Autologous fat transfer (AFT) enhances the cosmetic results of breast reconstruction and corrects breast conserving operation sequelae. The question of its oncological safety remains, as in-vitro experiences have shown that adipocytes can stimulate cancer cell proliferation. This study analysed the records of patients who had AFT after breast cancer from 2004-2009. The primary end-point was cancer recurrence. The secondary end-points were AFT complications and post-AFT mammogram modifications. Sixty-four patients (100 AFT) were included. The mean follow-up for AFT was 46.44 months (SD = 21.4). Two breast cancer recurrences were recorded (3.1%). Among 55 mammograms analysed, only one patient presented radiological abnormalities. One complication of AFT (donor-site infection) was recorded. This series is in favour of the oncological safety of AFT after breast cancer. An accurate evaluation of the recurrence risk, before performing AFT, is an essential prerequisite and must lead one to postpone or avoid this procedure in high-risk patients.
PURPOSE: To evaluate the clinical outcomes of a very-accelerated partial breast irradiation (vAP-BI) in the elderly based on a single fraction of multicatheter interstitial high-dose rate brachytherapy (MIB). Mature results with a median follow-up of 5 years. METHODS AND MATERIALS: From November 2012 to September 2014, 26 patients (pts) ($70) with early breast cancer were enrolled in a prospective phase II trial (NCT01727011). After lumpectomy, intraoperative catheter implant was performed for postoperative APBI (single fraction 16 Gy). Surveillance was performed twice a year after APBI. Oncologic outcome (local [LRFS], metastasis-free survival, cancer-specific survival, and overall survival [OS]) as well as late toxicity and cosmetic outcome were investigated. RESULTS: Median age was 77 years [69e89]. After a median follow-up of 63 months [60e68], 5-year LRFS, metastasis-free survival, cancer-specific survival, and overall survival rates were 100%, 95.5%, 100%, and 88.5%, respectively. Late toxicity was observed in 5 pts (19.2%) with a total of five events: 3 pts G1 (60%); and 2 pts G2 (40%). The observed late side effects were breast pain in 1 pt (G2 cytosteatonecrosis with occasional acetaminophen consumption), hypopigmentation (puncture site) in 2 pts (G1) and breast fibrosis in 2 pts (G1: 1 pt; G2: 1 pt). Cosmetic evaluation was excellent for 21 pts (81%) and good for 2 pts (19%). CONCLUSION: For elderly with early breast cancer, a vAPBI using a single fraction of postoperative MIB (16 Gy) provides excellent oncologic results, mainly in terms of local control and cancer death. Late toxicity and cosmetic profile are acceptable.
QASICC has proved to be efficient, and to detect known issues regarding daily activities and body image. As our population was mostly composed of women with breast cancer, our results reflect specific aspects of this population. The TIVAD remains generally well-accepted and our questionnaire should help health-care workers to better address the specific needs of their patients based on the answers provided.
Rationale: Most cancer patients require a totally-implanted Central Venous Catheter (CVC) for their treatment. We develop and validate a French-language questionnaire dubbed QASICC (Questionnaire for Acceptance of and Satisfaction with Implanted Central Venous Catheter) assessing patient satisfaction with and acceptance of their CVC. Method: The construction and first validation of the questionnaire was made using validated methodology consisting in four phases. Phase 1 aimed at collecting a comprehensive list of relevant items. Phase 2 consisted in converting items into questions followed by a first item selection procedure. Phase 3 tested the acceptance of the provisional module to a small number of patients. Phase 4 involved a first validation on patients to determine its psychometric characteristics. Results: Responses to the questionnaire were collected from 215 patients. The final tool included 27 questions assessing seven dimensions: pain, contribution to the comfort of the treatment, esthetics and privacy, impact on professional activities, social and sports, impact on daily activities, local discomfort and overall satisfaction. Conclusions: This first statistical validation seems very promising and allows us to confirm the structure and the psychometric properties of the tool. Further validation studies are required on standard and specific populations in order to confirm these first results.
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