scholarly journals Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeeyeon Lee ◽  
Ho Yong Park ◽  
Wan Wook Kim ◽  
Jeong Ju Lee ◽  
Hee Jung Keum ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Natural Course ◽  
University Hospital ◽  
Excision Biopsy ◽  
Fat Necrosis ◽  
Total Mastectomy ◽  
Clinicopathologic Characteristics ◽  
National University

Abstract Background Although fat necrosis is a minor postoperative complication after breast reconstruction, occasionally it mimics to tumor recurrence in patients with breast cancer. Therefore, the surgeon should distinguish between benign fat necrosis and true local recurrence. The authors evaluated the clinical characteristics of fat necrosis after breast reconstruction and investigated the natural course of fat necrosis. Methods Between 2007 and 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital. Clinicopathologic characteristics and the occurrence of fat necrosis were assessed during surveillance for 10 years of mean follow-up period. Results There were 42 cases (11.6%) of fat necrosis after breast reconstruction with partial or total mastectomy which were confirmed by needle or excision biopsy. The fat necrosis was resolved after a mean period of 45.9 months (SD, ± 42.1) and 26 cases (61.9%) of fat necrosis were almost completely resolved (less than 5 mm) during 10-year follow-up period. Conclusion Based on the natural course of fat necrosis, the fat necrosis after breast reconstruction can be only monitored, if pathologic confirmation was done. More than half of the cases will be resolved within 2–3 years.

scholarly journals Natural Course of Fat Necrosis After Breast Reconstruction: A 10-Year Follow-Up Study

2020 ◽  
Author(s):  
Jeeyeon Lee ◽  
Ho Yong Park ◽  
Wan Wook Kim ◽  
Jeong Ju Lee ◽  
Hee Jung Keum ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Natural Course ◽  
University Hospital ◽  
Excision Biopsy ◽  
Fat Necrosis ◽  
Total Mastectomy ◽  
Clinicopathologic Characteristics ◽  
National University

Abstract Background: Although fat necrosis is a minor postoperative complication after breast reconstruction, occasionally it mimics to tumor recurrence in patients with breast cancer. Therefore, the surgeon should distinguish between benign fat necrosis and true local recurrence. The authors evaluated the clinical characteristics of fat necrosis after breast reconstruction and investigated the natural course of fat necrosis.Methods: Between 2007 and 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital. Clinicopathologic characteristics and the occurrence of fat necrosis were assessed during surveillance for 10 years of mean follow-up period.Results: There were 42 cases (11.6 %) of fat necrosis after breast reconstruction with partial or total mastectomy which were confirmed by needle or excision biopsy. The fat necrosis was resolved after a mean period of 45.9 months (SD, ± 42.1) and 26 cases (61.9 %) of fat necrosis were almost completely resolved (less than 5 mm) during 10-year follow-up period.Conclusion: Based on the natural course of fat necrosis, the fat necrosis after breast reconstruction can be only monitored, if pathologic confirmation was done. More than half of the cases will be resolved within 2–3years.

scholarly journals Gastric epithelial dysplasia: Characteristics and long-term follow-up results after endoscopic resection according to morphological categorization.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 190-190
Author(s):  
Bong Eun Lee ◽  
Gwang Ha Kim ◽  
Dong Hoon Baek
Keyword(s):  
Endoscopic Resection ◽  
Epithelial Dysplasia ◽  
University Hospital ◽  
Clinicopathologic Characteristics ◽  
Morphologic Characteristics ◽  
Study Results ◽  
National University ◽  
Long Term Follow Up

190 Background: Gastric epithelial dysplasia (GED) can be morphologically categorized into adenomatous and foveolar types. To date, there have been few studies on the clinical characteristics of GEDs according to the morphologic types. Therefore, we here aimed to elucidate the clinicopathologic characteristics of patients with GED and the long-term follow-up results after endoscopic resection according to the morphologic characteristics of GEDs. Methods: A total of 357 patients who underwent endoscopic resection for GEDs at Pusan National University Hospital between January 2008 and December 2009 were included in the study. Results: Patients with GED were divided into 3 groups: adenomatous (n = 167, 46.8%), foveolar (n = 103, 28.9%), and hybrid (n = 87, 24.3%) types. Compared to the adenomatous type, foveolar type lesions were more frequently located in the antrum/pylorus, flat/depressed lesions, and normal/reddish in color; and showed more frequent high-grade dysplasia. During the follow–up period (median, 37.3 months), the overall incidence of synchronous and metachronous lesions was 20.8% and 20.1%, respectively; of these, the incidence of synchronous and metachronous gastric cancer was 8.7% and 5.4%, respectively. There were no significant differences in the incidence of synchronous and metachronous lesions according to morphologic types. Conclusions: GEDs appear to have different clinicopathologic characteristics according to morphologic types. Irrespective of the morphology, synchronous and metachronous gastric cancers are commonly found after endoscopic resection of GEDs. Therefore, close follow-up surveillance after endoscopic resection of GEDs should be performed for all patients.

Does triple-negative breast cancer (TNBC) have distinct clinicopathologic characteristics and prognostic significance?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21088-21088
Author(s):  
J. Rhee ◽  
S. Oh ◽  
D. Oh ◽  
S. Im ◽  
S. Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Significance ◽  
Histologic Grade ◽  
University Hospital ◽  
Her2 Status ◽  
Positive Staining ◽  
Clinicopathologic Characteristics ◽  
Node Negative ◽  
Node Positive

21088 Background: Studies have suggested that TNBC, defined by estrogen receptor-negative, progesterone receptor-negative, and HER2-negative, may represent the subset of breast cancer(BC) with different biologic behavior. Here we investigated the clinicopathologic characteristics of TNBC and its prognostic significance in Korean BC patients. Methods: Patients diagnosed as invasive BC and underwent curative surgery at Seoul National University Hospital between Jan. 2000 and Jun. 2003, were reviewed, retrospectively. We excluded the patients whose immunohistochemistry for hormone receptor nor HER2 status had not been evaluated, and who had been treated with adjuvant trastuzumab or neoadjuvant chemotherapy (CT). Clinicopathologic variables (age, T and N stage, endovascular or lymphatic tumor emboli, nuclear and histologic grade, p53, bcl2, Ki67) and 3 year relapse free survival (3YRFS) rate of TNBC were compared with those of non- TNBC. Results: 1,136 patients were eligible for analysis. The median follow-up was 48.7 months. 341 patients underwent breast conserving surgery followed by adjuvant radiotherapy. 249 patients were TNBC and 62.1% of those were node negative. 86.4% of node negative TNBC, 88.3% of node positive TNBC, 53.9% of node negative non-TNBC, and 90.2% of node positive non-TNBC received adjuvant CT. Compared with non-TNBC, TNBC was correlated with younger age (age<35,14.1% vs. 8.2%, p=0.013), higher nuclear and histologic grade(62.2% vs. 23.6%, p=0.001;60.2% vs. 24.6%, p=0.001, respectively); positive staining for p53 (p=0.001) and higher positivity for Ki67 (p=0.001), suggesting the biologic aggressiveness of TNBC. During the follow-up periods, 17.3% of TNBC were relapsed. In particular, 3YRFS in node negative TNBC and non-TNBC were 86% and 96%, respectively (p<0.001). But, in node positive BC, 3YRFS was not different between TNBC and non-TNBC (80.6% vs. 83%, p=0.99). Conclusions: We confirm that TNBC shows more aggressive clinicopathologic characteristics and in particular, higher relapse in node negative BC. Thus, triple-negativity(TN) may be integrated into risk factor analysis in node negative BC. Final results of more detailed molecular analysis for TNBC would be available in the meeting. No significant financial relationships to disclose.

scholarly journals Reliance on double pedicle TRAM flap technique in breast reconstruction based on mammographic evidence

2004 ◽  
Vol 37 (01) ◽  
pp. 44-50 ◽  
Author(s):  
Fuat Yüksel ◽  
Emir Silit ◽  
Bahattin Çeliköz
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Reconstruction ◽  
Tumor Recurrence ◽  
Tram Flap ◽  
Fat Necrosis ◽  
Minor Complication ◽  
Vascular Delay ◽  
Risk Patients

ABSTRACTBreast reconstruction is now a part of the overall treatment of breast cancer. Its main drawback is rather the suspicion to conceal any probable recurrence. Fat necrosis is a particularly important finding because it can be mistaken for a local recurrence. Alternatively, local recurrences may be dismissed as areas of fat necrosis. Fat necrosis is a relatively minor complication of TRAM flap breast reconstruction but one that can induce anxiety, expense, and inconvenience for patients and concerns about tumor recurrence. The techniques selected for reconstruction must carry the least risks for these awful complications.15 breast cancer cases were treated in our center by using Bostwick′s principles. These include double-pedicle technique in cases with one or two risk factors and added vascular delay two weeks prior to this procedure in cases with more risk factors.During the follow up period, neither the patients nor her physicians experienced any nodules in their treatment sites clinically. One case is the only exception that she felt hardness but it softened. Mammographically, no images of fat necrosis were observed in any of the cases.In contrary to other studies reporting no advantages of double pedicle technique to lessen the risk for fat necrosis, we observed fat necrosis only in one of 15 cases. This may be because both sides of the flap are supplied axially and delay procedures are added in high risk patients.

scholarly journals Breast reconstruction after breast cancer surgery – persistent pain and quality of life 1–8 years after breast reconstruction

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nina Honkanen ◽  
Laura Mustonen ◽  
Eija Kalso ◽  
Tuomo Meretoja ◽  
Hanna Harno
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Perforator Flap ◽  
Persistent Pain ◽  
Rectus Abdominis ◽  
Preoperative Pain ◽  
Significant Difference

Abstract Objectives To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Methods A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p=0.40), mood (BDI-II, p=0.41 and HADS A, p=0.54) or sleep (p=0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusions Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Emotional expectations reported by hospitalized women in southeastern Brazil before being submitted to mastectomy with immediate breast reconstruction: A clinical-qualitative study

2017 ◽  
Vol 41 (S1) ◽  
pp. s507-s507
Author(s):  
G.L. Almeida ◽  
R.M.C. Sena ◽  
V.L.P. Alves ◽  
C. Cardoso-Filho ◽  
E.R. Turato
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
University Hospital ◽  
Southeastern Brazil ◽  
Immediate Reconstruction ◽  
Female Population ◽  
Competing Interest ◽  
Health Assistant ◽  
The Aesthetic

IntroductionBreast cancer is a type that more affects female population in the world. Surgical indication, present in most cases, is a mutilating procedure and mentally traumatic for majority of women subjected. Thus, immediate breast reconstruction, which is the choice to rebuild the breast during the mastectomy surgery, is an alternative to reduce discomforts associated with loss of the breast, in addition to being associated potentially with improved emotional and psychosocial quality of life.ObjectiveTo discuss, from psychological viewpoint, the emotional expectations about surgical results of a planned mastectomy with immediate breast reconstruction, reported by women with breast cancer treated in a university hospital in Campinas, state of São Paulo.MethodQualitative design, particularized in the clinical-qualitative method, adequate to health assistant settings, using the semi-directed interview with open-ended questions in-depth, fully transcribed and after submitted to content clinical-qualitative analysis. Intentional sample closed by criterion of information theoretical saturation with 12 sequential participants.ResultsAmongst the emergent categories from free-floating readings, we have chosen the following to presentation:.–The desire of healing above expectations of the aesthetic aspects;–The perception of the surgical approach predominantly with aesthetic effects;–The desire of a contra-lateral healthy breast withdrawal, too.ConclusionsFace the proposal of mastectomy with immediate reconstruction, days before the surgery, women reported to be well emotionally organized for the procedure, although in different ways. This occurs probably due to emotional meanings built by many experiences from their psychological histories, as well as from values provided by the socio-cultural environments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinicopathologic Characteristics and Long-Term Outcome of Gastric Cancer Patients with Family History: Seven-Year Follow-Up Study for Korean Health Check-Up Subjects

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jooyoung Lee ◽  
Su Jin Chung ◽  
Ji Min Choi ◽  
Yoo Min Han ◽  
Joo Sung Kim
Keyword(s):  
Gastric Cancer ◽  
Family History ◽  
University Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Clinicopathologic Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
National University ◽  
Gastric Cancer Patients

Background/Aims. Family history (FHx) has been reported to be a risk factor for gastric cancer (GC). However, the long-term prognosis of GC with FHx remains controversial. We aimed to investigate the clinicopathologic characteristics and long-term outcomes of GC according to the presence or absence of GC FHx. Methods. This study was conducted on asymptomatic healthy individuals who underwent upper gastrointestinal endoscopy for the purpose of GC screening. Patients who were diagnosed with GC between October 2003 and December 2013 at Seoul National University Hospital Healthcare System Gangnam Center were identified. Demographic and clinicopathologic characteristics were compared between the groups with and without FHx of GC. Overall survival (OS) and recurrence-free survival (RFS) were assessed as primary outcomes. Results. There were no significant differences in tumor characteristics according to FHx of GC. However, preexisting adenoma was more frequent in patients with FHx than in those without FHx (14.5% vs. 6.3%, p = 0.035 ). The proportion of patients with microsatellite instability (MSI) was also higher in groups with FHx of GC (43.2% vs. 13.2%, p = 0.006 ). Helicobacter pylori infection rates of patients with FHx of GC tended to be higher although not significant (70.5% vs. 61.3%, p = 0.188 ). However, OS and RFS at 5 years of the GC patients with FHx were not significantly different from those of patients without FHx. Conclusion. Preexisting adenoma and GC with MSI are more common in patients with FHx of GC than in those without. There were no significant differences in the survival rate according to FHx.

Underweight and breast cancer recurrence and death

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22054-e22054
Author(s):  
H. Moon ◽  
W. Han ◽  
J. Lee ◽  
E. Ko ◽  
E. Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Cancer Registry ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
University Hospital ◽  
National University ◽  
Seoul National University ◽  
Breast Cancer Registry

e22054 Background: The association of body mass index or body weight and breast cancer outcome is controversial. Furthermore, the impact of underweight on breast cancer recurrence and death has not been adequately addressed. Methods: We investigated this issue in a large nation-wide database of 14,039 Korean breast cancer patients (Korean Breast Cancer Registry). Furthermore, to test whether the association was due to more frequent non-cancer death in underweight women, we used breast cancer recurrence data of 4,345 women from single institution (Seoul National University Hospital). Results: The results from Korean Breast Cancer Registry data showed significantly lower overall survival in underweight patients compared to normal weight after adjusting known prognostic factors [hazard ratio=1.36 (95% CI 1.08–1.72)], which was not observed in obese patients. The association between body mass index and breast cancer recurrence was further investigated in Seoul National University Hospital data. Underweight women had significantly higher risk of distant metastasis and local recurrence of breast cancer [hazard ratio=1.86 (95% CI 1.25–2.76) and 2.62 (95% CI 1.55–4.41), respectively]. Conclusions: These findings suggest that underweight could be considered as high risk factor of death and recurrence after breast cancer surgery. No significant financial relationships to disclose.

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