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Monaghan A, Copson E, Cutress R. Hereditary genetic testing and mainstreaming: a guide for surgeons. Ann R Coll Surg Engl 2024; 106:300-304. [PMID: 38555867 PMCID: PMC10981983 DOI: 10.1308/rcsann.2024.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
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Bundred N, Bundred J, Michael S, Cutress R, Holleczek B, Beckmann K, Dahlstrom J, Stuart B, Dodwell D. Margin status and Survival outcomes following breast conservation surgery: a metaanalysis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gilmour A, Cutress R, Gandhi A, Harcourt D, Little K, Mansell J, Murphy J, Pennery E, Tillett R, Vidya R, Martin L. Oncoplastic breast surgery: A guide to good practice. Eur J Surg Oncol 2021; 47:2272-2285. [PMID: 34001384 DOI: 10.1016/j.ejso.2021.05.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 04/08/2021] [Revised: 04/18/2021] [Accepted: 05/05/2021] [Indexed: 02/08/2023] Open
Abstract
Oncoplastic Breast Surgery has become standard of care in the management of Breast Cancer patients. These guidelines written by an Expert Advisory Group; convened by the Association of Breast Surgery (ABS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), are designed to provide all members of the breast cancer multidisciplinary team (MDT) with guidance on the best breast surgical oncoplastic and reconstructive practice at each stage of a patient's journey, based on current evidence. It is hoped they will also be of benefit to the wide range of professionals and service commissioners who are involved in this area of clinical practice.
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Affiliation(s)
- A Gilmour
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, United Kingdom
| | - R Cutress
- University of Southampton and University Hospital Southampton, United Kingdom
| | - A Gandhi
- Manchester Academic Health Sciences Centre & Manchester University Hospitals NHS Trust, Manchester, United Kingdom
| | - D Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - K Little
- Liverpool Breast Unit, Liverpool University Foundation Trust, United Kingdom
| | - J Mansell
- Gartnavel General Hospital, Glasgow, United Kingdom
| | - J Murphy
- Manchester University Hospitals NHS Trust, United Kingdom
| | | | - R Tillett
- Royal Devon and Exeter NHS Trust, Exeter, United Kingdom
| | - R Vidya
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - L Martin
- Liverpool Breast Unit, Liverpool University Foundation Trust, United Kingdom.
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Sewart E, Turner N, Conroy EJ, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. O77: DOES MESH IMPROVE PATIENT SATISFACTION AND HEALTH-RELATED QUALITY OF LIFE AFTER IMPLANT-BASED BREAST RECONSTRUCTION? A MULTICENTRE PROSPECTIVE COHORT STUDY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Biological and synthetic meshes may improve outcomes of immediate IBBR by facilitating single-stage direct-to-implant procedures. However, high-quality supporting evidence is limited, particularly regarding PROs.
Method
2108 consecutive women undergoing IBBR at 81 centres were prospectively recruited between 2014-2016. Demographic, operative, oncological and 3-month complication data were collected. An 18-month questionnaire assessed PROs using the validated BREAST-Q and a five-point Likert scale rating of overall reconstructive outcome.
The impacts of different IBBR techniques on PROs were explored using mixed-effects regression models adjusted for clinically-relevant confounders and including a random effect to account for clustering by centre. The reference group was two- stage submuscular reconstruction without mesh.
Result
1470 participants consented to receive the questionnaire and 891 completed it. 67 patients underwent two-stage submuscular reconstruction; 764 patients received subpectoral reconstructions with biological mesh (n=495) synthetic mesh (n=95) or dermal sling (n=174). 14 patients underwent prepectoral reconstructions (introduced late in the study).
Compared with two-stage reconstructions, no differences in PROs were seen in biological or synthetic mesh-assisted or dermal sling procedures (p>0.05). However, prepectoral IBBR patients reported better satisfaction with breasts (difference=6.63, 95% confidence interval[1.65–11.61], p=0.009). Outcomes were similar to those in the NMBRA 2008/9 cohort, which included submuscular procedures only.
Conclusion
This study does not suggest that mesh improves PROs of IBBR. It provides early data supporting improved satisfaction with breasts following prepectoral reconstructions. Future trials are needed to robustly evaluate prepectoral techniques.
Abbrev
IBBR: implant-based breast reconstruction, PRO: patient-reported outcome, NMBRA: National Mastectomy and Breast Reconstruction Audit
Take-home message
Although mesh-assisted techniques have become widely adopted, this large, prospective, multicentre cohort study does not suggest that mesh improves patient-reported outcomes of implant-based breast reconstruction compared with standard submuscular techniques. However, it provides early data to support improved satisfaction with breasts in the prepectoral setting, which now requires robust evaluation.
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Affiliation(s)
| | | | | | | | - J Skillman
- University Hospitals Coventry and Warwickshire NHS Trust
| | - L Whisker
- Nottingham University Hospitals NHS Trust
| | | | - N Barnes
- Manchester University NHS Foundation Trust
| | - C Holcombe
- Royal Liverpool and Broadgreen University Hospital
| | - S Potter
- University of Bristol
- North Bristol NHS Trust
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Sewart E, Turner N, Conroy EJ, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. O58: THE IMPACT OF RADIOTHERAPY ON PATIENT-REPORTED OUTCOMES OF IMMEDIATE IMPLANT-BASED BREAST RECONSTRUCTION: RESULTS OF A PROSPECTIVE MULTICENTRE COHORT STUDY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Post-mastectomy radiotherapy (PMRT) is increasing given to improve breast cancer outcomes but can increase complication rates following implant-based breast reconstruction (IBBR). Little, however, is known about the impact of PMRT on patient-reported outcomes (PROs) of IBBR, especially in the context of mesh-assisted techniques.
Method
2108 consecutive women undergoing IBBR at 81 UK centres were prospectively recruited between 2014 and 2016. Demographic, operative, oncological and 3-month complication data were collected, and patients who consented received post-operative questionnaires. An 18-month questionnaire assessed PROs using the validated BREAST-Q. The effect of IBBR on PROs was investigated using mixed-effects regression models adjusted for clinically relevant confounders and including a random effect to account for potential clustering by centre.
Result
1693 iBRA participants underwent mastectomy for malignancy, of whom 1187 (70%) consented to receive the 18-month questionnaire and 732 (43%) completed it. Patients undergoing PMRT (n=214) reported significantly worse scores across 3 BREAST-Q domains: satisfaction with breasts (-6.27 points, p=0.008, 95% confidence interval (CI)[-10.91,-1.63]), satisfaction with outcome (-7.53 points, p=0.002, CI[-12.20,-2.85]) and physical well-being (-6.55 points, p<0.001, CI[-9.43,-3.67]). Overall satisfaction was worse in the PMRT group (OR 0.497, p=0.002, CI[0.32,0.77]). Use of biological mesh did not ameliorate the impact of PMRT on patient satisfaction (interaction term p-values [0.173 - 0.826]).
Conclusion:
PMRT adversely affects PROs of IBBR. This should be discussed with patients considering IBBR, especially if PMRT is anticipated or indications are borderline, to enable informed decisions regarding oncological and reconstructive options.
Abbrev
PMRT: post-mastectomy radiotherapy, PRO: patient-reported outcome
Take-home message
This multicentre, prospective cohort study of 732 patients undergoing implant-based breast reconstruction demonstrates worse 18-month patient-reported outcomes in women who received post-mastectomy radiotherapy than those who did not. These data should be discussed with patients to help them make informed decisions about reconstructive surgery.
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Affiliation(s)
| | | | | | | | - J Skillman
- University Hospitals Coventry and Warwickshire NHS Trust
| | - L Whisker
- Nottingham University Hospitals NHS Trust
| | | | - N Barnes
- Manchester University NHS Foundation Trust
| | - C Holcombe
- Royal Liverpool and Broadgreen University Hospital
| | - S Potter
- University of Bristol
- North Bristol NHS Trust
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Sewart E, Turner N, Conroy E, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. The impact of radiotherapy on patient-reported outcomes of immediate implant-based breast reconstruction: Results of a prospective multicentre cohort study. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30614-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eccles DM, Copson ER, Maishman T, Tapper W, Cutress R, Gerty S, Stanton L, Altman DG, Durcan L, Simmonds P, Decker B, Allen J, Luccarini C, Easton D, Dunning A. Abstract S2-03: Does BRCA status affect outcome in young breast cancer patients? Results from the prospective study of outcomes in sporadic and hereditary breast cancer (POSH). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-s2-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Germline mutations in BRCA1/2 account for ∼3% of breast cancer cases but >10% of young patients who present with triple negative (TN) breast cancer. Young age at diagnosis is also associated with an increased risk of recurrence and inferior survival compared to older patients. Numerous publications describe an increased incidence of adverse biological features in tumours from young breast cancer patients; however it is unclear whether these fully explain the poor outcome.
The effect of carrying a BRCA1/2 mutation on the prognosis of breast cancer remains controversial with retrospective studies reporting better, similar and worse outcomes for mutation carriers compared to patients with sporadic tumours. BRCA carriers could feasibly have enhanced or reduced sensitivity to certain chemotherapeutics; however retrospective studies are problematic due to missing data and biased ascertainment. POSH is multicentre prospective observational cohort study designed to investigate factors which affect prognosis in young breast cancer patients (Copson et al, JNCI, 2013). Here we report the pathology, treatment and outcome of patients with TN tumours as a preliminary analysis to determine the impact of a germline BRCA1 mutation on survival. The whole cohort analysis including BRCA1 and BRCA2 is in progress.
Methods
2956 patients aged ≤40 at breast cancer diagnosis were recruited from 127 UK oncology centres between 2000 and 2008. Patient characteristics, family history, risk factors, tumour pathology and treatment information, and blood DNA were collected at recruitment. Follow-up data were collected at 6 and 12 months, then annually. Summary statistics were used to describe patients by BRCA1 status. Kaplan-Meier estimates were used to describe univariate survival data.
Results
BRCA1 status is currently available for 542 patients with TN tumours. Pathogenic BRCA1 mutations were identified in 122 patients (BRCA1+); 420 had no BRCA1 mutation (BRCA1-). BRCA1+ were younger than BRCA1- (median age 34 vs 36 years, p<0.001) and more likely to have a positive family history (p<0.001). There were no significant differences between BRCA1+ vs BRCA1- for: median tumour size (20.8mm vs 23.0mm); tumour grade distribution (95.8% grade 3 vs 93.6%); nodal involvement (35.2% node positive vs 39.9%); or presence of metastases at diagnosis (0.0% vs 1.0%).
Median follow-up was 7.3 years. Overall survival of patients with stage 1-3 disease treated with anthracycline +/- taxane neoadjuvant chemotherapy (n=538; 151 deaths) was better for BRCA1+ vs BRCA1- (79.1% vs 73.6% at 5-yrs; HR[95%CI]=0.84[0.57,1.25],p=0.388). Distant disease-free survival (DDFS) was also higher for BRCA1+ (5-yr DDFS 76.1% vs 71.5%; HR[CI]=0.92[0.63,1.35], p=0.682). Moreover, survival after first distant relapse was better for BRCA1+ patients (41.9% vs 36.8% at 1-yr; HR[CI]=0.78[0.51,1.18], p=0.233).
Conclusions
Our prospective data show better survival in young BRCA1+ patients with early TN breast cancer treated with anthracycline/-taxane chemotherapy than BRCA1- patients. However, the difference between the groups was not significant in this partial sample. Results for the whole cohort will be available by the time of the meeting.
Citation Format: Eccles DM, Copson ER, Maishman T, Tapper W, Cutress R, Gerty S, Stanton L, Altman DG, Durcan L, Simmonds P, Decker B, Allen J, Luccarini C, Easton D, Dunning A, POSH Steering Group and Collaborators. Does BRCA status affect outcome in young breast cancer patients? Results from the prospective study of outcomes in sporadic and hereditary breast cancer (POSH) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr S2-03.
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Affiliation(s)
- DM Eccles
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - ER Copson
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - T Maishman
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - W Tapper
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - R Cutress
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - S Gerty
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - L Stanton
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - DG Altman
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - L Durcan
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - P Simmonds
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - B Decker
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - J Allen
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - C Luccarini
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - D Easton
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
| | - A Dunning
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, United Kingdom; Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; Strangeways Research Laboratories, Cambridge University, Cambridge, United Kingdom; POSH Steering Group and Collaborators
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Annels NE, Simpson GR, Denyer M, McGrath SE, Falgari G, Killick E, Eeles R, Stebbing J, Pchejetski D, Cutress R, Murray N, Michael A, Pandha H. Spontaneous antibodies against Engrailed-2 (EN2) protein in patients with prostate cancer. Clin Exp Immunol 2014; 177:428-38. [PMID: 24654775 PMCID: PMC4226594 DOI: 10.1111/cei.12332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Accepted: 03/16/2014] [Indexed: 11/27/2022] Open
Abstract
We reported the expression of the homeodomain-containing transcription factor Engrailed-2 (EN2) in prostate cancer and showed that the presence of EN2 protein in the urine was highly predictive of prostate cancer. This study aimed to determine whether patients with prostate cancer have EN2 autoantibodies, what the prevalence of these antibodies is and whether they are associated with disease stage. The spontaneous immunoglobulin (Ig)G immune response against EN2 and for comparison the tumour antigen New York Esophageal Squamous Cell Carcinoma 1 (NY-ESO-1), were tested by enzyme-linked immunosorbent assay (ELISA) in three different cohorts of prostate cancer patients as well as a group of men genetically predisposed to prostate cancer. Thirty-two of 353 (9·1%) of the SUN cohort representing all stages of prostate cancer demonstrated EN2 IgG responses, 12 of 107 patients (11·2%) in the advanced prostate cancer patients showed responses, while only four of 121 patients (3·3%) with castrate-resistant prostate cancer showed EN2 autoantibodies. No significant responses were found in the predisposed group. Anti-EN2 IgG responses were significantly higher in patients with prostate cancer compared to healthy control males and similarly prevalent to anti-NY-ESO-1 responses. While EN2 autoantibodies are not a useful diagnostic or monitoring tool, EN2 immunogenicity provides the rationale to pursue studies using EN2 as an immunotherapeutic target.
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Affiliation(s)
- N E Annels
- Oncology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
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9
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Gerty S, Cutress R, Simmonds P, Eccles D. Breast oncological surgical treatment in 2409 young women recruited to a Prospective study of Outcome of Sporadic versus Hereditary breast cancer (POSH). Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.03.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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10
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Brown V, Cutress R, Simoes T, Wise M, Yiangou C. The use of both cytokeratin19 and mammaglobin in the intraoperative analysis of sentinel lymph nodes. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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11
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Layfield DM, Robertson S, Aldridge T, Laban C, Cutress R, Royle G. The efficacy of small versus large surface area diathermy tips for mastectomy. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Hayward L, Oeppen R, Grima A, Royle G, Rubin C, Cutress R. Can conventional breast imaging accurately determine the extent of screen detected high grade ductal carcinoma in situ (DCIS)? Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Robson N, Cutress R, Sainsbury R, Rew D, Royle G. Day care breast cancer surgery. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Brown V, Cutress R, Simoes T, Agrawal A, Wise M, Cree I, Yiangou C. O-59 Single centre experience of 500 patients with intra-operative RT-PCR breast sentinel node analysis. EJC Suppl 2010. [DOI: 10.1016/j.ejcsup.2010.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Eyre K, Oakley T, Gill J, Cutress R, Nicol R, Agrawal A, Yiangou C, Wise M. To dilute or not to dilute? A study of the effect of dilution of patent blue dye on the identification rate of sentinel lymph nodes in breast cancer. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Edgar I, Gill J, Agrawal A, Wise M, Yiangou C, Cutress R. Coding and revenue: impact on Portsmouth Breast Unit. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Byrne B, Cutress R, Gill J, Wise M, Yiangou C, Agrawal A. Does sentinel node biopsy or the timing of completion axillary clearance alter the axillary nodal harvest in breast cancer surgery? Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Zeidan B, Murray N, Cutress R, Eccles D, Packham G, Townsend P. Identification of 27 putative breast cancer proteomic biomarkers by SELDI-TOF MS. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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McDowell A, Cutress R, Gabriel F, Jeffrey M, Agrawal A, Wise M, Yiangou C, Raftery J, Cree I. PP83 Implementation and cost effectiveness of intra-operative qRT-PCR analysis of sentinel lymph nodes (SLN) in breast cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72187-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Johns R, Cutress R, Agrawal A, Wise M, Yiangou C. The yield of pre-operative staging investigations in patients undergoing elective surgical treatment of breast cancer. Eur J Surg Oncol 2008. [DOI: 10.1016/j.ejso.2008.06.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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Harding L, Cutress R, Wise M, Yiangou C, Agrawal A. Triaging Referrals for immediate radiology within the rapid access outpatient clinic. Eur J Surg Oncol 2008. [DOI: 10.1016/j.ejso.2008.06.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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22
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Abstract
BACKGROUND Conventionally, a large symptomatic and unresolved pancreatic pseudocyst is treated surgically by internal drainage to a neighboring adherent viscus such as stomach, duodenum or jejunum. Recently, the various minimal invasive approaches have been used to treat this condition. Depending on the expertise available, the cyst can be also be drained endoscopically or laparoscopically. We present a case of a large pseudocyst treated laparoscopically. METHOD A 60-year-old lady was admitted for an elective laparoscopic cholecystectomy as a day case. Under general anaesthesia during her elective laparoscopic cholecystectomy a mass was visible and palpable in the left upper abdomen. Post-operatively, a CT scan of abdomen confirmed the presence of a giant pseudocyst of the pancreas. She successfully underwent a laparoscopic cystogastrostomy four weeks later. CONCLUSION Laparoscopic cystogastrostomy for pseudocyst of the pancreas is safe, feasible and with good outcome.
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Affiliation(s)
- V Golash
- Department of Surgery, Sultan Qaboos Hospital, Salalah, Sultanate of Oman.
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Abstract
We report the case of a primary non-Hodgkin's lymphoma of the breast, masquerading as a breast abscess.
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Affiliation(s)
- M P Stanton
- The Breast Unit, Southampton University Hospitals NHS Trust., Address: The Royal South Hants Hospital, Brintons Terrace, Southampton, SO14 0YG, UK
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Cutress R. The author replies. Arch Emerg Med 1996. [DOI: 10.1136/emj.13.4.301-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- R Cutress
- Nuffield Department of Surgery, John Radcliffe Hospital, Headington, Oxford, UK
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