Introduction: Breast cancer is currently the most common malignant tumour in women worldwide. Objective: To evaluate conservative treatment of breast cancer and oncoplasty at the teaching hospital Mother and Child of ...Introduction: Breast cancer is currently the most common malignant tumour in women worldwide. Objective: To evaluate conservative treatment of breast cancer and oncoplasty at the teaching hospital Mother and Child of Jeanne Ebori Foundation (CHUMEFJE). Patients and methods: This is an observational, descriptive study, which took place from August 2019 to December 2021 at CHUMEFJE. Data were collected using patients’ medical records, and operative and pathological anatomy reports. Results: Conservative treatment and oncoplasty were performed in 12 (34.2%) patients. Of these patients, 8 (66.7%) benefited from an external technique and 2 (16.7%) from a pamectomy. Post-operative complications were dominated by lymphocele in 5 (41.6%) patients. Ten (83.3%) patients were satisfied with the post-operative aesthetic result. At the time of updating the records, 1 (8.3%) patient had died and 11 (91.7%) were alive. Conclusion: Conservative treatment and oncoplasty are giving satisfactory results at the CHUMEFJE in Libreville.展开更多
Esophageal cancer (EC) is a highly lethal disease. Approximately 50% of patients present with metastatic EC and most patients with localized EC will have local recurrence or develop metastases, despite potentially cur...Esophageal cancer (EC) is a highly lethal disease. Approximately 50% of patients present with metastatic EC and most patients with localized EC will have local recurrence or develop metastases, despite potentially curative local therapy. The most common sites of distant recurrence are represented by lung, liver and bone while brain and breast metastases are rare. Usually patients with advanced disease are not treated aggressively and their median survival is six months. We report a woman patient who developed breast and brain metastases after curative surgery. We treated her with a highly aggressive chemotherapeutic and surgical combination resulting in a complete remission of the disease even after 11-year follow-up. We think that in super selected patients with more than one metastasis, when functional status is good and metastases are technically resectable, a surgical excision may be considered as a salvage option and chemotherapy should be delivered to allow a systemic control.展开更多
Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their pro...Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.展开更多
Metastatic lesions to the eye and optic nerve have incidence of 12% and are observed predominantly in patients, diagnosed with breast and lung cancer. However, isolated involvement of the optic nerve by breast cancer ...Metastatic lesions to the eye and optic nerve have incidence of 12% and are observed predominantly in patients, diagnosed with breast and lung cancer. However, isolated involvement of the optic nerve by breast cancer metastasis is much rarely reported with only 13 cases reported in the literature by 2013, according to Cherkaev et al., that were often preoperatively misdiagnosed. Herewith we present a rare case of optic nerve metastasis in a previously diagnosed breast cancer patient. Review of the literature was done with analysis of the diagnostic difficulties that these cases present and the role of the neurosurgeon in the management of the patients.展开更多
Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pat...Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.展开更多
三阴性乳腺癌(triple-negative breast cancer,TNBC)缺乏明确的生物标志物,现有治疗手段以化疗为主,疗效有限且不良反应大。10%~21%的TNBC为老年患者,多伴随心、脑、肾疾病等诸多慢性合并症,对化疗耐受性差,是临床诊疗实践的一大难题。...三阴性乳腺癌(triple-negative breast cancer,TNBC)缺乏明确的生物标志物,现有治疗手段以化疗为主,疗效有限且不良反应大。10%~21%的TNBC为老年患者,多伴随心、脑、肾疾病等诸多慢性合并症,对化疗耐受性差,是临床诊疗实践的一大难题。同时,专门针对老年TNBC患者的临床研究较少,导致这部分患者的安全及合理用药缺乏充足的循证医学证据,在疾病诊疗方面存在很多难点和争议。此外,老年TNBC有其特征,非肿瘤因素所致死亡率较高。因此,患者生存获益与生活质量及耐受性之间的平衡尤为重要。本文主要针对老年TNBC的流行病学、疾病生物学行为及特征、诊疗现状及未被满足的治疗需求等进行总结分析,并初步探索新型抗体药物偶联物(antibody-drug conjugate,ADC)在老年TNBC中的获益,以期为老年TNBC系统治疗策略的选择提供参考。展开更多
Background Adjuvant chemotherapy has become an important component of standard therapy for breast cancer. However, until now, there have been few reports on the surgical site infections （SSI） after breast cancer sur...Background Adjuvant chemotherapy has become an important component of standard therapy for breast cancer. However, until now, there have been few reports on the surgical site infections （SSI） after breast cancer surgery, specially after adjuvent chemotherapy. To study the risk factors of SSI of breast cancer, we analyzed patients diagnosed with breast cancer and treated with surgery. Methods Fifty-five patients diagnosed with breast cancer and received breast conserving or modified radical operations in our hospital during January 2008 to March 2008 were selected. Factors （patients＇ age, body mass index （BMI）, diabetes mellitus, no or administered adjuvant chemotherapy, with or without onset of myelosuppression and the degree, surgical approaches, duration of operation, postoperative drainage duration and total drainage volume） associated with SSI were retrospectively reviewed and statistically analyzed by single factor analysis. Results Five patients suffered SSI （5/55, 9.1%）; nineteen receiving adjuvant chemotherapy experienced Grade III＋ myelosuppression, among which 4 had SSI; only 1 out of the remaining 36 patients without adjuvant chemotherapy had SSI. The difference between the two groups was significant （P=-0.043）. The incidence of SSI in patients with postoperative drainage tube indwelling longer than 10 days was 5/21, whereas no SSI occurred in that less than 10 days （P=0.009）. In our study, there was no significient difference in other associated factors. Conclusions Concurrent Grade III＋ myelosuppression after adjuvant chemotherapy is an important risk factor of SSI in breast cancer and needs further study. No SSI was detected with indwelling time of post operative drainage less than 10 days.展开更多
文摘Introduction: Breast cancer is currently the most common malignant tumour in women worldwide. Objective: To evaluate conservative treatment of breast cancer and oncoplasty at the teaching hospital Mother and Child of Jeanne Ebori Foundation (CHUMEFJE). Patients and methods: This is an observational, descriptive study, which took place from August 2019 to December 2021 at CHUMEFJE. Data were collected using patients’ medical records, and operative and pathological anatomy reports. Results: Conservative treatment and oncoplasty were performed in 12 (34.2%) patients. Of these patients, 8 (66.7%) benefited from an external technique and 2 (16.7%) from a pamectomy. Post-operative complications were dominated by lymphocele in 5 (41.6%) patients. Ten (83.3%) patients were satisfied with the post-operative aesthetic result. At the time of updating the records, 1 (8.3%) patient had died and 11 (91.7%) were alive. Conclusion: Conservative treatment and oncoplasty are giving satisfactory results at the CHUMEFJE in Libreville.
文摘Esophageal cancer (EC) is a highly lethal disease. Approximately 50% of patients present with metastatic EC and most patients with localized EC will have local recurrence or develop metastases, despite potentially curative local therapy. The most common sites of distant recurrence are represented by lung, liver and bone while brain and breast metastases are rare. Usually patients with advanced disease are not treated aggressively and their median survival is six months. We report a woman patient who developed breast and brain metastases after curative surgery. We treated her with a highly aggressive chemotherapeutic and surgical combination resulting in a complete remission of the disease even after 11-year follow-up. We think that in super selected patients with more than one metastasis, when functional status is good and metastases are technically resectable, a surgical excision may be considered as a salvage option and chemotherapy should be delivered to allow a systemic control.
文摘Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.
文摘Metastatic lesions to the eye and optic nerve have incidence of 12% and are observed predominantly in patients, diagnosed with breast and lung cancer. However, isolated involvement of the optic nerve by breast cancer metastasis is much rarely reported with only 13 cases reported in the literature by 2013, according to Cherkaev et al., that were often preoperatively misdiagnosed. Herewith we present a rare case of optic nerve metastasis in a previously diagnosed breast cancer patient. Review of the literature was done with analysis of the diagnostic difficulties that these cases present and the role of the neurosurgeon in the management of the patients.
基金supported by the Project of the Science and Technology Commission of Beijing Municipality(No.D16110000816002,No.Z181100002218001)。
文摘Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.
文摘三阴性乳腺癌(triple-negative breast cancer,TNBC)缺乏明确的生物标志物,现有治疗手段以化疗为主,疗效有限且不良反应大。10%~21%的TNBC为老年患者,多伴随心、脑、肾疾病等诸多慢性合并症,对化疗耐受性差,是临床诊疗实践的一大难题。同时,专门针对老年TNBC患者的临床研究较少,导致这部分患者的安全及合理用药缺乏充足的循证医学证据,在疾病诊疗方面存在很多难点和争议。此外,老年TNBC有其特征,非肿瘤因素所致死亡率较高。因此,患者生存获益与生活质量及耐受性之间的平衡尤为重要。本文主要针对老年TNBC的流行病学、疾病生物学行为及特征、诊疗现状及未被满足的治疗需求等进行总结分析,并初步探索新型抗体药物偶联物(antibody-drug conjugate,ADC)在老年TNBC中的获益,以期为老年TNBC系统治疗策略的选择提供参考。
文摘Background Adjuvant chemotherapy has become an important component of standard therapy for breast cancer. However, until now, there have been few reports on the surgical site infections （SSI） after breast cancer surgery, specially after adjuvent chemotherapy. To study the risk factors of SSI of breast cancer, we analyzed patients diagnosed with breast cancer and treated with surgery. Methods Fifty-five patients diagnosed with breast cancer and received breast conserving or modified radical operations in our hospital during January 2008 to March 2008 were selected. Factors （patients＇ age, body mass index （BMI）, diabetes mellitus, no or administered adjuvant chemotherapy, with or without onset of myelosuppression and the degree, surgical approaches, duration of operation, postoperative drainage duration and total drainage volume） associated with SSI were retrospectively reviewed and statistically analyzed by single factor analysis. Results Five patients suffered SSI （5/55, 9.1%）; nineteen receiving adjuvant chemotherapy experienced Grade III＋ myelosuppression, among which 4 had SSI; only 1 out of the remaining 36 patients without adjuvant chemotherapy had SSI. The difference between the two groups was significant （P=-0.043）. The incidence of SSI in patients with postoperative drainage tube indwelling longer than 10 days was 5/21, whereas no SSI occurred in that less than 10 days （P=0.009）. In our study, there was no significient difference in other associated factors. Conclusions Concurrent Grade III＋ myelosuppression after adjuvant chemotherapy is an important risk factor of SSI in breast cancer and needs further study. No SSI was detected with indwelling time of post operative drainage less than 10 days.
