Relationship between Breast Cancer Surgical Treatment and Psychiatric Symptomatology: Which Sociodemographic and Clinical Factors Could Influence It? A Preliminary Study

This study aimed to investigate psychiatric symptomatology in a sample of patients affected by breast cancer undergoing surgery, evaluating the potential mediators on perceived stress levels, depression and hopelessness. The study was conducted on eighty-five patients with breast cancer, admitted consecutively to the Breast Unit of the IRCCS Ospedale Policlinico San Martino, between May 2018 and December 2019. Sociodemographic (age of diagnosis, gender, marital and occupational status, educational level, having children) and clinical (type and side of surgery, previous breast surgery, neoadjuvant chemotherapy and axillary dissection) characteristics were investigated through a semi-structured interview. The following rating scales were administered: Beck Depression Inventory, Beck Hopelessness Scale, and Perceived Stress Scale. Our findings indicate that the presence of children and of a partner was associated with a lower total score on the clinical dimensions evaluated. Furthermore, we found demolitive surgery to be a mediator between perceived stress and hopelessness, while history of previous breast surgery was found to be a mediator between demolitive surgery and perceived stress. In conclusion, patients affected by breast cancer undergoing more complex and demolitive surgery or with history of previous breast surgery should be mostly monitored from a psychological and psychiatric point of view from the beginning of treatments to evaluate the first manifestations of psychiatric symptomatology.

Tranexaminezuur in de gynaecologische en senologische heelkunde: een literatuuroverzicht

Tranexamic acid in gynecological and breast surgery: a literature review In gynecological and breast surgery, intra- or postoperative blood loss can cause many complications. A large number of interventions have already been described in literature to limit intraoperative blood loss. Tranexamic acid significantly reduces the amount of vaginal blood loss in women with menorrhagia and is also recommended as a treatment for postpartum hemorrhage. Tranexamic acid has been shown to be safe and efficient in limiting blood loss in many other surgical disciplines. In this literature review, the different applications of the use of tranexamic acid in gynecological and breast surgery are explained. The conclusion is that tranexamic acid can be a safe additional treatment that can reduce the total blood loss and the risk of postoperative complications and blood transfusion in various types of gynecological and breast surgery.

COMPARISON OF ULTRASOUND GUIDED MODIFIED PECTORAL NERVE BLOCK WITH LOCAL ANAESTHESTIC INFILTRATION FOR ANALGESIA IN BREAST CANCER SURGERY

Objective: To compare the frequency of pain and mean analgesia requirement after breast surgery under general anaesthesia when comparing pectoral nerve block with local anaesthesia infiltration. Study Design: Comparative prospective study. Place and Duration of Study: Combined Military Hospital, Rawalpindi from Mar 2018 to Sep 2019. Methodology: A total of 60 patients undergoing modified radical mastectomy were included in the study. Group A (n=30) received pectoral nerve blocks while Group B (n=30) received local anaesthetic infiltration. Outcome was assessed at 12 hours after injection of local anaesthetic. Results: Pain in 7 (23.33%) patients in Group A (Pectoral nerve blocks) and in 20 (66.67%) patients in Group B (Local anaesthetic infiltration), p-value of 0.001 which was considered statistically significant. Mean analgesic requirement was found to be 80 ± 33.73 mg in the Group A (pectoral nerve blocks) compared with 141.67 ± 47.50 mg in Group B (Local anaesthesia infiltration) patients with a p-value of <0.001 which was statistically significant. Conclusion: Pectoral nerve block significantly reduces early postoperative pain and analgesia requirement when compared with Local anaesthesia infiltration after breast surgery.

Thoracic fascial planes blocks in operative bed of modified radical mastectomy and their role in alleviating post-mastectomy pain: a prospective randomized study

Background: Proper pain management after modified radical mastectomy is crucial for improving postoperative outcomes, reducing tumor recurrence, enhancing anti-metastatic activity and achieving excellent patient`s satisfaction. Thoracic fascial planes (TFP) blocks are novel, and safe analgesia modalities to control postmastectomy pain. This study was designed to assess the efficacy and safety of intraoperative TFP blocks for providing postoperative analgesia after modified radical mastectomy.Methods: During the period from March 2020 to April 2021, 30 females (ages 25–67 years) were scheduled for elective MRM and selected randomly to one of two groups; group-A included 15 patients who underwent MRM and anesthetized with both general anesthesia and regional anesthesia (TFP blocks), group-B included 15 patients who underwent MRM and anesthetized with only general anesthesia.Results: The group-A had statistically significantly lower pain scores. The time of first rescue nalbuphine dose post-operatively was statistically significantly longer in group-A compared to group-B. The total 24h nalbuphine consumption and postoperative non-steroidal ketorolac requirements/48h were significantly lower in group-A compared to group-B. Satisfaction score in group-A was statistically significantly better than that in group-B.Conclusions: Intraoperative thoracic fascial planes blocks are simple, safe, and highly effective analgesic modalities after breast surgery.

The quality of life of patients after reconstructive and reconstructive breast surgery

The quality of life indicators of 70 patients who underwent reconstructive and reconstructive breast surgery were studied. We used a depression test questionnaire and questionnaires on the quality of life. The patients were divided into 3 groups. It was found that a higher level of depression in group II compared to group I. Low level of depression in group III. Indicators of the physical component of health are the highest in group II compared to groups I and III. Low indicators of the physical component of health in group III patients. Indicators of the psychological component of health are higher in group III compared to groups II and I. Higher indicators of the psychological component of health in patients of groups II and III. Key words: quality of life, mammary glands, reconstructive and reconstructive operations, neoplasms, psycho-emotional status.