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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Treatments include surgery and radiation therapy. In some cases, mastectomy is required, with breast-conserving surgery preserving as much breast tissue as possible. This depends on a determination of tumor size. To describe the extent of breast tissue that must be removed, the terms lumpectomy, quadrantectomy, and wide excision are used. The patient’s preference is important and breast-conserving surgery with radiation therapy has the advantage of less extensive surgery. Therefore, the breast can be kept as intact as possible. Preoperative chemotherapy is often used to shrink the tumor. After the axillary nodes are removed, radiation therapy is required. The patient should exercise every day as instructed. After lymphedema reduces over 1–4 weeks, the patient continues daily exercise and overnight bandaging for as long as the lymphedema is present.
The breast
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Conservative breast cancer surgery This is aimed at removing the tumour plus a margin of normal breast tissue. This is commonly referred to as a wide local excision. The term lumpectomy should be reserved for an operation in which a benign tumour is excised and in which a large amount of normal breast tissue is not resected. A quadrantectomy involves removing the entire segment of the breast that contains the tumour. Both of these operations are usually combined with axillary surgery, usually via a separate incision in the axilla. There are various options that can be used to deal with the axilla, including sentinel node biopsy, sampling, removal of the nodes behind and lateral to the pectoralis minor (level II) or a full axillary dissection (level III). The width of the margin has attracted much controversy, with some units adopting a 1-cm margin and others 1 mm. A recent consensus meeting has suggested that no tumour at the inked margin is sufficient, although the trials upon which this is based have been challenged and many still regard 1 mm as a safer margin. There is no need for wider margins than this.
Malignant breast disease
Published in S Asbury, A Mishra, KM Mokbel, M Fishman Jonathan, Principles of Operative Surgery, 2017
S Asbury, A Mishra, KM Mokbel, M Fishman Jonathan
In quadrantectomy, an ellipse of the overlying skin and the underlying pectoral fascia are removed, in addition to wide local excision of the lump. Quadrantectomy has a lower recurrence rate than wide local excision, but the cosmesis is inferior.
When a metastatic breast cancer is mimicking a pancreatic cancer: case report and review of the literature
Published in Acta Clinica Belgica, 2020
Françoise Derouane, Jean-Cyr Yombi, Jean-François Baurain, Etienne Danse, Mina Komuta, Halil Yildiz
A 51 year-old woman was diagnosed with breast cancer in 2008 without any metastasis. The tumor marker CA15–3 was normal at the time of diagnosis. The treatment consisted of quadrantectomy with lymphadenectomy. Histopathological examination revealed invasive ductal carcinoma classified pT2pN0cM0 consisting of a 3 × 4 × 2.5 cm tumor without any axillary spread (0/8). Immunohistochemical analyses were positive regarding estrogen receptor (ER), progesterone receptor (PR) and Human Epidermal growth Receptor 2 (HER2). Due to its high-risk profile (luminal-B HER 2 positive carcinoma) she was treated with 6 cycles of chemotherapy with Docetaxel and Capecitabine following the protocol-study MINDACT, in association with a HER2 targeted drug (Trastuzumab), the latest one given for a total duration of one year. After chemotherapy, she was treated by radiotherapy and hormonotherapy for a total duration of 5 years (Letrozole 1 year followed by Goserelin and Tamoxifen for 4 years).
Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2019
Most reports suggested that surgery is still the main treatment for IGLM. Based on the resection sizes from small to large, the surgeries include breast abscess incision and drainage, extensive lumpectomy, quadrantectomy and ipsilateral masctectomy, and the first stage of plastic surgery according to the patient's wishes.23 Since breast abscess incision and drainage may not completely remove the lesion area, the wound may not be easy to heal, which may produce fistula, surgery is only suitable for the treatment of patients with larger abscess to shrink the lesion in order to facilitate secondary surgical resection. We believe that extensive lumpectomy and quadrantectomy are suitable for most patients. Because IGLM is a benign disease, simple mastectomy must not be accepted by the majority of patients. In this study, only one patient accepted the procedure, because of previous breast surgery, which had removed the part of the breast tissue. Because the patient suffered from IGLM in a larger range, and because a glandular flap repair could not achieve satisfactory results, and her financial conditions could not support the first phase plastic surgery, she chose ipsilateral masctectomy.
Role of self-efficacy for pain management and pain catastrophizing in the relationship between pain severity and depressive symptoms in women with breast cancer and pain
Published in Journal of Psychosocial Oncology, 2023
Hannah M. Fisher, Juliann Stalls, Joseph G. Winger, Shannon N. Miller, Jennifer C. Plumb Vilardaga, Catherine Majestic, Sarah A. Kelleher, Tamara J. Somers
At enrollment, mean time since diagnosis was approximately 10 months (SD = 6.21). For most women (97.2%), this was their first diagnosis of breast cancer. Over half the sample reported Stage I disease (56.0%). Breast-conserving surgery was common, with 56.9% of the sample having undergone lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy. Only 8.3% (n = 27) reported receipt of chemotherapy during the week before the baseline assessment, while 10.8% (n = 35) reported receipt of radiation during that same time frame. At the time of the baseline assessment, 15.1% and 9.6% of women endorsed receipt of endocrine therapy or immunotherapy, respectively. Additional medical characteristics of the sample are reported in Table 2.