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At least 19 recordsLinked to original sources
PubMed1979

Outpatient breast surgery under intercostal block anesthesia.

During the past 3 years, we have performed various breast operations in 320 patients under local anesthesia, using intercostal nerve block. The amount of local anesthetic solution required has been about 20 ml 1% lidocaine for blocking both sides, and an additional 24 ml of 0.5% lidocaine during the surgery. This dosage is well within safe limits. We have found that various breast operations, ranging from augmentation mammaplasty to a staged reconstruction after mastectomy, can be done with this method of anesthesia. The complications attributable to the nerve block were nil in our series.

Ambulatory Care↗
PubMed1977

Breast surgery.

Initial diagnostic errors are related to the presumption that symptoms or findings are due to benign causes. Physical examination augmented by mammographic study will disclose those benign-appearing lesions which may harbor a carcinoma. All palpable lesions and mammographically suspicious areas require that their identity be determined. The final resolution depends upon biopsy. Missing the tumor also causes diagnostic error. An accurate biopsy or "sample" must be obtained for study. Negative results of sampling techniques should be followed by formal biopsy. Failure to eliminate the primary disease by leaving tumor or breast tissue behind increases the incidence of recurrence. Total mastectomy reduces this risk. It is our view that removal of the axillary nodes also aids in obtaining cure, as well as providing prognostic information. Well intentioned attempts to obtain a better cosmetic appearance or to reconstruct the breast are secondary to the patient's chief need which is to achieve cure. Complications of the surgical procedures are due to improper flap dissection, desiccation and trauma to tissues, incomplete hemostasis, and inadequate drainage. Attention to operative details and adherence to well established surgical principles will minimize complications.

Biopsy↗
PubMed2025

Long-Term Outcomes of Radiation Monotherapy Versus Combined Radiation Monotherapy + Hormone Therapy in Low-Risk Early-Stage Breast Cancer Patients 70 Years or Older After Breast-Conserving Surgery.

PURPOSE: Standard therapy for breast cancer after breast-conserving surgery is radiation therapy (RT) plus hormone therapy (HT). For patients with a low-risk of recurrence, there is an interest in deescalating therapy. METHODS AND MATERIALS: A retrospective study was carried out for patients treated at the Swedish Cancer Institute from 2000 to 2015, aged 70 years or older, with pT1N0 or pT1NX estrogen receptor-positive and ERBB2-negative unifocal breast cancer without positive surgical margins, high nuclear grade, or lymphovascular invasion. RESULTS: Patient numbers were sufficient to carry out analyses for RT + HT (n = 307) and RT alone (n = 148). The median follow-up was 9.6 years. There were no statistically significant differences in adjusted overall survival (OS), disease-specific death, progression-free survival (PFS), distant recurrence, and second primary cancers with RT monotherapy compared with RT + HT. Cumulative rates of all of these outcomes were <5%, even at 15 years of follow-up, regardless of treatment, greatly outweighed by the incidence of death from other causes in this elderly population. In matched analysis, we calculated a hazard ratio of 1.12 (95% CI, 0.82-1.53) for RT versus RT + HT for OS and a hazard ratio of 1.12 (95% CI, 0.82-1.53) for RT versus RT + HT for PFS. CONCLUSIONS: Our data suggest that elderly, low-risk breast cancer patients have similarly high OS and PFS with low rates of local recurrence, distant recurrence, and death from breast cancer with much higher rates of death from competing causes, whether treated with RT or HT + RT. These patients are likely to die of other causes without disease recurrence, regardless of which of these treatments is used. Thus, they may benefit from the administration of more modern forms of breast irradiation without the need for adjuvant systemic hormone therapy. A detailed analysis of which clinical, pathologic, genomic, and comorbidity variables are needed to select these patients.

Humans↗
PubMed1977

Radiotherapy after definitive surgery for breast cancer.

(1) Radiotherapy after definitive surgery for breast cancer has not been proved to have a deleterious effect on patient survival. (2) The beneficial effect of radiation therapy is to decrease significantly local recurrences (P less than .001), which are very difficult to control once they develop. (3) In the hands of experienced radiotherapists, the incidence of complications is quite low. (4) Adjuvant chemotherapy effects on the prevention of local recurrence are most encouraging but still experimental and should at this stage be used mainly in study situations. (5) Until more detailed information is obtained, radiation therapy remains the most effective, least toxic method for the control of local disease.

Antineoplastic Agents↗
PubMed1977

[Present status of breast cancer surgery in Italy (author's transl)].

Radical mastectomy is the most frequent surgical procedure in breast surgery in Italy. It is indicated in all stages associated or not to complementary therapies. Extended radical mastectomies are performed less frequently than previously. In initial stages of the disease partial mastectomies are performed more frequently. Generally, castration is performed as therapeutic means, not any more for prophylactic reasons. Adrenalectomy and hypophysectomy are seldom associated procedures. As postoperative treatment, Roentgen-Cobalt-Betatrone therapy is still widely used. However, chemotherapy (CMF) is progressively replacing radiation therapy, mostly in the advanced stages.

Biopsy↗
PubMed1979

A critical viewpoint by a general surgeon toward reconstructive surgery after mastectomy.

Reconstructive breast surgery is accompanied by hazards, both known and unknown, which may endanger the life of the patient. On the other hand, the benefits are largely a modest gesture toward the physical and emotional adjustment. It is the duty of the physician to present all aspects of the contemplated procedure and let the patient decide whether her emotional needs justify the risks entailed.

Breast↗
PubMed1979

[Reconstruction of the breast after surgery for cancer (author's transl)].

The tendency towards less radical, stage-dependent procedures in the surgical management of breast cancer has opened the way to improvement in the reconstructive measures available. Reconstruction of the female breast can be undertaken with greater or lesser success and facility according to whether the initial procedure was subcutaneous mastectomy, modified radical mastectomy or the Rotter--Halstedt radical operation. The different plastic reconstructive methods developed over the past years are discussed and illustrated by cases treated under our care.

Breast↗