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Sasada S, Nagura N, Shimo A, Ogiya A, Saiga M, Seki H, Mori H, Kondo N, Ishitobi M, Narui K, Nogi H, Yamauchi C, Sakurai T, Shien T. Impact of radiation therapy for breast cancer with involved surgical margin after immediate breast reconstruction: A multi-institutional observational study. Eur J Surg Oncol 2024; 50:108360. [PMID: 38669780 DOI: 10.1016/j.ejso.2024.108360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/26/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Involved surgical margins are risk factors for local recurrence and re-excision is often difficult, particularly in patients with breast cancer undergoing immediate breast reconstruction (IBR). However, the magnitude of the effect of radiation therapy on preventing local recurrence for breast cancers with involved margins has not been sufficiently assessed. MATERIALS AND METHODS We retrospectively assessed sites of involved surgical margins and local recurrence after mastectomy with IBR in patients with early breast cancer between 2008 and 2016. The effect of postoperative radiation therapy was evaluated in patients with involved margins, adjusted for nuclear grade, lymphatic invasion, surgical procedures, and primary systemic therapy. RESULTS A total of 274 (5.8 %) out of 4726 patients who underwent mastectomy with IBR had involved surgical margins: 133, 68, 88, and 26 had involvement of the skin, deep margin, lateral margins, and nipple, respectively (including duplicates). Radiation therapy was administered to 54 patients with involved margins. In patients with involved margins, 7-year cumulative incidences of local recurrence were 1.9 % and 12.6 % with and without radiation therapy, respectively (adjusted hazard ratio, 0.17; 95 % CI, 0.04-0.80). Local recurrence occurred in 28 patients, and the sites were skin, subcutaneous tissue, muscle, and nipple-areola complex in 7, 17, 1, and 3 patients, respectively. Among them, 23 (82.1 %) were associated with involved margin sites. CONCLUSIONS Radiation therapy meaningfully reduced the incidence of local recurrence in patients with breast cancer with margin involvement after mastectomy with IBR. Most local recurrences occurred at involved margin-related sites.
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Affiliation(s)
- Shinsuke Sasada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
| | - Naomi Nagura
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Ayaka Shimo
- Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan
| | - Akiko Ogiya
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Hirohito Seki
- Department of Breast Surgery, Saitama Medical Center, Saitama, Japan; Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroki Mori
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoto Kondo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University School of Medicine, Mie, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Medical Center, Yokohama City University, Kanagawa, Japan
| | - Hiroko Nogi
- Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Chikako Yamauchi
- Department of Radiation Oncology, Shiga General Hospital, Shiga, Japan
| | | | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
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Kato S, Mori H, Saiga M, Watanabe S, Sasada S, Sasaki A, Ogiya A, Yamamoto M, Narui K, Takano J, Seki H, Nagura N, Ishitobi M, Shien T. Nipple-areolar complex malposition in breast reconstruction after nipple-sparing mastectomy: a multi-institutional retrospective observational study in Japan. Breast Cancer 2024:10.1007/s12282-024-01578-2. [PMID: 38589713 DOI: 10.1007/s12282-024-01578-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Position of the nipple-areolar complex (NAC) is an important factor in the esthetic impression of the breast, and NAC malposition is often an issue in breast reconstruction after nipple-sparing mastectomy (NSM). The purpose of this study was to evaluate the degree of NAC malposition depending on several factors using data quantified with the Mamma Balance application (Medic Engineering K.K., Kyoto, Japan). METHODS Patients who underwent unilateral breast reconstruction after NSM at eight hospitals in Japan between 2007 and 2020 were retrospectively investigated. Using Mamma Balance, NAC malposition was quantified separately in horizontal and vertical directions using patient photographs from pre-operatively and 6-24 months post-operatively. The degree of malpositioning was then statistically compared using various factors. RESULTS The NAC deviated more cranially and medially with implants than that with flaps. Cases with latissimus dorsi flap showed lateral malposition more often than cases with deep inferior epigastric artery perforator flap. With flaps, lateral incisions showed more lateral malposition, and peri-areolar incisions tended to show more medial NAC malposition. In cases with severe post-operative infection of the implant, the NAC tended to deviate cranially. In radiation cases, the NAC deviated cranially. No significant difference was observed according to the degree of breast ptosis or use of the pull-down operation. Only a very weak correlation was observed between a larger amount of mastectomy and more cranial NAC malposition with both flaps and implants. CONCLUSIONS This study provides insights into the tendencies and characteristics of NAC malposition.
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Affiliation(s)
- Sayuri Kato
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
| | - Hiroki Mori
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan
| | - Shinsuke Sasada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Akiko Ogiya
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mao Yamamoto
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Junji Takano
- Department of Plastic Surgery, Saitama Medical Center, Saitama, Japan
| | - Hirohito Seki
- Department of Surgery, Saitama Medical Center, Saitama, Japan
- Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Naomi Nagura
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University Hospital, Mie, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
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Saiga M, Yamamoto Y, Okuda R, Fukada M. Relationship Between Clinical Nursing Competence and Work Environment by Career Stage for Nurses with 1-10 Years of Clinical Experience. Yonago Acta Med 2024; 67:9-21. [PMID: 38371280 PMCID: PMC10867233 DOI: 10.33160/yam.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/14/2023] [Indexed: 02/20/2024]
Abstract
Background Clinical nursing competence includes ethics, cooperation with other professionals, and management, in addition to nursing abilities and responding per situation. Therefore, it may vary depending on one's experience and the work environment. However, there is a lack of studies exploring the competence for different experience levels. Therefore, this study aimed to clarify the association between clinical nursing competence and the work environment by experience groups. Methods Anonymous self-administered questionnaire surveys were conducted on 717 nurses in regional core hospitals from December 2017 to March 2018. Clinical nursing competence was measured using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). Association of CNCSS with experience and work environment was examined. Results Responses from 231 nurses with 1-10 years of experience were analyzed. Compared with those in the 2-year experience group, those in the 3-5- and 6-10-year experience groups assessed their "planned development of nursing care" and "assessment of care" competencies to be higher. Additionally, compared with those in the 2-year experience group, those in the 6-10-year experience group assessed their "clinical judgment" and "care coordination" competencies to be higher. Nurses with 1 year of experience showed significant positive correlations between clinical nursing competence and "good interpersonal relationship," "clarity about the organization's vision," and "ease of taking time off"; and those with 6-10 years of experience showed significant positive correlations between clinical nursing competence and "support from superiors and senior coworkers" and "established and easily accessible support system for taking time off for childcare and caregiving." Conclusion The relationship between clinical nursing competence and the work environment differed according to years of experience. Interventions to improve clinical nursing competence should be developed for each experience group considering the associations.
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Affiliation(s)
- Miho Saiga
- Tottori University Hospital, Yonago 683-8504, Japan and
| | - Yoko Yamamoto
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Reiko Okuda
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Mika Fukada
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Mukai Y, Taira N, Kitaguchi Y, Nakagiri R, Saiga M, Kochi M, Iwamoto T, Shien T, Doihara H, Kimata Y. An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines. Surg Today 2023; 53:1305-1316. [PMID: 37212931 DOI: 10.1007/s00595-023-02700-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/21/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Perioperative inflammatory cytokines may be related to cancer proliferation, although few studies have investigated this issue in patients undergoing breast reconstruction surgery. METHODS We conducted a prospective study of patients scheduled for mastectomy only, mastectomy plus deep inferior epigastric perforator flap reconstruction (DIEP), or mastectomy plus tissue expander reconstruction (TE), with or without axial dissection (Ax), for primary breast cancer. Blood samples were collected for analysis of serum IL-6 and VEGF preoperatively, then within 24 h postoperatively (POD 1), and 4-6 days postoperatively (POD 4-6). We investigated the difference in serum cytokine levels over time for each surgical procedure and the difference in serum cytokine levels among the procedures at the three measurement time points. RESULTS There were 120 patients included in the final analysis. Serum IL-6 was significantly higher than the preoperative level on POD 1 in patients who underwent mastectomy only, DIEP, or TE and Ax (+), with higher values persisting on POD 4-6 except in those who underwent DIEP. IL-6 was significantly higher after DIEP than after mastectomy only on POD 1, but no differences were observed at POD 4-6. VEGF did not differ significantly among the surgical procedures at any time. CONCLUSIONS The increase in IL-6 was short term and immediate breast reconstruction is considered a safe procedure.
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Affiliation(s)
- Yuko Mukai
- Department of Plastic and Reconstructive Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Kita-ku, Okayama Prefecture, Japan.
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan.
- Department of Plastic Surgery, Okayama Rousai Hospital, 2-10-25 Chikko -Midorimachi, Minami-ku, Okayama-City, Okayama Prefecture, 702-8055, Japan.
| | - Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki-City, Okayama Prefecture, Japan
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Yohei Kitaguchi
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Ryoko Nakagiri
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Mariko Kochi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime Prefecture, Japan
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
- Department of Surgery, Kawasaki Medical School General Medical Center, Kurashiki-City, Okayama Prefecture, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Kita-ku, Okayama Prefecture, Japan
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan
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Mukai Y, Taira N, Kajiwara Y, Iwamoto T, Kitaguchi Y, Saiga M, Watanabe S, Shien T, Doihara H, Kimata Y. Impact of Immediate Breast Reconstruction on Survival of Breast Cancer Patients: A Single-Center Observational Study. Acta Med Okayama 2023; 77:281-290. [PMID: 37357629 DOI: 10.18926/amo/65493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox's regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures.
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Affiliation(s)
- Yuko Mukai
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
| | - Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Yukiko Kajiwara
- Department of Breast Surgery, Hiroshima Citizens Hospital
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Yohei Kitaguchi
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
- Department of Plastic Surgery, Kawada Plastic Surgery
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital
- Department of Surgery, Kawasaki Medical School General Medical Center
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
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Saiga M, Nakagiri R, Mukai Y, Matsumoto H, Kimata Y. Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review. Int J Clin Oncol 2023:10.1007/s10147-023-02347-5. [PMID: 37160493 DOI: 10.1007/s10147-023-02347-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023]
Abstract
Breast reconstruction (BR) aims to improve the satisfaction and quality of life (QOL) of breast cancer survivors. Clinical studies using patient-reported outcomes (PROs) can therefore provide relevant information to the patients and support decision-making. This scoping review was conducted to analyze recent trends in world regions, methods used, and factors investigated. The literature search was conducted in August 2022. Databases of PubMed, MEDLINE, and CINAHL were searched for relevant English-language studies published from 2017 to 2022. Studies involving women with breast cancer who underwent BR after mastectomy and investigated PROs after BR using BR-specific scales were included. Data on the country, publication year, study design, PRO measures (PROMs) used, time points of surveys, and research themes were collected. In total, 147 articles met the inclusion criteria. BREAST-Q was the most widely used, contributing to the increase in the number and diversification of studies in this area. Such research has been conducted mainly in North America and Europe and is still developing in Asia and other regions. The research themes involved a wide range of clinical and patient factors in addition to surgery, which could be influenced by research methods, time since surgery, and even cultural differences. Recent BR-specific PROMs have led to a worldwide development of research on factors that affect satisfaction and QOL after BR. PRO after BR may be influenced by local cultural and social features, and it would be necessary to accumulate data in each region to draw clinically useful conclusion.
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Affiliation(s)
- Miho Saiga
- Department of Plastic Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan.
| | - Ryoko Nakagiri
- Department of Plastic Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan
| | - Yuko Mukai
- Department of Plastic Surgery, Okayama Rosai Hospital, Okayama, Japan
| | - Hiroshi Matsumoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Watanabe S, Saiga M, Motoki T, Shien T, Taira N, Doihara H, Kimata Y. Safety and Efficacy of a Well-Fitting Brassiere after Breast Reconstruction: A Qualitative Study. Acta Med Okayama 2023; 77:11-19. [PMID: 36849141 DOI: 10.18926/amo/64356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The importance of a well-fitted, comfortable brassiere to overall quality of life after breast reconstruction has not been evaluated. Our aim was to determine the impact of a semi-customized brassiere on patients' health-related quality of life after breast reconstruction. The subjects were prospective patients with mastectomy who were to undergo immediate or delayed breast reconstruction at our hospital. After surgery, a professional bra fitter sized each patient for a semi-customized brassiere and provided follow-up consultations. A self-reported questionnaire on breast aesthetics, postoperative pain, and satisfaction was used to assess the primary outcomes. Data were prospectively collected at baseline (before surgery) and at 1, 3, 6, and 12 months after surgery and analyzed. Forty-six patients (50 breasts) were included in the analysis. Consistent wearing of the brassiere reduced pain (p<0.05), with good overall satisfaction (p<0.001). Aesthetic scores on breast shape and size were higher with than without the custom brassiere at 3 months (p=0.02) and 6 months (p=0.03) after surgery. Wearing the brassiere reduced anxiety at all time points of measurement. A well-fitting brassiere ensured safety and provided a high degree of satisfaction without anxiety for patients after breast reconstruction.
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Affiliation(s)
- Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
| | - Takayuki Motoki
- Department of General Surgery, Okayama Saiseikai General Hospital
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital
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Yamakado R, Ishitobi M, Kondo N, Yamauchi C, Sasada S, Nogi H, Saiga M, Ogiya A, Narui K, Seki H, Nagura N, Shimo A, Sakurai T, Niikura N, Mori H, Shien T. Physicians' perception about the impact of breast reconstruction on patient prognosis: a survey in Japan. Breast Cancer 2023; 30:302-308. [PMID: 36527601 PMCID: PMC9758461 DOI: 10.1007/s12282-022-01421-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND One barrier to the widespread use of breast reconstruction (BR) is physicians' perception that BR adversely affects breast cancer prognosis. However, there is limited information regarding physicians' understanding of the impact of BR on patient prognosis and which physicians have misunderstandings about BR. METHODS We conducted an e-mail survey regarding the impact of BR on the prognosis of patients with breast cancer among members of the Japanese Breast Cancer Society. RESULTS Of 369 respondents, 99 (27%) said that they believe BR affects patient prognosis. Female respondents and those who treat fewer new breast cancer patients per year were more likely to state that they believe BR affects patient prognosis (P = 0.006 and 0.007). Respondents who believed that BR affects patient prognosis underestimated 5-year overall survival rates in patients who receive BR and subsequently have local or regional recurrence in different sites. CONCLUSION Our survey demonstrated that a quarter of respondents believe that BR affects patient prognosis and underestimate survival rates in patients who receive BR and have subsequent local or regional recurrence. Because of the lack of evidence regarding the impact of BR on patient prognosis, educating physicians by providing accurate knowledge regarding BR and patient prognosis is highly recommended.
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Affiliation(s)
- Rena Yamakado
- grid.260026.00000 0004 0372 555XDepartment of Breast Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Naoto Kondo
- grid.260433.00000 0001 0728 1069Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Chikako Yamauchi
- grid.416499.70000 0004 0595 441XDepartment of Radiation Oncology, Shiga General Hospital, Shiga, Japan
| | - Shinsuke Sasada
- grid.257022.00000 0000 8711 3200Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hiroko Nogi
- grid.411898.d0000 0001 0661 2073Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Miho Saiga
- grid.412342.20000 0004 0631 9477Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Akiko Ogiya
- grid.410807.a0000 0001 0037 4131Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazutaka Narui
- grid.268441.d0000 0001 1033 6139Department of Breast and Thyroid Surgery, Medical Center, Yokohama City University, Yokohama, Kanagawa Japan
| | - Hirohito Seki
- grid.415020.20000 0004 0467 0255Department of Breast Surgery, Saitama Medical Center, Saitama, Japan
| | - Naomi Nagura
- grid.430395.8Department of Breast Surgical Oncology, St. Luke’s International Hospital, Tokyo, Japan
| | - Ayaka Shimo
- grid.412764.20000 0004 0372 3116Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan ,Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan
| | | | - Naoki Niikura
- grid.265061.60000 0001 1516 6626Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroki Mori
- grid.265073.50000 0001 1014 9130Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tadahiko Shien
- grid.412342.20000 0004 0631 9477Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
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Saiga M, Hosoya Y, Utsunomiya H, Kuramoto Y, Watanabe S, Tomita K, Aihara Y, Muto M, Hikosaka M, Kawaguchi T, Miyaji T, Yamaguchi T, Zenda S, Goto A, Sakuraba M, Kusano T, Miyabe K, Kuroki T, Yano T, Taminato M, Sekido M, Tsunoda Y, Satake T, Doihara H, Kimata Y. Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study. BMJ Open 2021; 11:e042099. [PMID: 33589456 PMCID: PMC7887355 DOI: 10.1136/bmjopen-2020-042099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The aim of breast reconstruction (BR) is to improve patients' health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient's life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR). METHODS AND ANALYSIS This ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system. ETHICS AND DISSEMINATION This study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000032177.
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Affiliation(s)
- Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuko Hosoya
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Hiroki Utsunomiya
- Department of Surgery and Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yukiko Kuramoto
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukiko Aihara
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Hikosaka
- Department of Plastic and Reconstructive Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Aya Goto
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Minoru Sakuraba
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | | | - Kenta Miyabe
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoaki Kuroki
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoyuki Yano
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mifue Taminato
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mitsuru Sekido
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yui Tsunoda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Toyama University Hospital, Toyama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
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Mukai Y, Watanabe S, Matsumoto M, Saiga M, Kimata Y. Reliability and validity of Mamma Balance ®: Novel software to assess the symmetry of the nipple-areola-complex position. J Plast Reconstr Aesthet Surg 2017; 70:1147-1149. [PMID: 28619485 DOI: 10.1016/j.bjps.2017.05.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/14/2017] [Accepted: 05/24/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Yuko Mukai
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama-shi, Okayama, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama-shi, Okayama, Japan.
| | - Mio Matsumoto
- Department of Plastic Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni-shi, Yamaguchi, Japan
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama-shi, Okayama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama-shi, Okayama, Japan
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