Introduction
The best local management for breast cancer recurrence following conservative treatment for breast cancer (BC) continues to be an open question. In this study, we compared patients' outcome after salvage lumpectomy (SL) vs mastectomy for ipsilateral breast tumor recurrence (IBTR).
Materials and methods
Between 1987 and 2014 we identified 121 patients with pT0‐2, N0‐3, M0 BC who had BCT as their primary treatment, and subsequently had IBTR (unifocal). 47 patients underwent SL and 74 salvage mastectomy (SM) as the local treatment for their 1st recurrence.
Results
Median follow‐up was 14 years (1‐30) from first BC diagnosis. For the SL and SM cohorts, 8 and 10 patients (17%, 13.5%, P = 0.22), respectively, developed subsequent local recurrence as a 3rd event. Although in MVA, woman who underwent SL had higher chances of having a 2nd recurrence (3rd event), P = 0.020, at a median follow‐up of 14 years, 95.8% of SL patients are alive, NED, 85% are mastectomy free. 87% of patients who opted for SM are alive, NED. Having re‐irradiation following SL did not protect against 2nd breast cancer recurrence (3rd event, P = 0.42).
Conclusion
Salvage lumpectomy following IBTR, while associated with higher second LR rate than SM is not associated with inferior outcome. With survival >95% at 14 years in the SL cohort, salvage lumpectomy with or without re‐radiation, in a selected population (unifocal T), represents an acceptable treatment option for patients in order to delay time to mastectomy without reducing BC survival. Both options should be discussed prior to any surgical decision.
and 166.2-337.0 in the severely obese subgroup alone. Conclusions: Further to the wide-ranging health benefits of maintaining normal body weight, even modest improvements in BMI could significantly reduce the financial burden of obesity in the US. Effective strategies to treat obesity may be best aimed at more overweight individuals for whom greatest changes in medical costs may be achieved.
gradually declined until it reached 49% in 2017. Other main drivers of costs were hospital care (14%), medical devices (8%) and outpatient care (7%). The mean total direct costs pppy were 1) V656 (without complications; denoted as baseline), 2) V1,058 (microvascular complications; +61% relative to baseline costs without complications), 3) V1,281 (macrovascular complications; +95%) 4) V2,025 (micro-and macrovascular complications; +209%). Conclusions: Results suggest that the costs of T2DM are substantial and are growing both over time and with associated complications. To our knowledge, this is the first Czech study providing contemporary realworld evidence on the average diabetic patient costs and associated complications. Our estimates may support health care stakeholders in evaluating the optimal resource allocation across different prevention and intervention programs.
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