Objective decision making between conventional and oncoplastic breast-conserving surgery or mastectomy: An aesthetic and functional prospective cohort study

Pukancsik, Dávid; Kelemen, P. B.; Újhelyi, Mihály; Kovács, Eszter; Udvarhelyi, Nóra; Mészáros, Norbert; Kenessey, István; Kovács, Tibor; Kásler, Miklós; Mátrai, Zoltán

doi:10.1016/j.ejso.2016.11.010

Cited by 51 publications

(33 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, undiagnosed COVID-19 patients, symptomatic or not, could potentially be in contact with BC patients amidst the health system reorganization. Surgeons should take advantage of techniques such as awake surgery (34)(35)(36), oncoplastic techniques (37)(38)(39), and prepectoral reconstruction (40)(41)(42) in order to shorten hospitalization and surgery recovery (34,36,39). Our study has some limitations such as its retrospective design.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

Vanni

Materazzo

Pellicciaro

et al. 2020

In Vivo

142

146

View full text Add to dashboard Cite

Background/Aim: Coronavirus-19 (COVID-19) pandemic outbreak is currently having a huge impact on medical resource allocation. Breast Cancer (BC) patients are concerned both with BC treatment and COVID-19. This study aimed to estimate the impact of anxiety among patients, caused by the spreading of COVID-19. Patients and Methods: Between the 16th of January and the 20th of March 2020, we retrospectively enrolled 160 patients. Eighty-two patients with a suspected breast lesion (SBL) were divided into two groups: PRE-COVID-19-SBL and POST-COVID-19-SBL. Seventy-eight BC patients were divided into PRE-COVID-19-BC and POST-COVID-19-BC. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure Refusal (PR) and Surgical Refusal (SR) were also recorded with their reason. Results: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). Both POST-COVID-19-SBL and POST-COVID-19-BC groups showed higher rates of PR and SR (p=0.0208, p=0.0065 respectively). Infection risk represented primary reason for refusal among POST-COVID-19 patients. Conclusion: COVID-19-related anxiety could affect patients' decisionmaking process. Since December 2019, the novel coronavirus (SARS-COV-2) has emerged as a highly contagious human pathogen. On March 20, 2020 more than 234000 cases were confirmed worldwide , with more than 9800 registered deaths (1). Following the initial outbreak in the Chinese Hubei Province on March 11, WHO has labelled the latest coronavirus disease COVID-19 (caused by SARS-COV-2) as a pandemic. The reported fatality rate is 4.2% globally (1, 2). Human to human transmission occurs through direct contact or air droplets (2) placing health care providers at a high risk due to the close proximity to potentially infected patients (3). Preliminary data of nationwide analysis in China demonstrated cancer as a risk factor for developing severe complications/disease course among COVID-19 patients (4, 5). Although further studies are required in order to accurately estimate the risk (6, 7) among patients who underwent chemotherapy or surgery in the months prior to the outbreak, the risk of developing severe conditions seems considerably higher compared to the general population (6). Breast Cancer (BC) is the most common neoplasm worldwide representing the primary cause of death due to neoplasms in Italy (5). A report published in 2017 stated that more than 50% of BC patients were older than 60 years (8). Therefore, due to the higher risk of adverse events in older patients, underlined in the preliminary data (9), it is essential to evaluate the risk of COVID-19 infection among these frail BC patients (10). Furthermore, during the COVID-19 outbreak, hospital resources are reallocated from elective and semi-elective procedures to meet the needs of COVID-19 patients in critical conditions (11). The subsequent scarcity of resources could potentially delay diagnostic evaluations and treatment of BC ...

show abstract

Section: Discussionmentioning

confidence: 99%

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

Vanni

Materazzo

Pellicciaro

et al. 2020

In Vivo

142

146

View full text Add to dashboard Cite

show abstract

“…Breast Cancer treatment requires a profound knowledge of cancer behavior in order to reduce the risk of tumors progression (22)(23)(24). On the other hand, a surgical plan should be seen as an opportunity for breast remodeling that may enhance the woman's appearance (25)(26)(27)(28)(29)(30). For these reasons, BCC HCWs' workload may be assumed as homogenous in terms of effect by perceived stress, anxiety and depression.…”

Section: Discussionmentioning

confidence: 99%

“…The total scores of these measurement tools were interpreted as follows: Depression, normal [0-9], mild [10][11][12][13], moderate [14][15][16][17][18][19][20], severe [21][22][23][24][25][26][27], extremely severe (28+); Anxiety, normal [0-7], mild [8][9], moderate [10][11][12][13][14], severe [15][16][17][18][19], extremely severe [20+]; Stress, normal [0-14], mild [15][16][17][18], moderate [19][20][21][22][23][24][25], severe [26][27][28][29][30][31][32][33], extremely severe [34+].…”

Section: Methodsmentioning

confidence: 99%

The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey

Vanni

Materazzo

Santori

et al. 2020

In Vivo

View full text Add to dashboard Cite

Background/Aim: Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). Patients and Methods: In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. Results: A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. Conclusion: Working in a COVID-19-hospital represents a factor that negatively affects psychosocial wellbeing. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP. The first case of atypical pneumonia previously named as Severe Acute Respiratory Syndrome Corona Virus 2 (COVID-19) was recorded in December 2019 in China. Italy has been the first European country to be involved in this outbreak. The national health care system (NHS) is currently reallocating resources from elective and semi-elective patients toward severe COVID-19 patients (1, 2). Italy has exceeded the cases recorded in China and unfortunately, up to now (May, 17th), 225,435 cases and 31908 deaths have been registered with still over 700 admitted to intensive care units (3). The Italian outbreak is mainly located in clusters along the north of Italy (Lombardia, Veneto and Emilia Romagna) and a low incidence in central and southern regions (1, 3, 4). In order to control COVID-19, resource reallocation eventually led to the creation of hospitals partially or totally dedicated to COVID-19 patients (COVID-hospital), therefore 1685 This article is freely accessible online.

show abstract

“…However, in our series, surgical strategy distribution did not change between BCS and Mx. In our opinion, the choice of surgical procedure of primary tumor was mostly affected by well-known variables such as breast volume, clinical tumor size and location of the tumor [ 22 ]. Similarly, axillary management was not affected by the period of treatment.…”

Section: Discussionmentioning

confidence: 99%

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

et al. 2020

View full text Add to dashboard Cite

Introduction COVID-19 is a declared worldwide pandemic. In our country, due to shortage of hospitals and beds in intensive care unit, oncological and breast cancer (BC) resources are temporarily shifted to COVID-19 patients. In addition, risk of cross-infections should be considered in these frail patients. To accomplish more surgical procedures and to reduce the length of hospital stay (LOS), fast track awake BC surgery should be implemented. The aim of the study is to estimate the effects of surgical shift in our facility during the early COVID-19 outbreak. Materials and methods From 30th January 2020 to 30th of March 2020, 86 consecutive patients were retrospectively enrolled and divided into pre-COVID-19-BC and COVID-19-BC. Clinical parameters and anamnestic data were collected and analyzed. Surgical procedures, relative complications and type of anaesthesia were reported. The effect on surgical time (ST), operative room time (ORT) and length of stay (LOS) were described and examined. Results No statistical difference was found in complications rate, clinical data and surgical procedures ( p > 0.05). Awake breast conservative surgery (BCS) was the most frequent procedure in COVID-19-BC ( p = 0.006). A statistically significant decrease in ORT and LOS was reported in COVID-19-BC ( p = 0.040 and p = 0.0015 respectively), while comparable time resulted for ST ( p = 0.976). Mean ORT and LOS reduction were 20.79 min and 0.57 hospital bed days. Conclusion In the “COVID-19 era”, fast track awake breast surgery provides a reduction of ORT, LOS and potentially surgical treatment for a wider number of oncological patients.

show abstract

Objective decision making between conventional and oncoplastic breast-conserving surgery or mastectomy: An aesthetic and functional prospective cohort study

Cited by 51 publications

References 37 publications

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey

Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency

Contact Info

Product

Resources

About