Staging computerized tomography before delayed breast reconstruction could alter the management plan
Autor: | Sherif Youssef, Marco Malahias, Poonam Pradhan, Javeria Iqbal, Amar Shimal, Platon Trigkatzis, Haitham H Khalil, Kareem Alsharkawy, Maninder S Kalkat |
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Rok vydání: | 2020 |
Předmět: |
Adult
medicine.medical_specialty Time Factors Mammaplasty Breast Neoplasms 030230 surgery Asymptomatic 03 medical and health sciences 0302 clinical medicine Breast cancer Statistical significance medicine Humans Aged Neoplasm Staging Retrospective Studies business.industry Incidentaloma Cancer Middle Aged medicine.disease Prognosis Surgery 030220 oncology & carcinogenesis Cohort Nottingham Prognostic Index Female Radiology medicine.symptom business Breast reconstruction Tomography X-Ray Computed |
Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 74(12) |
ISSN: | 1878-0539 |
Popis: | Summary Background Delayed breast reconstruction (DBR) comprises a significant proportion of breast reconstruction practice post completion of breast cancer treatment. The tumour's biology, staging, time constraints, ongoing treatment, and patient and surgeon's preference influence the decision to pursue DBR. There are no guidelines for assessing the oncological status before DBR in otherwise asymptomatic patients, particularly in those with a higher risk of recurrence. The purpose of this study was to identify the cohort of patients who could potentially benefit from staging CT scan before DBR regardless of the reconstructive modality and its impact on the overall management. Material and methods A retrospective review on 207 consecutive patients, who underwent staging CT scan before DBR in the period between 2009 and 2019 was performed. The CT scan findings were correlated with the breast prognostication scoring model (Nottingham Prognostic Index [NPI]) as an indicator factor for staging reasons. Results Incidental findings were reported in 34% (71/207) of the reviewed CT scans (incidentaloma group). There was no statistical significance in the NPI scores between non incidentaloma and incidentaloma groups. However, 5.7% (12/207) had their DBR procedure cancelled or the surgical plan altered. Conclusion The patients with moderate to poor prognosis (NPI score 3.4 and above) could benefit from CT staging scan before DBR. This scan could detect adverse prognostic features precluding major surgery, which saves patients from unnecessary surgical risks and discomfort, and direct them towards the relevant management pathway. |
Databáze: | OpenAIRE |
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