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Bilateral and multifocal breast carcinoma. A clinical and autopsy study with special emphasis on carcinoma in situ.

https://arctichealth.org/en/permalink/ahliterature24907
Source
Eur J Surg Oncol. 1991 Feb;17(1):20-9
Publication Type
Article
Date
Feb-1991
Author
A. Ringberg
B. Palmer
F. Linell
V. Rychterova
O. Ljungberg
Author Affiliation
Department of Plastic and Reconstructive Surgery, University of Lund, Malmö General Hospital, Sweden.
Source
Eur J Surg Oncol. 1991 Feb;17(1):20-9
Date
Feb-1991
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - pathology - surgery
Adult
Aged
Aged, 80 and over
Biopsy
Breast - pathology - surgery
Breast Neoplasms - pathology - surgery
Carcinoma in situ - pathology - surgery
Carcinoma, Intraductal, Noninfiltrating - pathology - surgery
Female
Humans
Mastectomy, Subcutaneous
Middle Aged
Abstract
Bilateral clinical breast carcinoma has been reported to appear in up to approximately 10% of patients with breast carcinoma. Increasing diagnostic activity has raised figures of bilaterality, mainly due to detection of lesions of the in situ type. Knowledge of the natural history of carcinoma in situ is incomplete and clinical implications are uncertain. In the present study bilateral lesions were analysed by extensive histological examination in the following groups of patients: (1) Forty-six women (median age 44 years) with clinical and mammographical unilateral invasive breast carcinoma, where the contralateral breast was removed at subcutaneous mastectomy (SCM) during the course of breast reconstruction, 24/46 (52%) had bilateral malignant lesions, four invasive carcinomas and 20 in situ carcinomas (two ductal carcinomas in situ /DCIS/, 15 lobular carcinomas in situ (LCIS), three both DCIS and LCIS). (2) Fifty-two women (median age 50 years) with a unilateral diagnosis of in situ carcinoma (32 DCIS, 16 LCIS, four both DCIS and LCIS), in whom both breasts were removed at SCM. 25/52 (48%) had bilateral malignant lesions, one invasive carcinoma, 24 in situ carcinomas (three DCIS, 18 LCIS, three both DCIS and LCIS). Twelve of 20 cases with LCIS (60%) were bilateral. Of 36 cases with DCIS, seven (19%) were bilateral. (3) The contralateral breast was removed at autopsy in 64 women previously unilaterally mastectomized (at median age 65) for invasive breast carcinoma. Fifteen of 64 (23%) had contralateral primary carcinoma at autopsy, four invasive carcinomas, 11 in situ carcinomas (six DCIS, five LCIS) and 8/64 (13%) had metastases in the breast. Multifocal malignant findings were also analysed in 47 SCM specimens after excisional biopsy for in situ carcinoma. In 35/47 (75%) further malignant lesions were present in spite of normal mammographic and clinical findings. Four were invasive and 31 had in situ lesions (16 DCIS, 10 LCIS, five both DCIS and LCIS): These findings may favour the hypothesis that some carcinomas in situ may remain silent or even regress. It is thus important to embark upon randomized trials to clarify the natural history of breast carcinoma in situ. Such a trial has been started in the southern region of Sweden.
PubMed ID
1847343 View in PubMed
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Breast cancer incidence subsequent to surgical reduction of the female breast.

https://arctichealth.org/en/permalink/ahliterature22707
Source
Br J Cancer. 1996 Apr;73(7):961-3
Publication Type
Article
Date
Apr-1996
Author
M. Baasch
S F Nielsen
G. Engholm
K. Lund
Author Affiliation
Danish Cancer Society, Division for Cancer Epidemiology, Copenhagen.
Source
Br J Cancer. 1996 Apr;73(7):961-3
Date
Apr-1996
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Breast - pathology - surgery
Breast Neoplasms - epidemiology
Cohort Studies
Comparative Study
Female
Follow-Up Studies
Humans
Hypertrophy - surgery
Incidence
Mammaplasty
Middle Aged
Postoperative Complications
Abstract
The incidence of breast cancer among 1240 women who were treated surgically for breast hypertrophy in Copenhagen, Denmark between 1943 and 1971 was determined and compared with age- and calendar period-specific rates for the Danish female population. A total of 32 cases of breast cancer had developed by the end of 1990; the expected number was 52.55, yielding a relative risk (RR) of 0.61 [95% confidence interval (CI) 0.42-0.86]. The greatest reduction in risk was observed for women who had 600 g or more of breast tissue removed (RR=0.30; 95% CI 0.10-0.69). This suggests that the number of potential foci is important for cancer development in the female breast. In the group of women who were operated on before the age of 20, four cases of breast cancer developed, compared with 2.23 expected cases, to give an RR of 1.79, suggesting that the aetiology of their breast hypertrophy may be different from that for the rest of the group.
PubMed ID
8611415 View in PubMed
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Cost-effectiveness of reduction mammaplasty.

https://arctichealth.org/en/permalink/ahliterature70902
Source
Int J Technol Assess Health Care. 2004;20(3):269-73
Publication Type
Article
Date
2004
Author
Andrew J Taylor
David Tate
Yvonne Brandberg
Lennart Blomqvist
Author Affiliation
University of Hull, Hull, UK.
Source
Int J Technol Assess Health Care. 2004;20(3):269-73
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast - pathology - surgery
Cost-Benefit Analysis
Female
Humans
Hypertrophy
Mammaplasty - economics
Middle Aged
Quality-Adjusted Life Years
Abstract
OBJECTIVES: The purpose of this study is to provide a comparison of the benefits of reduction mammaplasty (RM) for women with heavy breasts often termed macromastia or breast hypertrophy (BH) surgery. The rationale is to provide information to allow decision-makers to make judgments about the cost-effectiveness of this intervention and make comparisons with other interventions which are commonly undertaken within publicly financed health-care systems. METHODS: Data from a previous outcomes study in Sweden is re-analyzed to derive quality of life measures, from which a mean level of benefit outcome is derived and a cost per quality-adjusted life year is calculated (cost per QALY). RESULTS: The low Cost per QALY suggests that reduction mammaplasty is cost-effective when compared with other treatments which are commonly undertaken. CONCLUSIONS: The authors suggest that the evidence in favor of funding reduction mammaplasty is strong and that decision-makers review their policy in light of this new evidence.
PubMed ID
15446755 View in PubMed
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Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node.

https://arctichealth.org/en/permalink/ahliterature104966
Source
Eur J Surg Oncol. 2014 Apr;40(4):435-41
Publication Type
Article
Date
Apr-2014
Author
T F Tvedskov
T J Meretoja
M B Jensen
M. Leidenius
N. Kroman
Author Affiliation
Department of Breast Surgery, Copenhagen University Hospital, Afsnit 4124, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: tft@dadlnet.dk.
Source
Eur J Surg Oncol. 2014 Apr;40(4):435-41
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Area Under Curve
Breast Neoplasms - pathology - surgery
Carcinoma, Ductal, Breast - pathology - surgery
Carcinoma, Lobular - pathology - surgery
Denmark
Female
Finland
Humans
Lymph Node Excision
Lymph Nodes - pathology - surgery
Lymphatic Metastasis
Middle Aged
Models, Statistical
Neoplasm Grading
Neoplasm Micrometastasis - diagnosis
Neoplasm Staging
Predictive value of tests
Risk assessment
Risk factors
Sentinel Lymph Node Biopsy
Abstract
We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment.
Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort.
The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22% of the patients as high-risk patients with over 30% risk of non-sentinel node metastases while less than 1% was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases.
The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.
PubMed ID
24534362 View in PubMed
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Recurrences after immediate reconstruction in breast cancer.

https://arctichealth.org/en/permalink/ahliterature175009
Source
Scand J Surg. 2005;94(1):21-4
Publication Type
Article
Date
2005
Author
P. Mustonen
V. Kataja
M. Berg
T. Pietiläinen
A. Papp
Author Affiliation
Department of Plastic Surgery, Kuopio University Hospital, Kuopio, Finland. paula k.mustonen@kuh.fi
Source
Scand J Surg. 2005;94(1):21-4
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Brain Neoplasms - secondary
Breast - pathology - surgery
Breast Neoplasms - epidemiology - pathology - surgery
Disease-Free Survival
Female
Finland - epidemiology
Follow-Up Studies
Humans
Incidence
Mammaplasty
Middle Aged
Neoplasm Recurrence, Local
Treatment Outcome
Viscera - pathology
Abstract
To determine the incidence of and reasons for recurrences after immediate breast reconstruction in breast cancer patients.
The data of 79 patients undergoing immediate breast reconstruction between 1998 and 2001 in Kuopio University Hospital were re-examined from both the local cancer register and the patient charts at the end of year 2003.
There were five local recurrences (6.3%), one regional recurrence (1.2%), and three cases (3.8%) presented bone and/or visceral metastases. All recurrences except one (primary tumor noninvasive) appeared within the first two years after primary therapy. Young age and increasing size of the tumour were risk factors for distant or logoregional metastases.
Immediate breast reconstruction is a safe procedure in breast cancer patients, but a multidisciplinary team is needed for careful patient selection.
PubMed ID
15865111 View in PubMed
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Reoperation Rates in Ductal Carcinoma In Situ vs Invasive Breast Cancer After Wire-Guided Breast-Conserving Surgery.

https://arctichealth.org/en/permalink/ahliterature282249
Source
JAMA Surg. 2017 Apr 01;152(4):378-384
Publication Type
Article
Date
Apr-01-2017
Author
Linnea Langhans
Maj-Britt Jensen
Maj-Lis M Talman
Ilse Vejborg
Niels Kroman
Tove F Tvedskov
Source
JAMA Surg. 2017 Apr 01;152(4):378-384
Date
Apr-01-2017
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Breast Neoplasms - pathology - surgery
Carcinoma, Ductal, Breast - pathology - surgery
Carcinoma, Intraductal, Noninfiltrating - pathology - surgery
Carcinoma, Lobular - pathology - surgery
Denmark
Female
Humans
Margins of Excision
Mastectomy, Segmental
Middle Aged
Reoperation
Retrospective Studies
Risk factors
Abstract
New techniques for preoperative localization of nonpalpable breast lesions may decrease the reoperation rate in breast-conserving surgery (BCS) compared with rates after surgery with the standard wire-guided localization. However, a valid reoperation rate for this procedure needs to be established for comparison, as previous studies on this procedure include a variety of malignant and benign breast lesions.
To determine the reoperation rate after wire-guided BCS in patients with histologically verified nonpalpable invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS) and to examine whether the risk of reoperation is associated with DCIS or histologic type of the IBC.
This nationwide study including women with histologically verified IBC or DCIS having wire-guided BCS performed between January 1, 2010, and December 31, 2013, used data from the Danish National Patient Registry that were cross-checked with the Danish Breast Cancer Group database and the Danish Pathology Register.
Reoperation rate after wire-guided BCS in patients with IBC or DCIS.
Wire-guided BCS was performed in 4118 women (mean [SD] age, 60.9 [8.7] years). A total of 725 patients (17.6%) underwent a reoperation: 593 were reexcisions (14.4%) and 132 were mastectomies (3.2%). Significantly more patients with DCIS (271 of 727 [37.3%]) than with IBC (454 of 3391 [13.4%]) underwent a reoperation (adjusted odds ratio, 3.82; 95% CI, 3.19-4.58; P?
PubMed ID
28002557 View in PubMed
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Re-resection rates and risk characteristics following breast conserving surgery for breast cancer and carcinoma in situ: A single-centre study of 1575 consecutive cases.

https://arctichealth.org/en/permalink/ahliterature265800
Source
Breast. 2014 Dec;23(6):784-9
Publication Type
Article
Date
Dec-2014
Author
C G Kryh
C A Pietersen
H B Rahr
R D Christensen
P. Wamberg
M D Lautrup
Source
Breast. 2014 Dec;23(6):784-9
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Antineoplastic Agents - therapeutic use
Breast Neoplasms - pathology - surgery
Carcinoma in situ - pathology - surgery
Carcinoma, Ductal, Breast - pathology - surgery
Carcinoma, Intraductal, Noninfiltrating - pathology - surgery
Carcinoma, Lobular - pathology - surgery
Cohort Studies
Denmark
Female
Humans
Mastectomy, Segmental
Neoadjuvant Therapy
Reoperation
Risk factors
Abstract
To examine the frequency of re-resections and describe risk characteristics: invasive carcinoma or carcinoma in situ (CIS), palpability of the lesion, and neoadjuvant chemotherapy.
1703 breast conserving surgeries were performed: 1575 primary breast conserving surgeries (BCS), and 128 diagnostic excisions (DE). 176 BCS (11.2% [9.6; 12.7]) and 100 DE had inadequate margins indicating re-resection. The overall re-resection rate was 16.2% [14.5; 18.0]. 10.3% of invasive carcinoma BCS patients, and 28.6% CIS patients underwent re-resection (relative risk (RR) 2.8 [1.9; 4.1]). Invasive lobular carcinoma (ilc) had an RR of re-resection of 2.5 [1.7; 3.8], compared with invasive ductal carcinoma (idc).
Overall 11.2% of the BCS patients needed a re-resection. For isolated CIS (28.6%), RR of re-resection was almost three times as high compared to invasive carcinoma (10.3%). Ilc had an RR of re-resection of 2.5 compared to idc. Palpability and neoadjuvant chemotherapy did not significantly influence the risk of re-resection.
PubMed ID
25227964 View in PubMed
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[Risk of locally-advanced recurrences of breast cancer following organ-saving surgery].

https://arctichealth.org/en/permalink/ahliterature151040
Source
Vopr Onkol. 2009;55(1):33-7
Publication Type
Article
Date
2009
Author
S S Gurbanov
D E Matsko
S V Kanaev
V F Semiglazov
Source
Vopr Onkol. 2009;55(1):33-7
Date
2009
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms - pathology - surgery
Carcinoma, Ductal, Breast - pathology - surgery
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lymphatic Metastasis
Mastectomy, Segmental
Middle Aged
Neoplasm Recurrence, Local - epidemiology - pathology
Neoplasm Staging
Risk assessment
Risk factors
Russia - epidemiology
Survival Analysis
Abstract
A long-term (15 years) investigation of risk factors of locally-advanced recurrences of breast cancer following organ-saving surgery was carried out involving a large number of cases (667). It was shown that tumor size larger than 2 cm (T2), presence of intraductal component (EIC+), high grade (III), lymph node involvement (pN+), multicentricity and positive wound edge contribute to risk of such recurrences by 10-15%.
PubMed ID
19435196 View in PubMed
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Technical factors, surgeon case volume and positive margin rates after breast conservation surgery for early-stage breast cancer.

https://arctichealth.org/en/permalink/ahliterature140615
Source
Can J Surg. 2010 Oct;53(5):305-12
Publication Type
Article
Date
Oct-2010
Author
Peter J Lovrics
Sylvie D Cornacchi
Forough Farrokhyar
Anna Garnett
Vicky Chen
Slobodan Franic
Marko Simunovic
Author Affiliation
Department of Surgery, McMaster University, Hamilton, Ontario, Canada. lovricsp@mcmaster.ca
Source
Can J Surg. 2010 Oct;53(5):305-12
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - pathology - surgery
Carcinoma, Ductal, Breast - pathology - surgery
Carcinoma, Lobular - pathology - surgery
Cohort Studies
Early Diagnosis
Female
Hospitals - utilization
Humans
Mastectomy, Segmental
Middle Aged
Ontario
Outcome Assessment (Health Care)
Retrospective Studies
Workload - statistics & numerical data
Abstract
For patients with breast cancer, a negative surgical margin at first breast-conserving surgery (BCS) minimizes the need for reoperation and likely reduces postoperative anxiety. We assessed technical factors, surgeon and hospital case volume and margin status after BCS in early-stage breast cancer.
We performed a retrospective cohort study using a regional cancer centre database of patients who underwent BCS for breast cancer from 2000 to 2002. We considered the influence of patient, tumour and technical factors (e.g., size of specimen and preoperative diagnosis of cancer available) and surgeon and hospital case volume on margin status at first and final operation. We performed univariate and multivariate regression analyses.
We reviewed 489 cases. There were no differences in patient or tumour characteristics among the low-, medium- and high-volume surgeon groups. High-volume surgeons were significantly more likely than other surgeons to operate with a confirmed preoperative diagnosis and to resect a larger volume of tissue. In our univariate analysis and at first operation, the rates of positive margins were 16.4%, 32.9% and 29.1% for high-, medium- and low-volume surgeons, respectively (p = 0.002). In the multivariate analysis, tumour factors (palpability, size, histology), presence of a confirmed preoperative diagnosis and size of resection specimen significantly predicted negative margins. However, when we controlled for these and other factors, high surgeon volume was not a predictor of negative margins at first surgery (odds ratio 1.8, 95% confidence interval 0.9-3.8, p = 0.09). Increased hospital volume was not associated with a lower rate of positive margins at first surgery.
Various tumour and technical factors were associated with negative margins at first BCS, whereas surgeon and hospital volume status were not. Technical steps that are under the control of the operating surgeon are likely effective targets for quality initiatives in breast cancer surgery.
Notes
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PubMed ID
20858374 View in PubMed
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[Waiting lists and reality. Revision of the waiting list for reduction of breast hyperplasia in health region 1]

https://arctichealth.org/en/permalink/ahliterature73762
Source
Tidsskr Nor Laegeforen. 1990 May 30;110(14):1864-5
Publication Type
Article
Date
May-30-1990
Author
M H Kveim
S. Trender
O M Ugland
T. Rusli
Author Affiliation
Plastikkirurgisk avdeling, Røde Kors Klinikk.
Source
Tidsskr Nor Laegeforen. 1990 May 30;110(14):1864-5
Date
May-30-1990
Language
Norwegian
Publication Type
Article
Keywords
Adult
Appointments and Schedules
Breast - pathology - surgery
English Abstract
Female
Humans
Hyperplasia
Middle Aged
Norway
Surgery, Plastic
Waiting Lists
Abstract
The Red Cross Hospital is the only public hospital providing plastic surgical services for the Oslo population. The waiting list for reduction mammaplasty had become unacceptably long. Some women had been waiting for as long as 4.5 years. We therefore decided to reexamine all the 309 patients in question. Only 22% were cleared for operation. 19% were removed temporarily from the waiting list due to obesity (awaiting weight reduction). The remainder was found to be either mainly motivated or to be motivated for mainly oesthetic reasons and therefore not eligible for public health funding.
PubMed ID
2363157 View in PubMed
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10 records – page 1 of 1.