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355 POSTER Breast reconstruction
S106
Poster session: Breast cancer
not correlated with microcalcifications. Positive association tended to appear between microcalcifications and c-erbB-2 positive receptors (p=0.084). Tumor grade, histologic type and lymph node positivity did not have any association with the presence of microcalcifications in mammography. Conclusions: The present study indicates a tendency of positive association between c-erbB-2 positive expression and microcalcifications in mammography. All the other parameters were not correlated with this mammographic finding. 355
POSTER
Breast reconstruction M. Ribeiro, C. Pinho, J. Pontes. Instituto Portugues de Oncologia - Centro do Porto, Surgical Oncology - Plastic Surgery Unit, Porto, Portugal Introduction: Breast reconstruction is a constituent part of the breast cancer treatment, being its main goal the improvement of quality of life of the patient with breast cancer. As a rule and when possible, we use autogenous tissues, being the breast reconstruction with TRAM flap our first option. Material and Methods: In our institution and for several years we have been performing immediate and differed breast reconstruction with prosthesis and/or musculocutaneous Flaps. Therefore, between January 1995 and December 2005, 377 patients underwent breast reconstruction, from which 305 with pedicled TRAM Flap and 72 with breast implants. Results: From a clinical point of view results were satisfactory. The majority of the complications that occurred were dealt by conservative means. In what concerns satisfaction of patients’ expectations, an inquest we have performed revealed that the same was achieved in 90% of the cases. Conclusion: Results analysis allows us to conclude that the main goal, i.e., the improvement of patients’ quality of life, was achieved. We believe that Breast reconstruction had a significant impact on the emotional and social stability of these patients. 356
POSTER
Comparative study on quality of life of women after modified radical mastectomy(MRM) and breast conserving therapy(BCT) during chemotherapy A. Stanislawek, M. Kaminska, E. Stasiak, H. Kachaniuk, M.E. Krasuska. Medical University of Lublin, Chair of Social Health Care, Lublin, Poland Introduction: Surgical treatment of breast cancer is conducted using two basic methods: Modified Radical Mastectomy (MRM) and Breast Conserving Therapy (BCT). Most patients receive combined follow-up treatment of chemotherapy, radiotherapy and hormonotherapy. Chemotherapy produces a number of harmful side effects whose type and intensification depend both on administered medications, their dosages and a patient’s individual sensitivity. The most frequent side effects are nausea and vomiting, which occur rather early. In addition, they may be followed by diarrhoea, constipation, partial alopecia, and temporary lowering of immunity which may result in infection, or even severe septic infections. Poor physical condition in the course of treatment is usually accompanied by a feeling of dejection, or even depression. Anticancer medications impair bone marrow functions, causing a decrease in the number of blood cells, mostly leucocytes, but also erythrocytes and thrombocytes. A factor which plays an important role is the quality of care received by a patient in the course of his/her treatment. The actions and activities of the whole therapeutic team, which also includes nurses, should be undertaken in such a way that a patient is convinced that her health and safety are of the utmost importance. A nurse participates in diagnosing, treatment, rehabilitation, and identifying nursing problems, planning nursing care and evaluates the undertaken actions and activities. Careful monitoring of a course of treatment and use of different methods of adjuvant therapy may reduce the incidence and intensity of such problems, and consequently result in the improvement of the quality of life. Apart from total survival, quality of life has recently become an important indicator of the quality of treatment. In medicine, the aim of the evaluation of quality of life is to learn about physical, emotional and living conditions of patients. Aim: The aim of the study was to compare the quality of life of patients after MRM and BCT in the course of chemotherapy. Material and Method: The study was performed on 179 patients receiving
systemic adjuvant therapy in the Department of Surgical Oncology, Medical University of Lublin after surgical treatment. The data of 85 female patients treated with BCT and 94 female patients treated with MRM in the period from August 2005 to June 2006 were analyzed. The standard adjuvant chemotherapy after the surgical treatments mentioned above was conducted using the following regimens: FAC regimen was used in 78% of the female patients, and CMF regimen in 22% of the patients. In order to assess the quality of life there were used EORTC questionnaires marked with the symbols QLQC-30 and QLQ-BR23. Results: Declared quality of life was higher in the group of female patients treated with BCT in comparison to the group of women after MRM. The conserved breast signifies the retention of a feminine attribute, which has a positive effect on the self-appraisal of one’s appearance and better predictions about one’s health. Chemotherapy side effects were tolerated better by the female patients treated with BCT. 357
POSTER
The autologous breast reconstruction after mastectomy for invasive breast cancer is oncologicaly safe N. Suvorov 1 , M. Snoj 2 , Z.M. Arnez 1 . 1 University Clinical Centre, Department of Plastic Surgery, Ljubljana, Slovenia; 2 Institute of Oncology, Department of Surgical Oncology, Ljubljana, Slovenia Introduction: Breast conserving treatment (BCT) is nowadays the method of choice for early stage (I and II) breast cancer, however total mastectomy (TM) is still performed where the tumor is large, multifocal or centrally located. Most women after mastectomy are experiencing severe psychological stress, suffering from breast loss and impairment of self-esteem and body image. To decrease the depression and improve the psychological wellbeing, early breast reconstruction with prosthesis and different types of autologous myocutaneous flaps is suggested. The objective of he study was to analyze the rate of local and regional recurrence in patients with invasive breast cancer, who underwent mastectomy, followed by solely autologous breast reconstruction in single institution from February 1987 till December 2003. Experimental: The charts of 156 patients with different types of total mastectomy, followed by solely autologous breast reconstruction were retrospectively reviewed. All this patients were females with histology proven invasive breast cancer without evidence of metastatic disease (M0). In all of them the resection was complete with no microscopically residual disease, confirmed by histological negative margins (R0). The reconstructions were done with different types of myocutaneous flaps. The median follow up was 65 months, ranging from18 to 276 months. Results: Most of the carcinomas we studied were invasive ductal carcinoma (87,2%), followed by invasive lobular carcinoma (10,8%) and other types of carcinoma (2%). High percent of them were multifocal (28%). Median tumor diameter in unifocal disease was 2,0 cm (range from 0,4 to10,0 cm). Most reconstructions (94,3%) were performed with free flaps using microsurgical technique. Most of these reconstructions were free transverse rectus abdominis muscle (TRAM) flap (66,9%), and deep inferior epigastric perforator (DIEP) flap (23,7%), Other types performed were conventional TRAM flap (3,2%), conventional latissimus dorsi (c-LD) flap (2,5%), superficial inferior epigastric artery (SIEA) flap (1,9%), superior gluteal artery perforator (s-GAP) flap, free latissimus dorsi flap (f-LD) and transverse gracilis (TUG) flap (each 0,6%). In 49,7% the reconstruction was immediate and in 51,3% delayed. Loco regional recurrence occurred in only three patients (1,8%). Two (1,3%) presented with regional recurrence and one patient (0,6%) with local recurrence. Conclusion: In our retrospective study of 156 patients we found autologous breast reconstruction to be ontologically safe procedure of breast reconstruction in patients after mastectomy for breast cancer.
Poster session: Breast cancer
not correlated with microcalcifications. Positive association tended to appear between microcalcifications and c-erbB-2 positive receptors (p=0.084). Tumor grade, histologic type and lymph node positivity did not have any association with the presence of microcalcifications in mammography. Conclusions: The present study indicates a tendency of positive association between c-erbB-2 positive expression and microcalcifications in mammography. All the other parameters were not correlated with this mammographic finding. 355
POSTER
Breast reconstruction M. Ribeiro, C. Pinho, J. Pontes. Instituto Portugues de Oncologia - Centro do Porto, Surgical Oncology - Plastic Surgery Unit, Porto, Portugal Introduction: Breast reconstruction is a constituent part of the breast cancer treatment, being its main goal the improvement of quality of life of the patient with breast cancer. As a rule and when possible, we use autogenous tissues, being the breast reconstruction with TRAM flap our first option. Material and Methods: In our institution and for several years we have been performing immediate and differed breast reconstruction with prosthesis and/or musculocutaneous Flaps. Therefore, between January 1995 and December 2005, 377 patients underwent breast reconstruction, from which 305 with pedicled TRAM Flap and 72 with breast implants. Results: From a clinical point of view results were satisfactory. The majority of the complications that occurred were dealt by conservative means. In what concerns satisfaction of patients’ expectations, an inquest we have performed revealed that the same was achieved in 90% of the cases. Conclusion: Results analysis allows us to conclude that the main goal, i.e., the improvement of patients’ quality of life, was achieved. We believe that Breast reconstruction had a significant impact on the emotional and social stability of these patients. 356
POSTER
Comparative study on quality of life of women after modified radical mastectomy(MRM) and breast conserving therapy(BCT) during chemotherapy A. Stanislawek, M. Kaminska, E. Stasiak, H. Kachaniuk, M.E. Krasuska. Medical University of Lublin, Chair of Social Health Care, Lublin, Poland Introduction: Surgical treatment of breast cancer is conducted using two basic methods: Modified Radical Mastectomy (MRM) and Breast Conserving Therapy (BCT). Most patients receive combined follow-up treatment of chemotherapy, radiotherapy and hormonotherapy. Chemotherapy produces a number of harmful side effects whose type and intensification depend both on administered medications, their dosages and a patient’s individual sensitivity. The most frequent side effects are nausea and vomiting, which occur rather early. In addition, they may be followed by diarrhoea, constipation, partial alopecia, and temporary lowering of immunity which may result in infection, or even severe septic infections. Poor physical condition in the course of treatment is usually accompanied by a feeling of dejection, or even depression. Anticancer medications impair bone marrow functions, causing a decrease in the number of blood cells, mostly leucocytes, but also erythrocytes and thrombocytes. A factor which plays an important role is the quality of care received by a patient in the course of his/her treatment. The actions and activities of the whole therapeutic team, which also includes nurses, should be undertaken in such a way that a patient is convinced that her health and safety are of the utmost importance. A nurse participates in diagnosing, treatment, rehabilitation, and identifying nursing problems, planning nursing care and evaluates the undertaken actions and activities. Careful monitoring of a course of treatment and use of different methods of adjuvant therapy may reduce the incidence and intensity of such problems, and consequently result in the improvement of the quality of life. Apart from total survival, quality of life has recently become an important indicator of the quality of treatment. In medicine, the aim of the evaluation of quality of life is to learn about physical, emotional and living conditions of patients. Aim: The aim of the study was to compare the quality of life of patients after MRM and BCT in the course of chemotherapy. Material and Method: The study was performed on 179 patients receiving
systemic adjuvant therapy in the Department of Surgical Oncology, Medical University of Lublin after surgical treatment. The data of 85 female patients treated with BCT and 94 female patients treated with MRM in the period from August 2005 to June 2006 were analyzed. The standard adjuvant chemotherapy after the surgical treatments mentioned above was conducted using the following regimens: FAC regimen was used in 78% of the female patients, and CMF regimen in 22% of the patients. In order to assess the quality of life there were used EORTC questionnaires marked with the symbols QLQC-30 and QLQ-BR23. Results: Declared quality of life was higher in the group of female patients treated with BCT in comparison to the group of women after MRM. The conserved breast signifies the retention of a feminine attribute, which has a positive effect on the self-appraisal of one’s appearance and better predictions about one’s health. Chemotherapy side effects were tolerated better by the female patients treated with BCT. 357
POSTER
The autologous breast reconstruction after mastectomy for invasive breast cancer is oncologicaly safe N. Suvorov 1 , M. Snoj 2 , Z.M. Arnez 1 . 1 University Clinical Centre, Department of Plastic Surgery, Ljubljana, Slovenia; 2 Institute of Oncology, Department of Surgical Oncology, Ljubljana, Slovenia Introduction: Breast conserving treatment (BCT) is nowadays the method of choice for early stage (I and II) breast cancer, however total mastectomy (TM) is still performed where the tumor is large, multifocal or centrally located. Most women after mastectomy are experiencing severe psychological stress, suffering from breast loss and impairment of self-esteem and body image. To decrease the depression and improve the psychological wellbeing, early breast reconstruction with prosthesis and different types of autologous myocutaneous flaps is suggested. The objective of he study was to analyze the rate of local and regional recurrence in patients with invasive breast cancer, who underwent mastectomy, followed by solely autologous breast reconstruction in single institution from February 1987 till December 2003. Experimental: The charts of 156 patients with different types of total mastectomy, followed by solely autologous breast reconstruction were retrospectively reviewed. All this patients were females with histology proven invasive breast cancer without evidence of metastatic disease (M0). In all of them the resection was complete with no microscopically residual disease, confirmed by histological negative margins (R0). The reconstructions were done with different types of myocutaneous flaps. The median follow up was 65 months, ranging from18 to 276 months. Results: Most of the carcinomas we studied were invasive ductal carcinoma (87,2%), followed by invasive lobular carcinoma (10,8%) and other types of carcinoma (2%). High percent of them were multifocal (28%). Median tumor diameter in unifocal disease was 2,0 cm (range from 0,4 to10,0 cm). Most reconstructions (94,3%) were performed with free flaps using microsurgical technique. Most of these reconstructions were free transverse rectus abdominis muscle (TRAM) flap (66,9%), and deep inferior epigastric perforator (DIEP) flap (23,7%), Other types performed were conventional TRAM flap (3,2%), conventional latissimus dorsi (c-LD) flap (2,5%), superficial inferior epigastric artery (SIEA) flap (1,9%), superior gluteal artery perforator (s-GAP) flap, free latissimus dorsi flap (f-LD) and transverse gracilis (TUG) flap (each 0,6%). In 49,7% the reconstruction was immediate and in 51,3% delayed. Loco regional recurrence occurred in only three patients (1,8%). Two (1,3%) presented with regional recurrence and one patient (0,6%) with local recurrence. Conclusion: In our retrospective study of 156 patients we found autologous breast reconstruction to be ontologically safe procedure of breast reconstruction in patients after mastectomy for breast cancer.