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Tian R, Zheng Y, Liu R, Jiang C, Zheng H. Efficacy and safety of oncoplastic breast-conserving surgery versus conventional breast-conserving surgery: An updated meta-analysis. Breast 2024; 77:103784. [PMID: 39126920 DOI: 10.1016/j.breast.2024.103784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 07/17/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Breast cancer is the most common cancer among women. The surgical treatment of breast cancer has transitioned progressively from radical mastectomy to breast-conserving surgery. In this meta-analysis, we are aiming to compare oncoplastic breast-conserving surgery (OS) with conventional breast-conserving surgery (BCS) in terms of efficacy and safety. METHODS We searched Medline, Web of Science, Embase, Cochrane databases, Clinicaltrial.gov, and CNKI until April 30, 2024. Data from cohort studies and randomized controlled trials (RCTs) were included. Outcomes included primary outcomes (re-excision, local recurrence, positive surgical margin, mastectomy), secondary outcomes and safety outcomes. The Cochrane Risk of Bias Assessment Tool and Newcastle-Ottawa Scale were used to evaluate the quality of outcomes. RESULTS Our study included 52 studies containing 46,835 patients. Primary outcomes comprise re-excision, local recurrence, positive surgical margin, and mastectomy, there were significant differences favoring OS over BCS (RR 0.68 [0.56, 0.82], RR 0.62 [0.47, 0.82], RR 0.76 [0.59, 0.98], RR 0.66 [0.44, 0.98] respectively), indicating superior efficacy of OS. Additionally, OS demonstrated significant aesthetic benefits (RR 1.17 [1.03, 1.33] and RR 1.34 [1.18, 1.52]). While total complications were significantly fewer in the OS group (RR 0.70 [0.53, 0.94]), the differences in specific complications were not significant. Furthermore, subgroup analyses were conducted based on nationality, sample size, quality, and type. CONCLUSION OS demonstrates either superior or at least comparable outcomes across various aspects when compared to BCS.
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Affiliation(s)
- Rui Tian
- Department of Breast Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Provincial Clinical Research Center for Breast Cancer, Wuhan Clinical Research Center for Breast Cancer No. 116 Zhuo Daoquan South Road, Wuhan, 430079, Hubei, China
| | - Yu Zheng
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruikang Liu
- Department of Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Jiang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei, 430022, China.
| | - Hongmei Zheng
- Department of Breast Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Provincial Clinical Research Center for Breast Cancer, Wuhan Clinical Research Center for Breast Cancer No. 116 Zhuo Daoquan South Road, Wuhan, 430079, Hubei, China.
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Liu S, Cai Y, Yao S, Chai J, Jia Y, Ge H, Huang R, Li A, Cheng H. Perceived social support mediates cancer and living meaningfully intervention effects on quality of life after breast cancer surgery. Future Oncol 2024:1-13. [PMID: 39011969 DOI: 10.1080/14796694.2024.2370237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Aim: To explore the role of perceived social support in enhancing psychological resilience and quality of life in postoperative breast cancer patients. Materials & methods: The Managing Cancer and Living Meaningfully (CALM) intervention was used to improve indicators such as psychological resilience in breast cancer patients, while the role of perceived social support in this was assessed. Results: The intervention group exhibited significant improvements compared with the control group in psychological resilience (F = 9.059, p < 0.01). The analysis showed that increased social support in the control group partly mediated the link between psychological resilience and quality of life. Conclusion: CALM improves overall well-being, indicating that incorporating it into standard care for post-mastectomy patients can positively impact their mental health.
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Affiliation(s)
- Shaochun Liu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Yinlian Cai
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Senbang Yao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Jiaying Chai
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Yingxue Jia
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Han Ge
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Runze Huang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Anlong Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Huaidong Cheng
- Shenzhen Clinical Medical School of Southern Medical University, Shenzhen 518000, Guangdong, China
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen 518000, Guangdong, China
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
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Turgeon MK, Willcox LM, Styblo TM, Losken A. Impact of Oncoplastic Surgery on Oncologic Outcomes in Patients with Breast Cancer. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5561. [PMID: 38292812 PMCID: PMC10827286 DOI: 10.1097/gox.0000000000005561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024]
Abstract
Background For patients with breast cancer, oncoplastic surgery (OPS) serves as a valuable technique that allows for immediate reconstruction at the time of resection. While the aim of OPS is to improve breast cosmesis, it is critical to ensure OPS does not negatively impact appropriate cancer treatment. Methods Based on current literature, this study provides a broad overview on the potential oncologic advantages of OPS for patients diagnosed with breast cancer. Results OPS has been shown to be a safe and reliable approach with oncologic advantages. More specifically, OPS broadens the indications for breast conservation therapy (BCT); allows for a more generous margin of resection, thus decreasing rates of re-excision; and provides the opportunity to sample additional breast tissue, which may detect occult disease. Reduction mammaplasty may also decrease the risk for developing breast cancer. Importantly, in the era of multimodality therapy, long-term oncologic outcomes and postoperative surveillance algorithms appear to be similar when comparing patients who undergo OPS and BCT. Conclusions For patients with breast cancer, oncoplastic surgery has emerged as a valuable technique to improve breast cosmesis while achieving optimal oncologic outcomes. As the landscape of breast oncology continues to evolve, it is critical for a multidisciplinary team to be involved to guide management and reconstructive strategies.
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Affiliation(s)
| | | | - Toncred M. Styblo
- Winship Cancer Institute, Division of Surgical Oncology, Department of Surgery, Emory University, Atlanta, Ga
| | - Albert Losken
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Emory University, Atlanta, Ga
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Anzali BC, Goli R, Faraji N, Torabzadeh A, Najafzad Z, Nikpey S. Invasion of undifferentiated pleomorphic sarcoma (UPS) in breast tissue; a case report study. Int J Surg Case Rep 2023; 107:108307. [PMID: 37178658 DOI: 10.1016/j.ijscr.2023.108307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/06/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Breast sarcomas are scarce, histologically heterogeneous with nonepithelial malignancies that originate from the connective tissue within the parenchyma of breast. They can develop primarily, after radio-therapy (RT), or secondary due to chronic condition, including metastatic cancers. CASE PRESENTATION The present case report concerns 58-year-old women which was unbeknown to her malignancy in the early stages, until the mass became substantial in size. Chemotherapy and also radiotherapy were not effective, and the growth of tumor could not be prevented which the patient eventually died, due to respiratory complications. CLINICAL DISCUSSION Breast sarcomas are categorized in very rare malignancies, and the mortality of these types of cancers are significantly high as they often are not diagnosed in early stages. Based on the location and condition of the malignant tumor, therapeutic methods considered as chemotherapy, radiotherapy, and surgery. CONCLUSION In advance stages of breast sarcoma, chemotherapy, radiotherapy, and even surgery cannot be effectual. Therefore, periodical evaluation of breast wellness by diagnostic methods are recommended to all adult women.
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Affiliation(s)
- Babak Choobi Anzali
- Department of Emergency Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Aysan Torabzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Zahra Najafzad
- Master of Science Medical and Surgical Nursing, Student Research Center of Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayan Nikpey
- Department of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, East Azerbaijan, Iran.
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Bonci EA, Anacleto JC, Cardoso MJ. Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures. Breast 2023; 69:265-273. [PMID: 36924556 PMCID: PMC10027565 DOI: 10.1016/j.breast.2023.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/11/2023] [Indexed: 03/14/2023] Open
Abstract
Simple breast conservation surgery (sBCS) has technically advanced onto oncoplastic breast procedures (OBP) to avoid mastectomy and improve breast cancer patients' psychosocial well-being and cosmetic outcome. Although OBP are time-consuming and expensive, we are witnessing an increase in their use, even for cases that could be managed with sBCS. The choice between keeping it simple or opting for more complex oncoplastic procedures is difficult. This review proposes a pragmatic approach in assisting this decision. Medical literature suggests that OBP and sBCS might be similar regarding local recurrence and overall survival, and patients seem to have higher satisfaction levels with the aesthetic outcome of OBP when compared to sBCS. However, the lack of comprehensive high-quality research assessing their safety, efficacy, and patient-reported outcomes hinders these supposed conclusions. Postoperative complications after OBP may delay the initiation of adjuvant RT. In addition, precise displacement of the breast volume is not effectively recorded despite surgical clips placement, making accurate dose delivery tricky for radiation oncologists, and WBRT preferable to APBI in complex OBP cases. With a critical eye on financial toxicity, patient satisfaction, and oncological outcomes, OBP must be carefully integrated into clinical practice. The thoughtful provision of informed consent is essential for decision-making between sBCS and OBP. As we look into the future, machine learning and artificial intelligence can potentially help patients and doctors avoid postoperative regrets by setting realistic aesthetic expectations.
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Affiliation(s)
- E-A Bonci
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; Surgical Oncology Department, "Prof. Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania; Surgical Oncology and Gynecologic Oncology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J Correia Anacleto
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; Hospital CUF Cascais, Cascais, Portugal
| | - M-J Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
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Aesthetic, Quality-of-Life, and Clinical Outcomes after Inferior Pedicle Oncoplastic Reduction Mammoplasty. Aesthetic Plast Surg 2023; 47:905-911. [PMID: 36735002 DOI: 10.1007/s00266-023-03257-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/26/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Oncoplastic breast surgery is more likely to achieve superior aesthetic outcomes compared to lumpectomy alone. Oncoplastic reduction mammoplasty (ORM) is a volume displacement oncoplastic technique that combines lumpectomy and reduction mammoplasty. Data on aesthetic and quality-of-life (QoL) outcomes after ORM are scarce in the literature. Based on a literature review, this present study reports outcomes on the largest group of ORM patients to date. METHODS A retrospective review was conducted of all patients who underwent ORM between 2011 and 2018 at a tertiary care centre. Patients were excluded if no pedicle information was available or did not undergo post-operative radiotherapy. All patients with available post-operative photographs were aesthetically evaluated by four blinded, independent investigators blinded based on breast symmetry, nipple symmetry, and overall appearance. The BREAST-Q (breast conserving module) was used to assess QoL outcomes. RESULTS Two-hundred-and-sixteen consecutive patients (223 breasts) were included. Macromastia (cup size D or higher) was present in 173 patients (80.1%). Inferior pedicle ORM was utilized in 179 (80.3%) breasts. Eighty-eight patients (40.7%) were aesthetically evaluated, of whom 69 patients (78.4%) had "good", "very good", or "excellent" grades in all aesthetic categories. Seventy-five patients (85.2%) had "good" or better grades in overall appearance. Preoperative ptosis grade, cup size, presence of post-operative complications, and breast specimen weight had no significant correlations with aesthetic grades. Inferior pedicle ORM was associated with a higher "satisfaction with breast" Q-score (p=0.017) compared to other pedicle approaches. CONCLUSION Inferior pedicle ORM achieves objectively excellent aesthetic outcomes and high patient satisfaction with the reconstruction. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Vieira RADC, Bailão-Junior A, de Oliveira-Junior I. Does breast oncoplastic surgery improve quality of life? Front Oncol 2023; 12:1099125. [PMID: 36713564 PMCID: PMC9877289 DOI: 10.3389/fonc.2022.1099125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Breast Oncoplastic Surgery (OS) has established itself as a safe procedure associated with the treatment of breast cancer, but the term is broad, encompassing procedures associated with breast-conserving surgeries (BCS), conservative mastectomies and fat grafting. Surgeons believe that OS is associated with an increase in quality of life (QOL), but the diversity of QOL questionnaires and therapeutic modalities makes it difficult to assess from the patient's perspective. To answer this question, we performed a search for systematic reviews on QOL associated with different COM procedures, and in their absence, we selected case-control studies, discussing the main results. We observed that: (1) Patients undergoing BCS or breast reconstruction have improved QoL compared to those undergoing mastectomy; (2) In patients undergoing BCS, OS has not yet shown an improvement in QOL, a fact possibly influenced by patient selection bias; (3) In patients undergoing mastectomy with reconstruction, the QoL results are superior when the reconstruction is performed with autologous flaps and when the areola is preserved; (4) Prepectoral implants improves QOL in relation to subpectoral implant-based breast reconstruction; (5) ADM do not improves QOL; (6) In patients undergoing prophylactic mastectomy, satisfaction is high with the indication, but the patient must be informed about the potential complications associated with the procedure; (7) Satisfaction is high after performing fat grafting. It is observed that, in general, OS increases QOL, and when evaluating the procedures, any preservation or repair, or the use of autologous tissues, increases QOL, justifying OS.
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Affiliation(s)
- René Aloisio da Costa Vieira
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos/SP, Brazil,Departamento de Cirurgia Oncológica, Divisão de Mastologia, Hospital de Câncer de Muriaé, Muriaé/MG, Brazil,Active Member of European Organisation for Research and Treatment (EORTC) Quality of life Group, Brussels, Belgium,*Correspondence: René Aloisio da Costa Vieira,
| | - Antônio Bailão-Junior
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Departamento de Mastologia e Reconstrução Mamária, Hospital de Câncer de Barretos, Barretos/SP, Brazil
| | - Idam de Oliveira-Junior
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos/SP, Brazil,Departamento de Mastologia e Reconstrução Mamária, Hospital de Câncer de Barretos, Barretos/SP, Brazil
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Li L, Yang Y, Li W, Zhao X, He J, Mei S, Guo X, Zhang X, Ran J. Latissimus dorsi myocutaneous flap repair is effective after neoadjuvant chemotherapy for locally advanced breast cancer. World J Surg Oncol 2022; 20:134. [PMID: 35477520 PMCID: PMC9044592 DOI: 10.1186/s12957-022-02598-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/16/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the clinical outcome and physical condition of patients with locally advanced breast cancer (LABC) who received neoadjuvant chemotherapy followed by mastectomy and latissimus dorsi myocutaneous flap repair. METHODS A retrospective review of 142 patients with locally advanced breast cancer was selected from 1156 breast cancer patients in the South and North areas of The Affiliated Calmette Hospital of Kunming Medical University between May 2008 and December 2018. RESULTS All participants (n = 142) were women aged 40-55 years (average age 47.35 ± 0.43 years) who received neoadjuvant chemotherapy followed by mastectomy and latissimus dorsi flap repair. The median follow-up period was 16 months (range 12-24 months). For stage of disease, there were 19 cases (13%) in stage IIB, 31 cases (22%) in stage IIIA, 39 cases (28%) in stage IIIB, and 53 cases (37%) in stage IIIC, which were statistically significant with the physical condition of patients (≤ 0.001). Neoadjuvant chemotherapy was administered to shrink the tumors, and an average tumor size decrease from 10.05 ± 1.59 cm × (8.07 ± 1.54) cm to 6.11 ± 1.72 cm × (3.91 ± 1.52) cm (P < 0.001) was considered statistically significant. A t test was used for the ECOG score statistics, and the results showed that the scores were statistically significant (≤ 0.001) before and after neoadjuvant chemotherapy and after surgery. CONCLUSIONS Neoadjuvant chemotherapy is an accepted treatment option for patients with locally advanced breast cancer, and the use of a latissimus dorsi musculocutaneous flap for post-mastectomy reconstruction may improve the patients' physical condition. Our results indicated that this strategy was safe and feasible.
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Affiliation(s)
- Lu Li
- Department of Breast Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Yue Yang
- Department of Breast Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Wang Li
- Department of Hepatopancreatobiliary Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Xian Zhao
- Department of Plastic Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Jia He
- Department of Plastic Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Shuo Mei
- Department of Breast Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Xuejun Guo
- Department of Breast Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Xibin Zhang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China
| | - Jianghua Ran
- Department of Hepatopancreatobiliary Surgery, The Affiliated Calmette Hospital of Kunming Medical University, No. 1228, Beijing Road, Panlong District, Kunming, 650224, Yunnan, China.
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Zhao R, Jin M, Gao J, Zhang L, Tao L, Bao X. A Cross-Sectional Study of Breast Cancer Surgery and the Cost Based on Data From 77 Chinese 3A Hospitals in 2015. Front Oncol 2022; 12:857359. [PMID: 35558511 PMCID: PMC9086896 DOI: 10.3389/fonc.2022.857359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 12/24/2022] Open
Abstract
Purposes We aimed to clarify the real-world status of breast cancer surgery and the cost in China. Methods This cross-sectional survey relied on data obtained from the hospitalization summary reports (HSRs) in 77 top-ranked (grade 3A) hospitals in China to analyze breast cancer patients who underwent surgery between January 2015 and December 2015. The surgery and cost were mainly evaluated. Results Overall, 31,900 breast cancer patients underwent surgeries in 77 hospitals. The mean age in our study was 51.5 years (SD, 11.7 years). The primary types of surgical procedures were mastectomy (n = 24,629, 77.2%) and breast-conserving surgery (6,210, 19.5%). The rate of mastectomy was the highest at age band 50-65 years (n = 10,861, 82.1%) and in non-first-tier cities (n = 7,651, 88.4%) as well as in Northeast China (n = 3,107, 93.2%). The rate of breast-conserving surgery was less than 10% in non-first-tier cities (9.8%), Southwest China (6.1%), and Northeast China (5.8%). The median cost was $3,352.4 (interquartile range (IQR), $2,492.6-4,588.0). Mastectomy cost was significantly higher than breast-conserving surgery cost in both different city tiers and regional distribution except Northeast China (p < 0.001). Conclusions This study demonstrated that the main breast cancer surgery in Chinese 3A hospitals was mastectomy and that the cost varied both across and within geographic regions and city tiers. This information helps describe the real-world status of breast surgery and the cost in China.
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Affiliation(s)
- Rong Zhao
- Department of Breast Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Meng Jin
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Jinnan Gao
- Department of Breast Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Linhui Zhang
- Department of Breast Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Institute of Rehabilitation Industry, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaoyuan Bao
- Peking University Medical Informatics Center, Peking University, Beijing, China
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Orsaria P, Grasso A, Caggiati L, Altomare M, Altomare V. Update on oncoplastic techniques in breast conserving surgery: algorithms for predictable results and custom-made reconstructions. Minerva Surg 2021; 76:512-525. [PMID: 34338466 DOI: 10.23736/s2724-5691.21.08976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Breast cancer surgery is going to be a relevant specialty involved in the multidisciplinary disease management, finalized to guarantee high performances on mortality reduction together with a quality of life improvement. The intellectual architecture of this field is characterized by its inclination to respect, sharing, empathy and scientific knowledge that can make it a high model of medical culture. In this context, oncoplastic breast conserving surgery is identified by special aesthetic sensitivities, as well as creativity and innovation. Knowing how to reshape the gland and fill the gaps, planning the targeted exeresis design, while anticipating the final outcome, respecting symmetries and ensuring first of all oncological safety, are the new skills that are required to the breast surgeon. Several tecniques could provide a refined surgical treatment but always challenging according to anatomical findings and patient expectations, as a systematic process of self-critical reflection, with the purpose to optimize criteria for improving therapeutic results.
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Affiliation(s)
- Paolo Orsaria
- Department of Breast Surgery, Campus Bio-Medico University Hospital, Rome, Italy -
| | - Antonella Grasso
- Department of Breast Surgery, Campus Bio-Medico University Hospital, Rome, Italy
| | - Lorenza Caggiati
- Department of Breast Surgery, Campus Bio-Medico University Hospital, Rome, Italy
| | - Michele Altomare
- Department of General Surgery, University of Milan, Milan, Italy
| | - Vittorio Altomare
- Department of Breast Surgery, Campus Bio-Medico University Hospital, Rome, Italy
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