Online ISSN: 2515-8260

Keywords : Mastectomy


Comparative study of surgical and oncological outcomes in oncoplastic versus non oncoplastic breast-conserving surgery for breast cancer treatment

Dr. Manas Ranjan Deo, Dr. Santsevi Prasad, Dr. Apurva Agarwal, Dr. Sunil Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1845-1851

Introduction: Recently, breast conserving surgery (BCS) followed by radiotherapy has been
gaining popularity for most patients with early breast cancer; though, this technique has
justified to be comparable with mastectomy in view of long-term survival in certain selected
groups of women. This surgical option includes lumpectomy and sentinel node biopsy with or
without radiotherapy and presents potential advantages over radical procedures as it is
potentially less invasive, less debilitating and more aesthetically acceptable. Oncoplastic
breast surgery (OBS) is a novel approach that developed greatly in the last decades that
combines BCS with concomitant breast reconstruction. The aim of this technique is to get a
safe and complete removal of the tumorous lesion while achieving the best possible aesthetic
result. OBS consists of large lumpectomy and remodelling techniques such as breastreshaping
by therapeutic reduction mammoplasty or volume reduction by local glandular
flaps or regional/distant flaps. Hence this study aimed at comparing the patients who had
undergone non-oncoplastic and oncoplastic breast conserving surgery based on the tumour
characteristics and its postoperative complications. Associated risk factors such as positive
margins and local recurrence were also evaluated

Incidence of Seroma Formation after using Flap Fixation Technique in Modified Radical Mastectomy

Emad Adel H. Soliman, Wael Ibrahim M. El Shelfa, Osama Abd El Aziz M. Eltih, Hassan Rabeaa G.Ashour .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 877-884

Background: Breast cancer is the most common female cancer and the second leading cause of cancer death among women. Seroma is a pocket of clear serous fluid that develops in the body after surgery. Seroma is thought to be caused by the fact that the mastectomy operation leaves a lot of an empty space which can ooze serous fluid causing it to gather up in the space beneath the wound. This study aimed to evaluate the mechanical closure effect of the dead space by suture fixation of the mastectomy flaps to the underlying chest wall on the seroma formation after mastectomy.
Patients and methods: A clinical trial study involved 54 patients with breast carcinoma admitted for modified radical mastectomy at the on cosurgery unit, general surgery department, faculty of medicine, Zagazig University Hospitals. Patients were divided equally into: (a) study group and (b) control group. The  postoperative results have been compared between the two groups and the effect of flap fixation on the amount and duration of fluid drainage and formation of seroma was concluded.
Results: The present study showed a statistically non-significant difference between the studied groups regarding age. There is statistically non-significant difference between the studied groups regarding side of lesion or presence of skin changes. There is statistically non-significant difference between the studied groups regarding pathological type. IDC was the commonest type in each group. There is significant difference between the studied groups regarding days till drain removal which was significantly higher in classic technique group. Regarding postoperative complications, there was 85.2% of flap fixation group had no postoperative complications compared to 59.3% of the classic group.
Conclusion: The flap fixation technique is proving its validity in decreasing the incidence of seroma formation and its subsequent complications, so that it can be introduced as a step in the mastectomy operation.

SURGICAL MANAGEMENT OF BREAST CANCER PATIENTS USING LIGASURE™ SMALL JAW VERSUS MONOPOLAR ELECTROCAUTERY

Taha Abdelwahab Biomy, Mohammed Mahmoud Elkilany, Joseph Rizk Israel, Ali Sabry Ali Helal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4614-4619

Background: Electrocautery  is commonly used for various surgical procedures such as mastectomy is used to stop bleeding and perform dissection. It has been suggested that thermal  spread can cause flap necrosis, wound infection, prolonged drainage, and damage to the surrounding tissues. Several studies have reported that the LigaSure Small Jaw device can reduce the incidence of seroma. The present study aimed to evlaute the effectiveness of monopolar electrocautery  compare to  LigaSure™ Small Jaw in reducing the postoperative seroma in patients  with breast cancer  who undergoing radical mastectomy. Patients and methods:  this study included 40 females with breast cancer who attending for modified radical mastectomy. The patients were divided equally into the monopolar electrocautery group and the LigaSure™ Small Jaw group. Results: There was statistically significant difference between groups as regard duration surgery. Also, amount of blood loss was statistically larger among Electrocautery group than LigaSure™ Small Jaw group.As regard Post-operative complications ,seroma was the commonest complication followed by flap necrosis and wound sepsis respectively, with no difference between both groups. There was statistically significant difference between different VAS readings at different timings between studied 2 groups. Conclusion: LigaSure™ Small Jaw was more effective than Electrocautery in reducing the intraoperative and postoperative complication in breast cancer patients undergoing modified radical mastectomy.
 

The Effect of Arm Exercises on The Prevention of Lymphedema in Post- Mastectomy Breast Cancer Patients at Haji Adam Malik Medan Hospital

Helinida Saragih; Nurmaini .; Ikhsanuddin Ahmad Harahap

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2025-2028

Breast cancer is a malignant neoplasm, an abnormal growth of breast tissue that does not see the surrounding tissue, grows infiltrative and destructive, and can metastasize. Every breast cancer patient experiences side effects from various treatment treatments. This is because the therapy that each patient gets varies and also that cancer sufferers have different genetic backgrounds and different environments. Mastectomy in breast cancer patients can cause many patients to suffer from decreased joint mobility, lymphedema, and limitation in daily activities. These complaints can be overcome with arm exercises. Arm exercises are done to improve circulation and muscle strength and to prevent joint stiffness, preventing lymphedema from occurring. The purpose of this study was to analyze the effect of arm exercises on lymphedema prevention by looking at the value of arm measurements before the intervention and after intervention in the intervention and control groups. The research design was a quasi-experimental study with a total sample size of 32 respondents per group so that the total sample was 64 respondents. The research results were based on the t-test. The independently obtained p=0.001, namely p <0.005, which means that there was a significant effect of the arm measurement value on post-mastectomy breast cancer. It is hoped that this study can be used as education for post-mastectomy patients to improve the lymph flow so that lymph flow obstruction does not occur.

Lived Experience Of Rural Indian Women With Low Socioeconomic Backgrounds Who Have Undergone Mastectomies For Breast Cancer

Saranya Sundarraju; Veenavani Nallepalli; Ragunathan S; Karthikeyan Perumal; Sankar R; Prasanna G; Balamurugan G; Krishnakumar .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4761-4772

Back ground / Purpose
Breast cancer is now the most common cancer among women in most urban areas in India and the second most common in the rural areas. The aim of the study was to examine the lived experiences of rural women with low socioeconomic backgrounds who have undergone mastectomies for breast cancer.
Method: Using a phenomenological method, semi-structured interviews were conducted that asked about knowledge, challenges, coping and spirituality with 23 rural women from low socio-economic status and agricultural backgrounds. The interviews were analyzed for themes that described their experiences. Several themes emerged from the data. These included ignorance about the disease, feelings of guilt, financial crisis, fear of change in intimate relationships, importance of spirituality, poor support systems and financial hard-ship.
Conclusion: In India, there are very few cancer studies on rural populations yet the incidence of cancer in this population is increasing. Future studies need to focus on the rural population in order to educate them about the disease and to assist access to treatment, and psychological support. Emotional distress and lack of knowledge could be addressed by psychosocial education. Community based approaches are needed to develop culturally appropriate interventions empowering the women and enhancing their self –efficacy.