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.

Correlation Between Toxicity and Dosimetric Parameters in Patients Treated with Adjuvant Intensity-Modulated Radiation Therapy for Breast Cancer: The Results of a Prospective Study.

2020 ◽  
Author(s):  
David Pasquier ◽  
Benoit Bataille ◽  
Florence Le Tinier ◽  
Raoudha Bennadji ◽  
Hélène Langin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Late Onset ◽  
Univariate Analysis ◽  
Intensity Modulated Radiation Therapy ◽  
Conservative Surgery ◽  
High Dose ◽  
Total Mastectomy ◽  
Intensity Modulated ◽  
A Prospective Study

Abstract Background. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Methods. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over five weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. Results. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. Most AEs were mild. The most common AEs were skin-related - mainly radiodermatitis (in 266 patients (92.4%)) and hyperpigmentation (in 178 (61.8%)). Smoking (odds ratio) [95%CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. Conclusions. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149

Management of Breast Cancer During Pregnancy Using a Standardized Protocol

1999 ◽  
Vol 17 (3) ◽  
pp. 855-855 ◽  
Author(s):  
David L. Berry ◽  
Richard L. Theriault ◽  
Frankie A. Holmes ◽  
Valerie M. Parisi ◽  
Daniel J. Booser ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Combination Chemotherapy ◽  
Radical Mastectomy ◽  
First Trimester ◽  
Therapeutic Interventions ◽  
Outpatient Chemotherapy ◽  
Gestational Age At Delivery ◽  
Segmental Mastectomy ◽  
First Trimester Of Pregnancy

PURPOSE: No standardized therapeutic interventions have been reported for patients diagnosed with breast cancer during pregnancy. Of the potential interventions, none have been prospectively evaluated for treatment efficacy in the mother or safety for the fetus. We present our experience with the use of combination chemotherapy for breast cancer during pregnancy. PATIENTS AND METHODS: During the past 8 years, 24 pregnant patients with primary or recurrent cancer of the breast were managed by outpatient chemotherapy, surgery, or surgery plus radiation therapy, as clinically indicated. The chemotherapy included fluorouracil (1,000 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2), administered every 3 to 4 weeks after the first trimester of pregnancy. Care was provided by medical oncologists, breast surgeons, and perinatal obstetricians. RESULTS: Modified radical mastectomy was performed in 18 of the 22 patients, and two patients were treated with segmental mastectomy with postpartum radiation therapy. This group included patients in all trimesters of pregnancy. The patients received a median of four cycles of combination chemotherapy during pregnancy. No antepartum complications temporally attributable to systemic therapy were noted. The mean gestational age at delivery was 38 weeks. Apgar scores, birthweights, and immediate postpartum health were reported to be normal for all of the children. CONCLUSION: Breast cancer can be treated with chemotherapy during the second and third trimesters of pregnancy with minimal complications of labor and delivery.

Acanthosis nigricans in patient with breast cancer and hepatocellular carcinoma: case report and review of the literature

2016 ◽  
Vol 19 (4) ◽  
pp. 196-199
Author(s):  
Erik K. Saribekyan ◽  
A. G Zubovskaya
Keyword(s):  
Breast Cancer ◽  
Hepatocellular Carcinoma ◽  
Ovarian Cancer ◽  
Bladder Cancer ◽  
Radiation Therapy ◽  
Clinical Case ◽  
Acanthosis Nigricans ◽  
Review Of The Literature ◽  
Skin Hyperpigmentation ◽  
Underlying Malignancy

Acanthosis nigricans (AN) is characterized by hyperpigmented, thickened skin plaques with a velvety texture. The histology of these lesions shows hyperkeratosis and dermal papillomatosis. According to the clinical data the key role in the development of acanthosis nigricans belongs to an excessive concentration of growth factors. Such condition is ofparticular interest because of its association with internal malignancies. Its malignant form is often associated with gastric adenocarcinoma (55-61%), though coexistence with a variety of other malignancies (ovarian cancer, endometrial carcinoma, bladder cancer, etc.) has been reported. Clinical case of patient with AN and coexisting breast cancer and hepatocellular carcinoma is presented. The severity of skin manifestations improved after chemotherapy, mastectomy and radiation therapy. However, skin hyperpigmentation relapsed after development of the hepatocellular carcinoma and the progression of the primary tumor. An underlying malignancy should be suspected in each case of AN.

scholarly journals The Impact of Locoregional Therapy in Nonmetastatic Inflammatory Breast Cancer: A Population-Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mahvish Muzaffar ◽  
Helen M. Johnson ◽  
Nasreen A. Vohra ◽  
Darla Liles ◽  
Jan H. Wong
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Inflammatory Breast Cancer ◽  
Proportional Hazards Model ◽  
Treatment Algorithm ◽  
Cox Proportional Hazards Model ◽  
Partial Mastectomy ◽  
Locoregional Therapy ◽  
Total Mastectomy ◽  
The Impact

Background.Inflammatory breast cancer (IBC) is a rare but most aggressive breast cancer subtype. The impact of locoregional therapy on survival in IBC is controversial.Methods.Patients with nonmetastatic IBC between 1988 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER) registry.Results.We identified 7,304 female patients with nonmetastatic inflammatory breast cancer (IBC) who underwent primary tumor surgery. Most patients underwent total mastectomy with only 409 (5.6%) undergoing a partial mastectomy. In addition, 4,559 (62.4%) were also treated with radiation therapy. The patients who underwent mastectomy had better survival compared to partial mastectomy (49% versus 43%,p= 0.003). The addition of radiation therapy was also associated with improved 5-year survival (55% versus 40%,p< 0.001). Multivariate analysis showed that black race HR (1.22, 95% CI 1.18–1.35), ER negative status (HR 1.22, 95% CI 1.16–1.28), and higher grade (HR 1.14, 95% CI 1.07–1.20) were associated with poor outcome. Cox proportional hazards model showed that total mastectomy (HR 0.75, 95% CI 0.65–0.85) and radiation (HR 0.64, 95% CI 0.61–0.69) were associated with improved survival.Conclusions. Optimal locoregional therapy for women with nonmetastatic IBC continues to be mastectomy and radiation therapy. These data reinforce the prevailing treatment algorithm for nonmetastatic IBC.

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.

Mastectomy versus Lumpectomy for Invasive Breast Cancer

2017 ◽  
Author(s):  
Michael E. Hochman
Keyword(s):  
Breast Cancer ◽  
Study Design ◽  
Invasive Breast Cancer ◽  
Clinical Case ◽  
Breast Conserving Therapy ◽  
Total Mastectomy ◽  
Design Study ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of the landmark study known as the B-06 trial, which compared total mastectomy versus breast-conserving therapy (i.e., lumpectomy) for treating women with invasive breast cancer. Do all women with invasive breast cancer require a total mastectomy, or is breast conserving therapy (i.e., lumpectomy) appropriate in some women? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving total mastectomy versus lumpectomy.

scholarly journals The use of xenopericardium in reconstructive surgery in patients with breast cancer

2021 ◽  
Vol 67 (3) ◽  
pp. 374-381
Author(s):  
Dzerassa Ortabaeva ◽  
Aziz Zikiryakhodzhayev ◽  
Elena Rasskazova ◽  
Erik Saribekyan ◽  
Shakhnoz Khakimova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Breast Reconstruction ◽  
Reconstructive Surgery ◽  
Clinical Case ◽  
Subcutaneous Mastectomy ◽  
Good Cosmetic Result ◽  
Simultaneous Reconstruction ◽  
Good Cosmetic ◽  
Lower Slope

Objective: to analyze the possibility of using xenopericardium for breast reconstruction in cancer Materials and methods: the article presents a clinical case of a patient diagnosed with breast cancer who underwent a subcutaneous mastectomy with simultaneous reconstruction with an endoprosthesis and a xenopericardium to strengthen the lower slope of the breast. Results: in our study, a good cosmetic result was obtained, and the presence of xenopericardium does not affect the conduct of postoperative courses of chemotherapy and radiation therapy. Conclusion: we present the first experience of using bovine pericardium in Russia for breast reconstruction in patients with breast cancer. Xenopericardium BioLAB-PP/PA of domestic origin was used to strengthen the lower slope of the reconstructed MJ using a silicone implant.

Perioperative sleep disturbance following mastectomy: A longitudinal investigation of the relationship to pain, opioid use, treatment, and psychosocial symptoms.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 192-192
Author(s):  
Desiree Rachel Azizoddin ◽  
Mieke A. Soens ◽  
Meghan Beck ◽  
Kelsey Mikayla Flowers ◽  
Robert R. Edwards ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Affect ◽  
Sleep Disturbance ◽  
Psychosocial Factors ◽  
First Year ◽  
Total Mastectomy ◽  
Opioid Use ◽  
Surgical Pain ◽  
Prospective Longitudinal ◽  
The Relationship

192 Background: Sleep disturbance negatively impacts quality of life and recovery. Our objective was to evaluate the relationship between individual patient factors (demographic, surgical, pain, opioid use, and psychosocial factors) and greater sleep disturbance. Methods: In this prospective longitudinal study, patients completed validated measures regarding their sleep disturbance, pain, opioid use, and psychological symptoms preoperatively and then 2 weeks, 6 and 12 months postoperatively. Objective pain sensitivity measures were evaluated at baseline using quantitative sensory testing. Univariable and multivariable generalized estimating equations (GEE) evaluated demographic, surgical, pain, and psychological predictors of sleep disturbance during the first year after surgery for breast cancer. Results: Female patients (n = 259) reported varying degrees of sleep disturbance, which were longitudinally associated with pain, psychosocial factors such as anxiety, depression, and affect. While the mean degree of sleep disturbance did not change substantially over time, the link to pain severity appeared to strengthen over the first postoperative year. Independent preoperative predictors of worse sleep disturbance on multivariable longitudinal GEE included younger age (B = -.09, p =.006), opioid use (B = 3.09, p =.02), higher pain (B =.19, p = <.001) and anxiety (B =.45, p = <.001) at baseline. On the other hand, higher basline positive affect (B = -.14, p = <.012) and the surgical category total mastectomy without reconstruction (B = -2.81, p = <.006) were indepently associated with lower sleep disturbance. Those with worse baseline sleep required more opioid analgesics during surgical recovery, and continued use of opioids at 2 weeks post-surgery was associated with disturbed sleep. Conclusions: Sleep disturbance in the first year following surgery for breast cancer varied substantially between individuals. Certain demographic, psychosocial, and pain factors explained more of this variance than surgical procedure, with the exception of total mastectomy without reconstruction that was associated with lower sleep disturbance. Sleep disturbance was associated with increased need for opioids in the perioperative period, and a propensity for more prolonged postoperative opioid use. Pre-surgical interventions in high risk individuals such as anxiety management, boosting positive affect, and controlling pain that have been shown to improve sleep quality could enhance postoperative recovery and decrease opioid use following breast surgery.

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