scholarly journals Clinical case: pregnancy-associated breast cancer

2021 ◽  
pp. 86-91
Author(s):  
A.Y. Kovtun ◽  
A.V. Hurando ◽  
V.V. Telnyi ◽  
L.O. Lisiutkin ◽  
O.H. Aksonova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Digital Breast Tomosynthesis ◽  
Diagnostic Algorithm ◽  
Breast Diseases ◽  
First Year ◽  
Pregnancy And Lactation ◽  
Radiological Methods

This article presents a clinical case of pregnancy-associated breast cancer. We have analyzed the features of the diagnostic algorithm, considered the radiological manifestations and presented the main literature sources about this pathology.Pregnancy-associated breast cancer is breast cancer that occurs during pregnancy or within the first year after a baby birth. It is most often diagnosed only after first clinical symptoms, the most characteristic of which is a feeling of compaction in the breast, less often bloody discharge from the nipple, pain, breast deformation and baby's refusal to breastfeed.Radiological signs of pregnancy-associated breast cancer are not pathognomonic and may mimic benign changes associated with pregnancy and lactation at early stage: lactation adenoma, mastitis, abscess, galactocele, fibroadenoma. Uncertainty of physicians about the harm of radiological methods of examination for pregnant women and the fetus and, consequently, incorrect diagnostic algorithms can delay the early detection of pathology, establish an accurate diagnosis and worsen the prognosis for the patient.Compliance with a sequential diagnostic algorithm using sonographic diagnostics, X-ray mammography with digital breast tomosynthesis, magnetic resonance imaging in accordance with the diagnostic categories of the BI-RADS scale allows you to verify breast tumors. Diagnosis should be consistent with American College Radiology guidelines.In case of detection of suspicious breast pathology in a pregnant woman or woman in labor, a doctor of any specialty should refer the patient to specialized specialists in the diagnosis and treatment of breast diseases. Adherence to the correct algorithms for the appointment, conduct and interpretation of radiological studies, taking into account changes in the breast structure, will allow timely diagnosis, proper treatment and save the lives and health of childbearing aged women.

scholarly journals Breast diseases and breast cancer screening in pregnant and puerperals in şanlıurfa province

2021 ◽  
Vol 8 (2) ◽  
pp. 60-63
Author(s):  
Mehmet Patmano ◽  
Durmuş Ali Çetin ◽  
Tufan Gümüş
Keyword(s):  
Breast Cancer ◽  
Breast Diseases ◽  
First Year ◽  
High Fertility ◽  
Palpable Mass ◽  
Breast Examination ◽  
Pregnancy And Lactation ◽  
The Mean ◽  
The Moment ◽  
Self Examination

Objective: Pregnancy-associated breast cancer is breast cancer that occurs during pregnancy or within 1 year after birth. It occurs in one out of 3000-10000 pregnancies and is the most common cancer occurring during pregnancy and the postpartum period. It was aimed to reveal the incidence of pregnancy-associated breast cancer in pregnant and lactating patients in a city with high fertility rates. Methods; Patients who presented with breast pain and palpable mass in the breast in the first year of pregnancy and lactation between December 2018 and November 2020 were prospectively recorded. 314 patients were included in the study. Results; The mean age of the patients was 28.7 ± 6.1 years. 258 (82.1%) of the patients were Turkish and 56 (17.8%) were Syrian nationals. The most common complaints were pain in the breast, palpable mass, redness, and breast swelling. A palpable mass in the breast was detected in 39 (12.4%) patients. As a result of the examinations and tests performed in both patients, a diagnosis of malignancy was made. Conclusion; Breast cancer risk increases in pregnant and breastfeeding patients. To reduce the incidence of breast cancer, it is important to perform a breast examination by a physician before or at the beginning of pregnancy and breast self-examination. From the moment of diagnosis, general surgery, obstetrics and oncology clinics should be followed with a multidisciplinary approach

Breast cancer associated with pregnancy: a clinical case

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 102-108
Author(s):  
Yu E Dobrokhotova ◽  
S E Arakelov ◽  
S Zh Danelyan ◽  
E I Borovkova ◽  
A E Zykov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Clinical Case ◽  
First Trimester ◽  
First Year ◽  
Total Mastectomy ◽  
First Time

Associated with pregnancy is breast cancer, which was first detected during pregnancy, during the first year after childbirth or at any time against lactation. Diagnosis of the disease in the first trimester is an indication for abortion. The detection of the disease after 20 weeks and the desire of the woman to maintain pregnancy is the basis for conducting a total mastectomy followed by polychemotherapy with doxorubicin with cyclophosphamide or with fluorouracil. Radiation therapy during pregnancy is not applied. The timing and method of delivery are determined individually and depend on the stage of the process and the period of pregnancy, when it was identified. A clinical case of a patient with edematous-infiltrative form of breast cancer of the IV stage, diagnosed for the first time in 22 weeks of pregnancy, is presented.

Breast Cancer Surgery

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.

Advanced Imaging Techniques for the Detection of Breast Cancer

2012 ◽  
pp. 65-69 ◽  
Author(s):  
Maxine Jochelson
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Breast Imaging ◽  
Early Stage ◽  
Imaging Techniques ◽  
Breast Cancer Mortality ◽  
Digital Breast Tomosynthesis ◽  
Ct Scanning ◽  
High Risk Women ◽  
Contrast Enhanced

Overview: Mammography is the only breast imaging examination that has been shown to reduce breast cancer mortality. Population-based sensitivity is 75% to 80%, but sensitivity in high-risk women with dense breasts is only in the range of 50%. Breast ultrasound and contrast-enhanced breast magnetic resonance imaging (MRI) have become additional standard modalities used in the diagnosis of breast cancer. In high-risk women, ultrasound is known to detect approximately four additional cancers per 1,000 women. MRI is exquisitely sensitive for the detection of breast cancer. In high-risk women, it finds an additional four to five cancers per 100 women. However, both ultrasound and MRI are also known to lead to a large number of additional benign biopsies and short-term follow-up examinations. Many new breast imaging tools have improved and are being developed to improve on our current ability to diagnose early-stage breast cancer. These can be divided into two groups. The first group is those that are advances in current techniques, which include digital breast tomosynthesis and contrast-enhanced mammography and ultrasound with elastography or microbubbles. The other group includes new breast imaging platforms such as breast computed tomography (CT) scanning and radionuclide breast imaging. These are exciting advances. However, in this era of cost and radiation containment, it is imperative to look at all of them objectively to see which will provide clinically relevant additional information.

Mammography use in breast cancer survivors: An administrative claims study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6531-6531 ◽  
Author(s):  
Kathryn Jean Ruddy ◽  
Lindsey R. Sangaralingham ◽  
Heather B. Neuman ◽  
Caprice Christian Greenberg ◽  
Rachel A. Freedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Tissue ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
First Year ◽  
Administrative Claims ◽  
Mammography Use

6531 Background: Annual mammography is recommended to screen residual breast tissue for new cancers and recurrent disease after treatment for early stage breast cancer. This study aimed to assess mammography rates over time in breast cancer survivors. Methods: We used administrative claims data from a large U.S. commercial insurance database, OptumLabs, to retrospectively identify privately- and Medicare Advantage-insured women with operable breast cancer who had residual breast tissue after definitive breast surgery between 2006 and 2015. We required coverage for at least 13 months following surgery. For each subsequent 13-month time period, we only included women without a loss of coverage, bilateral mastectomy, metastatic breast cancer diagnosis, or non-breast cancer diagnosis. We calculated the proportion of patients who had a mammogram during each 13-month period following breast surgery. We used multivariable logistic regression to test for factors associated with mammography in the first 13 months. Results: The cohort included 26,011 women followed for a median of 2.9 years (IQR 1.9-4.6) after surgery; 63.1% were less than 65 years of age, and 74.4% were white. In their first year of follow-up, 86% underwent mammography, but by year 7, this decreased to 73%. Fewer than 1% underwent MRI instead of mammography. In multivariable analysis, mammograms were less likely during the first year after surgery among women aged < 50 years (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8), African Americans (OR, 0.7; 95% CI, 0.7 to 0.8), patients who underwent mastectomy (OR, 0.7; 95% CI, 0.6 to 0.7), and patients residing in the Western part of the country (OR, 0.9; 95% CI, 0.7 to 0.9). Those with 1-2 comorbidities were more likely (OR, 1.1; 95% CI 1.1-1.2) than those with none to have a mammogram during that period. Mammography use did not differ significantly by year of diagnosis (2006-2015). Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance mammography. Mammography use falls as the time from the early stage breast cancer diagnosis increases. Understanding factors associated with lack of mammographic screening may help improve survivorship care.

scholarly journals Breast Cancer Integrative Oncology Care and Its Costs

2016 ◽  
Vol 16 (1) ◽  
pp. 85-95 ◽  
Author(s):  
Leanna J. Standish ◽  
Fred Dowd ◽  
Erin Sweet ◽  
Linda Dale ◽  
Morgan Weaver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Insurance Companies ◽  
Quality Data ◽  
First Year ◽  
Breast Cancer Patients ◽  
Integrative Oncology ◽  
Body Therapy ◽  
Oncology Care

Background. Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO). Clinics directed by oncology board certified NDs (Fellows of the American Board of Naturopathic Oncology or FABNOs) provide high-quality data for describing IO therapies, their costs and measuring clinical outcomes. Purpose. To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians. Study participants (n = 324). Women who sought care at 1 of 6 naturopathic oncology clinics in Washington State were asked to enroll in a prospective 5 year observational outcomes study. Methods. Medical records were abstracted to collect treatment recommendations and cost data. Results. More than 72 oral or topical, nutritional, botanical, fungal and bacterial-based medicines were prescribed to the cohort during their first year of IO care. Trametes versicolor was prescribed to 63% of the women. Mind-body therapy was recommended to 45% of patients, and 49% received acupuncture. Also, 26% were prescribed injectable therapy, including mistletoe, vitamin B complex (12%), IV ascorbate (12%), IV artesunate (7%), and IV nutrition and hydration (4%). Costs ranged from $1594/year for early-stage breast cancer to $6200/year for stage 4 breast cancer patients. Of the total amount billed for IO care for 1 year for breast cancer patients, 21% was out-of-pocket. Conclusions. IO care for women with breast cancer consists of botanical and mushroom oral therapies, parenteral botanical and nutrient therapy, mind-body medicine and acupuncture. IO clinic visits and acupuncture are partially paid for by medical insurance companies.

scholarly journals Incomplete Wolfram syndrome. Clinical case report

2019 ◽  
Vol 65 (1) ◽  
pp. 46-49
Author(s):  
Oleg A. Dianov ◽  
Ekaterina A. Lavrova ◽  
Vadim V. Maltcev ◽  
Darina A. Oleynik
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Clinical Case ◽  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Wolfram Syndrome ◽  
Sensorineural Hearing ◽  
First Year ◽  
Disease Manifestation

We describe clinical presentation of Wolfram syndrome and follow-up data in a child. Diagnostics of Wolfram syndrome takes time because clinical symptoms develop not at the time of disease manifestation, but usually several years later. The sequence of manifestations also varies. According to the literature, sensorineural hearing loss occurs in the 2nd decade, and bladder atony develops only by the 3rd decade. In the presented case, initial manifestations of bladder innervation disorders in the form of its dysfunction developed as early as the first year, and sensorineural hearing loss formed by the 4th year of the disease. As in other studies, the patient developed optic disc atrophy within the first year after diabetes onset. This clinical case confirms variability in the clinical symptoms of Wolfram syndrome. The sequence in which the disease picture develops (in this case, there was an incomplete form of syndrome the absence of diabetes insipidus) does not always coincide with the classic course of syndrome, which complicates timely diagnosis.

scholarly journals Characterization of Clinical Symptoms by Race Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer Before Starting Chemotherapy

2021 ◽  
Vol 4 (6) ◽  
pp. e2112076
Author(s):  
Xin Hu ◽  
Puneet K. Chehal ◽  
Cameron Kaplan ◽  
Rebecca A. Krukowski ◽  
Roy H. Lan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

Nonadherence to Adjuvant Tamoxifen Therapy in Women With Primary Breast Cancer

2003 ◽  
Vol 21 (4) ◽  
pp. 602-606 ◽  
Author(s):  
Ann H. Partridge ◽  
Philip S. Wang ◽  
Eric P. Winer ◽  
Jerry Avorn
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Early Stage ◽  
Tamoxifen Therapy ◽  
Poor Adherence ◽  
First Year ◽  
Suboptimal Adherence ◽  
Adjuvant Breast Cancer ◽  
The Mean ◽  
Adjuvant Tamoxifen Therapy

Purpose: Although clinical trials have clearly demonstrated the benefits of tamoxifen in women with primary breast cancer, little is known about how this drug is actually used in the general population. We sought to estimate adherence and predictors of nonadherence in women starting tamoxifen as adjuvant breast cancer therapy. Patients and Methods: Subjects were age 18 years or older initiating tamoxifen for primary breast cancer and enrolled in New Jersey’s Medicaid or Pharmaceutical Assistance to the Aged and Disabled programs during the study period, from 1990 to 1996 (N = 2,378). Main outcome measures were number of days covered by filled prescriptions for tamoxifen in the first year of therapy with the 4 years after tamoxifen initiation for a subset; predictors of good versus poor adherence. Results: Twenty-three percent of patients missed taking tamoxifen on more than one fifth of days studied, although on average, patients filled prescriptions for tamoxifen for 87% of their first year of treatment. The youngest, oldest, nonwhite, and mastectomy patients had significantly lower rates of adherence; patients who had seen an oncologist before taking tamoxifen had significantly higher rates of adherence. Overall adherence decreased to 50% by year 4 of therapy. Conclusion: The mean level of adherence to tamoxifen is high compared with other chronic medications. However, nearly one fourth of patients may be at risk for inadequate clinical response because of poor adherence. Because of the efficacy of tamoxifen therapy in preventing recurrence and death in women with early-stage breast cancer, further efforts are necessary to identify and prevent suboptimal adherence.

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