SEARCH · PubMed Health

Results for “Mastectomy, Modified Radical”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources

PubMedDate not supplied

[Immediate breast reconstruction and oncologic criteria: our current definition].

After a review of the literature, the authors attempt at a definition of the oncologically safe candidate to an immediate reconstruction after modified radical mastectomy for breast cancer. The analysis of the natural history of locally recurrent breast cancer indicates that the potential for its masking is negligible. Survival curves of patients submitted to immediate breast reconstruction are similar to those reported for historical controls. The ideal candidate for an immediate reconstruction is a stage I (negative axillary nodes) patient. As immediate breast reconstruction does not alter the prognosis of breast cancer patients nor does it harm the use of adjuvant therapies, the authors believe that even a well motivated stage II (positive axillary nodes) patient should be considered as a candidate for an immediate reconstructive procedure.

Breast↗

PubMed1999

Metaplastic carcinomas of the breast.

BACKGROUND AND OBJECTIVES: Metaplastic carcinomas of the breast are rare neoplasms. The purpose of the present study is to better characterize the clinical course, treatment, and prognostic factors of metaplastic breast carcinomas. METHODS: Data of 14 patients with metaplastic breast carcinoma were retrospectively reviewed. The follow-up period ranged from 2 months to 10 years, 10 months (median 4.3 years). RESULTS: The patients' ages ranged from 38 to 66 years (median 50.5 years). The tumors were 2.5 to 18 cm (median 4.8 cm) in size. Seven patients had axillary nodal metastases at the time of diagnosis. Estrogen and progesterone receptors were positive in only one tumor. Twelve patients underwent modified radical mastectomy and two patients underwent incisional biopsy. Adjuvant chemotherapy was administered to six patients, and radiotherapy to two patients after mastectomy. Two patients received preoperative chemotherapy. Seven patients were living without evidence of disease at a median of 7.3 years after surgery. A patient died of ovarian carcinoma without recurrence or metastasis of breast cancer. Metastases occurred in five patients at 4 to 16 months (median 8 months) after initial treatment. Duration of symptoms, TNM stage, tumor size, and axillary nodal status were significant prognostic factors of survival. CONCLUSIONS: The patients with metaplastic breast carcinomas may have a favorable prognosis.

Adult↗

PubMed1991

Postmastectomy brachial plexus injury exacerbated by tissue expansion.

A neurapraxic injury to the brachial plexus was seen after modified radical mastectomy and immediate tissue expander placement. Neurological recovery proceeded until a sudden deterioration 42 hours after the fourth expansion. Deflation of the expander from an initial pressure of 18 mm Hg to 8 mm Hg led to relief from all acute symptoms, which were primarily in the distribution of the nerve most severely involved at the time of the initial injury, the median nerve. The history of previous neurapraxia and anatomical relationships between the tissue expander, pectoralis minor tendon, and neurovascular structures suggest that impairment of nerve function occurred through a compressive mechanism resembling a double-crush phenomenon.

Adult↗

PubMed2000

Preoperative paclitaxel and radiotherapy for locally advanced breast cancer: surgical aspects.

INTRODUCTION: Approximately 15% of breast cancer patients present with large tumors that involve the skin, the chest wall, or the regional lymph nodes. Multimodality therapy is required, to provide the best chance for long-term survival. We have developed a regimen of paclitaxel, with concomitant radiation, as a primary therapy in patients with locally advanced breast cancer. METHODS: Eligible patients had locally advanced breast cancer (stage IIB or III). After obtaining informed consent, patients received paclitaxel (30 mg/m2 during 1 hour) twice per week for 8 weeks and radiotherapy to 45 Gy (25 fractions, at 180 cGy/fraction, to the breast and regional nodes). Patients then underwent modified radical mastectomy followed by postoperative polychemotherapy. RESULTS: Twenty-nine patients were enrolled. Of these, 28 were assessable for clinical response and toxicity, and 27 were assessable for pathological response. Objective clinical response was achieved in 89%. At the time of surgery, 33% had no or minimal microscopic residual disease. Chemoradiation-related acute toxicity was limited; however, surgical complications occurred in 41% of patients. CONCLUSIONS: Preoperative paclitaxel with radiotherapy is well tolerated and provides significant pathological response, in up to 33% of patients with locally advanced breast cancer, but with a significant postoperative morbidity rate.

Adult↗

PubMed1995

[Late symptoms among patients surgically treated for breast cancer. A questionnaire in the county of Southern Jutland].

The 1989 protocol of the Danish Breast Cancer Cooperative Group implied a more extensive axillary dissection and reduced frequency of regional lymphnode irradiation. A questionnaire concerning late symptoms was sent to all women operated from 1989 to 1993. The rate of response among women treated with modified radical mastectomy was 82%. Of 163 patients, 79% had one or more late symptoms. Most troublesome was pain in the neck, shoulder and arm or scar-related pain. Other symptoms were lymphoedema, paraesthesia of the arm and impaired shoulder function; each symptom occurring among 29-47% of the women. Most symptoms began three to four weeks postoperatively. The frequency of late symptoms corresponded with number of lymphnodes removed, number of tumourpositive nodes and irradiation of the scar. Thirty-five women were treated with tumourectomy and they experienced similar late symptoms with a similar degree of distress. It is concluded that late symptoms among women treated for breast cancer still occur frequently.

Breast Neoplasms↗

PubMed2006

[Mediastinal recurrence of breast cancer suspecting mediastinal fibrosis].

A 63-year-old female, who had undergone a modified radical mastectomy for breast cancer at the age of 45, was suffered from trachyphonia due to left recurrent nerve paralysis at the age of 53. She presented left phrenic nerve paralysis and dysphagia at the age of 61. Computed tomography (CT) revealed mediastinal fibrosis, stenosis of esophagus and superior vena cava, and slight lymph nodes swelling. Video-assisted thoracoscopic mediastinal biopsy was performed and the mediastinal fibrosis was diagnosed as recurrence of breast cancer 17 years after the breast cancer operation. She underwent mediastinal radiation and chemotherapy for mediastinal recurrence and stenting for esophageal stenosis.

Biopsy↗

PubMed1996

[Primary angiosarcoma of the breast].

We report on a 39 year old woman with a biopsy diagnosed angiosarcoma of the breast. Surgical treatment consisted of a modified radical mastectomy with axillary lymph node dissection (level I and II). The size of the tumor was 4.5 x 3.5 x 2.3 cm with G II grading. In addition the patient was put on postoperative chemotherapy (EC). Soft tissue sarcomas of the breast are very rare tumors (0.04 to < 1 % of all malignant breast tumors). The etiology of most of the vascular neoplasias of the breast is therapy associated such as preexisting surgery and radiotherapy. We found a primary angiosarcoma of the breast and tried to demonstrate aspects of the morphological diagnosis, prognosis and treatment of this disease.

Adult↗

PubMed2003

Adenomatous polyp--cause of postmenopausal bleeding in a breast cancer patient treated with tamoxifen.

We present a case of adenomatous polyp with degenerative changes causing abnormal postmenopausal bleeding in a patient who was treated with adjuvant therapy of Tamoxifen for breast cancer after surgery (Modified Radical Mastectomy). The association with prolonged unopposed estrogen--like stimulation with Tamoxifen as a possible factor in this development has been discussed. Until further cases are reported, it would seem imperative to advise all women who are to be treated with Tamoxifen for breast malignancy to have a pelvic examination before such treatment with strict follow up at regular intervals later on. Abnormal bleeding may also be the result of Tamoxifen stimulation and endometrial biopsy may be necessary in these patients should abnormal bleeding occur. Surgical exploration for enlarging leiomyomas or abnormal bleeding will still be necessary to ensure that malignancy is not present, but the pre-operative diagnosis will be less alarming.

Adenomatous Polyps↗

PubMed1999

The composition of serous fluid after axillary dissection.

OBJECTIVE: To analyse the composition of the serous fluid formed after axillary dissection. DESIGN: Descriptive study. SETTING: University hospital and teaching hospital, The Netherlands. SUBJECTS: 16 patients whose axillas were dissected as part of a modified radical mastectomy for stage I or II breast cancer. MAIN OUTCOME MEASURES: Chemical and cellular composition of axillary drainage fluid on the first, fifth, and tenth postoperative days compared with the same constituents in blood and with reported data on the composition of peripheral lymph. RESULTS AND CONCLUSION: On the first postoperative day the drainage fluid contained blood contents and a high concentration of creatine phosphokinase (CPK). After day one it changed to a peripheral lymph-like fluid but containing different cells, more protein, and no fibrinogen, making coagulation impossible. The reduction in the fluid production must be caused by other wound healing processes, such as formation of scars and connective tissue.

Axilla↗

PubMedDate not supplied

Postmastectomy morbidity after combination preoperative irradiation and chemotherapy for locally advanced breast cancer.

Neoadjuvant therapy for locally advanced breast cancer improves disease control, but the complications of treatment are not well established. The aim of this study was to assess the operative morbidity in 20 consecutive patients with locally advanced, noninflammatory breast cancer treated with preoperative chemotherapy and radiation. Patients received preoperative cyclophosphamide, methotrexate, 5-fluorouracil, prednisone, and tamoxifen (CMFPT) to maximum response followed by concurrent chemotherapy and radiation to the involved breast and regional lymph nodes. Following modified radical mastectomy, chemotherapy was continued for a total of 10 cycles. Disease progressed in 3 of 20 patients (15%). Seventeen patients underwent mastectomy, 4 (24%) of whom demonstrated a pathologic complete response to chemoradiotherapy. Seven patients (41%) developed wound infections, 2 (12%) necrosis, 5 (29%) delayed healing, 2 (12%) upper extremity lymphedema, and 8 (47%) seromas. Postoperative chemotherapy was delayed in 4 (24%) patients. There was no mortality, and hospitalization was for less than 1 week. Only one patient required readmission. Although this treatment regimen is aggressive with attendant morbidity, complications are easily managed and generally do not delay therapy. Treatment modification to further reduce complications may be indicated.

Adult↗

PubMed2002

A male patient with metachronous triple cancers of small cell lung, prostate and breast.

We present a very rare case of metachronous triple cancers, including small cell carcinoma of the lung, as well as prostate and male breast cancer. To our knowledge, this is the first documented case of its kind. A 64-year-old man was referred to our hospital with left nipple retraction. He had previously undergone lobectomy of the right lung as treatment for small cell lung cancer at 57 years of age, and at 61 years of age, he had undergone prostatectomy and bilateral orchiectomy for prostate cancer, histologically determined to be moderately or poorly differentiated adenocarcinoma. Physical examination identified a painless irregular hard tumor in the left breast. Ultrasonography and magnetic resonance imaging (MRI) showed a nodular mass, and fine needle aspiration cytology of the mass revealed adenocarcinoma. Modified radical mastectomy was performed. Histological examination revealed that the breast tumor was scirrhous carcinoma, t1, n0, m0, stage T. Immunohistochemistry demonstrated that the prostate tumor was positive for prostatic specific antigen (PSA) and negative for estrogen receptor (ER), while the breast tumor was positive for ER and negative for PSA. Primary breast cancer was diagnosed. At present, 1 year and 8 months after surgical removal of the breast cancer, the patient has had no recurrence of breast cancer, small cell lung cancer, or prostate cancer. We discuss the possible causes of the triple cancers in this case with reference to the literature.

Biopsy, Needle↗

PubMed1999

Occult breast carcinoma presenting as an axillary mass.

Breast carcinoma presents rarely (<5% of cases) as an axillary mass without an obvious primary tumor. The value of mammography in detecting an occult breast carcinoma is low, with a sensitivity of 29 per cent and specificity of 73 per cent. MRI and positron emission tomography (PET) are potentially more sensitive in this setting. We present a case recently seen at the Vanderbilt University Hospital, a 63-year-old woman with a 2-cm painless mass in the right axilla. Mammography was negative, and fine needle aspiration revealed atypical cells suspicious for malignancy. An excisional biopsy of the right axillary lymph node revealed metastatic adenocarcinoma, most likely breast primary. A PET showed increased uptake of 18-fluorodeoxyglucose and 99m Technetium in the right axilla and the right lateral breast. The patient underwent right modified radical mastectomy. The final pathological report revealed a 0.9-cm primary tumor in the upper inner quadrant of the breast and 1 of 41 nodes positive for tumor. This case confirms that mammography has low sensitivity in identifying the primary tumor in occult breast carcinoma and illustrates the usefulness of PET in identifying the primary tumor. We advocate an aggressive approach to evaluation of the breast in women presenting with metastatic adenocarcinoma in the axillary nodes. This evaluation should include clinical examination and mammography in all cases, and PET and MRI in selected cases. PET and MRI may be particularly useful when considering a breast-conserving surgical procedure.

Adenocarcinoma↗

PubMed1993

[A case of complete remission of breast cancer with bilateral multiple lung metastases by combination therapy of MPA, THP, CPM and 5-FU].

A 55-year-old female was admitted for right breast tumor with multiple bilateral lung metastases. Modified radical mastectomy (Auchincloss method) was carried out. And the combination chemoendocrine therapy was undertaken using CPA 100 mg p.o. days 1-18, THP 40 mg i.v. days 1, 8, 5-FU 500 mg i.v. days 1, 8 and MPA 1,200 mg p.o. daily. One month later, the lung metastases completely disappeared on chest CT gram. Nine courses of chemotherapy with the same drugs were undertaken intravenously every four weeks. This therapy has been continuously effective for one and half years now. These results suggested the importance of a severe adjuvant therapy for the initial phase of advanced breast cancer.

Administration, Oral↗

PubMed2005

Magnetic resonance-guided percutaneous microwave coagulation therapy for liver metastases of breast cancer in a case.

Real-time magnetic resonance (MR) imaging enables the application of percutaneous microwave coagulation for high-risk patients with metastatic liver tumours. The tumours, local vessels and bile ducts can be observed clearly in three-dimensional sections and a sufficient surgical margin can be confirmed on the MR image even during the coagulation procedure. MR-guided percutaneous microwave coagulation therapy is effective for treatment of not only primary liver tumours but also metastatic breast cancers in the liver, which are not diffuse but discrete, and difficult to treat with only chemo-and endocrine therapy. We report a 44-year-old Japanese woman who underwent modified radical mastectomy for right breast cancer (T1c N0 M0 Stage I). Three years after the operation, she developed two metastatic liver tumours and was treated by MR-guided percutaneous microwave coagulation, achieving a complete response (CR) without any recurrence for 15 months as of the present. The most beneficial aspect of MR-guided percutaneous microwave coagulation is its safety. It is only minimally invasive and can be repeated. This therapy, therefore promises to prolong the disease free period. Additional clinical trials will be valuable to delineate the effectiveness and safety of MR-guided percutaneous microwave coagulation therapy for controlling the liver metastases of breast cancer.

Adult↗

PubMed2004

Phyllodes tumor: an unexpected tumor of the breast. A report on six patients.

BACKGROUND AND PURPOSE: To evaluate the role of adjuvant radiotherapy for an unexpected malignancy of the breast, known as phyllodes tumor, a retrospective study was undertaken. PATIENTS AND METHODS: Between 1994 and 2002, six female patients with a phyllodes tumor (borderline, n = 2; malignant, n = 4) were irradiated after modified radical mastectomy at our institution. No patient received adjuvant systemic therapy. RESULTS: Two patients experienced local failure, after 17 months (malignant) and 23 (borderline) months of observation. One of the patients with local relapse died intercurrently, the other because of multiple pulmonary metastases. Four patients are alive and show no evidence of disease. Median follow-up was 33.8 months (range 29-42 months). CONCLUSION: Based on the data from the literature and the authors' findings, it is concluded that surgery with wide negative margins is the preferred initial treatment option. There is no indication for axillary dissection, since these tumors rarely metastasize to regional lymph nodes. In patients with phyllodes tumors showing adverse prognostic factors, postoperative irradiation is recommended.

Adult↗

PubMed1991

Ductal carcinoma in situ with microinvasion. A curable entity using surgery alone without need for adjuvant therapy.

Of 408 negative axillary node (NAN) patients surgically treated at Roswell Park Cancer Institute (Buffalo, NY, 1976 through 1987), 36 (8.8%) presented with ductal carcinoma in situ with microinvasion (DCISM). In more than 50% of the patients (20/36) the disease was detected solely by mammography (microcalcifications and/or radiological density less than 1.5 cm). Thirty-three patients underwent modified radical mastectomy; three had wide excision +/- axillary dissection. Residual disease after excisional biopsy was found in 22 of 33 mastectomy specimens (67%): 11 (33%) pure ductal carcinoma in situ, five (15%) DCISM, and six (18%) frankly invasive. Of the 22 incidents of residual disease, 50% (11) were multicentric (one third of all specimens). These findings imply a high likelihood of residual cancer after excisional biopsy in these patients. All patients were free of disease for a mean follow-up of 57 months (range, 16 to 137). These findings indicate that DCISM is an entirely curable disease when treated by mastectomy alone, without the need for adjuvant therapy, regardless of the status of other prognostic factors such as tumor size, histologic differentiation, age, or steroid receptor status.

Adult↗

PubMed1997

Idiopathic granulomatous mastitis: case report and review of the literature.

We report a case of idiopathic granulomatous mastitis in a 35-year-old Japanese woman, who came to our hospital complaining of a tender mass in her right breast. Because the results of initial aspiration cytology were considered highly suspicious for carcinoma, modified radical mastectomy was performed. However, the final histological diagnosis was granulomatous lobular mastitis with no evidence of malignancy. Idiopathic granulomatous mastitis is a rare inflammatory breast disease of unknown etiology. Since the clinical manifestations are similar to those of mammary carcinoma, this condition has been misdiagnosed as carcinoma and treated as such. A review of the literature revealed that idiopathic granulomatous mastitis has tended to occur in young patients with a history of childbirth or oral contraceptive usage. Clinical or imaging diagnosis has often been difficult. Complete resection or corticosteroid therapy can be recommended as the optimal treatment. Since 38% of patients experience recurrence, long-term follow-up is indicated.

Adrenal Cortex Hormones↗

PubMed1995

[A case of bilateral multiple lung metastases from breast cancer successfully treated with carboplatin].

A 57-year-old female was admitted for right breast tumor. Modified radical mastectomy (Kodama method) was carried out. A prophylactic postoperative radiation was undertaken because of large tumor (T4b) and histologic metastasis to a Rotter's lymph node. At the end of irradiation, bilateral lung metastases were found on chest CT gram. The combination endocrine chemotherapy using MPA 600 mg and UFT 3 capsules p.o. daily and ADM 10 or 20 mg i.v. every two weeks was performed on an outpatient basis. As the lung metastases were increased four months later, carboplatin 150 mg i.v. was replaced with ADM. Four months later, the metastases almost disappeared on CT gram. These results suggested the possibility of one of the therapeutic options for metastatic breast cancer.

Adenocarcinoma↗