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Vascular Trauma
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
Some people may individually ligate the splenic vessels, which is fair enough. As far as I am concerned, however, this is a life-saving manoeuvre, and this is trauma surgery, not elective breast surgery. I am not messing around, and I am not trying to impress anyone. The objective is to stop bleeding and save the patient's life ….
Antineoplastic Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The treatment plan should be contingent on (1) carcinoma stage and (2) gestational age at diagnosis. Generally, breast surgery may be performed during any stage of gestation (Eastwood-Wilshere et al., 2019; also see Chapter 6). Should the procedure be planned close to term, fetal exposure can be eliminated if the infant is delivered first (Bloss and Miller, 1995). The usual accepted surgical technique for breast carcinoma in the pregnant patient is modified radical mastectomy with axillary node dissection (Liberale et al., 2019; Marchant, 1994). “Lumpectomy” and sampling of axillary nodes followed by radiotherapy has not been satisfactorily evaluated in the pregnant patient: “Some guidelines still suggest that SLNB should not be performed during pregnancy, but mounting clinical and pre-clinical data suggest that the procedure can be performed safely” (McCartan and Gemignani, 2016). Concerns that radiotherapy may present a significant risk to the fetus (Petrek, 1994) Studies have demonstrated that the doses absorbed by the fetus are substantially less than the recommended fetal radiation doses. To minimize radiation exposure, it is advisable to inject the technetium radiocolloid on the morning of surgery as opposed to the preceding day (McCartan and Gemignani, 2016). These guidelines are consistent with the recommendations made in 2005 (Pentheroudakis and Pavlidis, 2006).
A worrying lump
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Prognosis after breast surgery is not altered much by more extensive excisions. Consequently, surgeons are performing fewer radical operations, tending to aim towards breast conservation surgery in suitable cases. The aims of surgery are to: remove the local tumour and reduce local growthreduce the risk of metastatic spreadprovide an aesthetic result (with nipple conservation if possible).
Mastectomy is a safe procedure in transgender men with a history of breast reduction
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Floyd W. Timmermans, Lian Elfering, Thomas D. Steensma, Mark-Bram Bouman, Wouter B. van der Sluis
Several concerns have been raised about increased complication and revision rates when prior breast surgery had been performed in subcutaneous mastectomy patients [11,12,21]. The study by Whitehead et al. reported that prior breast surgery was a significant overall predictor for both minor and major complications (hematoma and NAC necrosis). Unfortunately, a statistical comparison was not possible as key defining characteristics were missing. The study by Donato et al. presented a more in-depth analysis of risk factors for complications and revision rates and showed a significant association between prior breast surgery and the need for revision surgery [11]. The revision rate was reported to be 69%, versus 31% in those without prior breast surgery. This revision rate in our cohort is noticeably lower. This might be due to differences in practice, such as mastectomy choice, patient counseling, and expectation management. They also were one of the first studies to voice their concern that prior surgery on the breast leaves scars that make optimal skin resection and scar placement more challenging. This was not shown in our cohort. A possible explanation might be due to their small sample, resulting in an overstated proportion of people needing revision surgery.
Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine
Published in Acta Oncologica, 2023
Aymen Elsous, Mahmoud Radwan, Shahenaz Najjar, Atef Masad, Mohammed Abu Rayya
According to this study, women who do not undergo breast surgery (partial or total mastectomy) have more significant psychological and informational needs than those who undergo surgery [47]. Additionally, the unmet needs of newly diagnosed breast cancer women were higher until three years after diagnosis. The higher uncertainty of the disease patients encounter during the initial treatment may partly explain the higher anxiety about side effects. Moreover, Age-related differences can be explained largely by older patients’ emotional maturity, greater capacity to cope with breast cancer, and relative economic stability [48]. The findings of this study agree with other studies, which report a more significant number of unmet SCNs in younger patients [49]. Younger cancer patients may demand more body image and interpersonal relationship information.
Expert consensus on fertility preservation in patients with breast cancer occurring during pregnancy
Published in Gynecological Endocrinology, 2022
BC surgery does not increase the risk of maternal death and fetal congenital defects; delayed BC surgery may increase the risk of tumor metastasis. Surgery is feasible and relatively safe at any stage of pregnancy. Surgery at more than 28 weeks of pregnancy results in a premature birth rate of 1.5–2.0%, and surgery at less than 13 weeks of pregnancy results in spontaneous abortion or low birth weight infant [15]. Therefore, it is recommended that breast surgery is performed at 13–27 weeks of pregnancy, if there is a need to perform the breast surgery, it should get timely support from the department of anesthesiology, obstetrics, neonatal pediatrics, neonatal intensive care unit and nursing department, and do a good job of individualized nursing after surgery. Under the premise of ensuring R0 resection (there are no cancer cells at the cutting edge), clinicians should choose the appropriate surgical method according to the clinical stage.