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Cancer Biology and Genetics for Non-Biologists
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
Surgery has been used to remove tumours for at least two thousand years. It is usually the first-line treatment for many cancers and possibly in combination with other treatments, such as radiotherapy or chemotherapy. Surgery may remove all the cancer, but sometimes not. Often surgery is not possible. There was a time when radical surgery (extensive surgery) was thought to be the best option, but it was found that this was not always true. For breast cancer, radical mastectomy is generally not carried out, and most women have a lumpectomy where only the tumour is removed, followed by radiotherapy.
Breast Cancer: Surgical Perspectives
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Patricia J. Eubanks, Hernan I. Vargas, Stanley R. Klein
We advocate modified radical mastectomy (MRM) for those patients who: Request itHave large ulcerating tumorsHave large bulky tumors unresponsive to neoadjuvant chemotherapy or unwilling to undergo neoadjuvant chemotherapyHave multiple sites of cancer on mammographyHave had prior irradiation to the breastAre in the first or second trimester of pregnancyDo not want radiation therapy A small study by Leopold et al. found that two or more separate primary tumors in the breast may be associated with a higher incidence of local recurrence after BCT [40]. Prior irradiation to the breast is considered a contraindication to breast-conserving treatment. Usually this is the case in patients who develop a recurrence after previous lumpectomy and AND. Thus, patients with recurrent breast carcinoma should undergo modified radical mastectomy.
Hereditary Breast and Ovarian Cancer
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
For breast cancer patients, surgery includes (i) breast-conserving surgery (or lumpectomy, partial mastectomy, segmental mastectomy, quadrantectomy, or breast-sparing surgery) for removing the cancer and some normal tissue around it, but not the breast itself; (ii) total mastectomy (or simple mastectomy) for removing the whole breast that has cancer; breast reconstruction with the patient's own (nonbreast) tissue or by using implants filled with saline or silicone gel may be undertaken at the time of the mastectomy or at some time after; (iii) modified radical mastectomy for removing the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes part of the chest wall muscles.
Is the TCH-P regimen active in early or locally advanced HER2-positive breast cancer? Results of a retrospective study
Published in Acta Oncologica, 2022
Raffaele Longo, Victoire Thiebaut, Pierre-Olivier Legros, Marco Campitiello, Francesca Plastino, Christophe Goetz, Bogdan Margineanu, Julie Pujois, Michel Gunther, Julie Egea, Chloé Wendel
A clinical/radiological complete response was found in 6 patients (31.8%). Twelve patients (63.6%) presented a partial response and only 1 patient (5.3%) showed a local progression, but this patient achieved a pCR after surgery. The pathological tumor and lymph node response is reported in Figure 1. A primary tumor and lymph node pCR was achieved by 13 (68.9%) and 16 (84.8%) of the patients, respectively. Thirteen patients (68.9%) achieved a ypT0/is and ypN0 tumor response. Two patients (10.6%) presented a partial tumor and lymph node response and 3 patients (15.9%) a partial primary tumor and a complete lymph node response. Only one patient (5.3%) did not show any tumor and/or lymph node response. Subtype analysis showed a higher pCR rate in HR- tumors (Figure 1) and in patients with a Ki-67 grade > 20% (Figure 2). Among the 2 patients with a HER2 2+ score, one reported a pCR and one a partial primary tumor and a complete lymph node response (Figure 3). Breast-conserving surgery was done in 7 patients (37.1%). Twelve patients (63.6%) underwent a radical mastectomy. A radical axillary lymph node dissection was performed in 12 patients (63.6%). All patients received adjuvant radiotherapy and 10 patients (53%) a post-surgery hormonotherapy. T-DM1 vas administered in only one patient (5.3%) who did not achieve a pCR.
Effect of Pretreatment of S-Ketamine On Postoperative Depression for Breast Cancer Patients
Published in Journal of Investigative Surgery, 2021
Peirong Liu, Pengyi Li, Qingyang Li, Hongzhu Yan, Xiaowei Shi, Chunliang Liu, Yu Zhang, Sheng Peng
The present randomized, double-blinded controlled trial included a total of 303 breast cancer patients who received modified radical mastectomy from June 2017 to June 2018. All patients were consecutively enrolled during the study period, and were randomly divided into different groups according to different analgesia strategies. Furthermore, these patients were randomized into different groups through a computer-generated randomized list using the SPSS software (SPSS Inc., Chicago, USA). The diagnosis of these patients was all confirmed by imaging and histological methods. The Hamilton Rating Scale for Depression (HAMD-17) score was measured for all patients before the surgery, and patients with HAMD-17 scores within 8-24 were included into the study. All patients were within 18-65 years old, and had an American Society of Anesthesiologists (ASA) score of I-II. Patients with HAMD-17 scores ≥24 or ≤7 before surgery, patients with other mental diseases, such as schizophrenia and mania, or with a psychiatric history before the study, patients who previously received psychotropic substances, and patients with other severe system diseases, including severe heart, renal and liver diseases, were excluded from the study. Since studies have shown that immediate breast reconstruction might enhance the surgical complication and surgical failure rate, these patients were not recommended to receive immediate breast reconstruction [15,16]. An informed consent was obtained from all patients. The present study was approved by the Ethics Committee of the hospital.
Ultrasound-guided serratus anterior block versus instillation of local anaesthetic through surgical drain in modified radical mastectomy: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2022
Rabab S. S. Mahrous, Haytham Awad Fayed, Abdelrahman Mohamed Kamal
Breast cancer is one of the most diagnosed cancer worldwide. [1] This resulted in improvements in screening techniques for early detection and management. Surgery, chemotherapy, radiation, and hormonal therapy are used to treat it. [2] In most cases, a combination of these approaches yields the best results, allowing for the early and complete eradication of tumor cells while also improving both quality of life and survival. Modified radical mastectomy (MRM), either with or without axillary lymph node clearance, is one of the surgical options for treating breast cancer. [3] This procedure results in a significant surgical scar and intense pain after surgery. It is imperative that this pain be effectively handled so that no negative outcomes result.