Trends in breast cancer surgery at Brazil's public health system

Freitas‐Júnior, Ruffo; Gagliato, Débora Melo; Filho, João Wesley Cabral Moura; Gouveia, Pollyana Alves; Rahal, Rosemar Macedo Sousa; Paulinelli, Régis Resende; Oliveira, Luis Fernando Pádua; Freitas, Paola Ferreira de; Martins, Edésio; Úrban, Cícero; Lucena, Clécio Ênio Murta de

doi:10.1002/jso.24572

Cited by 25 publications

(20 citation statements)

References 29 publications

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“…Trends in breast surgery over time have been investigated in several populations, including the USA, South America, Europe and Asia. A trend towards increased use of unilateral and bilateral mastectomies has been reported, particularly in the USA.…”

Section: Introductionmentioning

confidence: 99%

Nationwide population-based study of trends and regional variation in breast-conserving treatment for breast cancer

Maaren

Strobbe

Koppert

et al. 2018

British Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

Nationwide population-based study of trends and regional variation in breast-conserving treatment for breast cancer

Maaren

Strobbe

Koppert

et al. 2018

British Journal of Surgery

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“…Thus, it is worth questioning whether breast reconstruction has been offered to patients treated at other health services in the Federal District or if there are difficulties in accessing the specialized breast reconstruction clinic. Results of a national study 4 with data from the Public Health System indicate that, between 2008 and 2014, the number of breast reconstructions was still insufficient to meet the entire demand, when taking into account the number of mastectomies performed. Even so, there has been a significant increase in breast reconstructions over the years.…”

Section: Discussionmentioning

confidence: 99%

“…To counteract these effects, breast reconstruction in Brazil has been increased by the Public Health System 4 , with the aim of improving the quality of life of women undergoing surgical treatment for breast cancer. As such, the goal is to establish body aesthetics and improve women's self-image by restoring the volume lost in their breast with cancer and recreating the symmetry with the contralateral breast 3 .…”

Section: Introductionmentioning

confidence: 99%

Stages of breast reconstruction and quality of life after breast cancer

Murici¹,

Barros²

2020

Mastology

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Objective: To evaluate which stage of breast reconstruction promotes improved quality of life for women treated for breast cancer, and to verify the socioeconomic and clinical factors associated with better quality of life. Methods: A cross-sectional study was conducted with 70 women treated for breast cancer in the perioperative period of late breast reconstruction in the Federal District. To assess quality of life, the Functional Assessment of Cancer Therapy — Breast (FACT-B) instrument was used. Results: Half of the women were under 50 years old. Tumor removal surgery had occurred on average 5.4 years ago. Women with axillary dissection had greater impairment in the physical well-being domain (p=0.001) and the breast cancer subscale (p=0.016). Among women who had undergone surgery more than one year previously, there were higher domains of emotional (p=0.006) and functional (p=0.003) well-being. Women who underwent breast reconstruction had higher values in the social/family well-being (p<0.001), emotional well-being (p=0.001), functional well-being (p=0.001), and breast cancer subscale (p=0.005) domains; and on the FACT-B score (p<0.001), right after the first stage. Conclusions: Breast reconstruction favored better quality of life from the first stage, suggesting that this therapeutic modality should be offered promptly, whenever possible, and guaranteed for all women treated for breast cancer.

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“…Breast-conserving surgery is widely used today in the treatment of locoregional breast cancer 1 . When radical surgery is required, immediate or delayed, breast reconstruction can be performed in a large proportion of cases.…”

Section: Introductionmentioning

confidence: 99%

The cosmetic outcome of breast reconstruction: reproducibility of different methods assessed by different professionals

Bayeh¹,

Paulinelli²,

Soares³

et al. 2019

Mastology

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Objetivo: Comparar a reprodutibilidade de métodos diferentes de avaliação dos resultados estéticos de cirurgias reconstrutivas da mama, por avaliadores distintos. Métodos: Foram incluídas fotografias de 270 pacientes portadoras de neoplasia da mama que passaram por cirurgias reconstrutivas da mama. As notas da avaliação foram dadas por um cirurgião plástico, um residente em cirurgia plástica, dois mastologistas, dois residentes em mastologia e dois psicólogos. Foram utilizadas as escalas de Harvard e Garbay modificada e a nota objetiva do programa BCCT.core. Foram calculados os índice Kappa de concordância interobservador e de correlação de Spearman. Resultados: A média de idade das pacientes foi de 55,7 anos (±11,1). No geral, 145 (53,7%) mulheres foram submetidas a tratamento conservador com cirurgia oncoplástica e 125 (46,3%) passaram por mastectomia e reconstrução total. A média de tempo de seguimento foi de 63,7±45,6 meses. Para a escala de Harvard, houve uma reprodutibilidade interobservador razoável para os diferentes profissionais, enquanto na escala de Garbay, a reprodutibilidade foi pobre entre os profissionais. De forma geral, a nota dada pelo programa BCCT.core correlacionou-se moderadamente com a escala de Harvard e a de Garbay modificada. Conclusão: As escalas de Harvard e de Garbay modificada correlacionam-se igualmente de forma moderada com o teste objetivo (BCCT.core). A escala de Harvard tem menor variabilidade interobservador, se comparada com a escala de Garbay.PALAVRAS-CHAVE: neoplasias da mama; procedimentos cirúrgicos reconstrutivos; cirurgia plástica. RESUMO ABSTRACTObjective: To compare the reproducibility of different methods for assessing the cosmetic outcome of breast reconstruction, which was assessed by different health professionals. Methods: Photographs of 270 breast cancer patients who had been submitted to breast reconstruction of some type were included. A plastic surgeon, a resident in plastic surgery, two mastologists, two residents in mastology, and two psychologists performed the evaluation. The modified Garbay and Harvard scales and the objective BCCT. core software program were used. Cohen's Kappa and Spearman correlation coefficients were calculated. Results: The mean age of the patients was 55.7 (±11.1) years. Overall, 145 women (53.7%) underwent partial breast reconstruction and 125 (46.3%), total breast reconstruction. The mean follow-up time was 63.7±45.6 months. By applying the Harvard scale, the interobserver reproducibility among the different professionals was minimal; whereas the Garbay scale had no agreement. The correlations between the BCCT.core software program and the Harvard and modified Garbay scales were moderate. Conclusion: Correlations between both the modified Garbay scale and the Harvard scale and the objective (BCCT.core) test were moderate. There was less interobserver variability with the Harvard scale compared to the modified Garbay scale.

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Trends in breast cancer surgery at Brazil's public health system

Abstract: We found a significant increase in breast reconstruction in public health system in Brazil, and also a reduction in simple mastectomy and axillary lymphadenectomy.

Cited by 25 publications

References 29 publications

Nationwide population-based study of trends and regional variation in breast-conserving treatment for breast cancer

Nationwide population-based study of trends and regional variation in breast-conserving treatment for breast cancer

Stages of breast reconstruction and quality of life after breast cancer

The cosmetic outcome of breast reconstruction: reproducibility of different methods assessed by different professionals

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