scholarly journals Well-Being, Depression, and Anxiety following Oncoplastic Breast Conserving Surgery versus Modified Radical Mastectomy Followed by Late Breast Reconstruction

2021 ◽  
Vol 18 (17) ◽  
pp. 9320
Author(s):  
Daciana Grujic ◽  
Cătălina Giurgi-Oncu ◽  
Cristina Oprean ◽  
Zorin Crăiniceanu ◽  
Ica Secoșan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Clinical Symptoms ◽  
Clinical Care ◽  
Statistical Significance ◽  
Radical Mastectomy ◽  
Well Being ◽  
Breast Conserving Surgery ◽  
Modified Radical Mastectomy ◽  
Group I

Breast cancer requires complex clinical care. Well-being is an intricate concept, encompassing physical, functional, emotional, and social aspects. Background: This study aims to evaluate the relationship between the type of surgery our patients underwent and the timing of the reconstructive surgery with physical, emotional, social, and functional well-being. Furthermore, through our research we tried to identify potential mental health comorbidities in patients with breast cancer, clinical symptoms, and well-being in women with breast cancer, depending on the type of required surgery. Methods: The study included 69 women diagnosed with breast cancer, in stages I to III, divided in two groups: I—patients with oncoplastic breast-conserving surgery and contralateral correction surgery, for symmetry reasons; II—patients who underwent modified radical mastectomy and late breast reconstruction with contralateral symmetrisation. We evaluated socio-demographic aspects, alongside depression, anxiety, stress (DASS 21), and well-being (FACT-B). Data were statistically processed; statistical significance was set at p < 0.05. Results: Clinical elements of depression, anxiety, and stress were noted in both groups, without statistical significance (p > 0.05). Significant differences were found regarding psycho-emotional (p = 0.035) and functional well-being (p = 0.001), with higher scores for group I. The chi-square test indicated statistically significant differences (at p < 0.01) between the groups, regarding the frequency of scores on items B4 and B9 (FACT-B items, related to feminine aesthetics and desirability), with evidently higher scores in group I than in group II. Conclusions: The state of well-being, as well as the items related to femininity and sexuality had higher values in the group of women treated by oncoplastic conservative surgery compared to late reconstruction after modified radical mastectomy.

scholarly journals Successful Outcomes of Single‐Port Insufflation Endoscopic Breast‐Conserving Surgery for Breast Cancer

2021 ◽  
Author(s):  
Zi-Han Wang ◽  
Shan-Shan Wu ◽  
Tian-Ran Gang ◽  
Guo-Xuan Gao ◽  
Fang Xie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Single Port ◽  
Early Stage ◽  
Statistical Significance ◽  
Well Being ◽  
Breast Conserving Surgery ◽  
Psychological Status ◽  
Minimally Invasive Surgical ◽  
Surgical Methods

Abstract PurposeIn the surgical treatment of breast cancer, the goal of surgeons is to continuously create and improve minimally invasive surgical methods to increase the quality of life of the patient. Currently, routine breast-conserving surgery is performed using two obvious incisions. Here, we compare the clinical efficacy and aesthetic perspectives between a novel technique using one incision called single-port insufflation endoscopic breast-conserving surgery and conventional breast-conserving surgery in early stage breast cancer.MethodsA total of 180 patients with stage I or stage II breast cancer participated in this study. Single-port insufflation endoscopic breast-conserving surgery was performed on 63 patients, while conventional breast-conserving surgery was performed on 117 patients. The evaluation of the aesthetic outcome was carried out by the BREAST-Q scale. Logistic regression was conducted to assess the risk of local recurrence and metastasis.ResultsThere were significant differences between the two groups for chest well-being, psychological well-being, and adverse effects of radiation. The scores for satisfaction of breasts and sexual well-being showed no statistical differences between the two groups. There was no statistical significance in local recurrence or metastasis between the two groups. Single-port insufflation endoscopic breast-conserving surgery did not increase the risk of local recurrence or metastasis.ConclusionThe novel surgical technique, single-port insufflation endoscopic breast-conserving surgery, is a feasible and safe surgery and has advantages in terms of cosmetic outcome and psychological status.

Inflammatory Breast Cancer

2019 ◽  
Author(s):  
Janine M Simons ◽  
Mediget Teshome ◽  
Kelly K Hunt
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Systemic Therapy ◽  
Clinical Symptoms ◽  
Radical Mastectomy ◽  
Multimodality Treatment ◽  
Breast Size ◽  
Modified Radical Mastectomy ◽  
Timely Diagnosis ◽  
Neoadjuvant Systemic Therapy

Inflammatory breast cancer is a rare but highly aggressive form of breast cancer. It is considered a distinct entity with unique clinicopathologic features. Symptoms of erythema and increase in breast size usually develop over the course of a few weeks. The clinical symptoms result from lymphovascular tumor emboli, which are pathognomonic for inflammatory breast cancer. Timely diagnosis may be challenging, as inflammatory breast cancer can mimic infectious disease such as mastitis or breast abscess. However, timely diagnosis and treatment are very important to provide trimodality management as early as possible. Patients should be imaged for distant metastasis at diagnosis. A combination of neoadjuvant systemic therapy, modified radical mastectomy, and adjuvant radiotherapy is standard of care for inflammatory breast cancer and improves local-regional and systemic control. This review contains 7 figures, 3 tables, and 59 references. Key Words: clinical presentation, diagnosis, imaging, inflammatory breast cancer, modified radical mastectomy, multimodality treatment, neoadjuvant systemic therapy, radiation therapy, staging

scholarly journals Awareness and Acceptability of Breast Reconstruction Among Women With Breast Cancer: A Prospective Survey

2021 ◽  
pp. 253-260
Author(s):  
Nita S. Nair ◽  
Prasanth Penumadu ◽  
Prabha Yadav ◽  
Nitin Sethi ◽  
Pavneet S. Kohli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Radical Mastectomy ◽  
Breast Conserving Surgery ◽  
Literacy Rate ◽  
Prospective Survey ◽  
Factors Affecting ◽  
Undergo Breast Reconstruction

PURPOSE Quality of life has become an integral aspect of the management of breast cancer. Many women still need to undergo a modified radical mastectomy (MRM). Factors affecting the choice a woman makes to undergo breast reconstruction (BR) are unclear and are hypothesized to be influenced by socioeconomic factors. We conducted a survey to evaluate the awareness and acceptability of BR among women with breast cancer at our institution. METHODS A novel questionnaire was designed and served to 3 groups of women: planned for MRM, follow up (FU) post-MRM, and FU post breast-conserving surgery. RESULTS Responses were analyzed from 492 women. Of these, 280 (56.91%) were planned for MRM and 212 (43.08%) women were on FU. Almost 45% women were older than 50 years of age, and literacy rate was 87.6%. More than 70% were homemakers and 15 women (3%) were unmarried. The aspects evaluating awareness of BR suggested that 251 (51.01%) women had knowledge about BR. Major source of information was the surgeon (45.81%) and media (32.87%). About 80% women on FU post-MRM did not want reconstruction, and 55% did not opt for BR as they had coped with the mastectomy and did not feel the need for BR. Only 6% cited family or financial reasons and 10% cited recurrence concerns. Among women planned for surgery, 65.71% had not considered BR. When questioned, 25 (12.88%) felt influenced by cost, 102 (52.58%) felt they did not need it, and 20 (10.31%) were worried it would affect treatment. CONCLUSION Our study shows high awareness regarding BR, but only 27.89% women opt for BR independent of economic issues. We recommend all patients should be counseled about the reconstructive options when their MRM is planned.

scholarly journals Deep Learning-Aided Automatic Contouring of Clinical Target Volumes for Radiotherapy in Breast Cancer After Modified Radical Mastectomy

2022 ◽  
Vol 9 ◽  
Author(s):  
Jinqiang You ◽  
Qingxin Wang ◽  
Ruoxi Wang ◽  
Qin An ◽  
Jing Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Data Augmentation ◽  
Radical Mastectomy ◽  
Qualitative Evaluation ◽  
Breast Conserving Surgery ◽  
Target Volume ◽  
Superior Performance ◽  
Dice Similarity Coefficient ◽  
Modified Radical Mastectomy ◽  
Automatic Contouring

Purpose: The aim of this study is to develop a practicable automatic clinical target volume (CTV) delineation method for radiotherapy of breast cancer after modified radical mastectomy.Methods: Unlike breast conserving surgery, the radiotherapy CTV for modified radical mastectomy involves several regions, including CTV in the chest wall (CTVcw), supra- and infra-clavicular region (CTVsc), and internal mammary lymphatic region (CTVim). For accurate and efficient segmentation of the CTVs in radiotherapy of breast cancer after modified radical mastectomy, a multi-scale convolutional neural network with an orientation attention mechanism is proposed to capture the corresponding features in different perception fields. A channel-specific local Dice loss, alongside several data augmentation methods, is also designed specifically to stabilize the model training and improve the generalization performance of the model. The segmentation performance is quantitatively evaluated by statistical metrics and qualitatively evaluated by clinicians in terms of consistency and time efficiency.Results: The proposed method is trained and evaluated on the self-collected dataset, which contains 110 computed tomography scans from patients with breast cancer who underwent modified mastectomy. The experimental results show that the proposed segmentation method achieved superior performance in terms of Dice similarity coefficient (DSC), Hausdorff distance (HD) and Average symmetric surface distance (ASSD) compared with baseline approaches.Conclusion: Both quantitative and qualitative evaluation results demonstrated that the specifically designed method is practical and effective in automatic contouring of CTVs for radiotherapy of breast cancer after modified radical mastectomy. Clinicians can significantly save time on manual delineation while obtaining contouring results with high consistency by employing this method.

scholarly journals Breast reconstruction following amputation for cancer

2009 ◽  
Vol 66 (6) ◽  
pp. 427-433
Author(s):  
Milan Visnjic ◽  
Predrag Kovacevic ◽  
Ljiljana Paunkovic ◽  
Goran Djordjevic ◽  
Dragana Budjevac ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Radical Mastectomy ◽  
Late Complications ◽  
Tram Flap ◽  
Primary Reconstruction ◽  
Modified Radical Mastectomy ◽  
Reconstruction Methods ◽  
Acceptable Method ◽  
Flap Elevation

Background/Aim. Today, breast reconstruction is a widely accepted method in the treatment of breast cancer after modified radical mastectomy. Reconstruction methods are associated with an acceptable number of complications and reconstruction favorably impacts quality of life. The aim of the study was to present our experience in breast reconstruction. Methods. We presented here a four-year experience with 84 patients with breast reconstruction after modified radical mastectomy. Results. Implant reconstructions were most common, 44 (52.3%), with primary reconstruction in 31(70.4%) and secondary in 13 (29.5%) women. Lattisimus dorsi flap (LDF) and implant were utilized in 32 (38%) of the patients, with primary reconstruction in 24 (75%) and secondary in 8 (25%) women. Transversal rectus abdominis myocutaneous (TRAM) flap was rarely used - just in 8 (9.5%) patients and only for secondary breast reconstruction. Postoperatively, some early complications such as hematoma, seroma, infections and partial flap necrosis were observed in 10 (11.9%) patients. Late complications, such as implant rejection, hypertrophic scarring and hernias at the flap elevation site, were noted in 10 (11.9%) cases. Implant loss occurred in 5 (5.9%) cases. All the complications were successfully managed, and patients rated their reconstruction as follows: excellent, 49 (59%) cases; very good, 20 (24%), and good, 14 (16.8%). In one case, disease progression was observed 6 months after the primary breast reconstruction. Conclusion. Breast reconstruction is an acceptable method in the treatment of breast cancer in patients in the need for or with already performed mastectomy. The choice of reconstruction approach depends on the breast volume, patient's wish and experience of surgical team. Our results suggest the advantage of breast reconstruction with LDF with implant, since the technique is safe, complications relatively rare and easily manageable, and the results are excellent or very good in each woman.

Childhood And Adolescent Period Breast Cancer

2021 ◽  
Author(s):  
Aysel Gül ◽  
Dilek Aygın
Keyword(s):  
Breast Cancer ◽  
Children And Adolescents ◽  
Treatment Process ◽  
Radical Mastectomy ◽  
Breast Conserving Surgery ◽  
Mortality Rates ◽  
Breast Cancers ◽  
Modified Radical Mastectomy ◽  
Secretory Carcinoma ◽  
Adolescent Period

Objective: Breast cancer is a global public health problem which draws attention with the gradual increase in morbidity and mortality rates. Unlike adults, breast cancers in children and adolescents are rarely seen. Since the risk factors are not well defined, cancer findings are mixed with other disease findings and follow-up/treatment processes differ. As a result, childhood/adolescent breast cancers are ignored. It is stated that the prognosis of childhood and adolescent breast cancers is not good, although they are seen in a limited number of patients, the mortality rate is high and it significantly affects the life of the patient and his/her family. The main aim of this compilation is to examine the literature on the pediatric and adolescent breast cancers and the treatment process. Its secondary purpose is to increase the awareness of health professionals and the society and help to create a guideline in this regard to pediatric surgeons, and nurses. Methods: We identified 24 case reports comprising the data of 24 cases of childhood or adolescent breast cancers that were reported between 2000 and 2018. Results: Twenty-four cases (10 males, 14 females) published about breast cancer in children and adolescents were reached. Pathologies of the patients with a mean age of 12.19±4.13 have been reported as secretory carcinoma (70.8%), infiltrative secretory carcinoma (8.3%), malignant phyllodes tumor (8.3%), pleomorphic carcinoma (4.2%), invasive ductal carcinoma (4.2%), secretory adenocarcinoma (4.2%). Modified radical mastectomy was performed in 26.31% of patients with secretory carcinoma, mastectomy in 52.63%, breast-conserving surgery in 10.53%, and wide local excision in 10.53%. While 33.3% of the patients received adjuvant chemotherapy, 29.2% were given radiotherapy. Two patients had recurrence after surgery (3-17 months; median: 10 months). Three patients died due to postoperative metastases. Conclusion: Breast malignancies are relatively rare in the pediatric and adolescent period. However, mortality rates are quite significant contrary to what’s believed. In these patients, difficulties in diagnosing the disease may affect the treatment process negatively. While there isn’t a consensus about the treatment of the disease, the authors reported a wide range of treatments with different combinations of radiotherapy, chemotherapy, breast-conserving surgery, modified radical mastectomy and radical mastectomy.

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