scholarly journals Prevention of Prolonged Lymphorrhea in Minor Pectoral Myoplasty in Women after Breast Cancer Surgery: Anatomical and Physiological Aspects

2020 ◽  
Vol 13 (2) ◽  
pp. 98-102
Author(s):  
Alexandr Vladimirovich Aseev ◽  
Dmitry Anatolyevich Maximov ◽  
Olga Olegovna Suleymanova

Introduction. Surgery remains the main method of treatment for breast cancer patients. However, in surgery a large number of lymphatic vessels are crossed which inevitably leads to a lymph flow damage. The article discusses the problem of lymphorrhea in breast cancer patients after the radical mastectomy and radical resection. The aim of the study was to assess the effectiveness of minor pectoral myoplasty in the axillary region of the "dead space" for lymphorrhea prevention after radical mastectomy and radical resection.Methods. The case group included 30 patients who underwent 30 surgeries with myoplasty of pectoralis minor (Maddens radical mastectomy or radial resection) in the Tver Oncological Center at the Department of breast pathology from 2016 to 2017. The control group included 30 patients who underwent Maddens mastectomy or radical resection without myoplasty (conventional option).Results. In the case group, during the mastectomy, the patients with lymphorrhea had the drainage removed on the 5,31,2 day. The total amount of the drainage was around 235,43,6 ml. The average daily volume of the drained liquid was 47,12,7 ml. In the control group, during the radical mastectomy without myoplasty, the drainage was removed on the 12,71,4 day. The average total amount of the drained liquid was 1691,632,5 ml. The average daily drained volume was 130,32,5 ml.The patients after radical resection in the case group had the drainage removed on the 5,21,2 day. The total amount of the drained liquid in patients with lymphorrhea was 25 ml/day. The total amount of the drained liquid was 223,711,3 ml. The average daily drained volume was 44,62,3 ml. The patients after radical resection in the control group had the drainage removed on the 11,22,0 day. The average total volume of the drained liquid was 835,526,4 ml. The average daily drained volume was 69,92,2 ml.Conclusion. Application of A. Kh. Ismagilov intraoperative technique dead space closure in minor pectoral myoplasty (patent No. 2385673, issued April 10, 2010) with the simultaneous application of compression garments appears to be a simple and effective method for reducing postoperative lymphorrhea. Myoplasty was effective in reducing lymphorrhea regardless of the type of surgical intervention (radical mastectomy or radical resection). Lymphorrhea duration reduced in more than 2 times.

1995 ◽  
Vol 13 (12) ◽  
pp. 2869-2878 ◽  
Author(s):  
R Arriagada ◽  
L E Rutqvist ◽  
A Mattsson ◽  
A Kramar ◽  
S Rotstein

PURPOSE To analyze different events that determine event-free survival (EFS) in a randomized trial on adjuvant radiotherapy in early breast cancer patients with more than 15 years of follow-up evaluation. PATIENTS AND METHODS The trial included 960 patients with a unilateral, operable breast cancer. Surgery consisted of a modified radical mastectomy. The trial compared three arms, as follows: preoperative radiotherapy, postoperative radiotherapy, and no adjuvant treatment. Events were analyzed by a competing-risk approach. A proportional hazards multiple regression model was used to analyze the effects of radiotherapy on the risk of distant metastasis. Similar analyses were performed separately for node-negative [N(-)] and node-positive [N(+)] patients in the two groups that did not include preoperative radiotherapy. RESULTS Radiotherapy produced a fivefold decrease of the risk of local recurrence (P < .0001). In N(+) patients, postoperative radiotherapy decreased the risk of distant dissemination (relative risk, 0.63). When local recurrence was introduced in the model as a time-dependent covariate, this factor was predictive of distant dissemination (P < .0001) and nullified the effect of postoperative radiotherapy. This finding suggests that the decrease of distant metastases was related to the prevention of local recurrence. A similar effect was found in models that used overall survival as an end point. CONCLUSION This study shows that postmastectomy radiotherapy in N(+) breast cancer patients may decrease the distant metastasis rate by preventing local recurrences and thus avoiding secondary dissemination.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kinoshita ◽  
H Yuzawa ◽  
R Wada ◽  
K Yano ◽  
S Yao ◽  
...  

Abstract Background The arrhythmic substrates of the myocardium such as depolarization and repolarization abnormalities are thought to reflect cardiac dysfunction prior to the morphologic left ventricular dysfunction. Activation time (AT), recovery time (RT) and T wave peek-end interval dispersion (Tpe-dispersion) are useful indicators of the arrhythmic substrate. We examined the appearance of depolarization and repolarization abnormalities in patients with cancer therapeutics-related cardiac dysfunction (CTRCD) using AT, RT and Tpe-dispersion. Methods We conducted a standardized case-control study of CTRCD with 40 patients who developed breast cancer and treated with trastuzumab (13 cases and 27 controls). We assessed the relation between electrocardiographic indexes, including AT, RT and corrected Tpe-dispersion, and CTRCD. QT intervals were measured by Fridericia method, and QT observer 3 software were used for the measurement of all electrocardiographic indexes. Results LVEF in case and control group were 45.7±8% and 69.2±6%, respectively. AT in aVR lead was significantly higher in case group compared with control (28.8±7ms vs 22.8±5ms, P=0.02). corrected Tpe-dispersion tended to be higher in case group than that of control group (43.2±19ms vs 31.9±10ms, P=0.06). QT dispersion and RT dispersion were not different between case and control group. Conclusions Our study demonstrated that AT in aVR may predict cardiac dysfunction in breast cancer patients with HER2-inhibitor related cardiac dysfunction. More detailed studies using other modalities which can detect depolarization and repolarization abnormalities, including ventricular late potentials and T wave alternans, are needed. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 20 (5) ◽  
pp. 41-48
Author(s):  
I. V. Reshetov ◽  
V. A. Khiyaeva ◽  
K. G. Kudrin ◽  
A. S. Fatyanova

The purpose of the study was to assess the feasibility of using the propeller flap to cover a large axillary fossa defect following lymph node dissection in breast cancer patients.Material and Methods. One hundred breast cancer patients underwent surgery. Out of them, 64 underwent Madden modified radical mastectomy and 36 radical breast resection using a propeller muscle flap. Out of 100 patients, 61 were followed up (50 after mastectomy and 11 after radical resection using a propeller flap). Fifteen patients were randomly selected for examination of the flap using ultrasound (2 patients after radical resection, 13patients after radical mastectomy). The follow-up time was from 3 to 6 months. We studied the following: bleeding in the postoperative period, hematoma, duration of lymphorrhea, duration of hospitalization, ultrasound findings, hand function, size of the upper limb, and physical activity.Results. No statistically significant differences in the number of complications related to the surgery extent were found. Here was no bleeding. Small hematoma was observed in one patient who underwent breast resection. Forty-three (70.49 %) patients did not have lymphorrhea after drainage removal. Lymphorrhea was observed for a month in 9 (14.75 %) patients, for 1–2 months in 4 (6.56 %) patients, and for 3 months or more in 5 (8.2 %) patients – 3 months or more. Twelve (19.67 %) patients developed lymphoedema of the arm. Hospitalization period was 7 bed-days in 90.0 % of cases. The flap viability reached 100.0 %. In 54 (88.53 %) of 61 patients, the active function of the arm recovered. Thirty-eight (62 %) patients had ECOG 1 status 3 years after surgery.Conclusion. The flap made it possible to solve the local problems of covering the axillary neurovascular bundle during lymphadenectomy for breast cancer and eliminating a large axillary fossa defect. The results obtained demonstrated high engraftment rates with a small number of complications, regardless of the surgery extent. 


2007 ◽  
Vol 125 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Claudio Battaglini ◽  
Martim Bottaro ◽  
Carolyn Dennehy ◽  
Logan Rae ◽  
Edgar Shields ◽  
...  

CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. DESIGN AND SETTING: Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. METHODS: Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). RESULTS: Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. CONCLUSION: The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abeer I Abd Elmagid ◽  
Hala Abdel Al ◽  
Wessam El Sayed Saad ◽  
Seham Kamal Mohamed

Abstract Background Breast cancer is the most common cancer among women and one of the most important causes of death among them.Angiogenesis is an important step for primary tumor growth, invasiveness, and metastases. Angiopoietins are well-recognized endothelial growth factors that are involved in angiogenesis associated with tumors. Aim To explore the diagnostic significance of serum angiopoietin-2 (Ang-2) in breast cancer and to evaluate its prognostic efficacy through studying the degree of its association with the TNM staging of the disease. Patients and Methods This study was conducted on (35) Egyptian female patients who were diagnosed as breast cancer according to histopathological examination of breast biopsy (Group 1, Breast Cancer Patients) and (25) female patients with benign breast diseases (Group II, Pathological Control Patients), in addition to (20) age - matched apparently healthy, free mammogram, females serving as healthy controls (Group III, Healthy Controls). For all participants, measurement of serum Ang-2 was done using enzyme linked immunosorbent assay (ELISA) technique. Results A highly significant increased levels of Ang-2 was observed in breast cancer patients when compared to healthy control group (Z = 4.95, p &lt; 0.01). However, no significant difference was observed in Ang-2 levels between breast cancer patients group and pathological control group (Z = 3.37, p &gt; 0.05). No significant difference was detected in Ang-2 levels in relation to TNM stage and histological grade. No significant correlation was found between Ang-2 levels and serum levels of CA15-3, hormone receptors, HER2/new receptor status (p &gt; 0.05, respectively). Conclusion This study revealed that Ang-2 serum levels were significantly increased in patient with breast cancer compared with healthy controls, indicating that high Ang-2 level is a promising non invasive biomarker for breast cancer diagnosis. However, no significant difference of Ang-2 levels was detected in relation of breast TNM staging in the population studied.


Author(s):  
Puji Hastuti ◽  
Yuli Nurhayati ◽  
Dwi Ernawati ◽  
Christina Yuliastuti ◽  
Merina Widyastuti

ABSTRACT Introduction : The mechanism of breast cancer is the cells growing and breeding become appear abnormal tissue of breast. One of the common treatments for it is chemotherapy using cytotoxic drugs. However, chemotherapy may cause nausea and vomiting as its side effects. Lemon aromatherapy is a complementary therapy in patients with breast cancer who experience nausea or vomiting. The study’s purpose was to know the effect of lemon aromatherapy on the intensity of nausea and vomiting experienced by the breast cancer patients as an effect of chemoterapy in the Chemo Center Room of RSAL Dr. Ramelan Surabaya. Material and Methods : The study was the pre-experimental design with pre-post test without control group. There are two variables, lemon aromatherapy is independent, and the intensity of nausea and vomiting is dependent. The sampling technique was nonprobability purposive sampling, with 34 breast cancer patients taken as the sample. A questionnaire was the instrument for collecting the data. The Data collected were analyzed using the Wilcoxon Test (α = 0,05). Results : The study’s result indicated that the lemon aromatherapy was effectively to decrease of the intensity of nausea and vomiting exeperienced by the respondents, with the value of Wilcoxon test p < 0.001. Conclusion : Lemon aromatherapy stimulates the raphe nucleus to produce serotonin. Which function to generate a sense of comfort and calm. For that reason, it can be used as an alternative for taking care of nausea and vomiting experienced by patients with breast cancer as the side effect of chemotherapy. Keywords:  Lemon Aromatherapy, Nausea, Vomiting, Chemotherapy  


2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Tuba Kayan Tapan ◽  
Zeynep Erdogan Iyigun ◽  
Serkan Ilgun ◽  
Vahit Ozmen

Objective: To determine the relationship between the dietary characteristics of breast cancer patients. Methods: Patients with breast cancer whose treatments have finished and are in remission formed the study group and healthy people formed the control group. Demographic, anthropometric characteristics, food consumption frequency form and exercise status were recorded with all groups. Data analysis was done by SPSS 22. Results: In the study group, mean carbohydrate percentage was lower, while fat, fat percentage, monosaccharide, glucose, fructose, omega3(n3), saturated fatty acids(SFA), monounsaturated fatty acids (MUFA), vitamin A, C, E, B6, biotin and copper values were significantly higher (p<0.05). Recurrence was observed in seven patients (7.1%) during the follow-up period, hormone receptor levels (ER) and vitamin B2 intake (accuracy 93.9%) were inversely related to the recurrence of the disease (p=0.02). Conclusions: While the percentage of carbohydrate taken was lower in study group; total fat, n3, SFA, MUFA, monosaccharide, glucose, fructose, water-soluble fiber, B6, biotin and copper values were higher. Further studies are needed for vitamin B2 deficiency in patients with recurrence. doi: https://doi.org/10.12669/pjms.36.7.2368 How to cite this:Tapan TK, Iyigun ZE, Ilgun S, Ozmen V. Evaluation of the eating habits of breast cancer patients. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2368 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.


2016 ◽  
Vol 4 ◽  
pp. 36-42
Author(s):  
Igor Motuzyuk ◽  
Oleg Sydorchuk ◽  
Yevhenii Kostiuchenko ◽  
Ivan Smolanka

In this article the authors described the experience of lipofilling usage at the National Cancer Institute. Aim of this work was to improve the aesthetic results of surgical treatment of breast cancer patients by the usage of lipofilling in patients after breast reconstruction. The description of methods of lipofilling and their application in cancer patients, the benefits of usage of LipiVage® system was performed. Materials and methods. The study included 42 women with breast cancer, who received special treatment in 2012–2016. The main group included 21 patients that have received special treatment and undergone lipofilling. The control group included 21 patients, who received only special treatment, (with no lipofilling). Different objective and subjective criteria for evaluating the effectiveness of lipofilling in achieving a satisfactory aesthetic result in patients, who underwent radical and reconstructive surgery for breast cancer, were used in this investigation. The results shows that the implementation of lipofilling improves the aesthetic perception after breast reconstruction in 20 % of patients, decreases the number of complications after reconstructive operations and are not accompanied by a worsening of results of special treatment in breast cancer patients. In conclusion it can be noted that our results show a high efficiency of lipofilling after special treatment, its safety and advisability for further usage.


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