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Di Pace B, Padley RH. Enhancing treatment compliance in breast cancer patients: A multi-faceted approach. J Surg Oncol 2024. [PMID: 38798274 DOI: 10.1002/jso.27679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Bruno Di Pace
- Division of Clinical and Translational Oncology, Scuola Superiore Meridionale, Naples, Italy
- School of Medicine, Anglia Ruskin University, Cambridge and Chelmsford, UK
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari, Italy
| | - Roxanne H Padley
- University Language Centre, University of Bergamo, Bergamo, Italy
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Di Pace B, Padley RH. Breast cancer survivorship: A viewpoint. J Surg Oncol 2024. [PMID: 38764328 DOI: 10.1002/jso.27680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Affiliation(s)
- Bruno Di Pace
- Clinical and Translational Oncology Division, Scuola Superiore Meridionale, Naples, Italy
- School of Medicine, Anglia Ruskin University, Cambridge and Chelmsford, UK
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Roxanne H Padley
- University Language Centre, University of Bergamo, Bergamo, Italy
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Di Pace B, Padley RH. Survivorship and breast cancer: Navigating the continuum of care. J Surg Oncol 2024. [PMID: 38691643 DOI: 10.1002/jso.27671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Bruno Di Pace
- Scuola Superiore Meridionale, Naples, Italy
- School of Medicine, Anglia Ruskin University, Cambridge and Chelmsford, UK
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Roxanne H Padley
- University Language Centre, University of Bergamo, Bergamo, Italy
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Di Pace B, Padley RH. Empowering Patients Through Shared Decision Making in Breast Cancer Consultations. Aesthetic Plast Surg 2024:10.1007/s00266-024-03937-y. [PMID: 38459380 DOI: 10.1007/s00266-024-03937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
Receiving a breast cancer diagnosis renders breast cancer consultations pivotal moments in a patient's journey, where decisions about treatment options, including breast reconstruction, can profoundly impact their physical and emotional well-being. Shared decision making (SDM) is a collaborative approach that involves healthcare professionals and patients working together to make decisions that align with the patient's values, preferences, and goals. SDM can hence lead to: 1. informed choices and patient empowerment; 2. enhanced patient satisfaction. One of the key decisions that patients face is whether or not to undergo breast reconstruction and the varying options available. However, while SDM has proven benefits, there still appears to be a lack of knowledge among some healthcare professionals. Hence, suggestions for mitigation include the employment of patient decision aids and clear communication strategies.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Bruno Di Pace
- Clinical and Translational Oncology Division, Scuola Superiore Meridionale, Via Mezzocacnnone, 4, 80138, Naples, Italy.
- School of Medicine, Anglia Ruskin University, Cambridge, Chelmsford, UK.
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
| | - Roxanne H Padley
- University Language Centre, University of Bergamo, Bergamo, Italy
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Rubenstein RN, Stern CS, Plotsker EL, Haglich K, Tadros AB, Mehrara BJ, Matros E, Nelson JA. Effects of COVID-19 on mastectomy and breast reconstruction rates: A national surgical sample. J Surg Oncol 2022; 126:205-213. [PMID: 35411946 PMCID: PMC9088456 DOI: 10.1002/jso.26889] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
Background The COVID‐19 pandemic profoundly impacted breast cancer treatment in 2020. Guidelines initially halted elective procedures, subsequently encouraging less invasive surgeries and restricting breast reconstruction options. We examined the effects of COVID‐19 on oncologic breast surgery and reconstruction rates during the first year of the pandemic. Methods Using the National Surgical Quality Improvement Program, we performed an observational examination of female surgical breast cancer patients from 2017 to 2020. We analyzed annual rates of lumpectomy, mastectomy (unilateral/contralateral prophylactic/bilateral prophylactic), and breast reconstruction (alloplastic/autologous) and compared 2019 and 2020 reconstruction cohorts to evaluate the effect of COVID‐19. Results From 2017 to 2020, 175 949 patients underwent lumpectomy or mastectomy with or without reconstruction. From 2019 to 2020, patient volume declined by 10.7%, unilateral mastectomy rates increased (70.5% to 71.9%, p = 0.003), and contralateral prophylactic mastectomy rates decreased. While overall reconstruction rates were unchanged, tissue expander reconstruction increased (64.0% to 68.4%, p < 0.001) and direct‐to‐implant and autologous reconstruction decreased. Outpatient alloplastic reconstruction increased (65.7% to 73.8%, p < 0.0001), and length of hospital stay decreased for all reconstruction patients (p < 0.0001). Conclusions In 2020, there was a nearly 11% decline in breast cancer surgeries, comparable mastectomy and reconstruction rates, increased use of outpatient alloplastic reconstruction, and significantly reduced in‐hospital time across all reconstruction types.
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Affiliation(s)
- Robyn N Rubenstein
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carrie S Stern
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ethan L Plotsker
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Haglich
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Audree B Tadros
- Breast Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Babak J Mehrara
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Evan Matros
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Padley RH, Di Pace B. Touch-ups, Rejuvenation, Re-dos and Revisions: Remote Communication and Cosmetic Surgery on the Rise. Aesthetic Plast Surg 2021; 45:3078-3080. [PMID: 33797578 PMCID: PMC8018227 DOI: 10.1007/s00266-021-02235-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/13/2022]
Abstract
The way in which communication takes place has undergone significant change over the last year leading to alterations regarding the way we perceive our own personal image. Indeed, the increase in remote video interaction seems to have led to an increase in the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA), the so-called Zoom Boom. The reasons connected to this increase are still under investigation, but it is likely that patients' greater exposure to seeing their own image in online video communication for prolonged periods has highlighted what patients perceive as flaws and/or their self-image does not correspond to the same image that they see in the mirror. However, the motivations for seeking cosmetic surgery cannot be solely attributed to seeing ourselves online more frequently; the psychological impact of the pandemic (lower moods, isolation and greater concerns) may also be to blame. Therefore, the reasons patients hope to touch-up, rejuvenate, re-do or revise their "lockdown faces" need careful attention with a view to understand the extent of which the online distortion of one's own body image may be the underlying cause.Level of Evidence V "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."
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Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3852. [PMID: 34584831 PMCID: PMC8460228 DOI: 10.1097/gox.0000000000003852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022]
Abstract
Introduction The COVID-19 pandemic posed unique challenges for breast reconstruction. Many professional organizations initially placed restrictions on breast reconstruction, leading surgeons to conceive innovative protocols for offering breast reconstruction. This study reviewed the current evidence on breast reconstruction during the COVID-19 pandemic to provide guidance for surgeons facing future crises. Methods The MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched for studies (1) describing implant and autologous breast reconstruction following mastectomy and (2) occurring during or pertaining to the COVID-19 pandemic. Results Of the 1347 studies identified, 26 were included. Studies discussed type of reconstruction (18, 69%), complications (11, 42%), timing of reconstruction (10, 38%), protocols (10, 38%), COVID-19 screening (7, 27%), and length of hospital stay (7, 27%). The type of reconstruction varied depending on the stage of the pandemic: early on, autologous breast reconstruction was halted to preserve resources, but was later resumed. Within implant-based reconstruction, direct-to-implant was favored over serial tissue expansion. Several protocols were developed, with many emphasizing multidisciplinary collaborations for patient selection, use of specialized measures to reduce risk of COVID-19 transmission, and optimization of same-day discharge. Complication rates following breast reconstruction were similar to pre-pandemic rates. Conclusions The COVID-19 pandemic has forever changed the landscape of breast reconstruction by raising important questions about delivery of care, cost, and resource utilization. The findings of this review may inform surgeons as they plan for similar future crises or strive for improved patient care and efficacy even during nonpandemic times.
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The Psychological Impact of Remote Communication on Body-Image Perception: Cosmetic Surgery on the Rise. Aesthetic Plast Surg 2021; 46:1507-1509. [PMID: 34467420 PMCID: PMC8407135 DOI: 10.1007/s00266-021-02554-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022]
Abstract
Abstract In recent times the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA) has increased. The correlation between this increase and the concept of “Zoom Boom” changing how we perceive our image is under speculation. However, this could also be linked to the psychological impact of the pandemic on patients’ moods. This study investigated the correlation between the pandemic era and seeking cosmetic surgery while focusing on the psychological impact of the pandemic on body-image perception. An anonymous web-based poll was distributed through social networks in Italy and the UK to patients seeking cosmetic surgery. The questions gathered responses on: 1. patient demographics; 2. cosmetic procedures requested; 3. motivations; 4. delays to cosmetic surgery caused by the pandemic; 5. pandemic effects on mood; 6. influence of video conferencing on body-image perception. A total of 159 respondents completed the online poll. Patients were more inclined to undergo cosmetic surgery during the pandemic citing the wish to improve their “lockdown face” (61%) and also the benefits of home recovery during smart working (36%). Eighty-one percent of respondents stated that video conferencing had impacted on their body-image perception, 95% indicated lower mood due to backlogs and surgery delays, while 72% of participants noted declined body-image perception during the pandemic. Data suggest that although video conferencing appears to play a key role in rising requests for cosmetic surgery consultations, a patient’s negative self-perception is also likely linked to the psychological impact of the pandemic on mood levels. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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PADLEY RH, DI PACE B. Medical advances in telehealth and innovative communication: new directions. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.21.04606-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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