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At least 1,261 records · Page 70Linked to original sources
PubMed1985

Prognosis of breast cancer patients after mastectomy and dissection of internal mammary nodes.

The results of the analysis carried out on data on 1119 patients with operable breast cancer treated at the National Cancer Institute of Milan from 1965 to 1979 with enlarged mastectomy are reported. Metastases to internal mammary chain were found to be significantly associated with the maximum diameter of primary (16.1% for tumors less than 2 cm and 24.5% for larger tumors, p = 0.007), the age of the patients (27.6% in patients younger than 40 years, 19.7% in patients between 41-50 years, and 15.6% in patients older than 50 years, p = 0.01). The site of origin of the cancer had no impact on internal mammary node metastases. Patients with positive axillary nodes showed metastases to internal mammary nodes in 29.1% of the cases, while 9.1% of patients with axillary negative nodes had positive retrosternal nodes. Survival was significantly affected by the presence of positive internal mammary nodes: the percentage of 10-year survival varied from 80.4% in patients with axillary and internal mammary negative nodes to 30.0% in patients with both nodal basins involved. Intermediate survival rates (54.6% and 53.0%) were found when one or the other of the nodal stations (axillary and internal mammary) was separately affected. Maximum diameter of the primary significantly affected the survival of each group identified by the status of both axillary and internal mammary nodes. In conclusion, the information on the presence or absence of internal mammary node metastases would be of great importance in formulating the prognosis of breast cancer patients. To obtain this information, a biopsy at the first intercostal space may be reasonable in selected patients (age, maximum diameter, and axillary node involvement being the basis for selection) as long as noninvasive methods of diagnosis are available.

Adenocarcinoma↗
PubMed1987

Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients.

The transverse abdominal island flap operation was the method of breast reconstruction after mastectomy and in chest wall reconstruction in 300 patients from September 1980 to July 1986. In 58% (221 of 383 breast reconstructions), the breast mound was formed in a single operation and required no further revision. Only 18 reconstructed breasts required modification after 1 year. Symmetry was achieved without altering the opposite breast in 113 (52% of the 217 unilateral reconstructions). Complications included one total flap loss (0.3%) and 18 partial flap losses (6%). There was one lower abdominal hernia (0.3%) and two small defects in the upper anterior rectus sheath (0.8%). Lower abdominal wall laxity occurred in two patients (0.8%), one requiring repair. As expected, there was some loss of abdominal wall strength after reconstruction but this did not affect sports or work performance in over 90% of patients. Ninety-eight per cent of respondents (272 or 278) judged the operation worth their time and effort. This major operative procedure is indicated only in healthy patients.

Abdominal Muscles↗
PubMed1988

The patient's appraisal of the cosmetic result of segmental mastectomy in benign and malignant breast disease.

Women's appraisal of the cosmetic result and their psychosocial adjustment after a standardized segmental mastectomy for benign or malignant breast disease was analyzed on the basis of a mailed questionnaire, which was satisfactorily answered by 263 (92%) of 285 women operated on consecutively. The overall result was favorable: 96.5% of the patients found the new appearance of their breast very good (30.7%), good (44.0%), or acceptable (21.8%). Women with a benign diagnosis ran a two-fold higher risk of being discontented with the new appearance of the breast than those with breast cancer. Complications of radiation therapy, preoperative concern that the breasts are important for the appearance, and anxiousness about the cosmetic result were associated with a significantly elevated risk of being less satisfied with the outcome. The main finding that it is possible to perform a locally radical operation that is highly acceptable to the woman is relevant to the surgical management of potentially malignant mammographic lesions and also to the scientific strategies for future evaluation of breast-conserving treatment modes in malignant disease.

Aged↗
PubMed1992

Immunohistochemical characteristics of human milk-fat globule antibodies in predicting chest wall and distant metastasis after mastectomy for localized cancer of the breast.

Because postoperative radiation reduces chest wall metastasis after mastectomy, it is important to identify patients in whom it might develop. Pathologic and immunohistochemical features in 59 patients with chest wall metastasis were compared with characteristics in disease-free patients and patients with systemic metastases without chest wall metastasis. Immunohistochemical studies with human milk-fat globule (HMFG)-2 were not predictive, but a membrane reaction with HMFG-1 was associated with fewer systemic metastases and tumors, in which most of the cells reacted with the antibody had significantly decreased likelihood of chest wall metastasis. Antigenic concordance between the primary breast cancer and the chest wall metastasis was demonstrated. Neither tumor size nor axillary node metastasis predicted development of chest wall metastasis, but systemic metastases were less common when fewer than four nodes were involved, the primary tumor was well differentiated, and estrogen receptors were positive.

Antigens, Neoplasm↗
PubMed2002

Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer.

OBJECTIVE: To examine the incidence of local recurrence (LR) and factors associated with it in a population of patients who underwent skin-sparing mastectomy (SSM) and immediate reconstruction for invasive carcinoma. SUMMARY BACKGROUND DATA: The efficacy of SSM has been challenged by concerns about increased risks of LR. METHODS: A consecutive series of 173 patients (176 cancers) with invasive carcinoma underwent SSM and immediate breast reconstruction (June 1986 to December 1997). Data were analyzed by the Kaplan-Meier method, the log-rank statistic test, and the Cox proportional hazards model. RESULTS: Mean patient age was 47 +/- 9 years (27% were 40 or younger). The AJCC stages were 1 = 43%, 2 = 52%, and 3 = 5%. Thirty percent of tumors were poorly differentiated. With a median follow-up of 73 months, the LR rate was 4.5%. The mean local relapse-free interval was 26 months. Seventy-five percent of patients who presented with LR developed distant metastases and died of disease within a mean of 21 months. On univariate analysis, factors associated with higher LR rate were tumor stage 2 or 3, tumor size larger than 2 cm, node-positive disease, and poor tumor differentiation. Actuarial 1-, 3-, and 5-year overall survival rates were 98%, 94%, and 88%, respectively. On multivariate analysis, factors associated with decreased survival were advanced stage, presence of LR, and absence of hormone therapy. LR was a highly significant predictor of tumor-related death. CONCLUSIONS: There is a low incidence of LR after SSM, and it is associated with advanced disease at presentation. LR is an independent risk factor for tumor-related death.

Adult↗
PubMed1992

Lymphedema 30 years after radical mastectomy.

Lymphedema is a common and often distressing consequence of the management of breast cancer. This is the first report of new onset lymphedema 30 yr after radical mastectomy for the management of breast cancer. The patient's swelling began 10 days after commencing daily finger sticks to follow blood sugar, stemming from a recent diagnosis of diabetes mellitus. If proper precautions had been observed, swelling may not have developed. The patient had marked reduction of her edema with appropriate use of graded compression garments and self administered massage therapy, after early recognition and prompt intervention into her problem. This case highlights efforts that need to be made to prevent the development of edema.

Aged↗
PubMed1985

Simulation of abnormal pulmonary thallium-201 activity following mastectomy.

Increased uptake of activity in one lung field was found on postexercise Tl-201 images in a woman who had undergone a previous mastectomy on that side. This was probably related to a partial loss of normal tissue attenuation following surgery, resulting in a simulation of abnormal pulmonary activity.

Female↗
PubMed1997

Home healthcare for patients receiving one-day mastectomy.

The pressure to cut costs has resulted in outpatient to 1-day hospital stays for women who have a modified radical mastectomy. This article discusses the need for early identification of patients who require home healthcare immediately after surgery to decrease complications and reduce postoperative anxiety.

Ambulatory Surgical Procedures↗
PubMed1975

Biological basis for management of benign disease of the breast. The case against subcutaneous mastectomy.

The biology of breast disease abnormalities which are primarily the result of hormonal imbalance, and the action of hormones upon breast tissue are discussed. An understanding of the basic biological principles makes it possible to manage these patients more accurately. An accurate diagnosis is necessary to predict what changes will occur with the progression of time. Our reservations about subcutaneous mastectomy are stated.

Adipose Tissue↗
PubMed1978

Breast reconstruction following radical mastectomy, using custom designed implants.

Procedures are described for total breast reconstruction in patients who have undergone radical and modified radical mastectomies. The reconstruction includes restoration of the contour of the breast, including the nipple-areola complex and filling the defect from loss of the pectoral muscles. The reconstructions have been done in 37 patients with good results, and several are illustrated.

Adult↗
PubMed1978

Breast reconstruction after a radical mastectomy.

Breast reconstruction after a radical mastectomy remains a complex problem. We describe the use of a latissimus dorsi myocutaneous flap, a transverse abdominal flap, or a pedicled flap of the greater omentum to obtain satisfactory cover for the implant and enable us to correct the deformity in one operation.

Breast↗
PubMed1978

Transfer of free flaps to provide well-vascularized, thick cover for breast reconstructions after radical mastectomy.

The use of a free flap to bring in well-vascularized cover for a breast reconstruction (following radical mastectomy) is presented. Eleven of 12 such transfers were successful. (One free groin glap failed, and that reconstruction was abandoned.) Patients for breast reconstruction who have a marked deficiency of healthy, well-vascularized skin and subcutaneous tissue in the area are suitable candidates for this operative procedure. When a free groin flap is transferred, the donor defect is minimal.

Axilla↗
PubMed1978

Subcutaneous mastectomy in small, large, or ptotic breasts with immediate submuscular placement of implants.

We present a series of 70 patients who have had bilateral subcutaneous mastectomies with immediate placement of implants under the intact pectoralis major and upper part of the serratus anterior. Twenty-two of these patients have had a simultaneous mastopexy, with a free nipple graft. All 70 patients have both of their implants now (up to 3 years) and have a satisfactory appearance.

Breast↗
PubMed1978

Loss of silicone implants after subcutaneous mastectomy and reconstruction.

We studied 89 patients who had immediate or delayed placement of implants after subcutaneous mastectomies. The complications of infection, necrosis of the skin or areola, and extrusion of the prosthesis occurred in 28 percent of these patients, and the incidence was the same after immediate or delayed placement. Only one of the 45 patients who received prophylactic antibodies preoperatively developed an infection after insertion of the prosthesis. The late complications in some of these patients indicate the need for long-term follow-up.

Adult↗
PubMed1979

"Apple coring" the nipple in subcutaneous mastectomy.

A simple technique is described for removing the ductal tissue from the nipple in a subcutaneous mastectomy. We believe that complete removal of all the ductal tissue is desirable in this operation, and that it will also decrease the incidence of subsequent infection. The operative technique, the problems, the advantages, and the disadvantages of the procedure are described.

Adenofibroma↗