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

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.

Breast cancer surgery during pregnancy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Rakesh Surapaneni ◽  
Jolanta Jozefara ◽  
Karen Hendershott ◽  
Krystal Hunter ◽  
Elyce Cardonick
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Node Biopsy ◽  
Significant Difference ◽  
Mastectomy Group

1127 Background: There is limited literature on breast surgery during pregnancy. We present prospective registry data on 88 breast cancer patients who underwent breast cancer surgery during pregnancy. Methods: The Cancer and Pregnancy Registry is a voluntary international registry that prospectively collects the clinical course, treatment, and disease outcome of women diagnosed with cancer during pregnancy and the perinatal and neonatal outcomes of their children. Results: We identified 88 patients who were diagnosed with breast cancer and had surgery while pregnant. 59 patients (67%) underwent Mastectomy while29 patients (32%) underwent breast conserving surgery (BCS). Out of 43 patients who underwent BCS as their first surgery 13 patients (30.23%) required subsequent mastectomy during pregnancy. 15 patients (34.88%) from the BCS group and 4 patients (8.69%) from the Mastectomy group had positive margins. There was no significant difference between patients who underwent mastectomy vs BCS based on Age (34.67 vs 34.72 P: 0.97), gestational age at surgery (14.05 vs 16.06 P: 0.23) or ER positivity (47.5% vs 46.4% P: 0.93). 2 patients had neo-adjuvant chemotherapy. 17 patients (19.31%) had sentinel lymph node biopsy. 37 patients (42%) had a pregnancy complication. There was no difference in the rate of complication based on mastectomy vs BCS(45.8% vs 34.5% P: 0.31). There was only 1 patient (from mastectomy group) that delivered within 2 weeks of surgery. Of the 17 patients (19.3%) with spontaneous preterm delivery, there was no difference between Mastectomy and BCS group (22% vs 13.2% P: 0.41). Of the 25 patients (28.4%) with birth complications, there was no significant difference between mastectomy vs BCS (30.5% vs 24.1% P: 0.53). There was also no difference in mean birth weight between the groups (2598 grams vs 2672.3 grams P: 0.57). Conclusions: The data supports the safety of breast cancer surgery during pregnancy. In addition, there were no identified adverse effects in patients who underwent BCS as opposed to mastectomy. Of note, only 19% of patients underwent sentinel node biopsy which is considered the standard of care in early breast cancer patients regardless of pregnancy status.

Demand for Plastic Surgical Operations after Primary Breast Cancer Surgery

2005 ◽  
Vol 94 (3) ◽  
pp. 211-215 ◽  
Author(s):  
T. Meretoja ◽  
E. Suominen
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Primary Breast Cancer ◽  
Age Groups ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Chi Square ◽  
Factors Affecting ◽  
Chi Square Test

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.

The effect of upper limb lymphedema in posture of patients after breast cancer surgery

2021 ◽  
pp. 1-9
Author(s):  
Mahmut Surmeli ◽  
Ozlem Cinar Ozdemir
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Body Posture ◽  
Breast Cancer Surgery ◽  
Lower Back ◽  
Significant Difference ◽  
Spine Mobility ◽  
Trunk Posture

BACKGROUND: Upper limb lymphedema is one of the complications following breast cancer-related surgery. It is a fact that there are alterations in posture of the trunk following surgery, however, there is not much data on whether upper limb lymphedema has any effect on body posture. OBJECTIVES: The main purpose of the study was to investigate the effect of upper limb lymphedema in the trunk posture and spine mobility of patients following breast cancer surgery. METHODS: Twenty-seven women with lymphedema and 29 women without lymphedema with mastectomy or breast-conserving surgery participated in the study. Posture was evaluated by the New York Posture Rating Chart and spinal stability and thoracic mobility were evaluated by the Spinal Mouse device. RESULTS: Posture and spine posture scores were significantly higher in the without lymphedema group (p= 0.004; 0.041; respectively). There was a significant difference between the groups in terms of lateral (p< 0.001) and posterior (p< 0.001) view of shoulders, spine (p= 0.027), upper (p< 0.001) and lower back (p= 0.009), and trunk postures (p= 0.001). CONCLUSIONS: Body posture and spine are more affected due to upper limb lymphedema following breast cancer surgery. Alterations of posture mainly occur on shoulders, spine, upper and lower back, and trunk, but not on head and neck postures.

scholarly journals Patient perceptions of physical rehabilitation education and treatment after breast cancer surgery: A mixed methods study

2021 ◽  
Author(s):  
Deirdre E McGhee ◽  
Anne T McMahon ◽  
Julie R Steele
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Critical Time ◽  
Content Delivery ◽  
Physical Rehabilitation ◽  
Cancer Surgery ◽  
Patient Perceptions ◽  
Breast Cancer Surgery ◽  
Delivery Format

Abstract Purpose To investigate the content and delivery of physical rehabilitation education and treatment received by women following breast cancer surgery and to establish patient perceptions of this physical rehabilitation.Methods 509 Australian women (55 years SD 6.5) who previously had breast cancer surgery retrospectively completed an online survey about the content, delivery, satisfaction with and perceptions of the physical rehabilitation they received for six physical side-effects. The percentage of respondents who received each delivery format for the six physical side-effects and their satisfaction levels were tabulated. A thematic analysis was conducted on patients’ perceptions of the physical rehabilitation they received.Results Pamphlets were the most common delivery format of physical rehabilitation following breast cancer surgery. Common physical side-effects, however, were not included in the content and at less than 50% of women were satisfied with their physical rehabilitation. Three major themes emerged: Women perceived (i) they were unaware of and unprepared for the physical side-effects of their surgery/treatment, (ii) information delivery was unsuitable in terms of the timing, delivery format and cognisance of patient needs, and (iii) follow-up was insufficient at critical time points of recovery.Conclusion The physical rehabilitation received by women after all types of breast cancer surgery is perceived to be poor in terms of its content, delivery format and follow-up and women perceive that their needs at various stages of recovery are not being met. Physical rehabilitation needs to improve after all types of breast cancer surgery.

Effect of Rapid Rehabilitation Concepts on Quality of Life and Pain in Patients Undergoing Radical Breast Cancer Surgery in Perioperative Period

2021 ◽  
Vol 7 (5) ◽  
pp. 1538-1544
Author(s):  
Xin Li ◽  
Hai-yan An ◽  
Yi Zhao ◽  
Mingli Ji ◽  
Jing An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Significant Difference

To study the effect of rapid rehabilitation nursing on patients’ quality of life and pain level during the perioperative period of radical breast cancer surgery. Methods: 126 patients who were hospitalized in our hospital from January 2018 to February 2020 and underwent radical breast cancer surgery were divided into control group and rapid rehabilitation group according to the perioperative period intervention method. Routine nursing intervention and rapid rehabilitation nursing intervention were used respectively. The general conditions of the two groups were recorded, and the differences of T cell subsets before operation and 3 days after operation were detected. Visual analogue pain (VAS) score was used to evaluate the changes of pain degree at 1 day, 3 days and 5 days after operation and on the day of discharge. Postoperative complications and satisfaction were compared between the two groups. Quality of life (QOL) was assessed at 1 month and 3 months after operation using the CARES-SF score. Results: Anesthesia waking time (26.12 ± 5.77) min, off-bed activity time (14.25 ± 2.87) h and hospital stay (7.82 ± 2.15) d in the rapid rehabilitation group were shorter than those in the control group (P < 0.05). The operation time (92.02 ± 14.78) min and intraoperative blood loss (57.96 ± 13.96) mL in the rapid rehabilitation group were not significantly different from those in the control group (P > 0.05). In the control group, 3d after operation, T lymphocyte subsets were decreased gradually than that before operation (P < 0.05), CD3+ was decreased 3d after operation than that before operation in the rapid rehabilitation group (P < 0.05), but CD4+, CD8+, CD4+ / CD8 + 3d after operation had no significant difference than that before operation (P > 0.05). In rapid rehabilitation group, T lymphocyte subsets at 3d after operation were higher than those in the control group (P < 0.05). The postoperative complication rate of the rapid rehabilitation group was lower than that of the control group, and the satisfaction degree was higher than that of the control group, with significant difference (P < 0.05). After follow-up, it was found that the scores of qualities of life, such as physiology, psychosocial, marriage, sexual life and relationship with medical staff in the rapid rehabilitation group were lower than those in the control group at 1 month and 3 months after operation (P < 0.05). Conclusion: The concept of rapid rehabilitation nursing can stabilize the immune function of patients after radical breast cancer surgery, promote the postoperative rehabilitation and improve the quality of life after operation.

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.

scholarly journals Financial Costs and Burden Related to Decisions for Breast Cancer Surgery

2019 ◽  
Vol 15 (8) ◽  
pp. e666-e676 ◽  
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.

Hiroki Takahashi et al. “Usefulness of endoscopic breast-conserving surgery for breast cancer” Surgery Today in November (2014) 44: 2037–2044

Surgery Today ◽  
2014 ◽  
Vol 45 (8) ◽  
pp. 1071-1072
Author(s):  
S. Singh ◽  
A. A. Agarwal ◽  
K. R. Singh ◽  
A. A. Sonkar ◽  
J. K. Khuswaha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery

scholarly journals Effects of breast cancer surgery and surgical side effects on body image over time

2010 ◽  
Vol 126 (1) ◽  
pp. 261-262 ◽  
Author(s):  
Alexandre Mendonça Munhoz ◽  
Rolf Gemperli ◽  
José Roberto Filassi
Keyword(s):  
Breast Cancer ◽  
Body Image ◽  
Side Effects ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Over Time

scholarly journals Dexmedetomidine as an Adjunctive Analgesic with Bupivacaine in Paravertebral Analgesia for Breast Cancer Surgery

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. E589-E598 ◽  
Author(s):  
Sahar A. Mohamed
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Side Effects ◽  
Pulse Rate ◽  
Radical Mastectomy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Postanesthesia Care Unit ◽  
Modified Radical Mastectomy ◽  
Group B

Background: There is little systematic research on the efficacy and tolerability of the addition of adjunctive analgesic agents in paravertebral analgesia. The addition of adjunctive analgesics, such as fentanyl and clonidine, to local anesthetics has been shown to enhance the quality and duration of sensory neural blockades, and decrease the dose of local anesthetic and supplemental analgesia. Objectives: Investigation of the safety and the analgesic efficacy of adding 1 µg/kg dexmedetomidine to bupivacaine 0.25% in thoracic paravertebral blocks (PVB) in patients undergoing modified radical mastectomy. Study Design: A randomized, double-blind trial. Setting: Academic medical center. Methods: Sixty American Society of Anesthesiologists physical status –I – III patients were randomly assigned to receive thoracicPVB with either 20 mL of bupivacaine 0.25% (Group B, n = 30), or 20 mL of bupivacaine 0.25% + 1 µg/kg dexmedetomidine (Group BD, n= 30). Assessment parameters included hemodynamics, sedation score, pain severity, time of first analgesics request, total analgesic consumption, and side effects in the first 48 hours. Results: There was a significant reduction in pulse rate and diastolic blood pressure starting at 30 minutes in both groups, but more evidenced in group BD (P < 0.001). Intraoperative Systolic blood pressure showed a significant reduction at 30 minutes in both groups (P < 0.001) then returned to baseline level at 120 minutes in both groups. There was a significant increase in pulse rate starting 2 hours postoperative until 48 hours postoperatively in group B but only after 12 hours until 48 hours in group BD (P < 0.001). The time of the first rescue analgesic requirement was significantly prolonged in the group BD (8.16 ± 42 hours) in comparison to group B (6.48 ± 5.24 hours) (P = 0.04). The mean total consumption of intravenous tramadol rescue analgesia in the postanesthesia care unit in the firtst 48 hours postoperatively was significantly decreased in group BD (150.19 ± 76.98 mg) compared to group B (194.44 ± 63.91 mg) (P = 0.03). No significant serious adverse effects were recorded during the study. Limitations: This study is limited by its sample size. Conclusion: The addition of dexmedetomidine 1 µg/kg to bupivacaine 0.25% in thoracic PVB in patients undergoing modified radical mastectomy improves the quality and the duration of analgesia and also provides an analgesic sparing effect with no serious side effects. Key words: Dexmedetomidine, paravertebral block, postoperative analgesia, breast cancer surgery

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