scholarly journals Comparison of electrocautery and plasmablade on ischemia and seroma formation after modified radical mastectomy for locally advanced breast cancer

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Husnu Alptekin ◽  
Huseyin Yılmaz ◽  
Bahadir Ozturk ◽  
Ilhan Ece ◽  
Mehmet Ertugrul Kafali ◽  
...  
Keyword(s):  
Locally Advanced Breast Cancer ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Modified Radical Mastectomy ◽  
Drainage Volume ◽  
Drain Removal ◽  
Postoperative Drainage ◽  
The Mean

The aim of this study was to compare postoperative drainage volumes and IMA levels in patients who underwent modified radical mastectomy (MRM) with using PlasmaBlade (PB) or electrocautery (EC). A total of 36 patients who underwent MRM with PB or EC in our clinic between August 2012 to February 2013 were enrolled. Number of removed and positive lymph nodes, duration of drainage and total drainage volume was recorded. Seroma formation after drain removal and number of aspirations were also recorded. Serum ischemia modified albümine (IMA) levels were analysed before surgery, 1 hour and 24 hour after surgery. In total, 36 patients were treated with MRM in the study period. Of the 36 patients, 16 underwent MRM with PB, and 20 underwent MRM with EC. The patients demographics were similar in both groups. The mean drainage volume and seroma formation were significantly higher in the PB group when compared with EC group (P<0.05). Number of aspirations due to the seroma were also high in PB group. The total aspiration volume of seroma was not different in both groups. IMA levels 24 hours after surgery in the PB group was significantly higher than EC group. There was no statistical significance between the groups for IMA levels at 1st hour. PB is a monopolar energy device and is associated with increased levels of ischemia. This situation resulted with an increased volume of total axillary drainage and elevated risk of seroma formation.

scholarly journals Effectiveness of Cyanoacrylate in Reducing Seroma Formation in Breast Cancer Patients Post-Axillary Dissection: A Randomized Controlled Trial

2021 ◽  
Vol 10 ◽  
Author(s):  
Mahmoud Al-Masri ◽  
Fade Alawneh ◽  
Faiez Daoud ◽  
Ali Ebous ◽  
Basem Hamdan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Axillary Dissection ◽  
Radical Mastectomy ◽  
Cost Effective ◽  
Seroma Formation ◽  
Modified Radical Mastectomy ◽  
Node Positive ◽  
Drain Removal ◽  
Positive Breast Cancer

Background/PurposeSeroma is a common complication after axillary dissection in women with node-positive breast cancer. We aim to determine the effect of Cyanoacrylate on reducing seroma formation in patients undergoing axillary dissection. This a randomized clinical trial.MethodsThis is a single-center, randomized, single-blinded, and two-arm parallel study. Women with node-positive breast cancer eligible for axillary dissection were enrolled. Patients with a Body Mass Index (BMI) greater than 35 kg/m2, those who underwent immediate breast reconstruction, and/or received neoadjuvant chemotherapy were excluded. Patients were randomized in a 1:1 ratio, and were stratified according to their age, BMI, tumor size, and operation type. The primary endpoint was the total seroma volume (the total drained volume and the total aspirated volume after drain removal). Data presented as mean and range when applicable.Results111 patients were randomized (Cyanoacrylate 57; control 54). 105 patients were analyzed. Sixty-nine patients underwent breast conserving surgery, and 36 underwent modified radical mastectomy. There was no difference in the total seroma volume between the Cyanoacrylate vs. control arms (1,304 (60–4,950) vs. 1,446 (100–5,223) ml, p=0.458). Wound infection, flap necrosis, number of manual aspirates, and hematoma formation were not statistically different between the two groups. Time to drain removal was shorter in the Cyanoacrylate arm (11.04(3–23) vs. 13.84(3–37) days, p=0.015). The use of Cyanoacrylate was not cost effective ($586.93 (550–748) vs. $29.63 (0–198), p&lt;0.001). Higher seroma volume was correlated with modified radical mastectomy, older age, and BMI more than 30 kg/m2.ConclusionCyanoacrylate did not reduce seroma formation and its use was not cost effective.Clinical Trial Registrationclinicaltrials.gov, identifier NCT02141373.

Preoperative Twice-Weekly Paclitaxel With Concurrent Radiation Therapy Followed by Surgery and Postoperative Doxorubicin-Based Chemotherapy in Locally Advanced Breast Cancer: A Phase I/II Trial

2003 ◽  
Vol 21 (5) ◽  
pp. 864-870 ◽  
Author(s):  
Silvia C. Formenti ◽  
Matthew Volm ◽  
Kristin A. Skinner ◽  
Darcy Spicer ◽  
Deidre Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Primary Treatment ◽  
Advanced Breast ◽  
Weekly Paclitaxel ◽  
Modified Radical Mastectomy ◽  
Grade 3

Purpose: Preoperative chemotherapy is the conventional primary treatment in locally advanced breast cancer (LABC). We investigated the safety and efficacy of primary twice-weekly paclitaxel and concurrent radiation (RT) before modified radical mastectomy followed by adjuvant doxorubicin-based chemotherapy. Patients and Methods: Stage IIB (T3N0) to III LABC patients were eligible. Primary chemoradiation consisted of paclitaxel, 30 mg/m2 delivered intravenously for 1 hour twice weekly for a total of 8 to 10 weeks, and concurrent RT (45 Gy at 1.8 Gy/fraction). Modified radical mastectomy was performed at least 2 weeks after completion of chemoradiation or on recovery of skin toxicity. Postoperatively, patients who responded to paclitaxel and RT received four cycles of doxorubicin/paclitaxel, whereas patients who did not respond received doxorubicin/cytoxan. Results: Forty-four patients were accrued. Toxicity from paclitaxel/RT included grade 3 skin desquamation (7%), hypersensitivity (2%), and stomatitis (2%). Postsurgery complications occurred in six patients (14%). The only grade 4 toxicity of postmastectomy chemotherapy was hematologic (10%). Grade 3 toxicities were leukopenia (24%), infection (22%), peripheral neuropathy (17%), arthralgia and pain (17%), stomatitis (12%), fatigue (10%), esophagitis (5%), and nausea (2%). Overall clinical response rate to preoperative paclitaxel and RT was 91%. Thirty-four percent of patients achieved a pathologic response in the mastectomy specimen: 16% pathologic complete responses (clearance of invasive cancer in the breast and axillary contents) and 18% pathologic partial responses (< 10 residual microscopic foci of invasive breast cancer). Conclusion: Twice-weekly paclitaxel with concurrent RT is a feasible and effective primary treatment for LABC. Future studies should compare primary chemoradiation to chemotherapy in LABC.

scholarly journals The Survival of Locally Advanced Breast Cancer Patients with Luminal Subtype after Modified Radical Mastectomy

2021 ◽  
Vol 8 (11) ◽  
pp. 191-197
Author(s):  
Jefri Adi Kam Sitepu ◽  
Marjono Dwi Wibowo ◽  
Iskandar Ali
Keyword(s):  
Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Breast Cancer Subtype ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Luminal A ◽  
Luminal Subtype ◽  
Luminal B ◽  
Cancer Subtype

Background: Breast cancer is the leading cause of cancer death in women worldwide. Breast cancer has been classified into several molecular subgroups with different prognostic consequences based on immunohistochemistry and molecular pathology. The prognosis that commonly used is 5-years survival. In this study we aimed to examine the relationship between luminal subtype and 5-year survival rate in patients with early post-mastectomy breast cancer. Methods: We recruited early breast cancer patient who underwent modified radical mastectomy (MRM) in Dr. Soetomo General Hospital (Surabaya, Indonesia) between 2010 – 2014. Breast cancer tissues were collected during surgery for immunohistochemistry. The patients’ 5-years survival data was obtained from medical records and by phone call to the patients or to the close relatives of the patients. Breast cancer subtype was determined based on the result of immunohistochemistry Results: A total of 84 patients was included in this study. The majority of patients were aged >40 years (72/84; 85.7%). There were 39 patients (39/84; 46.4%) with luminal A subtype and 45 patients (45/84; 53.6%) with luminal B subtype. Seventy-four patients were diagnosed as invasive ductal carcinoma histologically. Almost all of the patients were able to survive within 5 years (81/84; 96.4%). We found that luminal B had a 1.071 times higher risk of dying within 5 years after therapy than luminal type A, although the analysis did not show significant results (P = 0.101). Conclusion: Luminal B was the most prevalent breast cancer subtype in Surabaya, Indonesia. The prevalence of breast cancer was higher in patients aged >40 years. There was no significant difference between the 5-years survival of luminal A and luminal B subtypes. Keywords: survival, locally advanced breast cancer, luminal subtype, mastectomy.

Harmonic scalpel versus traditional ligation in axillary dissection for breast cancer: a retrospective multivariate analysis

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Breast Cancer ◽  
Axillary Dissection ◽  
Harmonic Scalpel ◽  
Breast Conserving Surgery ◽  
Seroma Formation ◽  
Nodal Involvement ◽  
Single Centre ◽  
Absorbable Material ◽  
Drain Removal ◽  
The Mean

Introduction: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. Methods: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. Results: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). Conclusion: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.ut any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

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