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Preserving Nipple Sensitivity after Breast Cancer Surgery: A Systematic Review and Meta-Analysis. 乳腺癌手术后保留乳头敏感性:系统回顾和荟萃分析。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/9654741
Varsha Harish, Zoe K Haffner, Jenna C Bekeny, Adaah A Sayyed, David H Song, Kenneth L Fan

Purpose: As breast-conserving procedures become increasingly safe and viable options for surgical management of breast cancer, efforts have focused on assessing and optimizing patient-reported outcome measures (PROMs), such as nipple sensation. This study aims to evaluate the current understanding of nipple-areolar complex (NAC) sensation outcomes in breast cancer patients undergoing breast cancer surgeries, namely, nipple-sparing mastectomies (NSM), skin-sparing mastectomies (SSM), and lumpectomies.

Methods: Articles including terms related to "nipple," "mastectomy," "sensation," and "patient-reported outcome" were queried from three databases according to PRISMA guidelines. Study characteristics, patient demographics, and surgical details were recorded. Outcomes of interest included objective nipple sensitivity testing and PROMs.

Results: Of 888 manuscripts identified, 28 articles met the inclusion criteria. Twelve studies (n = 578 patients) used objective measures to evaluate sensitivity, such as monofilament testing. Sixteen studies (n = 1785 patients) assessed PROMs through validated or investigator-generated surveys. Three of the included studies reported NAC sensitivity in patients who received NSM with neurotization (n = 203 patients) through a variety of techniques that used various grafts to coapt a lateral intercostal nerve to the NAC nerve stumps. Results of investigator surveys showed that of 1565 patients without neurotization, nipple sensation was maintained in 29.0% (n = 453) of patients. Of 138 NSM patients without NAC neurotization, SWM testing showed an average loss of protective sensation in the nipple (average SWM score: 4.7) compared to normal or diminished sensation to light touch in nonoperated controls (average SWM score: 2.9, n = 195). Of patients who underwent NSM with neurotization, one study (n = 78) reported maintenance of NAC sensation in 100% of patients, while another study (n = 7) reported average diminished protective sensation in the nipple (average SWM score: 3.9).

Conclusion: Our study has shown that objective and patient-reported results of nipple sensitivity support nipple-sparing techniques as a viable option for preserving NAC sensation, although patients can expect a decrease in sensation overall. Neurotization of the NAC during NSM shows promising results of improved postoperative nipple sensitivity, though additional studies are warranted to confirm this finding. Variations between study methodologies highlight the lack of standardization in sensory testing techniques when evaluating NAC sensation.

目的:随着保乳手术在乳腺癌手术治疗中变得越来越安全和可行,人们一直致力于评估和优化患者报告的结果测量(PROMs),如乳头感觉。本研究旨在评估目前对乳腺癌手术(即保留乳头乳房切除术(NSM)、保留皮肤乳房切除术(SSM)和乳房肿瘤切除术)患者乳头-乳晕复合体(NAC)感觉结果的认识。方法:根据PRISMA指南从三个数据库中查询包括“乳头”、“乳房切除术”、“感觉”和“患者报告的结果”相关术语的文章。记录研究特征、患者人口统计和手术细节。结果包括客观乳头敏感性测试和PROMs。结果:888篇文献中,28篇符合纳入标准。12项研究(n = 578例患者)采用客观方法评估敏感性,如单丝试验。16项研究(n = 1785例患者)通过验证或研究者生成的调查来评估PROMs。纳入的研究中有三项报告了接受NSM伴神经化的患者(n = 203例患者)的NAC敏感性,这些患者通过各种技术使用各种移植物将外侧肋间神经覆盖到NAC神经残端。研究者调查结果显示,在1565例未神经化的患者中,29.0% (n = 453)的患者保持乳头感觉。在138名没有NAC神经化的NSM患者中,SWM测试显示,与未手术对照组(平均SWM评分:2.9,n = 195)相比,乳头保护性感觉的平均丧失(平均SWM评分:4.7)。在接受神经化治疗的NSM患者中,一项研究(n = 78)报告100%的患者NAC感觉维持,而另一项研究(n = 7)报告乳头保护性感觉平均减少(平均SWM评分:3.9)。结论:我们的研究表明,客观和患者报告的乳头敏感性结果支持保留乳头技术作为保留NAC感觉的可行选择,尽管患者可能会预期感觉整体下降。NSM期间NAC神经化显示了改善术后乳头敏感性的良好结果,尽管需要进一步的研究来证实这一发现。研究方法之间的差异突出了在评估NAC感觉时感官测试技术缺乏标准化。
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引用次数: 0
Hospital Rurality and Gene Expression Profiling for Early-Stage Breast Cancer among Iowa Residents (2010-2018). 爱荷华州居民早期乳腺癌的医院乡村性和基因表达谱(2010-2018)
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/8582894
Danielle Riley, Mary Charlton, Elizabeth A Chrischilles, Ingrid M Lizarraga, Sneha Phadke, Brian J Smith, Adam Skibbe, Charles F Lynch

Objective: Given the challenges rural cancer patients face in accessing cancer care as well as the slower diffusion and adoption of new medical technologies among rural providers, the aim of our study was to examine trends in gene expression profiling (GEP) testing and evaluate the association between hospital rurality and receipt of GEP testing.

Methods: Data from the Iowa Cancer Registry (ICR) were used to identify women with newly diagnosed, histologically confirmed breast cancer from 2010 through 2018 who met eligibility criteria for GEP testing. Patients were allocated to the hospitals where their most definitive surgical treatment was received, and Rural-Urban Commuting Area codes were used to categorize hospitals into urban (N = 43), large rural (N = 16), and small rural (N = 48). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression to evaluate the association between hospital rurality and GEP test use, adjusting for demographic and clinical characteristics. The association between test result and treatment received was assessed among patients who received Oncotype DX (ODX) testing.

Results: Of 6,726 patients eligible for GEP test use, 46% (N = 3,069) underwent testing with 95% receiving ODX. While overall GEP testing rates increased over time from 42% between 2010 and 2012 to 51% between 2016 and 2018 (P trend < 0.0001), use continued to be the lowest among patients treated at hospitals in small rural areas. The odds of GEP testing remained significantly lower among patients treated at hospitals located in small rural areas (aOR 0.55; 95% CI 0.43-0.71), after adjusting for demographic and clinical characteristics. ODX recurrence scores were highly correlated with chemotherapy use across all strata of hospital rurality.

Conclusions: GEP testing continues to be underutilized, especially among those treated at small rural hospitals. Targeted interventions aimed at increasing rates of GEP testing to ensure the appropriate use of adjuvant chemotherapy may improve health outcomes and lower treatment-related costs.

目的:考虑到农村癌症患者在获得癌症治疗方面面临的挑战,以及新医疗技术在农村医疗机构中的传播和采用速度较慢,本研究的目的是研究基因表达谱(GEP)检测的趋势,并评估医院农村性与接受GEP检测之间的关系。方法:使用爱荷华州癌症登记处(ICR)的数据,确定2010年至2018年期间符合GEP检测资格标准的新诊断、组织学证实的乳腺癌女性。患者被分配到接受最明确手术治疗的医院,并使用城乡通勤区域代码将医院分为城市(N = 43)、大型农村(N = 16)和小型农村(N = 48)。校正优势比(aORs)和95%置信区间(ci)使用多变量logistic回归评估医院乡村性和GEP测试使用之间的关系,调整人口统计学和临床特征。在接受Oncotype DX (ODX)检测的患者中评估检测结果与所接受治疗之间的关系。结果:在6726名符合GEP测试使用条件的患者中,46% (N = 3069)接受了测试,95%接受了ODX。虽然总体GEP检测率随着时间的推移从2010年至2012年的42%上升到2016年至2018年的51% (P趋势< 0.0001),但在小农村地区医院接受治疗的患者中,使用率仍然最低。在小农村地区医院接受治疗的患者中,GEP检测的几率仍然明显较低(aOR 0.55;95% CI 0.43-0.71),在调整了人口统计学和临床特征后。ODX复发评分与医院农村各阶层的化疗使用高度相关。结论:GEP检测仍然未得到充分利用,特别是在小型农村医院接受治疗的患者中。有针对性的干预措施旨在提高GEP检测率,以确保适当使用辅助化疗,可改善健康结果并降低与治疗相关的费用。
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引用次数: 0
Ductal Carcinoma In Situ (DCIS) Diagnosed by MRI-Guided Biopsy among BRCA1/BRCA2 Mutation Carriers. BRCA1/BRCA2突变携带者mri引导活检诊断导管原位癌(DCIS)
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/4317693
Renata Faermann, Eitan Friedman, Orit Kaidar-Person, Jonathan Weidenfeld, Malka Brodsky, Anat Shalmon, Osnat Halshtok Neiman, Michael Gotlieb, Yael Yagil, David Samoocha, Dana Madorsky Feldman, Miri Sklair-Levy

Background: While BRCA1/BRCA2 pathogenic sequence variants (PSVs) clearly confer an increased risk for invasive breast cancer, the extent to which these mutant alleles increase DCIS risk is less clear.

Objective: To assess the rate of detection over a 5-year period, and MRI imaging features of pure noncalcified DCIS in a cohort of Israeli BRCA1/BRCA2 PSV carriers attending a high-risk clinic from 2015 to 2020.

Materials and methods: All female BRCA1/BRCA2 PSV-carriers followed at the Meirav High-risk clinic from 2015 to 2020 were eligible if they underwent semiannual breast imaging (MRI/mammography) and MRI-guided biopsy-proven pure DCIS. Clinical data, pathology information, and imaging characteristics were retrieved from the computerized archiving system.

Results: 18/121 (15.2%) participating BRCA1 PSV carriers and 8/81 (10.1%) BRCA2 PSV-carriers who underwent MRI-guided biopsy were diagnosed with DCIS. The median age of BRCA1 carriers and BRCA2 carriers was 49.8 years and 60.6 years, respectively (p = 0.55). Negative estrogen-receptor tumors were diagnosed in 13/18 (72%) BRCA1 and 2/8 (25%) BRCA2 PSV carriers (p < 0.05). Thirteen (13/18-72%) BRCA1 carriers had intermediate to high-grade or high-grade DCIS compared with 4/8 (50%) of BRCA2 carriers (p = 0.03). Over the 5-year study period, 29/1100 (2.6%) BRCA1/BRCA2 PSV carriers were diagnosed with DCIS seen on MRI only.

Conclusion: MRI-detected noncalcified DCIS is more frequent in BRCA1 PSV carriers compared with BRCA2 carriers, unlike the BRCA2 predominance in mammography-detected calcified DCIS. BRCA1-related DCIS is diagnosed earlier, more likely to be estrogen receptor-negative and of higher grade compared with BRCA2-related DCIS. Future prospective studies should validate these results and assess the actual impact they might have on clinical management of BRCA PSV carriers.

背景:虽然BRCA1/BRCA2致病序列变异(psv)明显增加了浸润性乳腺癌的风险,但这些突变等位基因增加DCIS风险的程度尚不清楚。目的:评估2015年至2020年在高风险诊所就诊的以色列BRCA1/BRCA2 PSV携带者队列中纯非钙化DCIS的5年检出率和MRI影像学特征。材料和方法:2015年至2020年在Meirav高危诊所随访的所有女性BRCA1/BRCA2 psv携带者,如果他们每半年进行一次乳房成像(MRI/乳房x光检查)和MRI引导活检证实的纯DCIS,则符合条件。临床资料、病理信息和影像学特征从计算机存档系统中检索。结果:接受mri引导活检的18/121 (15.2%)BRCA1 PSV携带者和8/81 (10.1%)BRCA2 PSV携带者被诊断为DCIS。BRCA1携带者和BRCA2携带者的中位年龄分别为49.8岁和60.6岁(p = 0.55)。BRCA1携带者中13/18(72%)和BRCA2 PSV携带者中2/8(25%)被诊断为阴性雌激素受体肿瘤(p < 0.05)。13名BRCA1携带者(13/18-72%)患有中度至高度或高度DCIS,而4/8名BRCA2携带者(50%)患有中度至高度DCIS (p = 0.03)。在5年的研究期间,29/1100 (2.6%)BRCA1/BRCA2 PSV携带者仅在MRI上被诊断为DCIS。结论:mri检测到的非钙化DCIS在BRCA1 PSV携带者中比在BRCA2携带者中更常见,这与乳房x线摄影检测到的钙化DCIS中BRCA2的优势不同。与brca2相关的DCIS相比,brca1相关的DCIS诊断更早,雌激素受体阴性的可能性更大,分级更高。未来的前瞻性研究应该验证这些结果,并评估它们可能对BRCA PSV携带者的临床管理产生的实际影响。
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引用次数: 2
Useful Reduction Mammoplasty Technique in Oncoplastic Breast Surgery and Reconstruction. 乳腺肿瘤整形手术及重建中有用的缩乳技术。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/2952322
Jong Ho Lee, Jeong Yeop Ryu, Kang Young Choi, Jung Dug Yang, Ho Yun Chung, Byung Chae Cho, Byeongju Kang, Jeeyeon Lee, Ho Yong Park, Joon Seok Lee

Background: A combination of the reduction mammoplasty technique and breast reconstruction allows surgeons to lift ptotic breasts through local flaps and skin reduction during surgery for breast cancer. This study presents a reliable course for the combination of partial and skin or nipple-sparing mastectomy with reduction-reconstruction surgery.

Methods: Fifty-seven patients underwent a partial mastectomy before reduction mammoplasty of both breasts during the same time period between 2014 and 2021 at our institution and thirteen patients underwent skin or nipple-sparing mastectomy, breast reconstruction with an extended latissimus dorsi flap or silicone implant, and aesthetic reduction mammoplasty of the contralateral breast during the same time period. Additional photos were obtained preoperatively, immediately after the operation, and at one, three, six, and twelve months postoperatively. Patient satisfaction was evaluated preoperatively and postoperatively and postoperative complications were noted.

Results: Among the patients who underwent a partial mastectomy, the mean age was 45.18 ± 11.05 years, the mean body mass index (BMI) was 26.74 ± 3.53 kg/m2, and the mean preoperative right and left breast volumes were 663.85 (±28.12) cc and 664.34 (±37.13) cc, respectively, and the mean excised mass weight was 177.74 (±213.93) g. Among the patients who underwent a skin-sparing mastectomy, the mean age was 51.62 ± 8.96 years, the mean BMI was 26.91 ± 4.34 kg/m2, and the mean preoperative right and left breast volumes were 624.17 (±98.52) cc and 562.31 (±80.81) cc, respectively, and the mean excised mass weight was 618.05 (±338.17) g. Four patients (5.3%) in the partial mastectomy group had fat necrosis. The mean patient satisfaction score was higher postoperatively in both groups.

Conclusion: Patients with breast cancer and large and/or ptotic breasts can successfully undergo reduction mammoplasty for both breasts immediately following partial mastectomy and nipple or skin-sparing mastectomy.

背景:乳房缩小成形术和乳房重建技术的结合使得外科医生在乳腺癌手术中通过局部皮瓣和皮肤缩小来提升上睑下垂的乳房。本研究提出了一个可靠的过程,结合部分和皮肤或乳头保留乳房切除术与复位重建手术。方法:2014年至2021年同一时期,我院57例患者在双侧乳房缩小成形术前接受了部分乳房切除术,13例患者在同一时期接受了保留皮肤或乳头的乳房切除术、延长背阔肌皮瓣或硅胶植入乳房重建和对侧乳房美观缩小成形术。术前、术后即刻、术后1、3、6、12个月分别拍摄其他照片。术前、术后及术后并发症评估患者满意度。结果:行乳房部分切除术的患者平均年龄为45.18±11.05岁,平均体重指数(BMI)为26.74±3.53 kg/m2,术前平均左右乳房体积分别为663.85(±28.12)cc和664.34(±37.13)cc,平均切除质量体重为177.74(±213.93)g。行保皮乳房切除术的患者平均年龄为51.62±8.96岁,平均BMI为26.91±4.34 kg/m2。术前平均右、左乳房体积分别为624.17(±98.52)cc、562.31(±80.81)cc,平均切除质量为618.05(±338.17)g。乳房部分切除组有4例(5.3%)出现脂肪坏死。两组患者术后平均满意度评分均较高。结论:乳腺癌和大乳房和/或上睑下垂的患者在乳房部分切除术和保留乳头或皮肤的乳房切除术后立即行双侧乳房缩小成形术是成功的。
{"title":"Useful Reduction Mammoplasty Technique in Oncoplastic Breast Surgery and Reconstruction.","authors":"Jong Ho Lee,&nbsp;Jeong Yeop Ryu,&nbsp;Kang Young Choi,&nbsp;Jung Dug Yang,&nbsp;Ho Yun Chung,&nbsp;Byung Chae Cho,&nbsp;Byeongju Kang,&nbsp;Jeeyeon Lee,&nbsp;Ho Yong Park,&nbsp;Joon Seok Lee","doi":"10.1155/2022/2952322","DOIUrl":"https://doi.org/10.1155/2022/2952322","url":null,"abstract":"<p><strong>Background: </strong>A combination of the reduction mammoplasty technique and breast reconstruction allows surgeons to lift ptotic breasts through local flaps and skin reduction during surgery for breast cancer. This study presents a reliable course for the combination of partial and skin or nipple-sparing mastectomy with reduction-reconstruction surgery.</p><p><strong>Methods: </strong>Fifty-seven patients underwent a partial mastectomy before reduction mammoplasty of both breasts during the same time period between 2014 and 2021 at our institution and thirteen patients underwent skin or nipple-sparing mastectomy, breast reconstruction with an extended latissimus dorsi flap or silicone implant, and aesthetic reduction mammoplasty of the contralateral breast during the same time period. Additional photos were obtained preoperatively, immediately after the operation, and at one, three, six, and twelve months postoperatively. Patient satisfaction was evaluated preoperatively and postoperatively and postoperative complications were noted.</p><p><strong>Results: </strong>Among the patients who underwent a partial mastectomy, the mean age was 45.18 ± 11.05 years, the mean body mass index (BMI) was 26.74 ± 3.53 kg/m<sup>2</sup>, and the mean preoperative right and left breast volumes were 663.85 (±28.12) cc and 664.34 (±37.13) cc, respectively, and the mean excised mass weight was 177.74 (±213.93) g. Among the patients who underwent a skin-sparing mastectomy, the mean age was 51.62 ± 8.96 years, the mean BMI was 26.91 ± 4.34 kg/m<sup>2</sup>, and the mean preoperative right and left breast volumes were 624.17 (±98.52) cc and 562.31 (±80.81) cc, respectively, and the mean excised mass weight was 618.05 (±338.17) g. Four patients (5.3%) in the partial mastectomy group had fat necrosis. The mean patient satisfaction score was higher postoperatively in both groups.</p><p><strong>Conclusion: </strong>Patients with breast cancer and large and/or ptotic breasts can successfully undergo reduction mammoplasty for both breasts immediately following partial mastectomy and nipple or skin-sparing mastectomy.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10417446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Associations between Physical Exercise, Quality of Life, Psychological Symptoms and Treatment Side Effects in Early Breast Cancer. 早期乳腺癌的体育锻炼、生活质量、心理症状和治疗副作用之间的关系
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/9921575
Leena Vehmanen, Johanna Mattson, Evangelos Karademas, Albino J Oliveira-Maia, Berta Sousa, Ruth Pat-Horenczyk, Ketti Mazzocco, Panagiotis Simos, Fátima Cardoso, Greta Pettini, Chiara Marzorati, Eleni Kolokotroni, Georgios Stamatakos, Diana Frasquilho, Paula Poikonen-Saksela

Background: Identifying and understanding modifiable factors for the well-being of cancer patients is critical in survivorship research. We studied variables associated with the exercise habits of breast cancer patients and investigated if the achievement of exercise recommendations was associated with enhanced quality of life and/or psychological well-being. Material and Methods. 311 women from Finland, Portugal, Israel, and Italy receiving adjuvant therapy for stage I-III breast cancer answered questions about sociodemographic factors and physical exercise. Quality of life was assessed by the EORTC C30 and BR23 questionnaires. Anxiety and depression were evaluated using the HADS scale.

Results: At the beginning of adjuvant therapy and after twelve months, 32% and 26% of participants were physically inactive, 27% and 30% exercised between 30 and 150 minutes per week, while 41% and 45% exercised the recommended 150 minutes or more per week. Relative to other countries, Finnish participants were more likely to be active at baseline and at twelve months (89% vs. 50%, p < 0.001 and 87% vs. 64%, p < 0.001). Participants with stage I cancer were more likely to be active at twelve months than those with a higher stage (80% vs. 70%,p < 0.05). The inactive participants reported more anxiety (p < 0.05) and depression (p < 0.001), lower global quality of life (p < 0.001), and more side effects (p < 0.05) than the others at twelve months. Accordingly, those who remained inactive or decreased their level of exercise from baseline to twelve months reported more anxiety (p < 0.01) and depression (p < 0.001), lower global quality of life (p < 0.001), and more side effects (p < 0.05) than those with the same or increased level of exercise.

Conclusion: For women with early breast cancer, exercise was associated with a better quality of life, less depression and anxiety, and fewer adverse events of adjuvant therapy. Trial registration number: NCT05095675. Paula Poikonen-Saksela on behalf of Bounce consortium (https://www.bounce-project.eu/).

背景:识别和理解癌症患者健康状况的可改变因素在生存研究中至关重要。我们研究了与乳腺癌患者运动习惯相关的变量,并调查了运动建议的实现是否与提高生活质量和/或心理健康有关。材料和方法:来自芬兰、葡萄牙、以色列和意大利的311名接受I-III期乳腺癌辅助治疗的妇女回答了有关社会人口因素和体育锻炼的问题。生活质量通过EORTC C30和BR23问卷进行评估。焦虑和抑郁采用HADS量表进行评估。结果:在辅助治疗开始和12个月后,32%和26%的参与者不运动,27%和30%的参与者每周运动30到150分钟,而41%和45%的参与者每周运动150分钟或更长时间。相对于其他国家,芬兰参与者在基线和12个月时更有可能保持活跃(89%对50%,p < 0.001, 87%对64%,p < 0.001)。I期癌症患者在12个月时的活动量比分期更高的患者高(80%比70%,p < 0.05)。在12个月时,不运动的参与者比其他人报告了更多的焦虑(p < 0.05)和抑郁(p < 0.001),更低的整体生活质量(p < 0.001)和更多的副作用(p < 0.05)。因此,那些从基线到12个月保持不运动或减少运动水平的人报告的焦虑(p < 0.01)和抑郁(p < 0.001),整体生活质量(p < 0.001)较低,副作用(p < 0.05)多于运动水平相同或增加的人。结论:对于早期乳腺癌女性,运动与更好的生活质量、更少的抑郁和焦虑以及更少的辅助治疗不良事件有关。试验注册号:NCT05095675。Paula Poikonen-Saksela代表Bounce财团(https://www.bounce-project.eu/)。
{"title":"Associations between Physical Exercise, Quality of Life, Psychological Symptoms and Treatment Side Effects in Early Breast Cancer.","authors":"Leena Vehmanen,&nbsp;Johanna Mattson,&nbsp;Evangelos Karademas,&nbsp;Albino J Oliveira-Maia,&nbsp;Berta Sousa,&nbsp;Ruth Pat-Horenczyk,&nbsp;Ketti Mazzocco,&nbsp;Panagiotis Simos,&nbsp;Fátima Cardoso,&nbsp;Greta Pettini,&nbsp;Chiara Marzorati,&nbsp;Eleni Kolokotroni,&nbsp;Georgios Stamatakos,&nbsp;Diana Frasquilho,&nbsp;Paula Poikonen-Saksela","doi":"10.1155/2022/9921575","DOIUrl":"https://doi.org/10.1155/2022/9921575","url":null,"abstract":"<p><strong>Background: </strong>Identifying and understanding modifiable factors for the well-being of cancer patients is critical in survivorship research. We studied variables associated with the exercise habits of breast cancer patients and investigated if the achievement of exercise recommendations was associated with enhanced quality of life and/or psychological well-being. <i>Material and Methods</i>. 311 women from Finland, Portugal, Israel, and Italy receiving adjuvant therapy for stage I-III breast cancer answered questions about sociodemographic factors and physical exercise. Quality of life was assessed by the EORTC C30 and BR23 questionnaires. Anxiety and depression were evaluated using the HADS scale.</p><p><strong>Results: </strong>At the beginning of adjuvant therapy and after twelve months, 32% and 26% of participants were physically inactive, 27% and 30% exercised between 30 and 150 minutes per week, while 41% and 45% exercised the recommended 150 minutes or more per week. Relative to other countries, Finnish participants were more likely to be active at baseline and at twelve months (89% vs. 50%, <i>p</i> < 0.001 and 87% vs. 64%, <i>p</i> < 0.001). Participants with stage I cancer were more likely to be active at twelve months than those with a higher stage (80% vs. 70%,<i>p</i> < 0.05). The inactive participants reported more anxiety (<i>p</i> < 0.05) and depression (<i>p</i> < 0.001), lower global quality of life (<i>p</i> < 0.001), and more side effects (<i>p</i> < 0.05) than the others at twelve months. Accordingly, those who remained inactive or decreased their level of exercise from baseline to twelve months reported more anxiety (<i>p</i> < 0.01) and depression (<i>p</i> < 0.001), lower global quality of life (<i>p</i> < 0.001), and more side effects (<i>p</i> < 0.05) than those with the same or increased level of exercise.</p><p><strong>Conclusion: </strong>For women with early breast cancer, exercise was associated with a better quality of life, less depression and anxiety, and fewer adverse events of adjuvant therapy. Trial registration number: NCT05095675. Paula Poikonen-Saksela on behalf of Bounce consortium (https://www.bounce-project.eu/).</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10336653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Comparison of Characteristics of Breast Cancer Detected through Different Imaging Modalities in a Large Cohort of Hong Kong Chinese Women: Implication of Imaging Choice on Upcoming Local Screening Program. 香港华裔妇女大队列不同影像学检查方式乳腺癌特征的比较:影像学选择对即将开展的本地筛查计划的影响
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1155/2022/3882936
Yik Shuen Chan, Wai Ka Hung, Lok Wa Yuen, Ho Yan Yolanda Chan, Chiu Wing Winnie Chu, Polly Suk Yee Cheung

Background: We compared the clinico-radio-pathological characteristics of breast cancer detected through mammogram (MMG) and ultrasound (USG) and discuss the implication of the choice of imaging as the future direction of our recently launched local screening program.

Methods: Retrospective study of 14613 Hong Kong Chinese female patients with histologically confirmed breast cancer registered in the Hong Kong Breast Cancer Registry between January 2006 and February 2020. Patients were classified into four groups based on the mode of breast cancer detection (detectable by both mammogram and ultrasound (MMG+/USG+), mammogram only (MMG+/USG-), ultrasound only (MMG-/USG+), or not detectable by either (MMG-/USG-). Characteristics of breast cancer detected were compared, including patient demographics, breast density on MMG, mode of presentation, tumour size, histological type, and staging. Types of mammographic abnormalities were also evaluated for MMG+ subgroups.

Results: 85% of the cancers were detectable by MMG, while USG detected an additional 9%. MMG+/USG+ cancers were larger, more advanced in stage, often of symptomatic presentation, and commonly manifested as mammographic mass. MMG+/USG- cancers were more likely of asymptomatic presentation, manifested as microcalcifications, and of earlier stage and to be ductal carcinoma in situ. MMG-/USG+ cancers were more likely seen in young patients and those with denser breasts and more likely of symptomatic presentation. MMG-/USG- cancers were often smaller and found in denser breasts.

Conclusion: Mammogram has a good detection rate of cancers in our local population. It has superiority in detecting early cancers by detecting microcalcifications. Our current study agrees that ultrasound is one of the key adjunct tools of breast cancer detection.

背景:我们比较了乳房x光检查(MMG)和超声检查(USG)检测到的乳腺癌的临床、放射、病理特征,并讨论了我们最近启动的局部筛查项目选择影像学的意义。方法:回顾性研究2006年1月至2020年2月期间在香港乳腺癌登记处登记的14613名组织学证实的香港中国女性乳腺癌患者。根据乳腺癌的检测方式将患者分为四组:乳房x光和超声均可检测(MMG+/USG+)、仅乳房x光检查(MMG+/USG-)、仅超声检查(MMG-/USG+)、两者均未检测(MMG-/USG-)。比较检测到的乳腺癌的特征,包括患者人口统计学、MMG上的乳腺密度、表现方式、肿瘤大小、组织学类型和分期。对MMG+亚组的乳腺x线检查异常类型也进行了评估。结果:MMG检测到85%的癌症,USG检测到9%。MMG+/USG+癌更大,更晚期,通常有症状表现,通常表现为乳房x光检查肿块。MMG+/USG-癌更有可能表现为无症状,表现为微钙化,早期和导管原位癌。MMG-/USG+癌症更可能出现在年轻患者和乳房致密的患者中,并且更可能出现症状。MMG-/USG-癌通常较小,多发于乳腺密度较大的部位。结论:乳腺x线摄影对肿瘤的检出率较高。通过检测微钙化对早期癌症的发现具有优势。我们目前的研究表明,超声是乳腺癌检测的关键辅助工具之一。
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引用次数: 1
Farewell to The Breast Journal: A novel scientific publication led by a pathologist who moved beyond the microscope and faced the patients 告别乳腺杂志:一份由病理学家领导的新颖科学出版物,他超越了显微镜,面对病人
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2021-12-12 DOI: 10.1111/tbj.14304
Shahla Masood MD
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引用次数: 0
Lower lymph node yield in axillary lymph node dissection specimens in breast cancer patients receiving neoadjuvant chemotherapy: Quality concern or treatment effect? 接受新辅助化疗的乳腺癌患者腋窝淋巴结清扫标本的低淋巴结率:质量问题还是治疗效果?
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2021-12-08 DOI: 10.1111/tbj.14303
Junko Ozao-Choy MD, FACS, Ashkan Moazzez MD, MPH, FACS, Christine Dauphine MD, FACS

Axillary lymph node dissection (ALND) specimens should have at least ten-lymph nodes for examination according to established guidelines. Nonetheless, recent evidence suggests that neoadjuvant chemotherapy (NAC) results in fewer nodes in the specimen. We sought to examine if NAC patients have lower lymph node yield from ALND specimens and whether the number of lymph nodes in the specimen is correlated with pathologic complete response (pCR). Using the National Cancer Database (NCDB), a study cohort of female patients with node-positive, non-metastatic invasive breast cancer diagnosed from 2012 to 2015 was identified. The axillary lymph node retrieval count was compared in NAC and non-NAC patients and then correlated with pCR. A multivariable analysis was performed to identify factors that were associated with less than ten-lymph nodes in the ALND pathologic specimen. Of 56,976 patients identified, 27,197 (48%) received neoadjuvant chemotherapy; 29,779 (52%) did not. NAC patients failed to meet the ten-lymph node minimum in the ALND specimen more often than non-NAC patients (35% vs. 27%, < 0.001). NAC patients with fewer than ten-lymph nodes were more likely to have a pCR than those with ten or more (22% vs. 16%, < 0.001). On multivariable analysis, pCR of the primary tumor and receptor status were found to be independent predictors of having fewer than ten-lymph nodes in the ALND specimen. Node-positive breast cancer patients that underwent NAC were more likely to not meet the ten-lymph node standard. However, NAC patients who did not meet the minimum were also more likely to have a pCR compared to NAC patients who did. This suggests lower lymph node yield may not truly be a marker of lower quality surgery but rather a potential marker of NAC treatment effect.

腋窝淋巴结清扫(ALND)标本应至少有十个淋巴结检查根据既定的指导方针。尽管如此,最近的证据表明,新辅助化疗(NAC)可减少标本中的淋巴结。我们试图研究NAC患者在ALND标本中是否有较低的淋巴结产量,以及标本中淋巴结的数量是否与病理完全缓解(pCR)相关。使用国家癌症数据库(NCDB),确定了2012年至2015年诊断为淋巴结阳性,非转移性浸润性乳腺癌的女性患者的研究队列。比较NAC和非NAC患者腋窝淋巴结恢复计数,并与pCR进行相关分析。进行多变量分析以确定与ALND病理标本中少于10个淋巴结相关的因素。在确定的56,976例患者中,27,197例(48%)接受了新辅助化疗;29779例(52%)没有。NAC患者在ALND标本中未能达到10个淋巴结最小值的比例高于非NAC患者(35% vs. 27%, p <0.001)。小于10个淋巴结的NAC患者比大于或等于10个淋巴结的NAC患者更容易出现pCR (22% vs. 16%, p <0.001)。在多变量分析中,发现原发肿瘤的pCR和受体状态是ALND标本中淋巴结少于10个的独立预测因子。接受NAC的淋巴结阳性乳腺癌患者更有可能不符合10个淋巴结的标准。然而,与达到最低要求的NAC患者相比,未达到最低要求的NAC患者也更有可能出现pCR。这表明较低的淋巴结产量可能不是手术质量较差的标志,而是NAC治疗效果的潜在标志。
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引用次数: 2
Bloody nipple discharge in Carney complex: A case report 卡尼综合症中乳头溢血1例
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2021-12-06 DOI: 10.1111/tbj.14302
Julian K K Chan MBChB MRCP, Natalia Garibotto BMedSci(Hons) MBBS MRCS(Edin) FRACS, Deepthi Dissanayake MBBS FRANZCR, Benjamin F Dessauvagie BMedSci MBBS FRCPA, Anmol Rijhumal MBBCh FRCPA, Elizabeth J Wylie MBBS FRANZCR

Carney complex (CNC) is an extremely rare, autosomal dominant genetic syndrome consisting of pigmented skin and mucosal changes with multiple endocrine and nonendocrine tumors, including the breast. Breast tumors are typically multiple and benign and are most commonly reported as myxoid fibroadenomas and/or intraductal papillomas. We present a young female patient with known CNC who presented with copious bloody nipple discharge with multiple breast lumps and discuss the breast imaging features regarding this complex and often underrecognized genetic condition.

卡尼综合征(CNC)是一种极其罕见的常染色体显性遗传综合征,由色素沉着的皮肤和粘膜改变以及包括乳腺在内的多种内分泌和非内分泌肿瘤组成。乳腺肿瘤通常是多发和良性的,最常报道为粘液样纤维腺瘤和/或导管内乳头状瘤。我们报告了一位年轻的女性患者,她患有已知的CNC,表现为大量带血的乳头溢液并伴有多个乳房肿块,并讨论了这种复杂且经常被忽视的遗传疾病的乳房影像学特征。
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引用次数: 1
Superficial angiomyxoma of the breast in a 16-year-old girl without carney’s complex: A case report 16岁女孩无卡尼综合症的乳房浅表性血管粘液瘤1例报告
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2021-12-03 DOI: 10.1111/tbj.14301
Iram Dubin MD, Shabnam Mortazavi MD, Tiffany Yu MD, Irene R. Riahi MD, Jennifer L. Baker MD

Superficial angiomyxoma (SA) is a rare benign soft-tissue tumor, arising sporadically or as the earliest manifestation of Carney's complex. When it arises sporadically, the breast is infrequently involved with only few cases reported in the literature. Key imaging findings include T2 signal hyperintensity on MRI and hypervascularity. In this study, we report the clinical, radiological, surgical, and histopathologic findings of a case of sporadic SA of the breast in a 16-year-old girl.

浅表性血管粘液瘤(SA)是一种罕见的良性软组织肿瘤,偶尔发生或作为卡尼氏综合征的早期表现。当它偶尔发生时,乳房很少涉及,文献中只有少数病例报道。主要影像学表现包括MRI上T2信号高信号和血管增生。在这项研究中,我们报告了一例16岁女孩散发的乳腺SA的临床、放射学、外科和组织病理学结果。
{"title":"Superficial angiomyxoma of the breast in a 16-year-old girl without carney’s complex: A case report","authors":"Iram Dubin MD,&nbsp;Shabnam Mortazavi MD,&nbsp;Tiffany Yu MD,&nbsp;Irene R. Riahi MD,&nbsp;Jennifer L. Baker MD","doi":"10.1111/tbj.14301","DOIUrl":"10.1111/tbj.14301","url":null,"abstract":"<p>Superficial angiomyxoma (SA) is a rare benign soft-tissue tumor, arising sporadically or as the earliest manifestation of Carney's complex. When it arises sporadically, the breast is infrequently involved with only few cases reported in the literature. Key imaging findings include T2 signal hyperintensity on MRI and hypervascularity. In this study, we report the clinical, radiological, surgical, and histopathologic findings of a case of sporadic SA of the breast in a 16-year-old girl.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39690099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Breast Journal
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