scholarly journals Magnetic Seed (Magseed) Localisation in Breast Cancer Surgery: A Multicentre Clinical Trial

Breast Care ◽  
2020 ◽  
pp. 1-6
Author(s):  
Jan Žatecký ◽  
Otakar Kubala ◽  
Oldřich Coufal ◽  
Markéta Kepičová ◽  
Adéla Faridová ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Surgical Oncology ◽  
Breast Tumour ◽  
Axillary Node ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Magnetic Marker ◽  
Magnetic Seeds

<b><i>Introduction:</i></b> The aim of this study was to evaluate the accuracy and reliability of the Magseed magnetic marker in breast cancer surgery. <b><i>Methods:</i></b> Thirty-nine patients with 41 implanted Magseeds undergoing surgical treatment in 3 surgical oncology departments were included in the retrospective trial to study pilot use of the Magseed magnetic marker in the Czech Republic for localisation of breast tumours or pathological axillary nodes in breast cancer patients. <b><i>Results:</i></b> Thirty-four breast cancer and 7 pathological lymph node localisations were performed by Magseed implantation. No placement failures, or perioperative detection failures of Magseeds were observed (0/41, 0.0%), but one case of Magseed migration was present (1/41, 2.4%). All magnetic seeds were successfully retrieved (41/41, 100.0%). Negative margins were achieved in 29 of 34 (85.3%) breast tumour localisations by Magseed. <b><i>Conclusion:</i></b> Magseed is a reliable marker for breast tumour and pathological axillary node localisation in breast cancer patients. Magseed is comparable to conventional localisation methods in terms of oncosurgical radicality and safety.

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.

Genetic variability of tramadol pharmacokinetic genes and pain treatment outcome after breast cancer surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23133-e23133
Author(s):  
Nikola Besic ◽  
Katja Goricar ◽  
Jakob Jeriha ◽  
Vita Dolzan ◽  
Branka Strazisar
Keyword(s):  
Breast Cancer ◽  
Genetic Variability ◽  
Cancer Patients ◽  
Pain Treatment ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection ◽  
One Year

e23133 Background: Tramadol is a treatment of choice for pain management after axillary lymph node dissection in breast cancer patients. Tramadol is metabolized via CYP2D6 and UGT2B7, while ABCB1, ABCC2 and SLC22A1 are involved in transport of tramadol metabolites. Genetic variability of metabolizing enzymes or drug transporters may therefore affect efficacy and adverse effects of tramadol. The aim of this study was to evaluate the association of genetic variability in tramadol pharmacokinetics pathway on long-term outcome of tramadol pain treatment after breast cancer surgery. Methods: The study included 102 breast cancer patients treated with either 75 or 37.5 mg of tramadol for pain relief after breast cancer surgery including axillary lymph node dissection as part of a randomized clinical trial KCT 04/2015-DORETAonko/si at Institute of Oncology Ljubljana. All patients were genotyped for 14 polymorphisms in ABCB1, ABCC2, CYP2D6, SLC22A1 and UGT2B7 genes, as well as for CYP2D6 duplication and deletion. CYP2D6 phenotype was predicted from the genotype data and patients were categorized as poor (PM), intermediate, extensive or ultrarapid metabolizers. The association of genetic factors with pain one year after treatment was evaluated using logistic regression and Mann-Whitney test. Results: One year after treatment, 21 (20.8%) patients were still experiencing chronic and 25 (24.8%) neuropathic pain. CYP2D6 PMs were significantly more likely to experience chronic and neuropathic pain after tramadol treatment (OR = 5.96, 95% CI = 1.22-29.13, p = 0.027 and OR = 9.31, 95% CI = 1.65-50.59, p = 0.011, respectively), even after adjustment for tramadol dose (p = 0.032 and p = 0.016, respectively). PMs also had higher average pain intensity compared to others regardless of tramadol dose (p = 0.042). In patients receiving lower tramadol dose, ABCB1 rs1128503, rs2032582 and rs1045642 were associated with more chronic pain in the dominant model (p = 0.004, p = 0.004 and p = 0.047, respectively). Conclusions: Genetic variability in tramadol pharmacokinetics pathway may be associated with pain treatment outcome in breast cancer patients, therefore pharmacogenetic testing could enable more effective tramadol treatment. Clinical trial information: EudraCT 2015-000992-28.

scholarly journals Surgical Site Infections in Breast Cancer Patients Undergoing Surgery During the Covid-19 Pandemic. Preliminary Data from an Italian Oncologic Hub.

2021 ◽  
Author(s):  
Sonia Cappelli ◽  
Fabio Pelle ◽  
Marco Clementi ◽  
Maddalena Barba ◽  
Patrizia Vici ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Median Time ◽  
Breast Surgery ◽  
Surgical Site Infections ◽  
Final Analysis ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Intrinsic Nature

Abstract Background: Over the Covid-19 pandemic, the compelling need of containing the virus spread while providing diseased people with adequate assistance has inevitably reflected on treatment priorities, which have been sometimes radically revised according to the intrinsic nature of the institution considered and its role and action within the pandemic context. We report on the experience matured at the Regina Elena National Cancer Institute concerning the effects of the restriction measures adopted during the pandemic on the outcomes of surgical site infections (SSIs) in breast cancer patients (BC-pts) undergoing non-deferrable breast cancer surgery. Methods: Within the frame of an observational study, we compared evidence from two cohorts, namely, the lockdown cohort (LDC) and non-lockdown cohort (NLDC). Patients from the LDC underwent breast cancer surgery between the 15th March 2020 and the 4th May 2020. Breast surgery was performed by the same team and postsurgical controls were performed regularly for a minimum of 12-months. SSIs were defined according to the criteria established by the Center for Disease Control and Prevention. Results: The LDC originally included 79 breast cancer patients, of whom 62 provided data to the final analysis. In the LDC, initially 64 breast cancer patients, only 52 were finally considered. No relevant differences emerged between LDC and NLDC by general characteristics. We observed significant evidence of lower SSIs in the subgroups of patients having undergone skin reducing mastectomy compared with the remaining subgroups (p=0.003). The overall number of surgical site infections was 10 (8.7%), and the median time to their occurrence17.1 days (7- 42). In the NLDC, 7 (13.5) SSIs were identified, with a median time to occurrence of 18.2 days (7-42). In the LDC, 3 (4.8%) SSIs occurred, with a median time to occurrence of 14.3 days (7 to 21). None of these patients was in need of re-hospitalization and there were no delays in adjuvant treatment starting. Conclusions: The restrictive measures issued during the lockdown period seemed to lower the SSI rates in breast cancer patients undergoing non-deferrable breast surgery, although, caution is needed due to the limited sample size.

scholarly journals Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
B. Shunnmugam ◽  
S. Sinnadurai ◽  
S.H. Chua ◽  
T. Islam ◽  
M.H. See ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Intraclass Correlation ◽  
Well Being ◽  
Cancer Surgery ◽  
Psychometric Validation ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Patient Reported ◽  
The Impact

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

scholarly journals Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach (Preprint)

2018 ◽  
Author(s):  
Yu-Ting Hung ◽  
Ching-Fang Wu ◽  
Te-Hsin Liang ◽  
Shin-Shang Chou ◽  
Guan-Liang Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Action Research ◽  
Cancer Patients ◽  
Medical Information ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Research Approach ◽  
Breast Cancer Patients ◽  
Action Research Approach

BACKGROUND Patients with early-stage breast cancer have numerous options when choosing the type of breast surgery method to be applied. Each of these options lead to a similar long-term survival rate, but result in significant differences in appearance, function, cost, recurrence rate, and various other relevant considerations. However, the time available for detailed communication with each patient is often limited in clinics, which puts these women under great psychological stress and can hinder their surgery-related decision making. OBJECTIVE The objective of this study was to develop a multipurpose surgery decision-making website providing medical information, psychological support, and decision-related simulation for women during breast cancer surgery-related decision making. METHODS Using the 4 steps of action research, which involve multigroup teamwork via regular team meetings, the following were performed: (1) Planning: searching, analyzing, and evaluating health websites to consensually decide the major infrastructure; (2) Action: work was performed simultaneously in 4 groups, which consisted of medical information collection and editing, patient interviews and data extraction, webpage content design, and programming to create or host the website; (3) Evaluation: the website was tested by clinical experts and focus groups of former breast cancer patients to assess its effectiveness and pinpoint appropriate improvements; and (4) Reflection: constant dialogue was conducted between the various participants at each step, which was used as the foundation and motivation of next plan-action-evaluation-reflection circle. RESULTS Using the action research approach, we completed the development of our website, which includes the following: (1) “Woman’s Voice”—an animated comic depicting the story of a female breast cancer patient with interspersed questions for the users that will help them better empathize with the experience; (2) “Cancer Information Treasure House”—providing breast cancer surgery-related information through text, tables, pictures and a presentation video; (3) “Decision-making Simulator”—helping patients think through and check the pros and cons of the different surgical options via visual-based interactions including “Stairs Climbing” and “Fruit of Hope”; and (4) “Recommended Links”—providing reliable websites for further reference. Additionally, we have further improved the website based on the feedback received from postsurgery breast cancer patients and clinicians. We hope to continue improving to better meet both the patients’ and health providers’ needs and become a practical decision-making aid for patients undergoing breast cancer surgery. CONCLUSIONS We have created the first breast cancer surgery decision-making assistance tool in Taiwan using a “Web-based” and multifunctional website design. This site aims to provide health care knowledge, psychological healing, and emotional support functions, as well as decision-making capability enhancement simulations. We look forward to assisting breast cancer patients in their decision-making process and expect our website to increase patient’s autonomy and improve their communication with clinicians.

scholarly journals Ultrasonographic evaluation of chronic shoulder pain after breast cancer surgery: single center, cross-sectional study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jung Hun Kim ◽  
Se Hee Kim ◽  
Hae-Rim Kim ◽  
Sang-Heon Lee ◽  
So Young Yoon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Shoulder Pain ◽  
Adhesive Capsulitis ◽  
Contralateral Side ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Adjacent Structures ◽  
Chronic Shoulder Pain

Abstract Chronic shoulder pain is a common complication in breast cancer patients after surgery. Chronic shoulder pain after breast cancer surgery was formerly considered as neuropathic pain, however the pathophysiology including structural damages has not been assessed comprehensively. We hypothesized that the structural change could be one of the cause of shoulder pain after breast cancer surgery and evaluated various ultrasonography findings of the shoulder in breast cancer patients with chronic shoulder pain. Patients who were suffering from chronic shoulder pain on unilateral side for at least 3 months after breast cancer surgery were enrolled from a single tertiary hospital. Demographic and clinical data were collected at the baseline. Articular and adjacent structures of both shoulders (painful and contralateral side) were evaluated by ultrasonography. The ultrasonography findings were compared between painful and contralateral sides. Logistic regression analysis was performed to determine the factors associated with abnormal ultrasonography findings. Fifty-two female patients (average age of 55) were enrolled. Significantly more abnormal ultrasonography findings were observed in the painful side than in the contralateral side [39 (75.0%) vs 11 (21.2%), P < 0.001]. The coracohumeral ligament was significantly thicker in the painful side than in the contralateral side (2.48 ± 0.69 vs 1.54 ± 1.25 mm, P < 0.001); adhesive capsulitis was also more frequent in the painful side [14 (26.9%) vs 0, P < 0.001]. Furthermore, patients with a history of breast cancer surgery on the ipsilateral side were associated with abnormal ultrasonography findings and adhesive capsulitis. This study is the first to evaluate ultrasonography in patients with chronic shoulder pain after breast cancer surgery. The results showed that ultrasonography could reveal several structural problems in these patients.

scholarly journals Usefulness of postoperative serum translocator protein as a predictive marker for delirium after breast cancer surgery in elderly women

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091004
Author(s):  
Guo-Wen Lu ◽  
Yi-Er Chou ◽  
Wan-Ling Jin ◽  
Xiao-Bao Su
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Elderly Women ◽  
Cancer Surgery ◽  
Translocator Protein ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Serum Samples ◽  
Inflammatory Biomarker ◽  
Postoperative Serum

Objective Postoperative delirium (POD) has rarely been investigated in breast cancer patients. Herein, we assessed the association between serum levels of the inflammatory biomarker translocator protein (TP) and the occurrence of POD in breast cancer patients. Methods In this prospective, observational study, TP levels were detected in preoperative and postoperative serum samples from 152 elderly breast cancer patients, samples from 152 healthy elderly women, and samples from 152 elderly women with benign breast diseases. The relationship between serum TP levels and POD was investigated using multivariate analysis. Results TP levels in postoperative patient serum samples were significantly higher than in preoperative patient serum samples and serum from women in the two control groups. Postoperative serum TP levels were independently correlated with serum C-reactive protein levels and the occurrence of POD. Postoperative serum TP levels had a high discriminatory ability for POD under the receiver operating characteristic curve. Conclusions Increased postoperative serum TP levels are independently associated with the degree of inflammatory response and the risk of POD in elderly breast cancer patients, substantializing TP as an inflammatory biomarker that can efficiently discriminate POD after breast cancer surgery.

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