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PubMed1995

[Mammaplasty immediately after mastectomy for breast cancer].

From March 1990 to March 1994, 7 cases of one stage breast reconstruction with silicone prosthesis after mastectomy for breast cancer were performed in our hospital. All the operations were successful and no operative complication observed. They were followed up for three months to four years. The contour was good, symmetrical, soft to touch and the patients did not complain uncomfortable sensation. The authors propose that immediate reconstruction of the breast be recommended. In this paper, the indications, methods, selection of opportune time for operation and precautions are discussed.

Adenocarcinoma↗
PubMed1996

Acquired lymphangiectasis following mastectomy and radiation therapy--report of a case and review of the literature.

A woman noted vesicles and papules on her left upper extremity fifteen years after she underwent mastectomy and received radiation treatment for left breast carcinoma. The vesicles showed clinical and pathologic features of acquired lymphangiectasis. The skin lesions were successfully treated with shave excision followed by electrodesiccation and sequential peristaltic compressions twice daily.

Adult↗
PubMed1997

[Subcutaneous mastectomy].

The subcutaneous mastectomy (SM) which cannot be standardized is the possible treatment in a given indication especially to reduce the risk of cancer to a large extent-though only through experienced hands. Any re-operation often resulting from the complications of reconstructions through silicon prostheses can be more extensive than mamma-carcinoma therapy itself. The patient as well as the surgeon must be aware that the aesthetic result of the therapy is not the primary reason for the operation but the prevention or therapy of a life-threatening disease. With this perspective in mind the high rate of complications with SM is an acceptable risk and may ensure a high degree of permanent tumor removal.

Breast Implants↗
PubMedDate not supplied

[Modified radical mastectomy. Experience of the Institut J. Bordet (author's transl)].

The authors report the results of a homogeneous series of 319 modified radical mastectomies where both pectoralis muscles are respected, in the treatment of breast cancer. Operative mortality is nill and morbidity is low. Persistant lymphedema of the arm is not marked. The frequency of axillary nodes is 64%. Local recurrences occur in 12% of cases. Total 5 year survival was 50.1%. It was 89% for stage I, 57.3% for stage II and 43.7% for stage 222. It was 61.5% if there were no involved nodes, 63.9% when 1 to 3 nodes were involved and 32% when 4 or more nodes were involved. The authors recommend this type of operation of tumors of state II and III as the 5 year survival is identical to that of other techniques, as morbidity and mortality are low and distant sequellae are unimportant.

Adult↗
PubMed1997

[The current indications for Madden's radical mastectomy in our experience. A critical review of 201 consecutive patients].

The clinical pathological data regarding the 201 patients (203 operations running) who underwent radical mastectomy according to Madden in the II Division of General Surgery at Brescia Civil Hospital in the period 1993-1994, have been reexamined in order to check the real need of radical surgery. This further analysis, apart from the patients with neoplasias of considerable dimensions (T2; > 2 cm), has been carried out on 100 tumors smaller dimensions (T1; < 2 cm) and has confirmed the necessity of radical surgery in 87 cases. Of the 13 operations (6.4%) that have been considered "improper" 2 were due to erroneous clinical staging (dubious cutaneous infiltration) and 5 (2.5%) presented a neoplastic diameter of exactly 2 cm which only partially justified radical surgery. In six patients (2.9%) we haven't found clinical pathological elements which contraindicated conservative surgery.

Adult↗
PubMed1997

[Liver metastases from breast cancer 14 years after radical mastectomy; successful treatment with hepatic arterial infusion chemotherapy and systemic endocrine therapy--a case report].

The patient was a 73-year-old woman who was admitted to our hospital for epigastric discomfort and body weight loss. She had undergone radical right mastectomy in March 1982. Ultrasonography and computed tomography revealed multiple tumors in the liver. Three of the tumor markers (CA-125, CA 19-9, and CA 15-3) were positive. US-guided fine needle aspiration biopsy of the liver tumor showed small atypical cells with solid cell nests. Immunohistochemical tests revealed estrogen receptor was positive. We diagnosed the patient as recurrent breast cancer metastatic to liver, 14 years postoperatively. The liver tumors were successfully controlled with the combination of intra-arterial infusion chemotherapy (5-fluorouracil, epirubicin, and mitomycin C) along with systemic endocrine therapy (medroxyprogesterone acetate and fadrozole hydrochloride hydrate).

Aged↗
PubMed1998

Manual lymphatic drainage for chronic post-mastectomy lymphoedema treatment.

BACKGROUND: The authors evaluated the chronic post-mastectomy lymphoedematous tissue and the effects of manual lymphatic drainage (Leduc method) with and without compressive bandage. METHODS: The arms were measured before and after physical therapy and the results were expressed as a percentage decrease. Physical therapy was performed first by manual lymphatic drainage only and after by manual lymphatic drainage plus compressive bandage. RESULTS: We observed that during manual lymphatic drainage plus compressive bandage the total percentage decrease of whole limb was the highest: 41.1 +/- 12.2% versus 30.4 +/- 15.8% (p < 0.05). Clinical and physiopathological implication are discussed.

Adult↗
PubMed1998

Problems in wearing external prosthesis after mastectomy and patient's desire for breast reconstruction.

BACKGROUND AND AIMS: To evaluate the inconvenience caused by an external prosthesis and the desire for breast reconstruction among Finnish breast cancer patients. MATERIAL AND METHODS: A questionnaire was sent to 345 mastectomized women 2-58 months after surgery between 1989 and 1993; 176 questionnaires were eliglible for review. Response rate was 63%. RESULTS: Mean age of the patients was 58 years, and 91% wore an external prosthesis. Of the patients under 65 years old, 46% wished to have reconstruction, but only one patient in the group 65 years old or older was interested in reconstructive surgery. In this study, interest in reconstructive surgery did not decrease with time. Younger patients had more difficulties and inconvenience with the prosthesis in every-day life while working, enjoying leisure time pursuits and wearing clothing. CONCLUSIONS: Breast cancer patients under 65 years have considerable problems with external prosthesis in every-day life. This is the group of patients therefore, that should be considered when evaluating the need for breast reconstruction in the community. Of new breast cancer patients in Finland, 40% per cent are between 45 and 59; about 50-70% of them will have a mastectomy. Our study suggests that breast reconstruction is needed for about half of these patients. Therefore, the annual need for breast reconstruction in Finland involves about 370 women.

Adult↗
PubMed1997

[The comparative characteristics of methods for breast reconstruction after a mastectomy].

Ablation of the breast because of cancer is a damaging operation leading the patients on a heavy psycho trauma. At the background of the main disease--cancer, deformation of the chest wall, caused by mastectomy their depression deteriorates. Therefore the breast reconstruction today is considered as an indivisible part of the complex treatment process. The techniques by means of witch the reconstruction could be achieved are: implantation of breast prosthesis, pedicle or free myocutaneous flaps. We enclose the comparative characteristic of the treatment results of 70 patients using different techniques.

Adult↗
PubMed1997

[Breast reconstruction after mastectomy and breast implants. Current status in the USA].

The author review breast reconstruction after mastectomy for cancer, taking account the technical progress and problems raised by breast implants over the last twenty years. Immediate breast reconstruction has become a routine clinical practice. The principle, indications and complications of reconstruction techniques are presented: temporary expansion prosthesis, permanent expansion prosthesis, latissimus dorsi myocutaneous flap associated with an implant, rectus abdominis myocutaneous pedicle flap, free flaps.

Breast Implantation↗
PubMed1998

[Breast reconstruction after mastectomy for cancer].

In spite of advances in breast cancerology, partial or total mastectomy still has wide indications and remains a mutilative procedure. Since its introduction over thirty years ago, breast reconstruction has become an accepted, codified and efficient procedure. The techniques which can be used can be broadly divided into two categories: reconstructions with implants, which have been greatly improved by skin expansion techniques, and reconstructions using myocutaneous flaps. Whatever method is used, the breast is modeled during the reconstruction procedure and surgery is frequently necessary to obtain a symmetric opposite breast; a good knowledge of plastic surgery is thus a requisite.

Breast Neoplasms↗
PubMed1998

[Local recurrences and mortality after mastectomy--a retrospective analysis].

It is the aim of the study to reveal the underlying causes of local recurrences and lethality in post-mastectomy patients. A retrospective analysis is done in a series of 293 patients presenting mammary gland carcinoma, operated in the period October 1994 through June 1996. The causes of local recurrences and lethality are linked to the stage of disease (TNM-system), pathohistological patterns of the neoplasm, malignancy degree, as well as inadequate surgical and therapeutic approach against the background of concomitant affections and age factor. The analysis is done using data-base elaborated by the author in computerized program "Paradox 5 for Windows". As shown by the results, in patients with high-degree neoplastic malignancy, inaccurate assessment by the TNM system preoperatively and in 2b and following stages, the rate of local relapses and lethality augment. 1. A more accurate elucidation of the preoperative stage of the disease using instrumental methods is absolutely necessary, since it contributes to reduce the risk of missing single stages in the complex management of this contingent of patients. 2. After obtaining a definitive pathohistological result and malignancy degree assessment, a revision of the complex management protocol worked out in advance is indispensable.

Adult↗
PubMed1978

Incidental discovery at radical mastectomy of inapparent Hodgkin's disease in long term survivors.

Two long-term survivors with nodular sclerosing Hodgkin's disease were found to have adenocarcinoma of the breast sixteen and twenty years after limited field radiotherapy. Examination of the axillary nodes at radical mastectomy showed both metastatic adenocarcinoma and clinically inapparent Hodgkin's disease. The occurrence of persistent but clinically inactive Hodgkin's disease as well as the development of secondary malignancies in this disease has important clinical ramifications. Skin testing and in vitro lymphocyte transformation studies in these two patients were also done.

Adenocarcinoma↗
PubMed1980

Radiation therapy of early carcinoma of the breast without mastectomy.

The results of the treatment of 176 patients with early breast cancer, using radiation therapy without mastectomy are reported. The likelihood of local recurrence was 5% for Stage I patients and 7% for Stage II patients. Local control was significantly greater in those patients receiving and iridium implant (1/73 vs. 10/111, P less than .05). The cumulative survival probability at five years is 96% for Stage I and 68% for Stage II. Local control with good cosmetic results is greatly influenced by surgical and radiotherapeutic technique. Gross tumor resection with careful reapproximation of the breast tissue and well-placed incisions facilitates the radiation therapy. Homogeneous external beam radiation to the breast and draining lymph nodes (4500--5000 rads) and supplemental local radiation to the sites of the primary lesion (in this series using interstitial implantation) are recommended.

Adult↗
PubMed1995

The Impacts of Breast Conserving Treatment and Mastectomy on the Quality of Life in Early-stage Breast Cancer Patients.

The quality of life (QOL) in 55 early-stage breast cancer patients after surgery was prospectively assessed using a newly developed Japanese QOL questionnaire: The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD). The impacts of breast conserving treatment (BCT) (22 cases) and modified radical mastectomy (MRM) (33 cases) on the QOL in those subjects were compared. The overallQOL scores were evaluated during four periods (before surgery, 0-2, 3-12, and 13-24 months after surgery). The mean scores of the four categories of the QOL-ACD (activity, physical condition, psychological condition, and social relationships) were also compared. The results demonstrated that a significant improvement was observed in the overall QOL scores among the three periods after surgery (0-2, 3-12, and 13-24 months) only in the BCT group (p<0.05). There were no significant differences between the two groups in the overall QOL scores during any of the three periods after surgery, and the mean score of the 'psychological condition' during 0-2 months period in the BCT group was significantly lower than that in the MRM group (p<0.05). These results suggest that BCT does not always improve the patients' QOL more than MRM does, and that the patients receiving BCT require more psychological support than those receiving MRM during the early postoperative period.

Journal Article↗
PubMed1995

Comparison of Modified Radical Mastectomy with Quadrantectomy, Axillary Dissection, and Radiation Therapy in Early Breast Cancer in Japaness Women.

From January 1987 to December 1993, Stage I (T1N0M0) breast cancers were treated by quadrantectomy with axillary lymph node dissection plus radiation therapy (QUART) in 57 cases and by modified radical mastectomy (MRM) in 57 cases. The results for these two treatment groups were compared retrospectively. Booster irradiation of 10 Gy to the tumor bed was given to 1 of 5 cases with a positive resection margin. The remaining 56 cases received 50 Gy lineac X-ray to the ipsilateral breast. Systemic adjuvant therapy, tamoxifen and /or 5-FU derivatives p.o., were given to the majority of cases in both groups. There were no significant differences between the two groups with regard to the patient background; ie, age, tumor size, pathological node status, histology and estrogen receptor status. During the follow-up period of 12 to 89 months (median 55 months) in the QUART group, no local recurrence was observed and only 1 case of bone metastasis occurred. In the MRM group, recurrence occurred in 4 cases during the follow-up period of 12 to 95 months (median 52 months). These consisted of 2 cases of regional lymph node recurrence and 2 cases of lung metastases. The differences in the disease-free survival rate and the overall survival rate between the two groups were not significant. In the QUART group, mild radiation pneumonitis and mild telangiectasia in the breast skin were observed in 2 cases(3.5%) and 1 case, respectively. Mild arm edema was observed in 4 cases (7%) in each group. These results demonstrated that QUART was as effective as MRM in treating T1M0M0 breast carcinoma in Japanese women.

Journal Article↗
PubMed2002

Treatment of necrotic infection on the anterior chest wall secondary to mastectomy and postoperative radiotherapy by the application of omentum and mesh skin grafting: report of a case.

We report herein the case of a patient who initially underwent right radical mastectomy for breast carcinoma in 1988, followed by left breast-conserving surgery in 1997. On both occasions she was given postoperative radiation therapy of 50 Gy. Repeated dressings and the administration of antibiotics failed to heal ulcerative infected lesions that had formed on the anterior chest wall in early 1998. In 1999, the sternum and surrounding tissue were debrided and the anterior chest wall was reconstructed by omentum transposition and mesh skin grafting. The patient is currently well and alive without any evidence of recurrence of either infection or breast cancer.

Adult↗