Bakgrund: Cancer är en livshotande sjukdom som kan orsaka dödsfall. Bröstcancer är den vanligaste cancerformen bland kvinnor över hela världen. Behandlingen för bröstcancer är vanligtvis ett kirurgiskt ingrepp som kallas mastektomi. Det är ett ingrepp där en del eller hela bröstet avlägsnas. Därefter kan kirurgin kompletteras med annan behandling för att förhindra spridningen. Bröstet är ett organ som har en betydelse för attraktivitet, sexualitet och kvinnlighet. Tanken på att förlora bröstet innebär en förändring hos den drabbade kvinnan och kan som konsekvens påverka kvinnans liv. Syftet: Syftet med denna studie var att beskriva kvinnors upplevelse av vardagen efter en mastektomi. Metod: Den valda metoden var en kvalitativ litteraturstudie, baserad på elva vetenskapliga artiklar som analyserades genom en manifest innehållsanalys. Resultat: Resultatet består av tre huvudkategorier Den nya kroppen, Den förändrade tillvaron och Upplevelse av stöd, och åtta subkategorier Förändrad kroppsbild, Förändrad sexualitet, Förändrad social funktion och påverkan på vardagen, Psykisk ohälsa, Känsla av acceptans och tacksamhet, Stöd från omgivning och Mötet med sjukvården. Konklusion: Kvinnor påverkas olika efter en mastektomi och upplevelsen kan variera beroende på ålder. Påverkan kan vara i form av depression, försämrad livskvalitet, förändring av kroppsbild och sexualitet. Därför är det avgörande för denna patientgrupp att ha kontakt med vården eftersom kvinnan behöver stöd för att kunna uttrycka känslor postoperativt. Således är sjuksköterskans roll att bemöta patienter på ett respektfullt sätt och tillhandahålla en rätt omvårdnad. / Background: Cancer is a life-threatening disease that can cause death. Breast cancer is the most common form of cancer among women worldwide. The treatment for breast cancer is usually a surgical procedure called mastectomy. It is a procedure where a part of or the whole breast is removed. The surgery can then be supplemented with other treatments to prevent the spread. The breast is a body part that is important for attractiveness, sexuality and femininity. The thought of losing the breast involves a change in the affected woman and can consequently affect the woman's life. Aim: The aim of this study was to describe women's experience of everyday life after a mastectomy. Method: The chosen method was a qualitative literature study, based on eleven scientific articles that were analyzed through a manifest content analysis. Result: The result consists of three main categories The new body, The changed existence and Experience of support, and eight subcategories Changed body image, Changed sexuality, Changed social function and impact on everyday life, Mental illness, Feeling of acceptance and gratitude, Support from the environment and Meeting with healthcare. Conclusion: Women are affected differently after a mastectomy and the experience can vary depending on age. Impacts can be in the form of depression, deteriorating quality of life, changes in body image and sexuality. Therefore, it is crucial for this patient group to have contact with the care because the woman needs support to be able to express feelings postoperatively. Thus, the role of the nurse is to treat patients in a respectful way and provide proper care

<p>Karcinom dojke predstavlja najče&scaron;ću malignu neoplazmu među ženskom populacijom, a po&scaron;tedna terapija dojke, preferirani je model lečenja bolesnica u ranom stadijumu bolesti. Smatra se da je optimalna hirur&scaron;ka resekciona margina 2 mm. Opisano je mnogo metoda koje služe za intraoperativnu proveru suficijentnosti resekcione hirur&scaron;ke margine i sve one imaju svoje prednosti i mane. Ciljevi ove studije bili su da se utvrdi, da li postoji statistički značajna razlika u određivanju &scaron;irine negativne resekcione hirur&scaron;ke margine izražene u milimetrima pri operacijama karcinoma dojke upotrebom palpatorne metode i intraoperativne mobilne radiografije, poređenjem nalaza merenja hiruga sa većim i manjim iskustvom u hirurgiji karcinoma dojke kao i nalaza radiologa u odnosu na patohistolo&scaron;ku ex tempore analizu. Istraživanje je sprovedeno kao retrospektivno&ndash;prospektivna studija na Klinici za operativnu onkologiju, Instituta za onkologiju Vojvodine i obuhvatilo je 150 bolesnica kod kojih je preoperativno dijagnostikovan karcinom dojke. Kriterijum za uključenje u studiju bilo je izvođenje po&scaron;tedne operacije dojke sa ili bez disekcije ipsilaterale aksile, dok su iz studije isključene bolesnice kod kojih nije bilo moguće izvesti po&scaron;tednu operaciju dojke, one sa radiolo&scaron;ki potvrđenom diseminovanom bole&scaron;ću, kao i bolesnice koje su ranije operisane zbog karcinoma iste dojke. Kod svih 150 ekstirpiranih karcinoma dojke urađena je procena &scaron;irine resekcione hirur&scaron;ke margine intraoperativno palpatornom metodom, zatim na aparatu za mobilnu digitalnu radiografiju, te radiogram analiziran od strane iskusnog i manje iskusnog hiruga u hirurgiji karcinoma dojke, kao i radiologa te upoređen sa nalazom ex tempore patohistolo&scaron;ke analize. Definitivna &scaron;irina resekcione hirur&scaron;ke margine potvrđena je na parafinskim patohistolo&scaron;kim preparatima. Srednja vrednost praćenja bolesnica, postoperativno, iznosila je 100,97 nedelja. Najveći broj bolesnica pripadao je starijoj životnoj dobi (56,67%). Preoperativna lokalizacija klinički nepalpabilnih tumora u dojci urađena je kod 52 (34,67%) bolesnice. Najče&scaron;će se tumor prezentovao kao solitarni fokus sa okolnim ognji&scaron;tima in situ karcinoma (72, 48%), dok je najče&scaron;ći histolo&scaron;ki subtip bio duktalni invazivni karcinom dojke (112 (74,67%)). Najveći broj operacija dojke okarakterisan je kao kvadrantektomija (85 (56,67)), dok je najučestalija operacija aksile bilo određivanje limfnog čvora stražara (119 (79,33%). Analizom rada aparata za mobilnu digitalnu radiografiju do&scaron;li smo do saznanja da nema statistički značajne razlike u oceni kvaliteta radiograma i &scaron;irine resekcione hirur&scaron;ke margine merene na aparatu za mobilnu digitalnu radiografiju između iskusnog hirurga i radiologa. Statistički značajna razlika nije uočena ni pri merenju &scaron;irine resekcione hirur&scaron;ke margine izražene u milimetrima na aparatu za mobilnu digitalnu radiografiju od strane iskusnog hirurga i radiologa u odnosu na ex tempore patohistolo&scaron;ku analizu, dok je ista uočena nakon definitivne patohistolo&scaron;ke analize. &Scaron;ansa doresekcije tkiva dojke nakon merenja na aparatu za mobilnu digitalnu radiografiju je 1,4 puta veća nego nakon patohistolo&scaron;ke ex tempore analize. Lokalni recidiv javio se kod jedne pacijentkinje tokom perioda praćenja. Ne postoji statistički značajna razlika u određivanju &scaron;irine resekcione hirur&scaron;ke margine izražene u milimetrima upotrebom aparata za mobilnu digitalnu radiografiju od strane iskusnog hirurga i radiologa u odnosu na patohistolo&scaron;ku ex tempore analizu, dok ista postoji nakon analize radiograma od strane manje iskusnog hirurga. Palpatorna metoda se ne može smatrati sigurnom metodom u određivanju &scaron;irine hirur&scaron;ke resekcione margine. Ne postoji statistički značajna razlika u broju doresekcije tkiva dojke između hirurga sa različitim hirur&scaron;kim iskustvom.</p> / <p>Breast cancer is the most common malignant neoplasm in the female population, and conservative breast therapy is the preferred treatment model for patients in early stages of the disease. The optimal surgical resection margin, from healthy breast tissue around the primary tumor is 2 mm. Many methods have been described that serve to check the resection margin during breast conservative surgery and all of them have their advantages and disadvantages. The aim of this study was to determine whether there was a statistically significant difference in the determination of the width of the negative resection margin expressed in millimeters in breast cancer surgery using palpatory method and intraoperative mobile specimen radiography, comparing the findings of measuring of surgeons with greater and lesser experience in breast cancer surgery as well as the findings of the radiologist in relation to histopathological ex tempore and definitive histopathological analysis. The study was conducted as a retrospective - prospective study at the Clinic for Operative Oncology, Oncology Institute of Vojvodina and included 150 patients who were preoperatively diagnosed with breast cancer. The criterion for inclusion in the study was the opportunity to perform breast conservative surgery with or without complete axillary lymph node dissection. Patients that were treated with breast amputation, those with radiological confirmed disseminated disease, as well as patients previously operated from cancer were excluded from the study. For all 150 extirpated breast cancers, an estimate of the width of the resection surgical margin was performed intraoperatively with a palpatory method, followed by measuring on device for mobile specimen digital radiography, and a radiogram was analyzed by an experienced and less experienced surgeon in breast cancer surgery, as well as by a radiologist and compared with an ex tempore histopathological analysis. The definitive width of the resection surgical margin was confirmed on histopathological preparations. The mean follow-up, postoperatively, was 100.97 weeks. The majority of patients belonged to the elderly age (56.67%). Preoperative localization of clinically impalpable breast tumors was performed in 52 (34.67%) patients. Most often the tumor was presented as a solitary focus with surrounding foci of in situ cancer (72, 48%), while the most common histological subtype was invasive ductal breast cancer (112 (74.67%)). The majority of breast operations were characterized like quadrantectomy (85 (56.67)), while the most frequent axillary surgery was the determination of the sentinel lymph node (119 (79.33%). No significant difference was observed in the evaluation of radiography quality and the width of the resection surgical margin measured on the mobile digital radiography device between the experienced surgeon and the radiologist. No statistically significant difference was observed in the measurement of the width of the resection surgical margin expressed in millimeters on the mobile digital radiography device by the experienced surgeon and radiologist versus ex tempore histopathological analysis, while the statistical difference was observed after definite histopathological analysis. The chance of breast tissue reexcision after measurement on a mobile digital radiography device is 1.4 times higher than after histopathological ex tempore analysis. Local relapse occurred in one patient during the follow-up period. There is no statistically significant difference in the determination of the width of the resection surgical margin expressed in millimeters using a mobile digital radiography device by an experienced surgeon in breast cancer surgery and radiologist with respect to histopathological ex tempore analysis. However, the statistical difference exists after radiogram analysis by a less experienced surgeon. The palpatory method cannot be considered as a safe method in determining the width of a surgical resection margin. There is no statistically significant difference in the number of breast tissue additional resections between surgeons with different surgical experience.</p>

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor både i Sverige och globalt. Mastektomi är en av behandlingsformerna för bröstcancer, vilket innebär att en del eller hela bröstet tas bort. Kvinnobrösten har utöver den fysiologiska funktionen en sexuell, samt kulturell betydelse. I vårt samhälle är brösten en symbol för femininitet samt sexualitet, vilket gör förlusten av ett bröst till en av de orsaker som ändrar kvinnors kroppsbild. Sjuksköterskan har en central roll i omvårdnadsarbetet och att hjälpa patienten att acceptera och förstå att kroppen har ändrats samt ge stöd. Syfte: Syftet med denna litteraturstudie var att beskriva upplevd självbild och behov av stöd hos kvinnor som genomgått mastektomi. Metod: Den valda metoden är en litteraturstudie med inriktning på kvalitativa studier. Informationssökningen gjordes i databaserna PubMed, CINAHL och Psycinfo. Relevanta studier kvalitetsgranskades med hjälp av SBU:s granskningsmall för kvalitativ forskningsmetodik. Studiernas data analyserades och nyckelord samt meningsenheter identifierades. Resultat: Bearbetning av data gav tre huvudteman; Faktorer som påverkar kvinnans sjukdomsförlopp, upplevelser av förändrad kropp och livet efter mastektomin. I dessa tre teman framkom sex subteman; Stöd från olika parter i kvinnas liv, information &amp; förberedelse, bröstensbetydelse och den emotionella påverkan, mastektomins inverkan på när relationer, bli vän med sin nya förändrade kropp, återfå livskvalitet. Konklusion: Mastektomi påverkade kvinnors fysiska samt psykosociala välbefinnande och ett behov av stöd uppstod. Stöd från sjuksköterskan behövdes innan, under och efter behandlingen. Ett personcentrerat arbetssätt var av vikt för att en anpassad vård skulle kunna ges där varje individs behov var i fokus. Trots att mastektomin innebar en förändring i vardagen utvecklade majoriteten av kvinnorna en acceptans gentemot den nya kroppsbilden. Livet var det som var betydelsefullt och ett förlorat bröst var obetydligt sett till helheten. / Background: Breast cancer is the most common form of cancer among women both in Sweden and globally. Mastectomy is one of the treatments for breast cancer, where a part or all of the breast is removed. In addition to the physiological function, the female breast has a sexual and cultural significans. In our society, the breasts are a symbol of femininity and sexuality, which makes the loss of a breast one of the reasons that women's body image changes. The nurse has a central role in the nursing work, helping the patient to accept and understand that the body has changed and provide support. Aim: The aim of this literature study was to describe perceived self-image and need for support in women who have undergone mastectomy. Method: The chosen method is a literature study with focus on qualitative studies. The information search was performed in the databases PubMed, CINAHL and Psycinfo. Relevant studies were quality reviewed using SBU's review template for qualitative research. The data from the studies were analyzed and keywords as well as units of meaning were identified. Results: The data process yielded three main themes; factors that influence women around the mastectomy, experiences of an altered body and the life after mastectomy. In these three themes, six sub themes emerged; Support from different parties in women's lives, information &amp; preparation, the meaning of the breast and the emotional impact, the impact of mastectomy on relationships, becoming friends with their new changed body, regain quality of life. Conclusion: Mastectomy affected women's physical and psychosocial well-being and a need for support arose. Nursing support was needed before, during and after treatment. A person-centered approach was important so that adapted care could be provided where everyone’s needs were in focus. Even though mastectomy meant a change in everyday life, most women developed an acceptance of the new body. The loss of a breast was insignificant, what mattered was being alive.

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor globalt och i Sverige, med över 20 nya fall dagligen. Behandlingar inkluderar kirurgi, strålning, kemoterapi, hormonbehandling och målinriktade terapier. Mastektomi är vanligt och påverkar livskvaliteten hos kvinnor. Att förstå deras upplevelser har betydelse för omvårdnad. Syfte: Att beskriva kvinnors upplevelser efter genomförd mastektomi. Metod: Metoden är en litteraturöversikt av vetenskapliga originalartiklar med kvalitativ ansats. Resultat: Litteraturöversikten identifierade två huvudtema: "Upplevelser av den förändrade kroppen", inklusive en förändrad kroppsuppfattning, anpassad klädsel och förändrat sexliv, samt "Upplevelser av relationer och stöd", med fokus på familjedynamik och stöd, stöd från sjukvårdspersonal, och det sociala livet. Resultaten visade på kvinnors utmaningar efter mastektomi och behovet av stöd och anpassning. Slutsats: Mastektomi hos kvinnor leder till kroppsuppfattningsförändringar och behov av omfattande stöd. Personcentrerad vård, psykologiskt stöd och korrekt information är viktigt för deras välbefinnande. / Background: Breast cancer is the most common cancer among women globally and in Sweden, with over 20 new cases daily. Treatments include surgery, radiation, chemotherapy, hormone therapy, and targeted therapies. Mastectomy is common and affects the quality of life for women. Understanding their experiences is crucial for nursing care. Aim: To describe women's experiences after undergoing mastectomy. Method: The method involves a literature review of scientific original articles employing a qualitative approach. Results: The literature review identified two main themes: "Experiences of the changed body", including a changed body image, adapted clothing and changed sex life, and "Experiences of relationships and support", focusing on family dynamics and support, support from healthcare professionals, and social life. The results showed the challenges faced by women after mastectomy and the need for support and adaptation. Conclusions: Mastectomy results in changes in body perception and the need for comprehensive support. Person-centered care, psychological support, and accurate information are crucial for their well-being.

Summaries in Afrikaans and English / ‘n Praktiese teologiese probleem is in die bediening geïndentifiseer: die man wie se vrou ‘n mastektomie gehad het, word nie pastoraal ondersteun nie. Hierdie probleem is deur middel van kwalitatiewe navorsing ondersoek. Met die kennis uit die navorsing en die literatuurstudie is daaraan die navorsingsdoelstelling beantwoord. Hierdeur is die praktiese teologie op ‘n unieke wyse verryk, deur ‘n wetenskaplike bydrae om die pastorale berader beter te bekwaam. Borskanker is ‘n lewensbedreigde siekte waarop geen man voorberei is nie. Met die verlies van ‘n kosbare liggaamsdeel van die vrou en haar behoefte aan ondersteuning van haar man, begin hy om sy ware-man wees (identiteit) te bevraagteken. Die verlies het ook trauma by die man tot gevolg. As die man deur sy emosies oorweldig word en hy nie oor die vermoë beskik om dit te verwerk nie, kan hy in wanhoop verval. Die man lewe in die postmoderne era. Die uitdagings en onsekerhede van hierdie era het ‘n bydrae tot die ontwikkeling van die “Post-foundational” praktiese teologiese benadering gelewer. Daarom het die navorser besluit om hierdie benadering in die studie te volg. Hierdeur is ‘n gesprek tussen die praktiese teologie, mediese- en geesteswetenskappe vanuit ‘n transversale perspektief moontlik, om die invloed van die mastektomie op die man te bepaal. Duidelike behoeftes en vrae kom navore wat vereis dat die berader homself sal onderskei in kennis van die onderskeie pastorale benaderings en tegnieke, toepaslike mediese, Bybel- en geestes wetenskappe. Die omstandighede waarin die man hom bevind het die bevraagtekening van sy spiritualiteit tot gevolg. Sy spiritualiteit kan vir hom van groot waarde wees. Die doel van die beradingsmodel is om die man te fasiliteer om sy ware identiteit in Christus te ontdek. Deur die genade van die Here word geloofsvolwassenheid in die man ‘n waarheid. Daardeur vind transendering ten opsigte van ‘n “bevraagde identiteit” na ‘n “identiteit van betekenis en hoop” plaas. Deur die werking van die Heilige Gees word die man op die vervulling van God se heilsbeloftes vir die nood waarin verkeer verseker. Die doel van hierdie beradingsmodel vir die praktiese teologie, is ‘n geloofsvolwasse man met ‘n nuwe toekomsverhaal. / A practical theological problem was identified in the ministry: a husband whose wife undergoes a mastectomy does not receive pastoral care. This problem was investigated through a qualitative research study. The research objective was answered by doing research and a literature study. This scientific research enriches the practical theology in an unique way so that the pastoral counsellor is supported and can be more competent. Breast cancer is a life-threatening disease that no husband is prepared for. The wife loses an intimate part of her body and needs to be supported by her husband. He starts to question his own manhood (identity). This loss is also a traumatic experiences for him. He is overwhelmed by his emotions and can fall into despair if he does not have the ability to process the problem. We live in the post-modern era. This has lead to the development of the Post-foundational practical theological approach. The researcher therefore decided to follow this approach in his study. This help to determine the influence of the disruption and uncertainties in the life of the man through a discourse between the practical theology, medical- and human science from a transversal perspective. Evident questions were raised for which the counsellor needs to distinguish himself with knowledge about the various pastoral approaches and techniques, appropriate knowledge of the Bible, medical- and human science. The circumstances in which the man finds himself raise questions about the meaning of his spirituality. Spirituality can be of great help for the husband. The aim of this counseling model is to facilitate the husband through the narrative approach to find the meaning of his true identity in Christ. Through the grace of God the husband becomes spiritually mature. The dependence on God through a process of transcendence changes the ‘question identity’ to an ‘identity of value and hope’. Through the work of Holy Spirit the husband is reassured of the fulfillment of the promises of salvation by God. The aim of this counseling model for the practical theology is a spiritually matured husband with a new future story. / Practical Theology / D. Th. (Practical Theology)

Summaries in Afrikaans and English / ‘n Praktiese teologiese probleem is in die bediening geïndentifiseer: die man wie se vrou ‘n mastektomie gehad het, word nie pastoraal ondersteun nie. Hierdie probleem is deur middel van kwalitatiewe navorsing ondersoek. Met die kennis uit die navorsing en die literatuurstudie is daaraan die navorsingsdoelstelling beantwoord. Hierdeur is die praktiese teologie op ‘n unieke wyse verryk, deur ‘n wetenskaplike bydrae om die pastorale berader beter te bekwaam. Borskanker is ‘n lewensbedreigde siekte waarop geen man voorberei is nie. Met die verlies van ‘n kosbare liggaamsdeel van die vrou en haar behoefte aan ondersteuning van haar man, begin hy om sy ware-man wees (identiteit) te bevraagteken. Die verlies het ook trauma by die man tot gevolg. As die man deur sy emosies oorweldig word en hy nie oor die vermoë beskik om dit te verwerk nie, kan hy in wanhoop verval. Die man lewe in die postmoderne era. Die uitdagings en onsekerhede van hierdie era het ‘n bydrae tot die ontwikkeling van die “Post-foundational” praktiese teologiese benadering gelewer. Daarom het die navorser besluit om hierdie benadering in die studie te volg. Hierdeur is ‘n gesprek tussen die praktiese teologie, mediese- en geesteswetenskappe vanuit ‘n transversale perspektief moontlik, om die invloed van die mastektomie op die man te bepaal. Duidelike behoeftes en vrae kom navore wat vereis dat die berader homself sal onderskei in kennis van die onderskeie pastorale benaderings en tegnieke, toepaslike mediese, Bybel- en geestes wetenskappe. Die omstandighede waarin die man hom bevind het die bevraagtekening van sy spiritualiteit tot gevolg. Sy spiritualiteit kan vir hom van groot waarde wees. Die doel van die beradingsmodel is om die man te fasiliteer om sy ware identiteit in Christus te ontdek. Deur die genade van die Here word geloofsvolwassenheid in die man ‘n waarheid. Daardeur vind transendering ten opsigte van ‘n “bevraagde identiteit” na ‘n “identiteit van betekenis en hoop” plaas. Deur die werking van die Heilige Gees word die man op die vervulling van God se heilsbeloftes vir die nood waarin verkeer verseker. Die doel van hierdie beradingsmodel vir die praktiese teologie, is ‘n geloofsvolwasse man met ‘n nuwe toekomsverhaal. / A practical theological problem was identified in the ministry: a husband whose wife undergoes a mastectomy does not receive pastoral care. This problem was investigated through a qualitative research study. The research objective was answered by doing research and a literature study. This scientific research enriches the practical theology in an unique way so that the pastoral counsellor is supported and can be more competent. Breast cancer is a life-threatening disease that no husband is prepared for. The wife loses an intimate part of her body and needs to be supported by her husband. He starts to question his own manhood (identity). This loss is also a traumatic experiences for him. He is overwhelmed by his emotions and can fall into despair if he does not have the ability to process the problem. We live in the post-modern era. This has lead to the development of the Post-foundational practical theological approach. The researcher therefore decided to follow this approach in his study. This help to determine the influence of the disruption and uncertainties in the life of the man through a discourse between the practical theology, medical- and human science from a transversal perspective. Evident questions were raised for which the counsellor needs to distinguish himself with knowledge about the various pastoral approaches and techniques, appropriate knowledge of the Bible, medical- and human science. The circumstances in which the man finds himself raise questions about the meaning of his spirituality. Spirituality can be of great help for the husband. The aim of this counseling model is to facilitate the husband through the narrative approach to find the meaning of his true identity in Christ. Through the grace of God the husband becomes spiritually mature. The dependence on God through a process of transcendence changes the ‘question identity’ to an ‘identity of value and hope’. Through the work of Holy Spirit the husband is reassured of the fulfillment of the promises of salvation by God. The aim of this counseling model for the practical theology is a spiritually matured husband with a new future story. / Philosophy, Practical and Systematic Theology / D. Th. (Practical Theology)

Estudo retrospectivo de 119 pacientes com diagnóstico de adenocarcinoma ductal invasivo no estádio clínico III tratadas com quimioterapia neoadjuvante (FEC), mastectomia e adjuvância. Destas, 85 optaram por reconstrução mamária imediata (RMI) com retalho transverso músculo-cutâneo de reto-abdominal e 34, não. Com seguimento médio de 52,7 meses avaliou-se o tempo de hospitalização, a inter-relação com a adjuvância, recidiva local, o tempo livre de doença e o tempo total de sobrevida, concluindo-se que, apesar de aumentar o tempo de hospitalização, a RMI não interfere com os demais ítens, podendo ser indicada para pacientes portadoras de carcinoma mamário em estádio clínico avançado / A retrospective study with 119 patients diagnosed with invasive ductal adenocarcinoma of the breast treated with neoadjuvant chemotherapy (FEC), mastectomy and adjuvant therapy. Eight-five patients chose immediate breast reconstruction (IBR) with transverse rectus abdominis myocutaneous flap and, 34 did not do it. The mean follow-up was 52.7 months. Length of stay, adjuvant therapy interrelation, local recurrence, disease-free survival and overall survival were evaluated. It was concluded that despite a longer stay, IBR did not interfere with any of the other factors analyzed and may be indicated for patients with advanced breast disease

Estudo retrospectivo de 119 pacientes com diagnóstico de adenocarcinoma ductal invasivo no estádio clínico III tratadas com quimioterapia neoadjuvante (FEC), mastectomia e adjuvância. Destas, 85 optaram por reconstrução mamária imediata (RMI) com retalho transverso músculo-cutâneo de reto-abdominal e 34, não. Com seguimento médio de 52,7 meses avaliou-se o tempo de hospitalização, a inter-relação com a adjuvância, recidiva local, o tempo livre de doença e o tempo total de sobrevida, concluindo-se que, apesar de aumentar o tempo de hospitalização, a RMI não interfere com os demais ítens, podendo ser indicada para pacientes portadoras de carcinoma mamário em estádio clínico avançado / A retrospective study with 119 patients diagnosed with invasive ductal adenocarcinoma of the breast treated with neoadjuvant chemotherapy (FEC), mastectomy and adjuvant therapy. Eight-five patients chose immediate breast reconstruction (IBR) with transverse rectus abdominis myocutaneous flap and, 34 did not do it. The mean follow-up was 52.7 months. Length of stay, adjuvant therapy interrelation, local recurrence, disease-free survival and overall survival were evaluated. It was concluded that despite a longer stay, IBR did not interfere with any of the other factors analyzed and may be indicated for patients with advanced breast disease

Background: Prophylactic mastectomies in carriers of mutations in BRCA1 or BRCA2 are becoming increasingly more accepted. We investigated the outcome after prophylactic mastectomy, especially regarding satisfaction with the procedure, in a monocenter study. Methods: BRCA1/2 mutation carriers and non-carriers with elevated pedigree-based cancer risk were followed prospectively in a structured surveillance program between 2000 and 2017. A retrospective telephone survey was conducted among all patients with documented prophylactic mastectomy. Complications and satisfaction with the decision for prophylactic mastectomy were recorded. Results: 39 patients who opted for a prophylactic mastectomy (38 BRCA1/2 mutation carriers and 1 noncarrier) were interviewed. Mostly nipple-sparing mastectomy with reconstruction was performed (87%). Half of the patients (22/39; 56.4%) had a history of unilateral breast cancer. The median time since prophylactic mastectomy was 5.6 years. While 61.5% did not report any complications, flap loss was seen in 15% (3/20) and moderate limitations in everyday life were present in 20% (7/35). An improvement in quality of life was noticed by 82% after prophylactic mastectomy and no patient expressed regret with regard to the decision. Conclusions: Prophylactic mastectomy is a procedure with risk for long-term complications in some cases. Our results confirm high satisfaction with the decision and improved quality of life.

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