scholarly journals Cutaneous Erythema at Scar Site of Modified Radical Mastectomy: An Unexpected Manifestation of Recurrent Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Awrad Mohammed-Reda Nasralla ◽  
Mohammed Abdulirazzaq Al-Duhileb ◽  
Ali Jamal-Aldein Arini ◽  
Samir Sami Amr
Keyword(s):  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Tram Flap ◽  
Rectus Abdominis Muscle ◽  
Modified Radical Mastectomy ◽  
Immediate Reconstruction ◽  
Inflammatory Carcinoma ◽  
Erythematous Skin ◽  
One Year

A 44-year-old woman presented with marked erythema over right mastectomy scar, while on Herceptin therapy. She had neoadjuvant chemotherapy, modified radical mastectomy, and radiotherapy less than one year earlier for the treatment of invasive ductal carcinoma. On physical examination, no palpable masses were detected in the erythematous skin. A biopsy revealed permeation of the skin lymphatics by emboli of metastatic ductal carcinoma, similar to what is seen in inflammatory carcinoma. The involved skin was excised, followed by immediate reconstruction with transverse rectus abdominis muscle (TRAM) flap. On follow-up, the wound was healing well, with no signs of inflammation.

scholarly journals Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan

2021 ◽  
Vol 10 (2) ◽  
pp. 89-94
Author(s):  
Usman Ali Rahman ◽  
Khalil Ahmad ◽  
Umair Nazir ◽  
Shabbar Hussain Changazi ◽  
Ayesha Choudary ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Hospital Stay ◽  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Clinicopathological Findings ◽  
Duration Of Surgery ◽  
The Mean ◽  
One Year

Background: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement.

scholarly journals Stewart–Treves syndrome: a case report

2013 ◽  
Vol 95 (5) ◽  
pp. e6-e8 ◽  
Author(s):  
DG McKeown ◽  
PJ Boland
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Early Treatment ◽  
Radical Mastectomy ◽  
Node Dissection ◽  
Modified Radical Mastectomy ◽  
Patient Death ◽  
Cutaneous Lesions ◽  
Chemotherapeutic Treatment

We present a case of chronic lymphoedema that progressed to Stewart–Treves syndrome in a 63-year-old woman with a previous modified radical mastectomy, associated lymph node dissection, chemotherapy and radiotherapy. While producing stabilisation of most cutaneous lesions initially, chemotherapeutic treatment of the angiosarcoma did not prevent subsequent metastasis and patient death. We urge vigilance and regular follow-up appointments for patients following a mastectomy with chronic lymphoedema to facilitate prevention or early treatment of this devastating syndrome.

scholarly journals Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Dhanya Vasudevan ◽  
P. S. Jayalakshmy ◽  
Suresh Kumar ◽  
Siji Mathew
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Tumor Characteristics ◽  
Modified Radical Mastectomy ◽  
Tumor Bed

Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT) in the setting of locally advanced breast cancer (LABC) can render inoperable tumor (T4, N2/N3) resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response.Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48) were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR).Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms) and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed.Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

Vascular enumeration as a significant prognosticator for invasive breast carcinoma.

1998 ◽  
Vol 16 (5) ◽  
pp. 1684-1688 ◽  
Author(s):  
M J Aceñero ◽  
J F González ◽  
M G Gallego ◽  
P A Ballesteros
Keyword(s):  
Ductal Carcinoma ◽  
Univariate Analysis ◽  
Radical Mastectomy ◽  
Image Analyzer ◽  
Free Survival ◽  
Node Negative ◽  
Manual Count ◽  
Node Metastases ◽  
Vessel Count

PURPOSE Vascular enumeration has been claimed to be an independent prognosticator for invasive breast cancer. Most of the studies have performed a manual count of the vessels. Few investigators have used image analyzers to reduce subjectivity in the measures. The aim of this retrospective study was to compare the manual vessel count to the counts obtained with an image analyzer and to estimate their possible prognostic influence. MATERIALS AND METHODS We selected 112 patients with invasive ductal carcinoma, treated with radical mastectomy followed by chemotherapy and with a minimal follow-up time of 60 months (5 years). After immunostaining with factor VIII, we performed a double count of the vessels. First, we performed a manual count following Gasparini's criteria, and second, we used an image analyzer (Microm, Barcelona, Spain) to count the vessels in eight adjacent microscopic fields with a 20x objective, to reach a total area of 0.98 mm2. The image analyzer calculated the total number of vessels, their size and also the percentage of the field occupied by the vessels. RESULTS In our series, vascular enumeration showed no significant association with histologic grade (Bloom-Scarff-Richardson grading), tumor size, or staging. CONCLUSION Vascular enumeration with both methods was an independent prognosticator for relapse-free-survival (RFS) in both node-negative and -positive patients in the univariate analysis, but only vascular enumeration with the image analyzer was an independent prognostic factor in the multivariate analysis, together with lymph node metastases.

Rationale for Immediate Reconstruction of the Breast following Modified Radical Mastectomy

1982 ◽  
Vol 8 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Gregory Georgiade ◽  
Nicholas Georgiade ◽  
Kenneth S. McCarty ◽  
Hilliard F. Seigler
Keyword(s):  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Immediate Reconstruction

scholarly journals Modified Radical Mastectomy with Immediate Reconstruction for Carcinoma of the Breast

1981 ◽  
Vol 193 (5) ◽  
pp. 565-573 ◽  
Author(s):  
GREGORY S. GEORGIADE ◽  
NICHOLAS G. GEORGIADE ◽  
KENNETH S. MCCARTY ◽  
B. J. FERGUSON ◽  
HILLIARD F. SEIGLER
Keyword(s):  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Carcinoma Of The Breast ◽  
Immediate Reconstruction

scholarly journals Breast reconstruction following amputation for cancer

2009 ◽  
Vol 66 (6) ◽  
pp. 427-433
Author(s):  
Milan Visnjic ◽  
Predrag Kovacevic ◽  
Ljiljana Paunkovic ◽  
Goran Djordjevic ◽  
Dragana Budjevac ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Radical Mastectomy ◽  
Late Complications ◽  
Tram Flap ◽  
Primary Reconstruction ◽  
Modified Radical Mastectomy ◽  
Reconstruction Methods ◽  
Acceptable Method ◽  
Flap Elevation

Background/Aim. Today, breast reconstruction is a widely accepted method in the treatment of breast cancer after modified radical mastectomy. Reconstruction methods are associated with an acceptable number of complications and reconstruction favorably impacts quality of life. The aim of the study was to present our experience in breast reconstruction. Methods. We presented here a four-year experience with 84 patients with breast reconstruction after modified radical mastectomy. Results. Implant reconstructions were most common, 44 (52.3%), with primary reconstruction in 31(70.4%) and secondary in 13 (29.5%) women. Lattisimus dorsi flap (LDF) and implant were utilized in 32 (38%) of the patients, with primary reconstruction in 24 (75%) and secondary in 8 (25%) women. Transversal rectus abdominis myocutaneous (TRAM) flap was rarely used - just in 8 (9.5%) patients and only for secondary breast reconstruction. Postoperatively, some early complications such as hematoma, seroma, infections and partial flap necrosis were observed in 10 (11.9%) patients. Late complications, such as implant rejection, hypertrophic scarring and hernias at the flap elevation site, were noted in 10 (11.9%) cases. Implant loss occurred in 5 (5.9%) cases. All the complications were successfully managed, and patients rated their reconstruction as follows: excellent, 49 (59%) cases; very good, 20 (24%), and good, 14 (16.8%). In one case, disease progression was observed 6 months after the primary breast reconstruction. Conclusion. Breast reconstruction is an acceptable method in the treatment of breast cancer in patients in the need for or with already performed mastectomy. The choice of reconstruction approach depends on the breast volume, patient's wish and experience of surgical team. Our results suggest the advantage of breast reconstruction with LDF with implant, since the technique is safe, complications relatively rare and easily manageable, and the results are excellent or very good in each woman.

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