rome and Breast-Neoplasms

COVID-19 has been officially declared as a pandemic by the WHO. Italy was the first European country to be strongly affected by this outbreak. All elective and health promotion activities were reduced. Accordingly, Italian Breast Units and breast cancer (BC) screening programs scaled down significantly their activities. The aim of this study was to evaluate measures that could potentially reduce the clinical impact of COVID-19 on BC patients. Temporary recommendations are needed that could assist specialists in preventing COVID-19 infection and optimizing resources for diagnosis and treatment of BC patients.

Topics: Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Carcinoma; Carcinoma, Intraductal, Noninfiltrating; Combined Modality Therapy; Coronavirus Infections; COVID-19; Delayed Diagnosis; Disease Management; Early Detection of Cancer; Elective Surgical Procedures; Estrogens; Female; Hospitals, University; Hospitals, Urban; Humans; Mammography; Mass Screening; Mastectomy; Neoadjuvant Therapy; Neoplasms, Hormone-Dependent; Pandemics; Pneumonia, Viral; Rome; Treatment Refusal; Triple Negative Breast Neoplasms

Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs).. In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated.. A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP.. Working in a COVID-19-hospital represents a factor that negatively affects psychosocial well-being. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP.

Topics: Adult; Breast Neoplasms; Cancer Care Facilities; Coronavirus Infections; COVID-19; Depression; Female; Humans; Male; Middle Aged; Occupational Diseases; Occupational Stress; Pandemics; Patient Care Team; Personnel, Hospital; Pneumonia, Viral; Prevalence; Protective Devices; Psychosocial Support Systems; Rome; Severity of Illness Index; Tertiary Care Centers; Uncertainty; Workload

Capsular contracture (CC) is a major complication of breast surgery with smooth and textured implants. Polyurethane (PU) foam-coated breast implants were developed to decrease the incidence of CC.. The authors determined the incidence of CC following 2-stage breast reconstruction using PU foam-covered implants, with and without radiation therapy.. The records of 92 patients who received 115 PU implants were retrospectively reviewed. The rates of CC over time were compared for irradiated and nonirradiated groups with a Kaplan-Meier analysis and log-rank test. CC rates also were analyzed with respect to age.. The median follow-up time for patients was 103.3 months. Nine patients experienced unilateral Baker grade III or IV fibrous CC, including 6 patients from the irradiated group and 3 patients from the nonirradiated group. The overall cumulative incidence of CC at 9 years was 8.1%. In the irradiated and nonirradiated groups, the 9-year cumulative incidence was 10.7% and 5.5%, respectively. CC occurred within 3 years in the irradiated group and within 7 years in the nonirradiated group. The incidence of CC appeared to be higher among younger patients.. Radiation therapy increases the risk of high-grade CC with textured or smooth implants. PU implants are associated with a much lower cumulative incidence of CC following 2-stage breast reconstruction, even when radiotherapy is performed. LEVEL OF EVIDENCE 3.

Topics: Adult; Age Factors; Aged; Breast Implantation; Breast Implants; Breast Neoplasms; Coated Materials, Biocompatible; Female; Humans; Implant Capsular Contracture; Incidence; Kaplan-Meier Estimate; Mastectomy; Middle Aged; Polyesters; Polyurethanes; Proportional Hazards Models; Prosthesis Design; Radiotherapy, Adjuvant; Retrospective Studies; Risk Factors; Rome; Surface Properties; Time Factors; Treatment Outcome

Nipple-sparing mastectomy (NSM) is a recognized treatment for selected patients with breast cancer (BC). Our study aimed to analyze 7 years' experience in NSM and breast reconstruction for patients with preoperative diagnosis of non-invasive BC.. All NSMs with breast reconstruction, performed between January 2007 and December 2013 in patients with preoperative diagnosis of non-invasive BC, were considered.. Thirty-five NSMs were performed, 23 cases confirming the diagnosis of non-invasive BC, and in 12 patients it also resulted in findings of an invasive component. Patients were stratified into two groups: breast reconstruction was performed i) with silicone definitive implant, ii) with a temporary breast tissue expander. An invasive component at the postoperative histological examination was significantly associated with tissue expander reconstruction (p=0.03).. In selected cases, NSM is a valid and safe procedure. Further critical evaluations are required for more evidence on this argument.

Topics: Adult; Breast Implantation; Breast Implants; Breast Neoplasms; Carcinoma; Female; Humans; Mastectomy; Middle Aged; Neoplasm Invasiveness; Nipples; Prosthesis Design; Retrospective Studies; Rome; Silicones; Time Factors; Tissue Expansion; Tissue Expansion Devices; Treatment Outcome

Breast conserving surgery (BCS) combined with postoperative radiotherapy has become the gold standard of locoregional treatment for the majority of patients with early-stage breast cancer, offering equivalent survival and improved body image and lifestyle scores as compared to mastectomy. In an attempt to optimize the oncologic safety and cosmetic results of BCS, oncoplastic procedures (OPP) have been introduced in recent years combining the best principles of surgical oncology with those of plastic surgery. However, even with the use of OPP, cosmetic outcomes may result unsatisfying when a large volume of parenchyma has to be removed, particularly in small-medium size breasts.. The aim of this article is to report our preliminary results with the use of oxidized regenerate cellulose (ORC) (Tabotamp fibrillar, Johnson & Johnson; Ethicon, USA) as an agent to prevent cosmetic defects in patients undergoing OPP for breast cancer and to analyze the technical refinements that can enhance its efficacy in optimizing cosmetic defects.. Different OPP are selected based on the location and size of the tumor as well as volume and shape of the breast. After excision of the tumor, glandular flaps are created by dissection of the residual parenchyma from the pectoralis and serratus muscles and from the skin. After careful haemostasis, five layers of ORC are positioned on the pectoralis major in the residual cavity and covered by advancement of the glandular flaps. Two additional layers of ORC are positioned above the flaps and covered by cutaneous-subcutaenous flaps.. The use of ORC after OPP has shown promising preliminary results, indicating a good tolerability and positive effects on cosmesis.. This simple and reliable surgical technique may allow not only to reduce the rate of post-operative bleeding and infection at the surgical site but also to improve cosmetic results.

Topics: Breast Neoplasms; Cellulose, Oxidized; Cicatrix; Depsipeptides; Female; Humans; Mammaplasty; Mastectomy, Segmental; Postoperative Hemorrhage; Rome; Surgical Flaps; Surgical Wound Infection; Time Factors; Treatment Outcome

A survey on knowledge, attitudes, and practice regarding breast and cervical cancer screening was conducted in Rome on a sample of women aged 18-64 years. Of the 793 interviewees, 31.9% had undergone at least one breast imaging examination; examinations were more frequent in women over 35 and in those familiar with breast self-examination and female pathophysiology. Seventy percent of the women had had at least one Pap smear. Women were classified as Pap smear underusers (26.0%), appropriate users (28.8%), and overusers (45.2%) as compared to standard screening recommendations, according to their age and their lifetime number of smears. Age over 35 was associated with both underuse and overuse. Such inappropriate screening patterns could be related in part to the fact that the women reported that their physicians recommendations for Pap smear frequency were once a year or more in 62%, and once every two or three years in only 2%.

Topics: Adult; Breast Neoplasms; Female; Health Knowledge, Attitudes, Practice; Humans; Mammography; Mass Screening; Middle Aged; Papanicolaou Test; Rome; Uterine Cervical Neoplasms; Vaginal Smears

Topics: Breast Neoplasms; Europe; Female; Greece; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Mastectomy; Medicine in the Arts; Radiotherapy; Rome; United States

Topics: Breast Neoplasms; Egypt; Female; France; Germany; Greece; History, Ancient; History, Modern 1601-; Humans; Mastectomy; Rome; Russia (Pre-1917); United Kingdom; United States