scholarly journals THE USE OF THE PROPELLER FLAP FOR COVERING SKIN DEFECT AFTER AXILLARY LYMPHADENECTOMY FOR BREAST CANCER

2021 ◽  
Vol 20 (5) ◽  
pp. 41-48
Author(s):  
I. V. Reshetov ◽  
V. A. Khiyaeva ◽  
K. G. Kudrin ◽  
A. S. Fatyanova
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Muscle Flap ◽  
Radical Mastectomy ◽  
Radical Resection ◽  
Skin Defect ◽  
Breast Cancer Patients ◽  
Propeller Flap ◽  
Hospitalization Period ◽  
Axillary Lymphadenectomy

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. 

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
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Dead Space ◽  
Radical Mastectomy ◽  
Radical Resection ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Case Group ◽  
Breast Cancer Patients ◽  
Simultaneous Application

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.

scholarly journals EARLY COMPLICATIONS AFTER RADICAL OPERATIONS IN BREAST CANCER PATIENTS

2020 ◽  
Vol 1 ◽  
pp. 3-9
Author(s):  
Yuri Vinnyk ◽  
Vadym Vlasenko ◽  
Anna Baranova
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Wound Infection ◽  
Cancer Patients ◽  
Lymph Node Dissection ◽  
Early Period ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection

Breast cancer is one of the most common malignancies in women. In many cases, a major component of complex treatment for breast cancer is surgery - radical mastectomy or radical breast resection. The aim of the work – to investigate the frequency and structure of complications after radical surgery with dissection of axillary lymph nodes in breast cancer patients. Material and methods. The baseline and surgical results of 147 women with breast cancer who underwent radical mastectomy or radical breast resection with lymph node dissection were analysed. Results. Complications in the early period after surgery for breast cancer were found in 76 (51.7 %), including postoperative extremity edema in 60 (40.8 %); lymphorrhea – in 37 (25.2 %), seroma – in 33 (22.4 %); wound infection in 18 (12.2 %), necrosis of the wound edges – in 15 (10.2 %) patients. Correlation of postoperative edema with almost all other complications was found, lymphorrhea and seroma were most associated with swelling and with each other; necrosis of edges with postoperative edema. Wound infection was significantly associated with lymphorrhea. Patients' age, stage of disease, and immunohistochemical type of tumour did not affect the development of complications. With increasing BMI, the incidence of complications increased significantly (χ2=9.530; p=0.009). The tendency to decrease the frequency of complications during reconstructive surgery was revealed (42.6 % versus 58.1 %, p=0.064), and adjuvant radiotherapy, on the contrary, contributed to the increase of complications (57.8 % versus 43.8 %, p=0.090). Conclusion. Radical operations with lymph node dissection in patients with breast cancer are characterized by a high frequency of early postoperative complications, mainly associated with disorders of lymphatic outflow, which indicates the need for a set of measures of preoperative preparation, improvement of surgical technique.

Adequate locoregional treatment for early breast cancer may prevent secondary dissemination.

1995 ◽  
Vol 13 (12) ◽  
pp. 2869-2878 ◽  
Author(s):  
R Arriagada ◽  
L E Rutqvist ◽  
A Mattsson ◽  
A Kramar ◽  
S Rotstein
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Distant Metastasis ◽  
Preoperative Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients

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.

scholarly journals Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jian Hu ◽  
Guang Han ◽  
Yu Lei ◽  
Ximing Xu ◽  
Wei Ge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Target Volume ◽  
Conformity Index ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Significant Difference

Introduction. This study is aimed at evaluating the dosimetric differences among target segmented planning (TSP), conventional 9-field intensity modulated radiation therapy (9FIMRT) planning, and volumetric modulated arc therapy (VMAT) planning for postmastectomy radiotherapy of left-sided breast cancer patients. Material and Methods. Fifteen left-sided breast cancer patients who underwent radical mastectomy were enrolled. In TSP, the planning target volume (PTV) was divided into four regions (supra/infraclavicular, chest wall, external mammary region, and internal mammary region), and each individual PTV region was treated with respective fixed fields. Results. The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p<0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p<0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques. Conclusions. Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.

Identification of Breast Cancer Patients With High Risk of Early Recurrence After Radical Mastectomy. I. Description of Study2

1974 ◽  
Vol 53 (3) ◽  
pp. 603-607 ◽  
Author(s):  
Gilbert H. Friedell ◽  
Ira S. Goldenberg ◽  
Ihor J. Masnyk ◽  
C. A. McMahan ◽  
Robert G. Ravdin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Radical Mastectomy ◽  
Early Recurrence ◽  
Breast Cancer Patients

Carcinoembryonic Antigen (CEA) in the Follow-Up of Disease-Free Breast Cancer Patients

1982 ◽  
Vol 68 (6) ◽  
pp. 477-480 ◽  
Author(s):  
Andrea Veronesi ◽  
Renato Talamini ◽  
Serenella Longhi ◽  
Diana Crivellari ◽  
Enzo Galligioni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoembryonic Antigen ◽  
Cancer Patients ◽  
Relapse Rate ◽  
Patient Population ◽  
Prognostic Value ◽  
Radical Mastectomy ◽  
Breast Cancer Patients ◽  
Disease Free

Carcinoembryonic antigen (CEA) assays (2536) were performed in 380 disease-free breast cancer patients after radical mastectomy. In the 334 evaluable patients with 3 or more determinations, the overall relapse rate after a median follow-up of 29 months was 11 %. Of 203 patients with normal CEA values, 19 (9.3 %) relapsed. In the 50 patients with the highest CEA value greater than 20 ng/ml, the relapse rate was 26 %; in the 12 patients with gradually increasing CEA elevations it was 50 %. However, CEA was unable to predict recurrence in N- patients. Premastectomy N+ was significantly associated with greater than 20 ng/ml or gradually increasing CEA values, suggesting the lack of an independent prognostic value of CEA in our patient population.

scholarly journals A Randomized Prospective Trial of Radical (Halsted) Mastectomy Versus Modified Radical Mastectomy in 311 Breast Cancer Patients

1983 ◽  
Vol 198 (2) ◽  
pp. 207-212 ◽  
Author(s):  
WILLIAM A. MADDOX ◽  
JOHN T. CARPENTER ◽  
HENRY L. LAWS ◽  
S. J. SOONG ◽  
GRETCHEN CLOUD ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Prospective Trial ◽  
Radical Mastectomy ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Randomized Prospective Trial
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