Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MASTECTOMY”

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 1,009 records · Page 56Linked to original sources
PubMed1993

[When will we stop mastectomies for intraductal carcinoma?].

There has been growing interest in intraductal carcinomas of the breast (DCIS) over the last ten years mainly because of their increasing frequency and their difficult diagnosis. Their natural history is often surprising. For the time being, it is impossible to establish which proportion of DCIS might turn into an infiltrating carcinoma, and which factors are predictive for such a risk. These uncertainties are responsible for many controversies about their treatment. Based on a critical review of the latest publications, this paper deals with the possibilities of conservative treatment, challenging the remarkable results of total mastectomy (nearly 100% survival at 10 years). The risk of conservative treatment depends on the frequency of local recurrence, and on the potential vital risk of such recurrences, knowing that half of these recurrences will develop in an invasive, and no longer in situ, pattern. Randomized trials are being conducted on this question; they will not give an answer before the year 2000. In the mean time, conservative treatment seems to be reasonable for small low grade histologic lesions widely excised by surgery, and with rigorous possibilities of follow-up. The operation is followed by external irradiation. In case of recurrence, mastectomy has to be. It is not impossible that, performed under these conditions, a slight increase in mortality might follow such a strategy, thus heavily balancing the benefits of conserving the breast. Besides, surgical excision alone should only be performed as part of randomized trials, or for infra-centimetric lesions discovered by histology after resection of supposed benign lesions.

Breast Neoplasms↗
PubMed1993

[Modified radical mastectomy in local anesthesia].

The authors report their experience on the use of local anesthesia for modified radical mastectomy. They have used this modality in five patients who could not undergo general anesthesia because of underlying severe medical illness and in a sixth one who adamantly refused general anesthesia. They describe in detail the technique used, stressing the importance of a thorough knowledge of regional neuroanatomy. There were no complications in their small series. The authors conclude by stating that the use of local anesthesia may expand the indications for "toilet mastectomy" to include patients in poor medical condition, unsuitable for general anesthesia.

Aged↗
PubMed1993

[Perioperative psychological status of patients undergoing radical mastectomy and total hysterectomy].

Using four different psychological tests, namely Spielberger's rating scale [The State-Trait Anxiety Inventory (STAI)], Self-Rating Depression Scale (SDS), Maudsley Personality Inventory (MPI) and Baum test, we investigated the perioperative psychological status of patients undergoing radical mastectomy for breast cancer and compared data with those of patients undergoing total hysterectomy for uterine myoma. Parameters reflecting the psychological status of hysterectomy patients disclosed lower postoperative anxiety, and slight nervousness and persistent depression perioperatively. In contrast, in patients with breast cancer, those with nervousness had persistent anxiety and depression, while those without nervousness showed the same persistent depression as in hysterectomy patients, as well as a high anxiety level postoperatively. Therefore, we speculate that the persistence of depressive mood during the perioperative period is a factor in the psychological disturbance of mastectomy patients with breast cancer, and moreover, they appear markedly apprehensive because of cancer. These results suggest that the persistence of anxiety and depressive mood associated with cancer is a prime factor in the etiology of postoperative psychological disturbance.

Adult↗
PubMed1993

Partial mastectomy and breast reduction as a valuable treatment option for patients with macromastia and carcinoma of the breast.

The essential goals of every reconstructive procedure of the breast are to create a breast mound and establish symmetry. Breast conservation operation is now a widely accepted treatment for carcinoma of the breast. Four patients who presented with macromastia or mammary hypertrophy and a simultaneous carcinoma of the breast were treated by combined partial mastectomy and bilateral breast reduction. Incisions on the breast were made using standard Wise pattern (keyhole) markings. In each instance, the tumor was removed with a generous margin of normal surrounding mammary tissue. Two procedures used the inferior pedicle technique and two were done by resection and transplantation of the nipple. The average mammary tissue resection was 825 grams. All incisions healed primarily and necessary adjuvant chemoradiation was not delayed. Each patient is alive and well without evidence of disease with a follow-up period ranging from seven to 43 months. Postoperatively, the appearance of the breast is esthetically improved and all symptoms related to macromastia have resolved. Advantages of combining these two techniques include improved symmetry, easier postoperative self-examination of the breast and decreased radiation effect noted with larger breasts. Postoperative mammograms have been useful for patient follow-up evaluation. Combined segmental mastectomy and breast reduction represents a valuable treatment option for the patient who presents with macromastia and carcinoma of the breast. The carcinoma ablative procedure is not compromised and the improved symmetry of the breast has resulted in an excellent cosmetic outcome in these patients.

Adult↗
PubMed1993

[Prospective randomized study on effect of duration of antimicrobial prophylaxis for mastectomy].

A prospective randomized trial was done to study effects of the duration of ofloxacin (OFLX) administration for prophylaxis against mastectomy wound infections. One hundred and seventeen women who were hospitalized, during periods between June 1990 and September 1992 were considered for enrollment in this study. Selected patients were treated with 600 mg of OFLX daily in 3 divided doses starting the day before surgery. One group was treated for 5 days and the other was treated for 10 days. A hundred and ten patients were found eligible to complete the study and 58 patients were assigned to the 5-day group and 52 patients were assigned to the 10-day group by the random-envelope method. Nine episodes of infections occurred among the patients in the 5-day group and 12 episodes of infections occurred among those in the 10-day group. The mean time until onset of infection was not significantly different between the 2 groups (12 versus 8 days). The number of strains isolated from the drainage tube when removed was highly correlated with occurrences of infections, and the number of strains isolated from infected wounds was also highly correlated with the need to use a different antibiotic. By multiple regression analysis, age was the only significant factor identified for wound infection. The duration of OFLX administration had no significant effect on the development of wound infections. Prolonged prophylactic use of this drug for mastectomy did not reduce the incidence of postoperative infections in this study.

Female↗
PubMed1977

Local recurrence of breast carcinoma after mastectomy and radiotherapy.

19% of 102 operable cases of breast carcinoma irradiated postoperatively developed local recurrences in the thoracic wall and/or regional lymph nodes during the observation time of five years. Of the 41 radically operated cases of stage I disease only one had recurrence in the chest wall and three metastases in the regional lymph nodes. As the number of local recurrences after mastectomy and evacuation of the axilla combined with postoperative irradiation was fairly small if compared with the results achieved with conservative surgery and irradiation presented in literature, the radical treatment schedule is recommended even in stage I breast carcinoma. The local reappearance of carcinoma is always strenuous for the patient even if the prognosis of a local recurrence after conservative surgery is better than that of the local recurrence after mastectomy.

Breast Neoplasms↗
PubMed1993

[Immediate reconstruction after radical mastectomy for breast carcinoma with a Becker-type expander prosthesis].

In recent years, the breast has won importance from the female psychology point of view. After ablative surgery for cancer, the loss of the breast gives rise in the woman to a feeling of refusal of her new body shape. Reconstruction produces positive feelings in the patient. The best-used surgical technique for operable breast cancer is modified radical mastectomy. An immediate reconstruction of the missing breast is considered when the following conditions are fulfilled: desire for reconstruction, age of the patient, clinical and pathologic evaluation (tumor size-tumor grade-lymph-node status). After modified radical mastectomy with "en bloc" removal of axillary lymph nodes, an immediate reconstruction is performed by lining the surfaces with human fibrin glue (Tissucol) followed by the insertion of a prosthesis of appropriate size (Becker Expander Mammary Prosthesis-Type 1) in the subserratus-subpectoral position. Human fibrin lining reduces the incidence of capsular contracture and effusion production. A suction drain is placed in the axillary area and is removed after 5 days. The use of expanding-type prostheses means that the patient must return for further expanding. When the pathologic features are negative, the delayed nipple areola reconstruction is possible with the full-thickness skin grafts in the groin or in pre-existent appendectomy incision. By this procedure, adjuvant chemotherapy or radiation therapy can be performed if required. From 1987 to 1991 the procedure has been performed in 35 cases of mammary neoplasm (mean age 40 years) at INRCA Department of Surgery of Ancona). No evidence of adverse effect on the natural course of the breast disease for have been seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Postoperative pain relief by preanesthetic administration of buprenorphine suppository in elective mastectomy].

Seventy female patients scheduled for elective mastectomy were divided into three groups: Buprenorphine suppository (BPS) 0.4 mg group (n = 29); BPS 0.2 mg (n = 23) group; and control (scopolia extract and tannic acid suppository) group (n = 18). Suppositories were administered rectally to patients of each group one hour before induction of anesthesia. Plasma buprenorphine concentrations, sedation scores at entering the operating room, postoperative pain scores and side effects were evaluated. There were no significant differences in sedation effects of suppository among the three groups. Although there were significant differences in pain scores except at the time when patients left the operating room between BPS 0.2 mg group and the control group, postoperative pain relief in BPS 0.2 mg group was judged not enough. However, postoperative pain relief was more satisfactory in the BPS 0.4 mg group. Plasma concentrations of the BPS 0.4 mg group were higher than those of the BPS 0.2 mg group. Although nausea and vomiting were observed in 5 patients (17.2%) of the BPS 0.4 mg group and 4 patients (17.4%) of the BPS 0.2 mg group, respiratory depression and changes in blood pressure and heart rate were not observed in all groups. In conclusion, preanesthetic administration of the BPS 0.4 mg seemed to be useful for postoperative pain relief after elective mastectomy.

Adolescent↗
PubMed1993

[Two cases of stage IIIb breast cancer treated by intra-arterial infusion chemotherapy using implantable reservoir combined with rectus-abdominis musculocutaneous flap reconstruction after mastectomy].

Intra-arterial infusion chemotherapy was performed using implantable reservoir for 2 cases of Stage IIIb breast cancer followed by rectus-abdominis musculocutaneous flap reconstruction after mastectomy. The first case is a 47-year-old female. A total dose of 150 mg ADM was injected via reservoir. After satisfactory local response, mastectomy followed by giant rectus-abdominis musculocutaneous flap reconstruction was performed. The other case is a 64-year-old female. A total dose of 160 mg ADM was injected via reservoir. She was also operated in the same manner as in the first case. Complications of both cases were minimal. It was concluded that this combined treatment was useful for controlling local lesion and sustaining QOL.

Breast Neoplasms↗
PubMed1993

Indications for prophylactic mastectomy.

This article reviews the current state of knowledge regarding factors which put women at highest risk for developing breast cancer and identifies that population we consider as potential candidates for prophylactic mastectomy. Specifically, we focus on the concept of cumulative predisposition and the relative risk assigned to more significant factors that increase a woman's chances of developing breast cancer: family history, proliferative breast histology, and previous cancer in one breast. In addition to outlining the results of reconstruction, the article also examines the controversy surrounding the issue of whether any mastectomy can be truly prophylactic. We conclude with advice to physicians who must counsel women concerned about their breast cancer risk so they can help their patients make fully informed choices.

Adolescent↗
PubMed1995

Post-mastectomy seroma: a new look into the aetiology of an old problem.

Postmastectomy seroma (PMS) remains an unresolved quandary as the risk factors for its formation have still not been identified. Sixty-four consecutive female patients undergoing Halsted mastectomy were prospectively studied for this purpose. The risk factors that were studied included age and weight, diabetes, hypertension, tumour (size and location) and nodal (positive or negative) status and the use of perioperative blood transfusion. Additionally, the effect of PMS on total hospital drainage (THD), post-operative hospital stay and other wound-related complications were assessed. The incidence of PMS in this study was 28%, and those patients with PMS were designated as group A while the remaining patients were designated as group B. Group A patients were significantly older (P < 0.02) and heavier (P < 0.05) than group B patients; also, there were significantly (P < 0.0001) greater number of hypertensive patients in group A than in group B. In terms of other risk factors the two groups were statistically similar. Group A patients had significantly greater (P < 0.01) amount of THD than group B patients. Although no septic complications were observed as a result of seroma, its presence significantly (P < 0.0001) lengthened the post-operative hospital stay in group A patients. It is concluded that (1) PMS is a common problem, (2) its occurrence significantly increases the post-operative hospital stay, and (3) hypertension is perhaps the most important risk factor for its causation. Hypertension contributes to seroma formation, probably by way of prolonged oozing from the large mastectomy wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

[Motivations for breast reconstruction after mastectomy. A comparative study].

The aim of this study is to define the psychosocial profile and the motivations of women who seek post-mastectomy reconstruction. A questionnaire was administered to 45 women who had breast reconstruction several months after mastectomy and 51 who did not. Statistical analysis of data shows significant differences between the two groups regarding age, education, leisure activities, sexual intercourse and fear of recurrence. A qualitative analysis shows how women feel about reconstruction. The results suggest that information concerning reconstruction must be adapted to the psychosocial profile of women. Moreover, reconstruction must be considered by the surgeon as an essential stage of breast cancer treatment. In order to help women in their choice, they must give them appropriate information on the technique of breast reconstruction, on the risk of relapse and on the possibility of reimbursement of medical expenses.

Adult↗
PubMed1997

[Two cases of coronary artery bypass grafting following radical mastectomy using bilateral internal thoracic arterial grafts].

We report two cases of coronary artery bypass grafting following radical mastectomy using bilateral internal thoracic arterial grafts. One was a 68-year-old woman with angina pectoris, and the other was a 71-year-old woman with old myocardial infarction. Dissection of the internal thoracic arterial pedicles from the chest wall was not so difficult in both cases. The pedicles had good patency and each free flow of them was enough. They had no postoperative complications. It may be a useful method to use the internal thoracic arterial grafts for a case of coronary artery bypass grafting after radical mastectomy.

Aged↗
PubMed1977

Combination of regional chemotherapy and mastectomy in the treatment of carcinoma of the breast. Five-year results.

Thirty-six women with cancer of the breast were treated with infusion of cytotoxic drugs into the first portion of the subclavian artery adjuvant to radical or simple mastectomy. The patients were followed up for five years and the results were compared with a matched group of patients treated by mastectomy alone. There was no difference between the two groups in the overall mortality at the end of the fith year. The survival rates of patients with stage 3 carcinoma receiving adjuvant chemotherapy were in the first three years significantly better than those of the controls. No impairment of the wound healing was observed and the systemic side effects of the cytotoxic drugs were unimportant. In two patients serious neurologic complications developed and one patient died of pulmonary abscess.

Adult↗
PubMed1996

[Surgical treatment of post-mastectomy lymphedema of the upper limb].

The authors analyze their experience of surgical treatment of post-mastectomy lympho-edemas of the upper arm. They have performed 14 operations, each upon patients with praecox or later oedema, following Cariati's classification, and with median age of 56.5 years. Seven patients were present at the follow-up in 6 has been performed microsurgical lympho-venous anastomosis, in 1 a fasciotomy of the forearm and in 1 patient some silastic tubes were positioned in her subcutaneous tissue. An improvement of the subjective symptoms has been recorded in 57.14% of the patients, while the objective ones have improved in 50% of the patients. The authors think that the microsurgical treatment of the lymphedema post-mastectomy of the upper arm is the first choice nowadays.

Adult↗
PubMed1997

[A case of breast cancer metastasis to the skin and bone 13 years after, and to the brain 17 years after mastectomy].

A case of breast cancer metastasis to the skin and bone 13 years after, and to the brain 17 years after mastectomy in a 54-year-old woman, is reported. In 1978, the patient, who was then 37 years old, underwent standard radical mastectomy for left breast cancer. In 1991, because of skin and bone metastasis, systemic chemotherapy with cyclophosphamide, epirubicin, and 5-fluorouracil (CAF) was performed, and she partially responded to CAF therapy. In April 1995, the patient was admitted for pain of left hip joint and left knee joint. Computed tomography of the head revealed a bleeding tumor with marked peritumoral edema. Serum levels of carcinoembryonic antigen (250 ng/ml) and CA 15-3 (810 U/ml) were increased. Bone metastases were found elsewhere in the body. Again, systemic chemotherapy with CAF was performed. CAF chemotherapy stopped the brain metastasis bleeding.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Breast conserving treatment versus modified radical mastectomy in Japanese patients with operable breast cancer.

From January, 1988 to October, 1995, 96 patients with operable breast cancer were treated by breast conserving treatment (BCT) including wide excision and axillary dissection followed by breast radiation. During the same period, 188 patients were treated by modified radical mastectomy (MRM) with or without breast reconstruction. In order to compare the survival of BCT and MRM groups, univariate and multivariate analyses were performed in this retrospective study. Univariate analysis revealed that the 5-year survival rates in the BCT and MRM groups were 97% +/- 2% and 87% +/- 3%, respectively (p < 0.05 with the Cox-Mantel test). However, the baseline variables were different between the groups. The adjusted Cox regression analysis revealed that the results of BCT were almost equivalent with those of MRM. Moreover, no breast recurrence was found in the BCT group. Therefore, it is suggested that our technique of BCT is as effective as modified radical mastectomy in treating operable breast cancer in Japanese patients.

Adult↗
PubMed1998

Choosing reconstruction after mastectomy: a qualitative analysis.

PURPOSE/OBJECTIVES: To describe women's perspectives on factors that influenced their decision to have reconstructive surgery after a breast cancer diagnosis. DESIGN: Exploratory, descriptive, qualitative study. SETTING: A comprehensive cancer center in an urban setting. SAMPLE: Eleven women who underwent mastectomy and reconstruction. Six participants had autologous transverse rectus abdominis musculocutaneous-flap reconstruction, four had saline implants, and one had a silicone implant. All but one reconstruction was performed at the time of mastectomy. METHODS: Open-ended, face-to-face interviews using an interview guide were conducted within one month of reconstruction. One to two follow-up interviews were conducted approximately six months later. MAIN RESEARCH VARIABLES: Decision making about reconstruction, perceptions of information needs and sources, sources of support, and factors important to decision making. FINDINGS: The main theme identified was Getting My Life Back. The participants described this in terms of the themes of Information Seeking, Talking It Over, and Seeking Normality. The interactive skills of the healthcare provider played an important role in the women's decision making. CONCLUSIONS: Reconstruction minimized the negative consequences of breast cancer and its treatment for the women in the study. The decision-making process was aimed at getting the person's life back as close to what it was before the diagnosis as possible or improving it. The three themes of decision making are interactive in nature, with participants returning to information Seeking and Talking It Over as necessary to increasing their understanding and clarifying their "normality goals." IMPLICATIONS FOR NURSING PRACTICE: Healthcare professionals should determine how a woman wants to participate in decision making as well as the kind, amount, and sources of information the individual with breast cancer wants to have to make her decisions. Healthcare providers are key sources of information about treatment options, and they are critical to patient satisfaction with the decision-making process and with the final results of the surgical procedure. Family members, friends, and other women with breast cancer play a crucial role in talking it over.

Adult↗