European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
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Comparative Study
Ductal carcinoma in situ of the breast. Long-term follow-up of health-related quality of life, emotional reactions and body image.
To investigate and compare long-term health-related quality of life (HRQoL), body image, and emotional reactions in women with ductal carcinoma in situ of the breast (DCIS) treated with different surgical methods. ⋯ Women treated for DCIS have a very satisfactory long-term HRQoL. However, body image appeared to be negatively affected in mastectomy and IBR patients. Our results indicate that these women need more preoperative information about what changes in body image to expect after surgery.
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English national guidelines recommend that breast reconstruction is made available to women with breast cancer undergoing mastectomy. We examined the use of immediate reconstruction (IR) across English Cancer Networks, who are responsible for the regional organisation of cancer services and ensuring equitable access to treatment. ⋯ There is substantial regional variation in immediate reconstruction use in England that is not explained by the characteristics of the local patient population. English Cancer Networks should act to reduce this variation. They should also examine why rates of reconstruction differ between particular patient groups.
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Comparative Study
Does immediate breast reconstruction using free flaps lead to delay in the administration of adjuvant chemotherapy for breast cancer?
Immediate breast reconstruction (IBR) using Free flaps is becoming increasingly popular. However, these are complex surgical procedures with more complications and longer recovery time, which can potentially delay adjuvant treatment. Our aim is to investigate the impact of free flap IBR on the timing of adjuvant treatment. ⋯ There is a significant delay in the commencement of adjuvant treatment after mastectomy and free flap IBR in comparison to mastectomy alone patients due to reconstruction related surgical complications. The effects of this delay on survival have not been fully investigated yet and may be significant for at least some of the patients.