30 research outputs found

    Surgery after Neoadjuvant Chemotherapy: A Clip-Based Technique to Improve Surgical Outcomes, a Single-Center Experience

    Get PDF
    SIMPLE SUMMARY: Neoadjuvant chemotherapy (NACT) has an important role in the treatment of locally advanced breast cancer. After NACT, some lesions may be no longer visible at preoperative imaging, making breast and axillary conservative surgery more difficult. Among others, radiopaque clips are the most commonly used method to mark lymph nodes and tumor sites to tailor surgery in the post neoadjuvant setting. ABSTRACT: Background: This study aims to describe the surgical management of breast cancer patients after neoadjuvant chemotherapy, with attention to the impact on surgical outcomes of a clip-based marking technique. Methods: Patients who underwent NACT at the Breast Unit of the A. O Ordine Mauriziano of Turin from January 2018 and had a surgical intervention by January 2022 were included. Data on the feasibility of clip insertion, after-treatment visibility, and successful removal during surgery were collected prospectively. Surgical outcomes in terms of breast-conserving surgery and axillary dissection reduction were described. Results: In 51 patients who had surgery after NACT, 55 clips were placed (34 breast and 21 axillary clips). Ultrasound visibility of the clips was optimal (91%) as well as preoperative localization and retrieval within the surgical specimen. Moreover, the use of the clip positively affected surgical outcomes. In our study, clip insertion allowed to avoid mastectomy and axillary dissection in patients with a complete radiological response. Conclusions: In our findings, the use of breast and/or lymph node clips has proved to be a simple and effective method to improve surgical conservative management of breast cancer patients after NACT

    A Cluster Analysis of the Acceptance of a Contact Tracing App鈥擳he Identification of Profiles for the Italian Immuni Contact Tracing App

    No full text
    Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person had in the recent past by means of interviews. The Italian government proposed the Immuni digital contact tracking app as a solution. Immuni uses Bluetooth technology to anonymously register all close contacts a person had: if she tests positive for COVID-19 then all registered contacts are notified. The main aim of the paper is to propose a cluster analysis of some factors concerning the possible acceptance of the Immuni app to build behaviour profiles that explain and predict the possible behaviours of the respondents. The factors considered referred to three different pillars: the technological pillar, investigated by considering factors from the technology acceptance models family; the health pillar, where variables of the health belief model were used; and the sociopolitical pillar, where some values of the respondents were considered as possible barriers to or facilitators of the acceptance of this technology. As a result of the cluster analysis, three behavioural profiles were built: the ProApp profile, the Hesitant profile, and the AntiApp profile. The first is the profile grouping the respondents who intend to use the contact tracing app; the second is more about people who are favourable of the use of the app, but some issues such as privacy reduce the strength of their intention; the last profile is about people who are less favourable to use the app. We are confident that the behaviour profiles found would be useful to build more tailored communication campaigns to help promote the use of the app by managing factors that could either be facilitators or barriers

    Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

    No full text
    Background: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality of women with hormone-receptor-positive tumors, but poor adherence remains a significant problem. The aim of this study was to analyze AET side effects and their impact on adherence to treatment. Methods: A total of 373 breast cancer patients treated with AET filled out a specific questionnaire during their follow up visits at the Breast Unit of our Centre. Results: Side effects were reported by 81% of patients, 84% of those taking tamoxifen and 80% of those taking aromatase inhibitors (AIs). The most common side effect in the tamoxifen group was hot flashes (55.6%), while in the AI group it was arthralgia (60.6%). The addition of GnRH agonists to both tamoxifen and AI significantly worsened all menopausal symptoms. Overall, 12% of patients definitively discontinued AET due to side effects, 6.4% during the first 5 years and 24% during extended therapy. Patients who had previously received chemotherapy or radiotherapy reported a significantly lower discontinuation rate. Conclusions: AET side effects represent a significant problem in breast cancer survivors leading to irregular assumption and discontinuation of therapy. Adherence to AET may be improved by trustful patient–physician communication and a good-quality care network

    Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

    Get PDF
    Background: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality of women with hormone-receptor-positive tumors, but poor adherence remains a significant problem. The aim of this study was to analyze AET side effects and their impact on adherence to treatment. Methods: A total of 373 breast cancer patients treated with AET filled out a specific questionnaire during their follow up visits at the Breast Unit of our Centre. Results: Side effects were reported by 81% of patients, 84% of those taking tamoxifen and 80% of those taking aromatase inhibitors (AIs). The most common side effect in the tamoxifen group was hot flashes (55.6%), while in the AI group it was arthralgia (60.6%). The addition of GnRH agonists to both tamoxifen and AI significantly worsened all menopausal symptoms. Overall, 12% of patients definitively discontinued AET due to side effects, 6.4% during the first 5 years and 24% during extended therapy. Patients who had previously received chemotherapy or radiotherapy reported a significantly lower discontinuation rate. Conclusions: AET side effects represent a significant problem in breast cancer survivors leading to irregular assumption and discontinuation of therapy. Adherence to AET may be improved by trustful patient鈥損hysician communication and a good-quality care network

    Clinical, Pathological, and Prognostic Features of Male Breast Cancer: A Multicenter Study

    No full text
    Male breast cancer (BC) represents less than 1% of male tumors. Little is known about male BC characteristics, management, and survival, with many studies based on a small number of cases. Consequently, the treatment of male BC lacks specific guidelines. The aims of the study are to compare male and female breast cancer (FBC) in terms of cancer clinical and anatomopathological features and treatment approach, and to identify differences between male BC and FBC in terms of survival. Patients and methods: Data from 2006 to 2018 were retrospectively acquired. Amounts of 49 males and 680 postmenopausal females with primary non-metastatic BC who underwent breast surgery at Mauriziano Hospital or IRCCS Candiolo (TO鈥擨taly) were included. The mean age at diagnosis for male BC was 68.6 years, and males presented a smaller tumor size than women (p p = 0.04). Comparing FBC and male BC, no differences have been identified in terms of DFS and OS, with a similar 10-year-relapse rate (12% male BC vs. 12.4% FBC). Propensity Score Matching by age, nodal status, pT, and molecular subtype had been performed and no differences in OS and DFS were seen between male BC and FBC. In conclusion, male BC and FBC have similar prognostic factors and survival outcomes. The drop-out rate of AET was higher in males, and side effects were the main reason for drug discontinuation

    Beef consumption and fatty acids serum concentration: relationship with salivary gland tumors in C贸rdoba, Argentina

    No full text
    The objective of the present study was to analyze beef consumption, conjugated linoleic acid (CLA) and n-3 fatty acid (FA) serum concentration and their relation to salivary gland tumors (SGT). A questionnaire on non-nutritional risk factors and a validated food frequency questionnaire were applied in 20 SGT and 20 control (Co) patients. Materials and Methods: Food data were processed by the Interfood v.1.3 software. Serum CLA was analyzed by chromatography. Results: Non-significant differences were found between SGT and Co regarding lean and fatty BC and serum CLA. Serum n-3 linolenic acid concentration was higher in Co than in SGT (p=0.004). No associations between BC and CLA serum concentration were found, but a strong-positive association between total energy intake and total fat intake and SGT were observed. A significant inverse association between oleic and linoleic FA intake and SGT was recorded. Conclusion: Serum oleic and linolenic FAs showed a significant negative association with SGT.http://ar.iiarjournals.org/content/34/10/5579.long#sec-3publishedVersionFil: Cittadini, Mar铆a C. Universidad Nacional de C贸rdoba. Facultad de Ciencias M茅dicas. Escuela de Nutrici贸n; Argentina.Fil: Cornaglia, Paola M. Universidad Nacional de C贸rdoba. Facultad de Ciencias Econ贸micas. Instituto de Estad铆stica y Demograf铆a; Argentina.Fil: Joekes, Silvia. Universidad Nacional de C贸rdoba. Facultad de Ciencias Econ贸micas. Instituto de Estad铆stica y Demograf铆a; Argentina.Fil: Perovic, Nilda R. Universidad Nacional de C贸rdoba. Facultad de Ciencias M茅dicas. Escuela de Nutrici贸n; Argentina.Fil: Heinze, Ver贸nica M. Universidad Adventista del Plata. Facultad de Ciencias de la Salud; Argentina.Fil: Bernal, Claudio. Universidad Nacional del Litoral. Facultad de Bioqu铆mica y Ciencias Biol贸gicas; Argentina.Fil: Actis, Adriana B. Consejo Nacional de Investigaciones Cient铆ficas y T茅cnicas. Instituto de Investigaciones en Ciencias de la Salud; Argentina.Fil: Actis, Adriana B. Universidad Nacional de C贸rdoba. Facultad de Ciencias M茅dicas; Argentina.Otras Ciencias de la Salu
    corecore