of

Abstract Background The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity following treatment with chemotherapy. However, the association between clinical risk factors and left ventricular (LV) function in breast cancer patients is currently unclear. Purpose Our purpose was to investigate the impact of baseline risk factors on LV function in patients with preserved LV ejection fraction (LVEF) who have undergone anthracycline or trastuzumab chemotherapy for breast cancer. Methods We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59±13 years and LVEF was 67±5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of &gt;10% to an absolute value of &lt;53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥240 mg/m2, (2) age ≥65-year-old, (3) body mass index ≥30 kg/m2, (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker. Results The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (−9.3±10.8% vs. −2.2±10.2%; p=0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p=0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3±29.0 g/m2 vs. 83.2±21.0g /m2, p&lt;0.001), lower global longitudinal strain (18.4±2.8% vs. 20.0±2.6%, p=0.06) and higher E/e' (10.4 (8.9–13.0) vs. 9.0 (7.4–10.9), p=0.06) compared to those without. Conclusions Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy. Funding Acknowledgement Type of funding source: None

scholarly journals Chemotherapy-Induced Nausea and Vomiting Breast Cancer Patients from a Chinese Multicenter Prospective Longitudinal Observational Study

2021 ◽  
Author(s):  
Xin-Juan Huang ◽  
Xu-Ying Li ◽  
Lu Luo
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Observational Study ◽  
Cancer Patients ◽  
Nausea And Vomiting ◽  
Breast Cancer Patients ◽  
History Of ◽  
Delayed Cinv ◽  
Acute Cinv ◽  
Prospective Longitudinal

Aims: To assess the occurrence of Chemotherapy-induced nausea and vomiting (CINV) after standard antiemetic therapy in the acute (24 h post-chemotherapy) and delayed (2&ndash;5 days post-chemotherapy) phases, as well as to identify risk factors for CINV in the acute and delayed phases. Methods: This prospective longitudinal and observational study analyzed the data of 400 breast cancer patients scheduled for chemotherapy over two cycles in two hospitals. The self-report survey was developed to assess the occurrence of CINV and their associated factors. CINV was evaluated with a Multinational Association of Supportive Care in Cancer Antiemetic Tool (MAT) on days 2 and 6 of chemotherapy. The incidence of acute and delayed CINV were presented by frequency and percentage. Generalized equation estimates (GEE) was used to identify risk factors of acute and delayed CINV. Results: There were 400 evaluable patients with complete Round 1 data, 334 for Round 2 data. Among 400 patients, 29.8% and 23.5% experienced acute and delayed CINV, respectively. Risk factors associated with for acute CINV were pain/insomnia, history of CINV, history of motion sickness (MS), and highly emetogenic chemotherapy regimen, while history of MS, CINV history, number of completed chemotherapy cycle number &lt; 3, and the incidence of acute CINV were risk factors of delayed CINV (all p &lt; 0.05). Conclusions: The findings may help nurses working for Chinese population in identifying patients at risk for CINV and in planning effective program to reduce the occurrence of CINV.

Outcomes of Combined Treatment for Breast Cancer with Immediate Implant-Based Breast Reconstruction, Chemotherapy and Conformal Radiotherapy

2018 ◽  
pp. 19-25
Author(s):  
Е. Тимошкина ◽  
E. Timoshkina ◽  
Сергей Ткачев ◽  
Sergey Tkachev ◽  
А. Назаренко ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Capsular Contracture ◽  
Late Complication ◽  
Combined Treatment ◽  
Tissue Expander ◽  
Complication Rates ◽  
Breast Cancer Patients ◽  
Immediate Implant

Purpose: To evaluate the oncological results and late complication rate in breast cancer patients who underwent immediate implant-based breast reconstruction and adjuvant radiotherapy. Material and methods: 32 patients with I–IIIC breast cancer after combined treatment which included immediate implant-based breast reconstruction, chemotherapy and radiotherapy, were reviewed. Results: All 32 patients got skin erythema as an acute adverse effect. 6 (18 %) of them got acute mucositis. Median follow-up was 35 months (range 12–112 months). 2 (6 %) patients had local recurrence after 46 and 31 months since the operation day. Locoregional control rate was 94 %. 9 (28 %) patients presented distant metastases at term 8–71 months since the operation day, and metastases in bones, brain, lungs, liver and non-regional lymph nodes were diagnosed. 2 (6 %) patients died because of disease progression. Late adverse effects of skin and soft tissue in irradiated area were found in 4 (13 %) patients – capsular contracture was diagnosed 1 (n = 1), 2 (n = 2) and 3 (n = 1) stages. In two cases of four, capsular contracture was asymptomatic and found during the second stage of breast reconstruction while changing tissue expander to implant. Capsulotomy was performed, and aesthetic effect was good. In one case capsular contracture was the reason of implant removal, and then second reconstruction using tissue expander was performed. Conclusion: Nowadays immediate implant-based breast reconstruction is an essential part of combined treatment. Breast cancer patients after immediate implant-based breast reconstruction can be treated in adequate manner, and breast reconstruction is not a contraindication for radiotherapy. Low complication rates can still be acquired with the use of state-of-art 3D and 4D radiotherapy techniques and supportive care.

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