Video-Assisted Skin-Sparing Breast-Conserving Surgery for Breast Cancer and Immediate Reconstruction with Autologous Tissue

e11580 Background: This study analyzed clinical results of video-assisted breast-conserving surgery for breast cancer. Methods: Video-assisted breast-conserving surgery is indicated for breast cancer that has not invaded the skin. A skin incision is made at an inconspicuous site. Skin-sparing partial mastectomy was performed endoscopically on 244 patients (stage I, n=94; stage II, n=150). Morbidity, curability and patient satisfaction were analyzed. Results: Skin necrosis was seen in 9 patients. Local recurrence was seen in 13 patients (mean postoperative interval, 65.3 months). Distant metastasis-free survival at 60 months was 93.6% for stage I and 90.5% for stage II. Overall survival was 95.7% for stage I and 96.9% for stage II. Satisfaction with surgery as investigated by questionnaire was “good” for 72.3% of patients. Conclusions: Video-assisted breast-conserving surgery showed no increases in local or distant recurrence and patient satisfaction was high. Video-assisted breast-conserving surgery appears useful for local treatment of breast cancer. No significant financial relationships to disclose.

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Transaxillary retromammary route approach of video-assisted breast surgery enables the inner-side breast cancer to be resected for breast conserving surgery

Breast Diseases A Year Book Quarterly ◽

10.1016/s1043-321x(09)79274-4 ◽

2009 ◽

Vol 20 (2) ◽

pp. 175

Author(s):

B.O. Anderson

Keyword(s):

Breast Cancer ◽

Breast Surgery ◽

Breast Conserving Surgery ◽

Video Assisted

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Doing More: Trends in Breast Cancer Surgery, 2005 to 2011

The American Surgeon ◽

10.1177/000313481508100133 ◽

2015 ◽

Vol 81 (1) ◽

pp. 74-80 ◽

Cited By ~ 18

Author(s):

Donald J. Lucas ◽

Jennifer Sabino ◽

Craig D. Shriver ◽

Timothy M. Pawlik ◽

Devinder P. Singh ◽

...

Keyword(s):

Breast Cancer ◽

Prophylactic Mastectomy ◽

Breast Conserving Surgery ◽

Breast Cancer Surgery ◽

Improvement Program ◽

Immediate Reconstruction ◽

Multivariable Regression ◽

American Society ◽

American Society Of Anesthesiologists

An increasing number of women may be choosing mastectomy over breast-conserving surgery for breast cancer as well as undergoing more bilateral resection, immediate reconstruction, and prophylactic operations. Women who had breast cancer operations between 2005 and 2011 were selected from the National Surgical Quality Improvement Program database. Annual trends were explored using robust Poisson multivariable regression as were predictors for mastectomy versus breast-conserving surgery. A total of 85,401 women were identified. Mastectomy increased from 2005 to 2011, starting at 40 per cent in 2005 and peaking at 51 per cent in 2008 ( P < 0.001). Bilateral resection, immediate reconstruction, and prophylactic mastectomy also increased (all P < 0.001). Independent predictors of mastectomy included young age, Asian race, invasive cancer (vs carcinoma in situ), bilateral resection, axillary dissection, higher American Society of Anesthesiologists class, and lower body mass index (all P < 0.001). There was an increase in mastectomy, bilateral resection, immediate reconstruction, and prophylactic mastectomy from 2005 to 2011.

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Reconstructive utilisation and outcomes following mastectomy surgery in women with breast cancer treated in England

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0101 ◽

2020 ◽

Vol 102 (2) ◽

pp. 110-114

Author(s):

R Jeevan

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Breast Conserving Surgery ◽

Hospital Episode Statistics ◽

Complication Rates ◽

Immediate Reconstruction ◽

Hospital Episode ◽

Differential Outcomes ◽

Patient Reported ◽

The Right

Introduction Breast cancer usually necessitates breast-conserving surgery or mastectomy, which adversely affect appearance and wellbeing. Immediate reconstruction restores the breast mound but its availability and efficacy are uncertain. Materials and methods Two discrete datasets were used to evaluate mastectomies in England: Hospital Episode Statistics to measure overall activity and variation over time and by region and a national prospective audit to evaluate immediate reconstruction decision making, complication rates and patient-reported satisfaction with information, choice and outcomes. Results The 2005–08 Hospital Episode Statistics analyses identified 20% breast-conserving surgery reoperation rates nationally, frequently involving mastectomy. Rates were higher with in-situ disease present (30% vs 18%) and varied across NHS trusts (10th–90th centiles 12–30%). The 2008–09 national audit examined 18,216 women. The 19% immediate reconstruction rate varied regionally (9–43%), as did 2006–09 Hospital Episode Statistics data (8–32%). A total of 48% of women were offered immediate reconstruction, again varying regionally (24–75%). Offer likelihood fell with increasing age. National immediate reconstruction rates increased from 10% to 23% from 2000 to 2014, but regional variation persisted. Despite high care satisfaction, just 65% of mastectomy patients received the right amount of reconstructive information (90% for immediate reconstruction). Women from deprived areas experienced higher complication rates. Flap-based immediate reconstruction led to greater satisfaction with breast area appearance, emotional and sexual wellbeing and overall outcome than mastectomy; implant-only immediate reconstruction scored no better. Conclusion Reconstruction is central to improving breast cancer outcomes. The differential outcomes and persistent regional inequalities identified should facilitate decision making, support improved access to all reconstructive options and inform the development of an optimal patient pathway.

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Risk factors for breast cancer-related upper extremity lymphedema: Is immediate autologous breast reconstruction one of them?

Open Medicine ◽

10.2478/s11536-009-0010-0 ◽

2009 ◽

Vol 4 (1) ◽

pp. 65-70 ◽

Cited By ~ 1

Author(s):

Akif Gur ◽

Bulent Unal ◽

Gretchen Ahrendt ◽

Michael Gimbel ◽

Oguz Kayiran ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Risk Factor ◽

Breast Reconstruction ◽

Upper Extremity ◽

Breast Cancer Patients ◽

Autologous Tissue ◽

Immediate Reconstruction ◽

Significant Difference ◽

Occupation Level

AbstractBreast cancer related upper extremity lymphedema (BCRL) reduces the quality of life of those who have had surgery for breast cancer. The aim of this study is to evaluate the risk factors for BCRL and determine whether immediate autologous tissue breast reconstruction is one of them. A case control study was conducted comparing patients with BCRL (n=97) to surgically treated breast cancer patients without BCRL (control, n=126). The groups were matched for age, type of breast surgery and radiation therapy. Postoperative upper extremity infection, body mass index (BMI), occupation (level of hand-use), and immediate autologous tissue breast reconstruction were investigated as a risk factor of BCRL. Mastectomy was performed on 47.6 % (n=60) and 37.2% (n=36) of patients in the control and the BCRL groups, respectively. Eight patients (13.3%) had immediate autologous tissue breast reconstruction in the control mastectomy group. Six of 36 BCRL patients (16.7%) underwent mastectomy with immediate autologous tissue breast reconstruction. There was no significant difference between groups with respect to incidence or method of immediate reconstruction (p=0.65). Patient occupation (level of hand use) was found to be positively correlated to development of BCRL (p=0.0001). Upper extremity infection rate was 22.7% in the BCRL group and 4.0% in the controls (p=0.0001). The mean BMI in the control and BCRL groups 26.8 kg/m2 and 29.1kg/m2, respectively (p=0.003). In conclusion, in this study characteristics positively associated with development of BCRL included occupation, infection, and increased BMI. Immediate reconstruction of the breast was not found as a risk factor for BCRL. However larger studies are needed, to further evaluate the effect of breast reconstruction on BCRL.

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