Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mastectomy, Simple”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed2004

The potential role of breast conservation surgery and adjuvant breast radiation for adenoid cystic carcinoma of the breast.

PURPOSE: Adenoid cystic carcinoma (ACC) of the breast is a rare breast cancer variant and optimal management is unclear. A review of this unusual tumour was performed at our Institution, to assess the role of breast conservation in the management of this disease. METHODS AND MATERIALS: A review of all cases of ACC of breast (1960-2000) treated at Princess Margaret Hospital (PMH) was undertaken. Information was collected on age at diagnosis, presenting features, tumour size and treatment modalities. Treatment outcomes were evaluated. RESULTS: Eighteen female and one male patient were identified. Median age at diagnosis was 58 years (range 35-76 years). Four patients had lymph-node positive disease at presentation; the single male patient presented with metastatic disease. Surgery was either a lumpectomy (10 cases) or a simple, radical or modified radical mastectomy (9 patients). Nine of 19 patients received adjuvant radiotherapy (RT). The median follow-up time was 14 years; the recurrence rate at 10 years was 31% (95% CI 7-54%) with a range in time of recurrence from 2.3 to 11.9 years. Seven recurrences were identified (4 local, 1 regional, 2 metastatic). Two of these patients developed metastatic spread and died. Six of the 19 cases went on to develop second malignancies of whom four died. Among the 18 female patients, the 10-year overall (OS), cause-specific (CSS), and relapse free survival (RFS) rates were 75, 100, and 46% respectively. CONCLUSIONS: ACC of the breast has a relatively prolonged natural history, and responds well to conservative management at presentation, with good outcome, even following local recurrence.

Adult↗
PubMedDate not supplied

[Correlation between surgical intervention, adjuvant therapy, and long-term survival in patients operated on for breast neoplasia].

INTRODUCTION: Breast cancer is the most frequent cancer among female sex, above all in rich countries where it occurs ten times more than the others. The most incidence of breast cancer is in female over 45 yrs and over 70 yrs with a plateau during menopause. So it is really very uncommon before 30 yrs. It is well known that breast cancer is related to several risk factors: these have always to be well evaluated before any treatment, especially in surgery. In the last years we can see an improvement of techniques to make diagnosis of breast cancer. Also surgery has improved in that way, so it can ensure better results to patients than before, also from the esthetical point of view. There are lot of discussions on which is the best surgical treatment to do, if lymphoadenectomy of the armpit is always required and if it has to be considered only as a prognostic element or also a therapeutical one. It is also important to plan radio, chemio and hormonal therapy, well chosen on the base of histological exams, and of the grading made either before either during surgery. Last studies moreover evaluate the specificity, the importance and the prognostic value of searching the so called "sentinel lymph node" who is always the first one to be interested in a metastatic process. STUDY AND DISCUSSION: Through a random and retrospective study among all our female patients (Department of Surgical Science in Rome University "La Sapienza") who had surgery for breast cancer in the last ten years (approving all the hystological exams) we have related the kind of surgical treatments to overall survival, to the therapies, and to any possible local recurrence of disease. We analyzed 270 female patients (age between 19 and 83). We considered all surgical treatments used in breast cancer: from the "simple" quadrantectomy up to radical mastectomy with the association of lymphoadenectomy of the armpit (both armpits in case of recurrence to disease). All these patients had then their own therapy (radio, chemo or hormonal one, it depended on each case) and follow up of the length of at least five years. The overall survival was of 82.2%. From these study we made important considerations about all the factors involved in breast cancer. The first step is to consider always all of these to have a well surgical approach, and to get the best compliance and performance from patients in order to have at distance the best results.

Aged↗
PubMed1995

[Breast myoepithelioma. Report of a case].

Myoepithelial cell tumors of the breast are rare. They present diagnostic difficulties not only on frozen sections but also after fixation and paraffin embedding. These tumors can give rise to a wide range of clinical evolution... Treatment vary from simple excision for myoepitheliosis to mastectomy with axillary node dissection for malignant myoepitheliomas. Large excision is necessary for adenomyoepitheliomas because of the risk of recurrence and, more uncommonly, their proclivity to metastasis. We report the case of breast myoepithelioma in a 42 years old woman. The tumor was clinically, radiologically and macroscopically well demarcated. Histologically the tumor was composed of myoepithelial cells with few cellular atypias and a low mitotic activity. Tumor cells expressed vimentin, actin, S100 protein and cytokeratin. This particular immunohistochemical phenotype allows the differential diagnosis with other breast tumors.

Adult↗
PubMed1984

Reconstruction of breasts following mastectomy with polyurethane-covered, gel-filled prostheses.

This article describes a simple, one-stage procedure to reconstruct breasts following radical and subcutaneous mastectomy by using subcutaneous placement of Natural-Y prostheses (polyurethane-covered, gel-filled implants with an internal Y-shaped septum). Breast reconstruction after mastectomy or immediately following subcutaneous mastectomy was performed in 36 patients using 62 Natural-Y prostheses. All patients still had implants in place six months to five years later. Neither spherical capsular contractures, infection, nor skin necrosis developed around any implants. Transfer of pedicle flaps was not required in any patient and the reconstructive procedures resulted in minimal scarring. Wrinkling of skin and a palpable implant edge in the superior quadrant were noticeable in some breast reconstructions following subcutaneous mastectomy but rarely in breasts reconstructed following mastectomy because the taut skin conformed to the implant.

Breast↗
PubMed1980

Alternatives in reconstructive surgery after mastectomy.

The modern era of breast reconstruction began about ten years ago. Today, reconstruction is possible for any woman who has had a mastectomy. The decision should be made only after discussion with both the woman's ablative surgeon and her plastic surgeon. Today there are a number of alternative methods to breast reconstruction. These include the following possibilities: immediate reconstruction, simple correction of a disturbing scar, reduction of a large remaining breast to simplify proper fitting of an external prosthesis, simple creation of a mound on the mastectomy side, insertion of a special prosthesis to fill in the subclavicular area, and reconstruction of the areolar nipple complex. Where more radical surgery has been done, the use of a myocutaneous flap, and in some special situations, reconstruction by means of microvascular anastomosis may be carried out. Some of these methods can be used in combination to fit the needs of the individual woman. It is the plastic surgeon's desire to help in the team approach in the treatment of breast cancer and by making suggestions to the ablative surgeon to make final reconstruction easier. Additional benefit might be the patients willingness to present herself earlier if she knows that in the long run reconstruction can be carried out.

Breast↗
PubMed1978

Influence of some operative and postoperative factors on capsular contracture around breast prostheses.

In a follow-up of 490 patients with breast implants, neither the size of the prosthesis nor the nature of the surgical procedure (simple augmentation mammaplasty or after subcutaneous mastectomy) increased the incidence of capsular contracture. Hematoma or infection were followed by a higher incidence of capsular contracture. Drainage with suction and the instillation of steroid around the prostheses seemed to be effective in reducing the incidence of capsular contracture. In the steroid-treated group, the need for open surgical treatment was reduced. The recurrence rate after closed capsulotomy, or open capsulotomy, was not significantly different from that following the more extensive procedure of capsulectomy.

Breast↗
PubMed1996

[Mastectomy with immediate reconstruction for invasive breast cancer. Comments on indications and technique. A series of 112 cases].

A series of 112 mastectomies with immediate breast reconstruction performed in women with invasive cancer of the breast were followed for a mean of 30 months to determine cancer outcome, morbidity and aesthetic results of the different surgical techniques. The patients were divided into 3 groups according to indications: 49 cases with local recurrence after conservative treatment; 37 cases of large or multifocal tumours operated after chemotherapy and radiotherapy; 26 cases after tentative conservative surgery with incomplete tumourectomy. A total of 98 patients (87.5%) were irradiated before mastectomy with immediate breast reconstruction. Twenty-eight simple implants, 50 musculocutaneous flaps using the latissimus dorsi with implant and 34 musculocutaneous flaps with the rectus abdominis. During follow-up 16 patients died and cancer relapsed in 13 surviving patients. Seven local recurrences were observed. In all cases of early relapse, which may have possibly been triggered by immediate breast reconstruction, the patients had very poor prognosis criteria. Surgery took longer for mastectomy with immediate breast reconstruction using the rectus abdominis flap and required transfusion in 88% of the cases. Combining all the techniques, 19% of the patients had postoperative complications and 25% late sequellae. The aesthetic results were considered as good immediately after surgery in 14% of the patients with a simple implant, in 45% of those with a latissimus dorsi flap and in 81% of those with a rectus abdominis flap. Second surgical procedures to improve the aspect were performed in half the patients with a simple implant giving 50% good results, in 40% of the patients with a latissimus dorsi flap giving 68% good results and in 12% of the patients with a rectus abdominis flap giving 84% good results. In this series, patient satisfaction was closely related to the aesthetic quality of the results. Integrated into a well-planned multidisciplinary protocol, mastectomy with immediate breast reconstruction does not appear to affect the cancer outcome. Immediate breast reconstruction is a complex procedure and requires experience in plastic surgery to reduce the number of complications and to improve aesthetic results. Reconstruction with a rectus abdominus flap appears as the superior technique.

Adult↗
PubMedDate not supplied

Future prospects for reconstructive surgery in breast cancer.

Reconstructive surgery has become an integral part of primary breast cancer therapy in patients requiring total mastectomy. State-of-the-art reconstructions with autogenous tissue are transverse rectus abdominis (TRAM) flap procedures. Superior aesthetic results in terms of both appearance and consistency, seem to outweigh the disadvantages of impaired abdominal wall competence and donor site scars. The "free," microvascular TRAM flap may be the way to minimize abdominal wall weakness, since only a little portion of the rectus abdominis muscle must be sacrificed. Despite all discussions, breast reconstruction using silicone (gel) implants is a safe and reliable method and will be in the future. However, not every patient may be the right candidate for silicone reconstruction. Advantages of using silicone implants include (relatively) simple technique, short operation time, and no donor site morbidity. In patients suffering from breast-conserving therapy failures, plastic surgery has to address skin and parenchymal loss in an irradiated environment. Oncoplastic surgery, such as volume shrinking or volume replacement techniques, are useful for immediate reconstruction in breast-conserving therapy.

Breast Implants↗
PubMed1992

[Plastic surgery and conservative treatment of breast cancer. Indications and results].

After conservative treatment for breast cancer, 75% of patients have good cosmetic results, but 20 to 25% of patients have a fair or a bad result. The tumor itself is responsible for some of these bad results (tumor volume, location in the inferior quadrants of the breast) but more often, failures are related to surgery and/or radiotherapy. Some patients will then ask for reconstructive surgery. It should always be preceded by a careful examination of the breast, both with an oncologic and a reconstructive approach. The techniques used are numerous, ranging from simple reexcision of the lumpectomy scar to mastectomy with immediate TRAM flap reconstruction. We believe that plastic surgery techniques should be used as soon as the initial lumpectomy, as they help to fill in the defect. In the case of a tumor located in the inferior quadrants, bad cosmetic results are twice as frequent as in the upper quadrants: we treated 16 of these patients with immediate bilateral breast reduction, reshaping the breast at the same time as the lumpectomy, and achieving symmetry of the contralateral breast. This technique did not interfere with radiotherapy or chemotherapy. When radiotherapy followed surgery, cosmetic results were good. Local and distant recurrences were not modified by the adjunction of a breast reduction to the lumpectomy. In 49 cases, we also proposed a bilateral breast reduction for larger tumors (T > 3 cm, bifocal cancer). 4-year local recurrence rate was less than 10%: this technique could help to extend the indications for conservative treatment for breast cancer. More cases and longer follow-up are necessary.

Breast Neoplasms↗
PubMedDate not supplied

[Curative radiotherapy with hope of saving the breast in operable breast cancers 403 cases with 5-year survival].

Between 1960 and 1975, 1 078 operable mammary carcinomas were treated by caesium therapy with the objective of conserving the breast. The authors analyse the indications for and results of this treatment in the 403 cases which have had more than 5 years follow up (241 cases were irradiated as primary treatment, 162 after having a simple tumorectomy). For the whole group 92 mastectomies were ultimately carried out: in 30 of them no tumour was found in the operative specimen. The tumorectomy cases, restricted to stage 1 of the UICC classification (pre 1962) -- PRV 0 IGR yielded the best results: 86 per cent 5 yeat cures with 9 out of 10 women retaining both breasts. The primary irradiation cases, all types considered, gave results comparable with those for primary radical surgery: 58 per cent 5 year cures-but 2 out of 3 women retained both breasts. By itself caesium therapy is capable of eradicating tumour in breast and axilla in half of the cases. It really amounts to a "double chance strategy"--an attempt at cure if possible with avoidance of mastectomy, this being in reserve in the event of failure.

Breast Neoplasms↗
PubMed1991

The early management of flap necrosis in breast reconstruction.

Flap necrosis is a potential complication of any type of breast reconstruction. Of 302 breast reconstructions performed by the author at the University of Texas M.D. Anderson Cancer Center, some degree of flap necrosis occurred in 59 (19.5 percent). Small areas of flap necrosis can be managed with simple observation, but secondary healing may not be complete for months. Early and aggressive excision of the ischemic tissue with immediate primary closure often can achieve rapid primary healing. In addition, early revision and reshaping of the breast may, in selected patients, permit achievement of a significantly better final result. This is true not only for TRAM and latissimus dorsi flaps, but also for the mastectomy flap necrosis sometimes encountered in immediate reconstruction with simple implants or tissue expanders.

Adult↗
PubMed1985

Prediction of recurrence after mastectomy for operable breast cancer.

A patient's risk of early recurrence after mastectomy for breast cancer has been estimated by using a combination of four prognostic factors. A computer program, designed to calculate the exact probability of recurrence within 2 years of mastectomy, was accurate when tested on 240 patients. A simple scoring system could identify patients at lower and greater risk than any single factor alone.

Breast Neoplasms↗
PubMed1996

Paravertebral block for breast cancer surgery.

PURPOSE: Major breast cancer surgery is associated with a high incidence of postoperative nausea, vomiting and pain. Regional anaesthesia, with intraoperative sedation, would seem an ideal alternative to general anaesthesia for this type of surgery. We report our initial experience using paravertebral blocks (PVB) to provide anaesthesia for major breast surgery. METHODS: Twenty-five patients agreeing to have surgery performed under paravertebral blocks were studied. Procedures performed varied from simple lumpectomy with axillary dissection to modified radical mastectomy with axillary dissection. During monitored sedation, blocks opposite spinous processes of C7-T6 were performed using bupivacaine 0.5% with epinephrine, 3-4 ml per segment. Patients were evaluated for 72 hr and were requested to document: (i) when sensation returned (ii) incidence and frequency of nausea or vomiting (iii) degree of discomfort and medication taken. RESULTS: Twenty patients had blocks that required no supplementation. Five patients had blocks that were incomplete. No complications were attributed to the blocks. Post-operatively, patients with successful blocks had minimal nausea, vomiting and pain. No patients found the procedure unsatisfactory. Patients with successful blocks were all very satisfied. CONCLUSION: Our initial results show that PVB for breast cancer surgery can be successfully performed in a majority of patients with few side effects. All patients with successful blocks were returned to the ambulatory care unit, bypassing the recovery room. That breast cancer surgery under regional anaesthesia can be safely performed as an ambulatory procedure has the potential for accomplishing major cost-saving.

Adult↗
PubMed1993

A 50-year experience of male breast cancer: is outcome changing?

During the period 1933-1983, 124 men (median age 62.5 years, range 33-86 years) were treated for breast carcinoma. Median length of follow-up was 6.7 years and was complete for 93% of patients. Presenting complaints were most frequently a mass (95%) or pain (31%) while physical examination revealed the tumour to be central in 95% of patients with nipple or skin retraction in 36% and associated gynaecomastia in 12%. Twenty-seven per cent of the patients had a positive family history of breast cancer, 6% noted previous breast trauma and 7% had prior chest wall irradiation. Mean tumour size was 2.5 cm, and the pathological stage was 0 in 3%, I in 17%, II in 22%, III in 35%, IV in 11%, and unknown in 12%. Ninety-four per cent were ductal carcinoma. Histological grading of tumours was 2% grade 1, 10% grade 2, 33% grade 3 and 48% grade 4. Ninety-two per cent of patients underwent mastectomy (41% radical, 39% modified radical and 12% simple), while adjuvant irradiation was used in 44% and chemotherapy in 9%. Median disease-free patient survival was 5 years (36% of patients developed tumour recurrence). Median overall patient survival was 6.3 years (57% at 5 years and 31% at 10 years). Tumour size (P < 0.05), pathological stage (P < 0.04), and tumour grade (P = 0.007) were adverse factors for recurrence, while pathological stage (P < 0.02), tumour size (P < 0.03), pain (P < 0.05) and age (P < 0.02) were associated with a decreased survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Erosive adenomatosis of the nipple.

Erosive adenomatosis of the nipple is a rare, usually benign neoplasm of the major nipple ducts. Although morphologic features may distinguish it from Paget disease, histopathological differentiation is simple. Recognition of this tumor may spare needless mastectomy.

Adenoma↗
PubMed1975

Results of conservative treatment of breast cancer at ten and 15 years.

The ten-year survival of patients at the Cleveland Clinic treated by operations less than radical mastectomy was 45% compared with 43% in identically staged patients of the "National Cancer Registry" treated predominantly by radical mastectomy. The five and ten-year survival rates of patients treated by simple operations was higher than that of a similar group of patients treated by radical operations, but at 15 years there was no difference. The late deaths from cancer in the patients treated conservatively occurred in patients with favorably staged cancers who never had local recurrences and most of whom had no involvement of nodes. The incidence of local recurrence was no higher after simple operations than after the radical procedure. The ten-year incidences of local recurrence and of death from cancer were the same after partial mastectomy as after total mastectomy. It is pointed out that differences in staging the cancers and in reporting the survival rates invalidate comparisons of results from different institutions. The figures presented suggest that conservative operations and radical operations give the same survival rates at ten and at 15 years.

Breast Neoplasms↗
PubMed1979

Conservation surgery and irradiation for the treatment of favorable breast cancer.

The results in 162 patients with clinically favorable breast cancer treated with conservation surgery and radiation therapy are presented. The surgical procedures were simple excision with and without positive microscopic margins, segmental mastectomy, and segmental mastectomy with axillary dissection. Details of the radiation techniques are described with an explanation of the modifications in technique depending on the prior surgical procedure. Excellent control of local and regional tumor (96%) gives support to the combined treatment without removing the breast.

Adult↗
PubMed1994

Adipose differentiation in cystosarcoma phyllodes. A study of 14 cases.

Adipose differentiation is an uncommon stromal alteration in cystosarcoma phyllodes (CP). We have studied 14 lesions to define the structural variation and prognostic significance of these rare forms of CP. All patients were women between 17 and 71 years of age (mean 40 years; median 42 years). Most were first seen with a mass; three were pregnant. Grossly, the lesions were circumscribed with lobulated cut surfaces. Microscopically, the mesenchymal component showed adipose differentiation that ranged from mature fat to liposarcoma with well-differentiated, myxoid, or pleomorphic components. Six lesions were high-grade malignant CP with immature cellular mesenchyme, abundant mitoses, and areas of pleomorphic liposarcoma. Seven tumors were low-grade malignant CP with few mitoses, relatively low cellularity, and myxoliposarcoma. One tumor with slight periductal condensation and mature adipose tissue was a benign CP, which we named lipophyllodes tumor. Two patients had concurrent breast carcinoma, and two others subsequently had carcinoma. The follow-up was 8-90 months (mean 46 months; median 39 months). There was one recurrence among eight patients treated with simple excision and no recurrences in six treated with mastectomy. One woman died of metastatic breast carcinoma. All others are alive and free of disease. CP with adipose differentiation can be graded histologically on the basis of this component. Despite the high-grade histology in some instances, the patients had an excellent prognosis when the tumors were completely excised.

Adipose Tissue↗