scholarly journals Impact of Oncoplastic Breast Surgery on Rate of Complications, Time to Adjuvant Treatment, and Risk of Recurrence

Breast Care ◽  
2020 ◽  
pp. 1-9
Author(s):  
Ida Oberhauser ◽  
Jasmin Zeindler ◽  
Mathilde Ritter ◽  
Jeremy Levy ◽  
Giacomo Montagna ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Breast Surgery ◽  
Breast Conserving Surgery ◽  
University Hospital ◽  
Consecutive Series ◽  
Short Term ◽  
Oncoplastic Breast Surgery ◽  
Delayed Wound Healing ◽  
The University

<b><i>Background:</i></b> The aim of this study was to compare the risk of complications and recurrence between oncoplastic and conventional breast surgery. <b><i>Methods:</i></b> This is a retrospective analysis of a consecutive series of 436 patients with stage I–III breast cancer who underwent surgery at the University Hospital of Basel between 2011 and 2018. <b><i>Results:</i></b> The nipple/skin-sparing mastectomy (NSM/SSM) group showed significantly more delayed wound healing (32.7 vs. 5.8%, <i>p</i> &#x3c; 0.001) and skin necrosis (13.9 vs. 1.9%, <i>p</i> = 0.020) compared to conventional mastectomy (CM), which corresponded to significantly higher odds of short-term complications (OR 2.34, 95% CI 1.02–5.35, <i>p</i> = 0.044). The incidence rate of long-term morbidity in oncoplastic breast-conserving surgery (OBCS) was significantly higher compared to conventional breast-conserving surgery (CBCS; 25.5 vs. 11.3 per 100 patient years [PY], <i>p</i> &#x3c; 0.001), in particular concerning chronic pain (13.3 vs. 6.6, <i>p</i> = 0.011) and lymphedema (4.1 vs. 0.4, <i>p</i> = 0.003). Seroma as a long-term morbidity occurred more often in the CM group compared to the NSM/SSM group (5.8 vs. 0.5 per 100 PY, <i>p</i> = 0.004). Patients received adjuvant treatment earlier after CM compared to NSM/SSM (HR 1.83, 95% CI 1.05–3.19, <i>p</i> = 0.034). There were no significant differences in the incidence of positive margins nor in the odds of recurrence after OBCS versus CBCS and after NSM/SSM versus CM. <b><i>Conclusions:</i></b> Even though the present study confirmed expected differences in complications and morbidity, it suggested that oncoplastic surgery is oncologically safe. Patients undergoing NSM/SSM should be followed closely to allow early detection and treatment of frequently associated complications and ensure timely start of adjuvant therapy.

Breast MRI in DCIS size estimation, breast-conserving surgery and oncoplastic breast surgery

2021 ◽  
Vol 94 ◽  
pp. 102158
Author(s):  
Alexander Bartram ◽  
Fiona Gilbert ◽  
Alastair Thompson ◽  
G Bruce Mann ◽  
Amit Agrawal
Keyword(s):  
Breast Surgery ◽  
Breast Mri ◽  
Breast Conserving Surgery ◽  
Size Estimation ◽  
Oncoplastic Breast Surgery

Oncoplastic breast surgery versus conventional breast conserving surgery – a prospective follow-up study of subjective loco-regional late morbidity

2021 ◽  
pp. 1-10
Author(s):  
Katrine Rye Hauerslev ◽  
Jens Overgaard ◽  
Tine Engberg Damsgaard ◽  
Helle Mikel Hvid ◽  
Eva Balling ◽  
...  
Keyword(s):  
Breast Surgery ◽  
Breast Conserving Surgery ◽  
Oncoplastic Breast Surgery ◽  
Follow Up Study ◽  
Late Morbidity

Athletes Play Through Pain—What Does That Mean for Rehabilitation Specialists?

2020 ◽  
Vol 29 (5) ◽  
pp. 640-649 ◽  
Author(s):  
Amy Barrette ◽  
Katherine Harman
Keyword(s):  
Well Being ◽  
Short Term ◽  
Semistructured Interviews ◽  
Sport Organization ◽  
The University ◽  
E Mail ◽  
Competitive Nature ◽  
And Training ◽  
Insight Into

Context: Pain in sport has been normalized to the point where athletes are expected to ignore pain and remain in the game despite the possible detrimental consequences associated with playing through pain. While rehabilitation specialists may not have an influence on an athlete’s competitive nature or the culture of risk they operate in, understanding the consequences of those factors on an athlete’s physical well-being is definitely in their area of responsibility. Objective: To explore the factors associated with the experiences of subelite athletes who play through pain in gymnastics, rowing, and speed skating. Design: The authors conducted semistructured interviews with subelite athletes, coaches, and rehabilitation specialists. They recruited coach participants through their provincial sport organization. Athletes of the recruited coaches who were recovering from a musculoskeletal injury and training for a major competition were then recruited. They also recruited rehabilitation specialists who were known to treat subelite athletes independently by e-mail. Setting: An observation session was conducted at the athlete’s training facility. Interviews were then conducted either in a room at the university or at a preferred sound-attenuated location suggested by the participant. Participants: The authors studied 5 coaches, 4 subelite athletes, and 3 rehabilitation specialists. Interventions: The authors photographed athletes during a practice shortly before an important competition, and we interviewed all the participants after that competition. Our photographs were used during the interview to stimulate discussion. Results: The participant interviews revealed 3 main themes related to playing through pain. They are: Listening to your body, Decision making, and Who decides. Conclusion: When subelite athletes, striving to be the best in their sport continue to train with the pain of an injury, performance is affected in the short-term and long-term consequences are also possible. Our study provides some insight into the contrasting forces that athletes balance as they decide to continue or to stop.

scholarly journals Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff

2020 ◽  
Author(s):  
Vanessa Rentrop ◽  
Johanna Sophie Schneider ◽  
Alexander Bäuerle ◽  
Florian Junne ◽  
Nora Dörrie ◽  
...  
Keyword(s):  
Medical Staff ◽  
Online Training ◽  
University Hospital ◽  
High Psychological Distress ◽  
Increased Risk ◽  
Psychosocial Emergency ◽  
Low Threshold ◽  
Long Term Consequences ◽  
The University

Abstract Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.

scholarly journals Oncoplastic and reconstructive breast surgery in Canada: breaking new ground in general surgical training

2018 ◽  
pp. 294-299
Author(s):  
Lashan Peiris ◽  
David Olson ◽  
Kelly Dabbs
Keyword(s):  
Breast Cancer ◽  
Surgical Training ◽  
Breast Surgery ◽  
Fellowship Training ◽  
Immediate Breast Reconstruction ◽  
Oncoplastic Breast Surgery ◽  
The Uk

Oncoplastic breast surgery combines certain plastic surgery procedures with a breast cancer resection to minimize the cosmetic penalty. We compared current practices in breast surgery in Canada and the UK, looking at the classification of oncoplastic breast surgery, management of larger tumours that would otherwise mandate a mastectomy, and the breast surgeon’s role in immediate breast reconstruction. Reconstructive breast surgery has always fallen within the domain of the plastic surgeon, but surgical subspecialization and more focused fellowship training have meant that breast surgeons with the appropriate skillset can offer these procedures. This evolution of the breast surgeon has led to the birth of a new field of breast surgery known as oncoplastic and reconstructive breast surgery. Those tasked with developing surgical training programs in Canada must now decide whether to train breast surgeons in these techniques to improve long-term quality of life among Canadian patients with breast cancer.

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