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Tulin Cil - One of the best experts on this subject based on the ideXlab platform.
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concurrent Risk Reduction Surgery in patients with increased lifetime Risk for breast and ovarian cancer an analysis of the national surgical quality improvement program nsqip database
Breast Cancer Research and Treatment, 2018Co-Authors: Maryam Elmi, Arash Azin, Ahmad Elnahas, David R Mccready, Tulin CilAbstract:Patients with genetic susceptibility to breast and ovarian cancer are eligible for Risk-Reduction Surgery. Surgical morbidity of Risk-Reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. A retrospective cohort analysis was conducted using the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP) 2007–2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO. Patients with genetic susceptibility to breast/ovarian cancer undergoing Risk-Reduction Surgery were identified. The primary outcome was 30-day postoperative major morbidity. Secondary outcomes included surgical site infections, reoperations, readmissions, length of stay, and venous thromboembolic events. A multivariate analysis was performed to determine predictors of postoperative morbidity and the adjusted effect of concurrent BSO on morbidity. Of the 5470 patients undergoing RRM, 149 (2.7%) underwent concurrent BSO. The overall rate of major morbidity and postoperative infections was 4.5% and 4.6%, respectively. There was no significant difference in the rate of postoperative major morbidity (4.5% vs 4.7%, p = 0.91) or any of the secondary outcomes between patients undergoing RRM without BSO vs. those undergoing RRM with concurrent BSO. Multivariable analysis showed Body Mass Index (OR 1.05; p < 0.001) and smoking (OR 1.78; p = 0.003) to be the only predictors associated with major morbidity. Neither immediate breast reconstruction (OR 1.02; p = 0.93) nor concurrent BSO (OR 0.94; p = 0.89) were associated with increased postoperative major morbidity. This study demonstrated that RRM with concurrent BSO was not associated with significant additional morbidity when compared to RRM without BSO. Therefore, this joint approach may be considered for select patients at Risk for both breast and ovarian cancer.
David R Mccready - One of the best experts on this subject based on the ideXlab platform.
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concurrent Risk Reduction Surgery in patients with increased lifetime Risk for breast and ovarian cancer an analysis of the national surgical quality improvement program nsqip database
Breast Cancer Research and Treatment, 2018Co-Authors: Maryam Elmi, Arash Azin, Ahmad Elnahas, David R Mccready, Tulin CilAbstract:Patients with genetic susceptibility to breast and ovarian cancer are eligible for Risk-Reduction Surgery. Surgical morbidity of Risk-Reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. A retrospective cohort analysis was conducted using the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP) 2007–2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO. Patients with genetic susceptibility to breast/ovarian cancer undergoing Risk-Reduction Surgery were identified. The primary outcome was 30-day postoperative major morbidity. Secondary outcomes included surgical site infections, reoperations, readmissions, length of stay, and venous thromboembolic events. A multivariate analysis was performed to determine predictors of postoperative morbidity and the adjusted effect of concurrent BSO on morbidity. Of the 5470 patients undergoing RRM, 149 (2.7%) underwent concurrent BSO. The overall rate of major morbidity and postoperative infections was 4.5% and 4.6%, respectively. There was no significant difference in the rate of postoperative major morbidity (4.5% vs 4.7%, p = 0.91) or any of the secondary outcomes between patients undergoing RRM without BSO vs. those undergoing RRM with concurrent BSO. Multivariable analysis showed Body Mass Index (OR 1.05; p < 0.001) and smoking (OR 1.78; p = 0.003) to be the only predictors associated with major morbidity. Neither immediate breast reconstruction (OR 1.02; p = 0.93) nor concurrent BSO (OR 0.94; p = 0.89) were associated with increased postoperative major morbidity. This study demonstrated that RRM with concurrent BSO was not associated with significant additional morbidity when compared to RRM without BSO. Therefore, this joint approach may be considered for select patients at Risk for both breast and ovarian cancer.
Arash Azin - One of the best experts on this subject based on the ideXlab platform.
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concurrent Risk Reduction Surgery in patients with increased lifetime Risk for breast and ovarian cancer an analysis of the national surgical quality improvement program nsqip database
Breast Cancer Research and Treatment, 2018Co-Authors: Maryam Elmi, Arash Azin, Ahmad Elnahas, David R Mccready, Tulin CilAbstract:Patients with genetic susceptibility to breast and ovarian cancer are eligible for Risk-Reduction Surgery. Surgical morbidity of Risk-Reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. A retrospective cohort analysis was conducted using the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP) 2007–2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO. Patients with genetic susceptibility to breast/ovarian cancer undergoing Risk-Reduction Surgery were identified. The primary outcome was 30-day postoperative major morbidity. Secondary outcomes included surgical site infections, reoperations, readmissions, length of stay, and venous thromboembolic events. A multivariate analysis was performed to determine predictors of postoperative morbidity and the adjusted effect of concurrent BSO on morbidity. Of the 5470 patients undergoing RRM, 149 (2.7%) underwent concurrent BSO. The overall rate of major morbidity and postoperative infections was 4.5% and 4.6%, respectively. There was no significant difference in the rate of postoperative major morbidity (4.5% vs 4.7%, p = 0.91) or any of the secondary outcomes between patients undergoing RRM without BSO vs. those undergoing RRM with concurrent BSO. Multivariable analysis showed Body Mass Index (OR 1.05; p < 0.001) and smoking (OR 1.78; p = 0.003) to be the only predictors associated with major morbidity. Neither immediate breast reconstruction (OR 1.02; p = 0.93) nor concurrent BSO (OR 0.94; p = 0.89) were associated with increased postoperative major morbidity. This study demonstrated that RRM with concurrent BSO was not associated with significant additional morbidity when compared to RRM without BSO. Therefore, this joint approach may be considered for select patients at Risk for both breast and ovarian cancer.
Alanna M Rebecca - One of the best experts on this subject based on the ideXlab platform.
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outcomes of concurrent breast and gynecologic Risk Reduction Surgery
Annals of Surgical Oncology, 2017Co-Authors: Irene T, Richard Gray, Nabil Wasif, Kristina A Butler, Jeffrey L Cornella, Javier F Magrina, Paul M Magtibay, William J Casey, Raman C Mahabir, Alanna M RebeccaAbstract:Background Women considering Risk Reduction Surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic Surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated multispecialty Surgery.
Terri W Mchugh - One of the best experts on this subject based on the ideXlab platform.
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factors influencing Risk Reduction Surgery among brca mutation carriers a qualitative analysis
Journal of Clinical Oncology, 2012Co-Authors: Rachael Brandt, Cristina Polinsky, Jessica Katz, Minal Dhamankar, Rosemarie Tucci, Jennifer L Sabol, Terri W MchughAbstract:53 Background: Women known to carry deleterious mutations in BRCA1 and BRCA2 have a substantially increased lifetime Risk to develop breast and ovarian cancer. Current Risk management options include increased surveillance, chemoprevention and Risk reducing Surgery. Several studies have quantitatively evaluated the reasoning of high Risk women for electing surgical intervention, noting mutation carrier status as a significant, but not sole rationale for this decision. The decision for Surgery has also been associated with family cancer history, anxiety, demographics, healthcare setting and prior counseling. More insights regarding factors influencing women’s choice for Risk Reduction are needed. Methods: To further assess factors influencing the decision to have Risk Reduction Surgery among women in a community hospital system, 129 BRCA mutation carriers in a community-based genetic counseling program were invited to participate in a qualitative study using questionnaires. A thematic analysis was performe...
