Demand for Plastic Surgical Operations after Primary Breast Cancer Surgery

Background and Aims: The aim of this study is to evaluate the demand for plastic operations after primary breast cancer surgery. In addition, this study aims to increase knowledge on factors affecting the wish of women for breast reconstruction. Material and Methods: A questionnaire was sent to some 111 patients who had undergone either mastectomy or breast conserving surgery. The response rate was 76 %. The questionnaire consisted of 20 structured questions. The data was analysed statistically using the t test and the chi-square test. Results: 28 % of the mastectomized patients wanted a breast reconstruction. Factors found to affect the patient's wish for reconstruction were age ( p < 0.001) and whether the patient had received radio- ( p < 0.05) or chemotherapy ( p < 0.05). A difference was found between the mastectomy group and the breast conserving surgery group as to satisfaction in the general ( p < 0.05) and the cosmetic ( p < 0.05) outcome of the surgery, as well as patient's expectations regarding the outcome ( p < 0.01). Conclusions: Rather fewer mastectomized patients wanted a reconstruction. The proportion, however, grew significantly larger in the younger age groups. This study also shows that receiving radio- or chemotherapy seems to predict a woman's choice against a reconstruction. Patients who receive radio- or chemotherapy may consider their illness more severe and life-threatening than those not receiving such treatments.

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Ultrasound surveillance on detection of nonpalpable supraclavicular recurrence after breast cancer surgery

Medical Ultrasonography ◽

10.11152/mu-2268 ◽

2020 ◽

Vol 22 (2) ◽

pp. 171

Author(s):

Eun Cho ◽

Jin Hwa Lee ◽

Eun Hwa Park ◽

Kyung Do Byun

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Primary Breast Cancer ◽

Multivariate Logistic Regression Analysis ◽

Breast Conserving Surgery ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Breast Cancer Patients ◽

Asymptomatic Patients ◽

Internal Mammary

Aims: To evaluate the clinical utility of supraclavicular scanning for locoregional lymph node (LN) assessment in postoperative screening surveillance using ultrasonography (US) in patients who underwent breast cancer surgery.Material and methods: From July 2004 to February 2019, 280 suspicious findings for locoregional recurrence in the lymph node (LRL) on postoperative screening US were detected in 266 asymptomatic patients who underwent breast cancer surgery. Suspicious features of LRL on US included the marked hypoechogenicity, round or irregular shape, eccentric cortical thickening and replacement of the fatty hilum of the LNs. The bilateral breasts, including mastectomy sites, bilateral axillae, internal mammary areas and supraclavicular areas, were included in the scan range of postoperative US.Results: Of 280 LNs with suspicious findings for LRL, LRL of supraclavicular LNs was confirmed in 24 LNs according to cytopathology results. Multivariate logistic regression analysis revealed that higher overall staging of primary breast cancer (odds ratio [OR] 2.361 [95% confidence interval (CI) 1.302–4.282]; p=0.005), higher N staging of primary breast cancer (OR 3.086 [95% CI 1.479–6.441]; p=0.003), older patient age (OR 1.060 [95% CI 1.026–1.095]; p<0.001) and breast-conserving surgery (OR 2.253 [95% CI 1.184–4.289]; p=0.013) were independently associated with LRL of supraclavicular LNs. Tumor size, nuclear grade, histological type, hormonal receptor status of the primary cancer, and bilateral cancer were not associated with LRL (p=0.216, p=0.205, p=0.789, p=0.899, and p=0.900, respectively).Conclusion: Routine supraclavicular scanning in postoperative screening surveillance using US in breast cancer patients with higher staging could be useful for the detection of LRL of supraclavicular LNs.

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Physical Rehabilitation: A Gap in Care Following all Types of Breast Cancer Surgery.

10.21203/rs.3.rs-220536/v1 ◽

2021 ◽

Author(s):

Deirdre E McGhee ◽

Julie R Steele

Keyword(s):

Breast Cancer ◽

Side Effects ◽

Breast Conserving Surgery ◽

Physical Rehabilitation ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Chi Square ◽

Entire Cohort ◽

Operative Care ◽

Significant Difference

Abstract Purpose: To investigate the access to and content of physical rehabilitation received by women after different types of breast cancer surgery. Methods: On-line survey of 632 Australia women (59.8 years SD 9.6) grouped according to their last reported breast cancer surgery: (i) breast conserving surgery (BCS; n=228), (ii) mastectomy (n=208; MAST), and (iii) breast reconstruction (BRS; n=196). Respondents retrospectively reported the physical rehabilitation education and treatment they received for six physical side-effects. Chi square of analysis of the percentage of respondents who received any form of physical rehabilitation for each physical side-effect amongst the three groups. Tabulation of the percentage of the entire cohort (n=632) that had lymph nodes removed, post-operative complications, or pre-existing musculoskeletal issues who received any form of physical rehabilitation as part of standard post-operative care.Results: No significant difference was found in the percentage of respondents who received any form of physical rehabilitation across the three groups, except for the physical side-effects of lymphoedema and breast support issues. Substantial variation was found in the percentage that received physical rehabilitation across the different physical side-effects. Physical rehabilitation for shoulder issues and lymphoedema was received by 75% and 70% of respondents respectively as part of standard care, compared to scar and torso issues and physical discomfort disturbing sleep, where less than 50% received any form of physical rehabilitation. Conclusion: Access to physical rehabilitation is poor following all types of breast cancer surgery, with gaps in the physical rehabilitation provided for specific physical side-effects.

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Can Anesthetic Technique for Primary Breast Cancer Surgery Affect Recurrence or Metastasis?

Survey of Anesthesiology ◽

10.1097/01.sa.0000296332.74182.39 ◽

2007 ◽

Vol 51 (6) ◽

pp. 321-322

Author(s):

&NA;

Keyword(s):

Breast Cancer ◽

Primary Breast Cancer ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Anesthetic Technique

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Teamwork in Breast Cancer Surgery: Factors Affecting Success Rate and Increasing Success Rate in the Operating Room

10.1007/978-3-030-73147-2_22 ◽

2021 ◽

pp. 231-244

Author(s):

Sibel Özkan Gürdal ◽

Sami Açar ◽

Nuh Zafer Canturk

Keyword(s):

Breast Cancer ◽

Success Rate ◽

Operating Room ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Factors Affecting

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Breast Cancer Surgery

Breast cancer: Global quality care ◽

10.1093/med/9780198839248.003.0013 ◽

2019 ◽

pp. 144-156

Author(s):

Peter A. van Dam ◽

Cary Kaufman ◽

Carlos Garcia-Etienne ◽

Marie-Jeanne Vrancken Peeters ◽

Robert Mansel

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Breast Conserving Surgery ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Breast Diseases ◽

Breast Cancer Patients ◽

Breast Conserving Treatment ◽

Sentinel Node Concept

Abstract: The role of the surgeon managing breast diseases has been the subject of continuous evolution, moving from the cancer-extirpative surgeon to a deeply informed surgical leader, who interacts in a multidisciplinary setting also encompassing tasks for risk assessment, genetic counselling, and new diagnostic approaches. Surgical removal of the tumour remains the cornerstone in treating early stage breast cancer. During the last century, breast cancer surgery became less radical, breast-conserving treatment emerged, and the role of axillary lymphadenectomy changed from a therapeutic procedure into a staging procedure with prognostic implications. Later, the sentinel node concept reduced the need for complete axillary clearance in most cases. Nowadays, thanks to breast-conserving surgery, oncoplastic techniques, and reconstructive procedures, most breast cancer patients can overcome this disease without serious permanent physical mutilation. A multidisciplinary approach, benchmarking, and quality assurance have improved outcomes markedly.

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Financial Costs and Burden Related to Decisions for Breast Cancer Surgery

Journal of Oncology Practice ◽

10.1200/jop.18.00796 ◽

2019 ◽

Vol 15 (8) ◽

pp. e666-e676 ◽

Cited By ~ 10

Author(s):

Rachel A. Greenup ◽

Christel Rushing ◽

Laura Fish ◽

Brittany M. Campbell ◽

Lisa Tolnitch ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Financial Burden ◽

Breast Conserving Surgery ◽

Treatment Costs ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Bilateral Mastectomy ◽

Financial Costs ◽

The Impact

PURPOSE: Financial toxicity is a well-recognized adverse effect of cancer care, yet little is known about how women consider treatment costs when facing preference-sensitive decisions for breast cancer surgery or how surgical treatment choice affects financial harm. We sought to determine how financial costs and burden relate to decisions for breast cancer surgery. METHODS: Women (≥ 18 years old) with a history of breast cancer were recruited from the Army of Women and Sisters Network to complete an 88-item electronic survey. Descriptive statistics and regression analysis were used to evaluate the impact of costs on surgical decisions and financial harm after breast cancer surgery. RESULTS: A total of 607 women with stage 0 to III breast cancer were included. Most were white (90%), were insured privately (70%) or by Medicare (25%), were college educated (78%), and reported household incomes of more than $74,000 (56%). Forty-three percent underwent breast-conserving surgery, 25% underwent mastectomy, 32% underwent bilateral mastectomy, and 36% underwent breast reconstruction. Twenty-eight percent reported that costs of treatment influenced their surgical decisions, and at incomes of $45,000 per year, costs were prioritized over breast preservation or appearance. Overall, 35% reported financial burden as a result of their cancer treatment, and 78% never discussed costs with their cancer team. When compared with breast-conserving surgery, bilateral mastectomy with or without reconstruction was significantly associated with higher incurred debt, significant to catastrophic financial burden, treatment-related financial hardship, and altered employment. Among the highest incomes, 65% of women were fiscally unprepared, reporting higher-than-expected (26%) treatment costs. CONCLUSION: Cancer treatment costs influenced decisions for breast cancer surgery, and comparably effective surgical treatments differed significantly in their risk of patient-reported financial burden, debt, and impact on employment. Cost transparency may inform preference-sensitive surgical decisions and improve patient-centered care.

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