Value of an intraoperative real time tissue perfusion assessment system following a nipple-sparing radical mastectomy for advanced breast cancer

This study described a technique for the reconstruction of large lateral thoracic defects after local advanced breast cancer resection that allows for complete cover of the defect and primary closure of the donor site. The authors performed reconstruction using the newly designed KISS flap in 2 women for coverage of their large skin defect (15 × 13 cm each) following mastectomies with extensive tissue resection. The KISS flap consisting of 2 skin islands (marked Flap A and Flap B; 15 × 6 cm each) was designed and transferred to the thoracic defect through the subcutaneous tunnel, and based on the same vessel. The flap covered properly without causing excessive tension and allowed primary closure of chest wound and donor defect. The security it brings is comparable with that of classical radical mastectomy, and its success rate is similar to that of single skin flap transplantation. Compared with the conventional pedicled latissimus-dorsi-musculocutaneous flap, we believe that the donor zone tension decreases, wherein the KISS flaps can reduce the incidence of incision dehiscence and nonhealing complications to some extent. The study reported good results from this technique and discussed the techniques that referenced previous reports.

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Simultaneous Chest Wall Reconstruction after Sternectomy and Modified Radical Mastectomy in Locally Advanced Breast Cancer with Solitary Sternal Metastasis

Journal of Breast Cancer ◽

10.4048/jbc.2012.15.4.462 ◽

2012 ◽

Vol 15 (4) ◽

pp. 462 ◽

Cited By ~ 1

Author(s):

Hyun Jong Kang ◽

Song Am Lee ◽

Kyoung Sik Park ◽

Jung-Hyun Yang ◽

Young Bum Yoo

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Chest Wall ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Chest Wall Reconstruction ◽

Advanced Breast ◽

Modified Radical Mastectomy

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The peculiarities of surgical service of locally advanced breast cancer after neoadjuvant systemic treatment

The Scientific Notes of the I P Pavlov St Petersburg State Medical University ◽

10.24884/1607-4181-2015-22-3-42-47 ◽

2015 ◽

Vol 22 (3) ◽

pp. 42-47

Author(s):

O. L. Petrenko

Keyword(s):

Breast Cancer ◽

Surgical Treatment ◽

Advanced Breast Cancer ◽

Systemic Treatment ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Conservative Surgery ◽

Advanced Breast ◽

Treatment Stage

Patients with locally advanced (T2-4N0-3M0) breast cancer, receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery) were selected from the data base. The data of the first cancer register in the Russian Federation, disposing the data base for more than 5000 patients with breast cancer were analyzed in this work. Consistent with the primary goal of the work the information about 286 patients with locally advanced breast cancer (clinical stages IIB-IIB), receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery), was obtained from the date base. The follow up period is from 2 to 10 years. The estimation of application efficiency of neoadjuvant chemotherapy, hormonal treatment and target therapy was done. The basic clinical, pathomorphological and biological factors (HER2, ER, PR, degree of malignancy), decisive for planning of relevant neoadjuvant treatment, enabling to customize medical disposal for a patient and contributing to the increase of comprehensive treatment, rising of general and relapse free survival of patients with locally advanced breast cancer, who underwent breast-conserving surgeries.

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Neoadjuvan Chemotheraphy Responses to Local Advanced Breast Cancer Patients at Dr Moh Hoesin Hospital Palembang

SRIWIJAYA JOURNAL OF MEDICINE ◽

10.32539/sjm.v3i3.131 ◽

2020 ◽

Vol 3 (3) ◽

pp. 51-58

Author(s):

Aldo Giovanno ◽

Mgs. Irsan Saleh ◽

Nur Qodir ◽

Mulawan Umar

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Breast Cancer ◽

Cancer Patients ◽

Univariate Analysis ◽

Locally Advanced ◽

Radical Mastectomy ◽

Advanced Breast ◽

Chemotherapy Response ◽

Breast Cancer Patients

Breast cancer is a malignancy which invaded breast tissue in the form of ductal or lobular. One most therapywhich is given is neoadjuvant chemotherapy. Neoadjuvant Chemotherapy can reduce tumor size so that surgerycan be performed with good breast removal with Modification of Radical Mastectomy (MRM) and BreastConservative Therapy (BCT). This purpose from this research is to find out neoadjuvant chemotherapy response inLocally Advanced Breast Cancer Patients which has received chemotherapy treatment in RSUP dr MohammadHoesin Palembang. This observational descriptive study was conducted at RSUP Mohammad Hoesin Palembang inthe period between October until November 2019. The sample of this study was locally advanced breast Cancerpatients who underwent chemotherapy that met the inclusion and exclusion criteria. The data were obtained byinterviews and observed medical records from the patients which were then analyzed by univariate analysis usingSPSS version 25. In this study there were 34 locally advanced breast cancer patients who fulfilled the inclusion andexclusion criteria. 24 of 34 patients (70,6%) received positive response and 10 of 34 patients (29,4%) receivednegative response.

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Locally advanced breast cancer in younger women

Archive of oncology ◽

10.2298/aoo0303149l ◽

2003 ◽

Vol 11 (3) ◽

pp. 149-149

Author(s):

Jadranka Lakicevic ◽

Dinka Lakic ◽

Milan Sorat

Keyword(s):

Breast Cancer ◽

Surgical Treatment ◽

Adjuvant Chemotherapy ◽

Advanced Breast Cancer ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Breast Conserving Surgery ◽

Advanced Breast ◽

Neo Adjuvant Chemotherapy

Background: Standard treatment of locally advanced breast cancer is not yet established. In most institutions treatment is multimodal and consists of primary chemotherapy, surgical treatment with or without radiotherapy (RT) and hormonal therapy. To find out whether the age influences the kind of surgical treatment in a group of locally advanced breast cancer patients (LABC patients) responding to neo-adjuvant chemotherapy. Methods: Analysis included 39 LABC patients treated from January 2000 till January 2003 with neo-adjuvant chemotherapy and surgical treatment in Clinical Center of Montenegro, Podgorica. All patients had locally advanced disease (T2, T3 or T4b and/or N1-2 M1 sc). Patients with T4d tumors were excluded. The treatment consisted of neo-adjuvant chemotherapy, mostly anthracycline based, and surgical treatment - radical mastectomy or breast conserving surgery. Additional procedures after surgical treatment included 3-4 cycles of the same chemotherapy, hormonal treatment and/or RT. Results: Median age of patients was 47 years (range: 24-67 years). Thirty patients were initially in stage IIIA (14 post- and 16 premenopausal patients respectively), 6 patients in stage IIIB (2 post- and 4 premenopausal respectively), and 3 patients in stage IV, with supraclavicular node involvement (M1+sc, 2 post- and 1 premenopausal, respectively). Applied preoperative chemotherapy was anthracycline-based regimen (FAC, 3-6 cycles) except in one patient in premenopausal group and 2 patients in postmenopausal group, who had been treated with CMF chemotherapy due to anthracycline contraindications. All analyzed patients responded to neo-adjuvant chemotherapy, mostly with partial or minimal remission of their tumors. In a whole group 15/39 (38%) patients had breast conserving surgery (8 pre-, 7 postmenopausal, respectively), 24/39 (61%) patients radical mastectomy (13 pre-, 11 postmenopausal, respectively). In a group of patients old 40 years and younger only 2 partial resections were performed (2/9, 22%), and 7 radical mastectomies. Conclusion: Although in a small group of patients, our results confirmed that effective neo-adjuvant chemotherapy enabled breast surgery of LABC, even breast conservative procedure in some patients. However, breast conservation was not possible in majority of young patients. This suggests the investigation of more aggressive neo-adjuvant treatments, especially in patients old 40 years or younger.

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Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries?

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.6.165 ◽

2019 ◽

Vol 35 (6) ◽

Author(s):

Shahneela Manzoor ◽

Mariyah Anwer ◽

Salim Soomro ◽

Dileep Kumar

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Advanced Breast ◽

Middle Income ◽

Diagnosis And Management ◽

Middle Income Countries ◽

Low Middle Income Countries

Background and Objective: Breast cancer incidence is increasing and it is highest in low income countries. The main challenge is regarding awareness, screening, late presentation and its management in a third-world country. Our objective was to share the experience faced in various presentations, diagnosis and management of locally advanced breast cancer (LABC) in a third world country and discuss if they are different with respect to developed countries. Methods: It is a retrospective case series study performed at Jinnah Postgraduate Medical Centre Karachi, from January 2015 to December 2017, over period of three years. Data was collected from the record maintained by authors about patients presenting in breast clinic. Patients of breast cancer were managed in breast clinic over 3 years. Our study included patients who presented with LABC based on their clinical presentation confirmed by histopathological diagnosis and followed by surgical management. Statistical analysis for students t-test was performed using SPSS (version 20.0). A p-value less than 0.05 was considered statistically significant. Results: One hundred twelve patients presented with LABC over period of 3 years. All but two were female. Mean age was 52 years (range 26-78 years), SD 18.96. On presentation size of tumor was 5cm & more in 103 (91.9%) patients. Involvement of axilla was in 86 (76.7%). Chest wall was involved in 22 (19.6%). Total T3 and T4 were 71 (63.3%) and 41 (36.6%) respectively Diagnosis of all patients was confirmed by histopathology. Neoadjuvant was given to all patients to downstage the tumor. ER/PR was positive in 46(41.1%), HER-2/neu positive in 31 (27.6%). On staging breast carcinoma was metastatic in 13(11.6%) with liver, lung and bone in 4 (3.5%), 3 (2.7%) and 6 (5.3%) respectively. Breast conservation was done in 6 (6.1%) patients, Modified Radical Mastectomy was done in 86 (86.9%), Radical Mastectomy in 3 (3.03%), Toilet Mastectomy in 4 (4.045) and 13 (11.6%) patients were not operated. Conclusion: In our series 65% of all breast cancers are LABC at presentation. In low/middle income countries high percentage of LABC at presentation result in high metastatic disease, poor prognosis and limits conservation of breast. Awareness and education can improve outcomes. doi: https://doi.org/10.12669/pjms.35.6.165 How to cite this:Manzoor S, Anwer M, Soomro S, Kumar D. Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries (LMICs)?. Pak J Med Sci. 2019;35(6):1554-1557. doi: https://doi.org/10.12669/pjms.35.6.165 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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VRAM flap for locally advanced breast cancer

Mastology ◽

10.29289/2594539420200086 ◽

2021 ◽

Vol 31 ◽

Author(s):

René Aloisio da Costa Vieira ◽

Raphael Luiz Haikel ◽

Luciano Ipólito Branquinho ◽

Idam de Oliveira-Junior

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Myocutaneous Flap ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Advanced Breast ◽

Extensive Resection ◽

Vram Flap

The authors presented a case of a patient with locally advanced breast cancer, with mammary and axillary localization, initially considered non-resectable, with good response after neoadjuvant chemotherapy. Due to the location of the lesion and the need for extensive resection, radical mastectomy was performed, associated with reconstruction with myocutaneous flap of the vertical rectus abdominis muscle. Different therapeutic options, the reasons that determine this choice, and local long-term control were discussed.

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Locally Advanced Breast Cancer—A Narrative Review of Management in the Indian Scenario

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1732785 ◽

2021 ◽

Vol 42 (02) ◽

pp. 137-145

Author(s):

Manjula Rao ◽

Manikandan Dhanushkodi

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Treatment Plan ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Significant Proportion ◽

Surgical Techniques ◽

Radical Mastectomy ◽

Advanced Breast ◽

Treatment Modalities

AbstractLocally advanced breast cancer (LABC) forms a significant proportion of the total breast cancer (BC) burden in the country. It is a heterogeneous entity, encompassing a variety of presentations indicative of advanced disease. The standard of care for the treatment of LABC is multimodal, involving chemotherapy, surgery, radiation, and/or hormonal therapy. With improved understanding of the biology of BC, addition of newer agents of systemic therapy to our armamentarium, advances in surgical techniques and radiation delivery, clinicians are now able to tailor treatment according to the individual and consider a more conservative approach to management (in contrast to a mandatory radical mastectomy, decades ago), disease biology, and stage permitting with better survival outcomes. Here, we review all the treatment modalities and options available to aid a clinician in formulating an optimal treatment plan for a patient presenting with LABC and also how best to tailor the treatment to enable cost effectiveness in the Indian setting.

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