[DELAYED AND PRIMARY RECONSTRUCTION OF MAMMARY GLAND IN PATIENTS WITH THE BREAST CANCER].

Immediate and late follow­up results of oncoplastic operations, performed in 75 patients, suffering mammary gland cancer (MGC), including in 22­a delayed, and in 53­primary reconstruction of the breast, were analyzed. In 66 patients musculo­ cutaneous flaps on nutrient pedicle, taken up from the back and abdominal wall tissues, with underlying mammary gland endoprosthesis,were applied as a transplant. Ductal invasive MGC was diagnosed in 70 patients, invasive lobular one ­ in 5. After delayed reconstruction of the breast 81.8% patients have survived five years, and after primary reconstruction ­ 73.6%. Performance of oncoplastic operations in patients, suffering MGC, have permitted to achieve satisfactory immediate and late follow­up results of treatment, it constitutes essential element in complex of rehabilitation measures after performance of radical mastectomy.

[Sentinel lymph node biopsy technique in breast cancer surgery in a hospital without a nuclear medical service]. / Técnica del ganglio centinela en la cirugía del cáncer de mama en un hospital sin servicio de medicina nuclear.

INTRODUCTION: Knowledge of lymph node stage is the most important prognostic factor in breast cancer. The sentinel lymph node biopsy technique (SLNBT), initially developed to avoid unnecessary dissection in melanoma, has been shown to be able to predict the axillary stage of breast cancer. The difficulty of applying the SLNBT in hospitals without a nuclear medicine service has led to the existence of external teams that allow these hospitals to apply the technique. OBJECTIVE: To test the application of the SLNBT in our hospital which has no nuclear medicine service. PATIENTS AND METHODS: Coinciding with the validation of the SLNBT in the Germans Trias i Pujol Hospital in Badalona in November 1999, and with their help, the Centre Hospitalari de Manresa began to apply this technique. In 2002, the technique was used in all the hospitals of the ALTHAIA-Xarxa Assistencial de Manresa. From November 1999 to June 2005, the technique was applied in 163 patients. RESULTS: Of the 163 patients, the technical success rate was 97.55%. In 98% of the patients, the sentinel lymph node was found in the axilla. In 10.7% of the patients, the node was found in the internal mammary basin. Twenty-six percent of the axillas had metastases of over 2 mm, and 16% had micrometastases. One hundred and five patients were spared axillary dissection. CONCLUSIONS: The SLNBT can be performed in a hospital without a nuclear medicine service. This technique improves and simplifies the surgical technique and reduces length of hospital stay and morbidity.

Mapping the quality of life and unmet needs of urban women with metastatic breast cancer.

Enhancing quality of life and reducing the unmet needs of women are central to the successful management of advanced breast cancer. The objective of this study was to investigate the quality of life and support and information needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Melbourne, Australia. A consecutive sample of 105 women with advanced breast cancer completed a questionnaire that contained the European Organization of Research and Treatment of Cancer Quality of Life Q-C30 and the Supportive Care Needs Survey. Between one quarter and a third of the women reported difficulties with their physical, role and social functioning, and a little over a quarter of the women reported poor global health status. Fatigue was a problem for most women. The highest unmet needs were in the psychological and health information domains. Almost no differences in unmet needs were detected when comparing different demographic and disease characteristics of women. Health care providers should routinely monitor the quality of life and needs of women with advanced breast cancer to ensure that appropriate treatment, information or supportive services are made available.

Quality of life of 5-10 year breast cancer survivors diagnosed between age 40 and 49.

BACKGROUND: The purpose of this report is to examine the correlates of quality of life (QOL) of a well-defined group of long-term breast cancer survivors diagnosed between the ages of 40 and 49. METHODS: Women were eligible if they were diagnosed with invasive breast cancer or ductal carcinoma in situ 5 to 10 years before June 30, 1998 and were enrolled at Group Health Cooperative, a health maintenance organization in western Washington State. A questionnaire was mailed to 290 women; 216 were included in this analysis. The questionnaire included standardized measures of QOL [e.g., the Cancer Rehabilitation Evaluation System (CARES-SF) and SF-36] as well as general demographic and medical information. ANOVA and logistic regression were used to estimate correlates of self-reported QOL. RESULTS: The mean age at diagnosis was 44.4 years, and the average time since diagnosis was 7.3 years. Women reported high levels of functioning across several standardized QOL scales; mild impairment was found on the CARES-SF Sexual Scale. The presence of breast-related symptoms at survey, use of adjuvant therapy, having lower income, and type of breast surgery were significantly associated with lower QOL 5 to 10 years post-diagnosis on one or more of the scales. CONCLUSIONS: Our results emphasize that younger long-term survivors of breast cancer have a high QOL across several standardized measures. However, the long-term consequences of adjuvant therapy and the management of long-term breast-related symptoms are two areas that may be important for clinicians and women with breast cancer in understanding and optimizing long-term QOL.