Factors associated with re-operation for oncological clearance in Breast Conserving Surgery (BCS) for Breast cancer

2021 ◽  
Vol 47 (2) ◽  
pp. e43-e44
Author(s):  
Huma Irshad ◽  
Prakash Sinha ◽  
Abdul Kasem ◽  
Sudeendra Doddi ◽  
Uhercik Michal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conserving Surgery ◽  
Factors Associated

HSR20-085: Real-World Study of Factors Associated With Breast Conserving Surgery for Females Diagnosed With Early Stage Breast Cancer

2020 ◽  
Vol 18 (3.5) ◽  
pp. HSR20-085
Author(s):  
Judy George ◽  
Joseph Tkacz ◽  
M. Christopher Roebuck ◽  
Fredy Reyes ◽  
Yull E. Arriaga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Real World ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Early Stage Breast Cancer ◽  
Factors Associated

Disparities in receipt of and time to adjuvant therapy after lumpectomy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 534-534
Author(s):  
Irene Dankwa-Mullan ◽  
M. Christopher Roebuck ◽  
Joseph Tkacz ◽  
Oluwadamilola Motunrayo Fayanju ◽  
Yi Ren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Breast Conserving Surgery ◽  
Relative Risk Ratio ◽  
Adjuvant Radiation ◽  
Factors Associated ◽  
Severe Liver Disease ◽  
Insured Patients ◽  
To Receive ◽  
Area Health

534 Background: Adjuvant treatment after breast conserving surgery (BCS) has been shown to improve outcomes, but the degree of uptake varies considerably. We sought to examine factors associated with post-BCS receipt of and time to treatment (TTT) for adjuvant radiation therapy (ART), cytotoxic chemotherapy (ACT) and endocrine therapy (AET) among women with breast cancer. Methods: IBM MarketScan claims data were used to select women diagnosed with non-metastatic invasive breast cancer from 01/01/2012 to 03/31/2018, who received primary BCS without any neoadjuvant therapy, and who had continuous insurance eligibility 60 days post-BCS. Logistic and quantile regressions were used to identify factors associated with receipt of adjuvant therapy (ART, ACT, AET) and median TTT in days for ART (rTTT), ACT (cTTT), and AET (eTTT), respectively, after adjustment for covariates including age, year, region, insurance plan type, comorbidities, and a vector of ZIP3-level measures (e.g., community race/ethnicity-density, education level) from the 2019 Area Health Resource Files. Results: 36,270 patients were identified: 11,996 (33%) received ART only, 4,837 (13%) received ACT only, 3,458 (10 %) received AET only, 5,752 (16%) received both ART and AET, and 9,909 (27%) received no adjuvant therapy within 6 months of BCS. (318) 1% of patients received combinations of either ART, AET or ACT. Relative to having no adjuvant therapy, patients > 80 years were significantly less likely to receive ART only (relative risk ratio [RRR] 0.65), ACT only (RRR 0.05), or combination ART/AET (RRR 0.66) but more likely to receive AET alone (RRR 3.61) (all p < .001). Patients from communities with high proportions of Black (RRR 0.14), Asian (RRR 0.13), or Hispanic (RRR 0.45) residents were significantly less likely to receive combination ART and AET (all p < .001). Having HIV/AIDS (+11 days; p = .01) and residing in highly concentrated Black (+8.5 days; p = .01) and Asian (+12.2 days; p = .04) communities were associated with longer rTTT. Longer cTTT was associated with having comorbidities of cerebrovascular disease (+6.0 days; p < .001), moderate to severe liver disease (+12.3 days; p < .001) and residing in high-density Asian communities (+18.0 days; p < .001). Shorter eTTT (-11.4 days; p = .06) and cTTT (-14.8 days; p < .001) was observed in patients with comorbidities of dementia. Conclusions: Results from this cohort of privately insured patients demonstrate disparities in receipt of post-BCS adjuvant radiation and systemic therapy along multiple demographic dimensions and expose opportunities to promote timely receipt of care.

scholarly journals Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008)

2012 ◽  
Vol 130 (6) ◽  
pp. 360-366 ◽  
Author(s):  
Débora Balabram ◽  
Fábio Braga Araújo ◽  
Simone Souza Porto ◽  
Joyce Soares Rodrigues ◽  
Atila Silva Sousa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Public Hospital ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Axillary Lymph ◽  
Chi Square ◽  
Factors Associated ◽  
Treatment Type ◽  
Chi Square Test

CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients' age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.

scholarly journals Factors Associated with Re-excision after Breast-Conserving Surgery for Early-Stage Breast Cancer

2012 ◽  
Vol 15 (4) ◽  
pp. 412 ◽  
Author(s):  
Woohyun Jung ◽  
Eunyoung Kang ◽  
Sun Mi Kim ◽  
Dongwon Kim ◽  
Yoonsun Hwang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Early Stage Breast Cancer ◽  
Factors Associated

Trends in the use of breast-conserving surgery and adjuvant radiation therapy in patients with DCIS: A U.S. population-based analysis from 1996 to 2007.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1110-1110
Author(s):  
Jennifer Nishimura ◽  
Audrey Choi ◽  
Sharon Kim ◽  
Julian Kim
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Breast Conserving Surgery ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy ◽  
Factors Associated ◽  
Breast Cancer Specific Mortality ◽  
Time Period ◽  
Specific Mortality ◽  
Cancer Specific Mortality

1031 Background: The treatment for patients with DCIS remains controversial. Current guidelines based upon best available evidence suggest that breast conserving surgery (BCS) followed by adjuvant radiation therapy (RT) result in acceptable local control and breast cancer specific survival. The purpose of this study was to analyze trends in patterns of care as well as identify factors associated with surgery type and use of adjuvant radiation therapy in a select cohort of patients enrolled into the SEER database. Methods: The study included females 18 years and older with focal DCIS and known tumor size of 5 cm or less diagnosed between 1996 and 2007. The Cochran-Armitage trend test was applied to identify trends in the use of BCS and RT over time. Multivariate logistic regression analyses were used to determine factors associated with receiving BCS vs. mastectomy and BCS plus RT vs. BCS alone. Cox proportional hazard model was used to determine associations with breast cancer-specific mortality. Results: Of the 34,233 women with DCIS, 76.59% were treated with BCS. 66.36% of BCS patients received adjuvant RT over the study period. The proportion of women receiving BCS increased from 71.5% in 1996 to 76.9% in 2007 (p<0.0001). Additionally, the proportion of women who underwent BCS and received adjuvant radiation therapy over the same time period increased from 55.3% to 69.7% (p<0.0001). Multivariate analysis demonstrated that year of diagnosis, race, marital status, geographic region, tumor size, tumor grade and comedo necrosis all were significantly associated with the use of adjuvant radiation therapy, but age was not. Cox proportional hazards models did not associate either surgery type or use of adjuvant radiation in patients undergoing BCS with breast cancer-specific mortality. Conclusions: Based upon reporting within the SEER database, the proportion of DCIS patients undergoing BCS and the BCS patients receiving adjuvant radiation increased over the study time period. Surgery type and use of adjuvant radiation therapy in patients with BCS was not associated with decreased risk of breast-cancer specific death in this cohort.

Harmonic scalpel versus traditional ligation in axillary dissection for breast cancer: a retrospective multivariate analysis

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Breast Cancer ◽  
Axillary Dissection ◽  
Harmonic Scalpel ◽  
Breast Conserving Surgery ◽  
Seroma Formation ◽  
Nodal Involvement ◽  
Single Centre ◽  
Absorbable Material ◽  
Drain Removal ◽  
The Mean

Introduction: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. Methods: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. Results: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). Conclusion: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.ut any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

Sign in / Sign up

Export Citation Format

Share Document