Laparoscopically harvested omental flap for immediate breast reconstruction

Background Breast cancer surgery and accompanying breast reconstruction have been diversified. We report our experience of immediate breast reconstruction using laparoscopically harvested omental flap (LHOF). Methods During a 44-month period, 44 immediate breast reconstructions with LHOF were performed. Patients were followed up for complications and cosmetic results. Results Forty cases of pedicled LHOF and 4 cases of free LHOF were performed after either nipple-sparing mastectomy (n =3D 21) or breast-conservation treatment (n =3D 23). Morbidity included 1 minor vascular injury (2.3%) of the LHOF, 4 wound and graft infections (9.1%), and 1 epigastric hernia (2.3%). Cosmetic results were mostly satisfactory, with a soft breast that was natural in appearance. Donor-site scars were minimal. However, in 5 patients (12.5%), omental flap size was found to be inadequate during the procedure. Conclusions Although there is a limit of volume, LHOF is an attractive autologous flap, which makes a natural soft breast and minimal deformity of the donor site

Significant Effect of Polymorphisms in CYP2D6 on Response to Tamoxifen Therapy for Breast Cancer: A Prospective Multicenter Study

CLINICAL CANCER RESEARCH2382019-2026CCRE

A genome-wide association study identifies three novel genetic markers for response to tamoxifen: A prospective multicenter study.

PURPOSE:Although association studies of genetic variations with the clinical outcomes of breast cancer patients treated with tamoxifen have been reported, genetic factors which could determine individual response to tamoxifen are not fully clarified. We performed a genome-wide association study (GWAS) to identify novel genetic markers for response to tamoxifen. EXPERIMENTAL DESIGN:We prospectively collected 347 blood samples from patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative, invasive breast cancer receiving preoperative tamoxifen monotherapy for 14 to 28 days. We used Ki-67 response in breast cancer tissues after preoperative short-term tamoxifen therapy as a surrogate marker for response to tamoxifen. We performed GWAS and genotype imputation using 275 patients, and an independent set of 72 patients was used for replication study. RESULTS:The combined result of GWAS and the replication study, and subsequent imputation analysis indicated possible association of three loci with Ki-67 response after tamoxifen therapy (rs17198973 on chromosome 4q34.3, rs4577773 on 6q12, and rs7087428 on 10p13, Pcombined = 5.69 x 10-6, 1.64 x 10-5, and 9.77 x 10-6, respectively). When patients were classified into three groups by the scoring system based on the genotypes of the three SNPs, patients with higher scores showed significantly higher after/before ratio of Ki-67 compared to those with lower scores (P = 1.8 x 10-12), suggesting the cumulative effect of the three SNPs. CONCLUSION:We identified three novel loci, which could be associated with clinical response to tamoxifen. These findings provide new insights into personalized hormonal therapy for the patients with breast cancer