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Tay MRJ, Wong CJ, Aw HZ. Prevalence and associations of axillary web syndrome in Asian women after breast cancer surgery undergoing a community-based cancer rehabilitation program. BMC Cancer 2021; 21:1019. [PMID: 34521359 PMCID: PMC8439086 DOI: 10.1186/s12885-021-08762-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background Patients who have breast cancer surgery are at risk of axillary web syndrome (AWS), an under-recognized postsurgical complication which can result in shoulder morbidity and functional impairment. Emerging studies have indicated that AWS may persist beyond the first few months after surgery, although few studies have assessed the prevalence and association of AWS beyond a year after diagnosis. Therefore, the aim of this study was to investigate the prevalence and associations for AWS in post-operative breast cancer patients up to 3 years after surgery. Methods This cross sectional observational study was conducted at a community-based cancer rehabilitation center. Patients were evaluated for the presence of AWS via physical examination. Disease-related data was obtained from clinical review and medical records. Descriptive statistics were utilized to illustrate patient demographics and clinical characteristics. Logistic regression analyses were used to determine associations of AWS. Results There were 111 Asian women who were recruited, who had undergone breast surgery and were referred to a national outpatient rehabilitation center. The prevalence of AWS in this population was 28.9%. In the multivariate regression model, significant factors were age < 50 years (OR = 3.51; 95% CI = 1.12–11.0; p = 0.031) and ALND (OR = 6.54; 95% CI = 1.36–31.3; p = 0.019). There was reduced shoulder flexion ROM (p < 0.001) in patients with AWS compared to patients without AWS. Conclusions A high prevalence of AWS was reported in breast cancer survivors even at 3 years after breast surgery. Our findings highlight the need to identify breast cancer survivors with AWS even in the survivorship phase, and develop strategies to raise awareness and minimize functional impairment in these patients.
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Affiliation(s)
- Matthew Rong Jie Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. .,Singapore Cancer Society Rehabilitation Center, Singapore Cancer Society, Singapore, Singapore.
| | - Chin Jung Wong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.,Singapore Cancer Society Rehabilitation Center, Singapore Cancer Society, Singapore, Singapore
| | - Hui Zhen Aw
- Singapore Cancer Society Rehabilitation Center, Singapore Cancer Society, Singapore, Singapore
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2
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Monib S, Chong K. Mondor's Disease of the Arm Following Breast Cancer Treatment. Cureus 2021; 13:e13421. [PMID: 33758712 PMCID: PMC7978151 DOI: 10.7759/cureus.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mondor's disease is a rare, peculiar form of superficial thrombophlebitis which mainly affects the subcutaneous veins of the breast, anterior chest wall, neck, axilla, upper limbs and penis. In most cases, it presents with rapid development of a painful subcutaneous cord-like structure that later becomes less painful, but a fibrous band persists. Unfortunately, aetiology and management are not very clear, but it is a self-limiting condition in most cases. We are presenting a rare case of a patient who developed Mondor's disease in the antecubital fossa of the right arm following chemotherapy for breast cancer.
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Affiliation(s)
- Sherif Monib
- Breast Surgery, West Hertfordshire Hospitals NHS Trust, St. Albans, GBR
| | - Kelvin Chong
- Breast Surgery, West Hertfordshire Hospitals NHS Trust, St. Albans, GBR
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3
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Obradovic K, Adzic N, Pavlovic Stankovic D, Petkovic I, Urban V, Milosevic Z. Superficial Thrombophlebitis of the Breast (Mondor's Disease): An Uncommon Localization of Common Disease. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2020; 13:1179547620972414. [PMID: 33239933 PMCID: PMC7673048 DOI: 10.1177/1179547620972414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/20/2020] [Indexed: 11/16/2022]
Abstract
Mondor's disease (MD), or superficial thrombophlebitis of the anterolateral thoracoabdominal wall, is a rare disease that presents with a palpable cord-like induration beneath the skin. It is a benign, self-limiting condition with probably underestimated significance due to the fact it may be a rare manifestation of an underlying breast carcinoma. It can also resemble breast malignancy and, if physician is not familiar with clinical features of MD, it may lead to unnecessary biopsy. The diagnosis is straightforward in most cases and it may be based on a thorough history and physical examination and it can be ultrasonographically confirmed. Raising awareness of this condition may facilitate recognition and diagnosing MD and eventually limit unnecessary diagnostic procedures.
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Affiliation(s)
- Katarina Obradovic
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Nina Adzic
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Dragana Pavlovic Stankovic
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ivana Petkovic
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Vladimir Urban
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Zorica Milosevic
- Clinic for Radiation Oncology and Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Viana MP, Tucunduva TCDM, Torres US, Aguillar VLN, Bresciani BH, Shimizu C, Chala LF, Barros ND, Mello GGND. Imaging of male breast disease: the good, the bad and the ugly - A pictorial review. Clin Imaging 2020; 68:45-56. [PMID: 32570009 DOI: 10.1016/j.clinimag.2020.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022]
Abstract
The male breast is affected by a broad spectrum of conditions, ranging from benign to malignant, many of which are similar to those occurring in its female counterpart. Despite the challenge motivated by different imaging characteristic features, correct imaging interpretation in male breast disease may aid at differentiation between benign and suspected conditions, narrow the differential diagnosis and guide subsequent management. The purpose of this review is to showcase a wide array of male breast diseases, discuss their imaging presentations and key features for diagnosis.
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Affiliation(s)
- Marcela Pacheco Viana
- Grupo Fleury, São Paulo, Brazil; Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tatiana Cardoso de Mello Tucunduva
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Bárbara Helou Bresciani
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Shimizu
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil; Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Nestor de Barros
- Grupo Fleury, São Paulo, Brazil; Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil
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5
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Kreuzpointner R, Ludwig M. Derbe, schmerzhafte Strangbildung an der ventralen Thoraxwand. GYNAKOLOGE 2019. [DOI: 10.1007/s00129-019-04540-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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6
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Lambat Emery S, Kalovidouri A, David-Montefiore E. Recurrent Mondor's breast disease -- Hormonal contraceptive involvement. Breast Dis 2019; 38:31-33. [PMID: 30530952 DOI: 10.3233/bd-180346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mondor's disease can be a challenging diagnosis. The case we present is of a 29 year-old Brazilian woman, under combined hormonal contraception, who consulted for a painful lump on her right breast. She presented a complete resolution after a local treatment of heparinoid cream and a non-steroidal anti-inflammatory oral treatment, but relapsed 18 months later. Oral combined hormonal contraception was the only "risk factor" found, in this case, and the modification of the latter helped resolve the relapse clinical symptoms.
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Affiliation(s)
- S Lambat Emery
- Department of Gynecology, Geneva University hospitals (HUG), Switzerland
| | - A Kalovidouri
- Department of Radiology, Geneva University hospitals (HUG), Switzerland
| | - E David-Montefiore
- Department of Gynecology, Geneva University hospitals (HUG), Switzerland
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Goldman A, Wollina U. Mondor's Disease after Aesthetic Breast Surgery: A Case Series and Literature Review. J Cutan Aesthet Surg 2018; 11:132-135. [PMID: 30533987 PMCID: PMC6243822 DOI: 10.4103/jcas.jcas_69_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Mondor’s disease of the subcutaneous veins of the breast is an uncommon disorder. The etiology of Mondor’s disease remains unclear. Usually, it is a self-limited disease. This condition has been associated with trauma, surgical biopsies, breast surgery (including silicone breast implant), physical activity, and a manifestation of breast cancer. Materials and Methods: This is a retrospective analysis of 652 female patients who underwent aesthetic breast surgery in the last 10 years. Results: We found three cases of Mondor’s disease after plastic surgery of the breast (0.46%) and performed an analysis of the clinical aspects and therapeutic measures. The disease onset was a couple of weeks to 2 years after surgery, never within the first 2 weeks after surgery. We did not observe ulceration or breast cancer. Treatment was unnecessary in two patients, whereas hot compresses and nonsteroidal medical drugs were prescribed in one patient. All lesions healed within 2–3 weeks. Conclusion: Mondor’s disease is a possible complication after aesthetic breast surgery but often runs a self-limiting course with spontaneous remission. It is important to exclude breast cancer. The patient should be informed that the disease runs a benign and self-limiting course.
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Affiliation(s)
- Alberto Goldman
- Clinica Goldman and Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
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8
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Shirah BH, Shirah HA, Alonazie WS. The Effectiveness of Diclofenac Sodium in the Treatment of Mondor's Disease of the Breast: The Topical Patch Compared to the Oral Capsules. Breast J 2017; 23:395-400. [PMID: 28079297 DOI: 10.1111/tbj.12752] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mondor's disease of the breast is a rare, benign sclerosing superficial thrombophlebitis of the subcutaneous veins of the anterior or lateral chest wall, which is treated conservatively. We aim in this study to evaluate the outcome and effectiveness of our treatment protocol using oral diclofenac sodium and topical diclofenac sodium patch in 172 patients. A retrospective database analysis of 172 female patients between January 2001 and December 2010 was done. The treatment protocol consisted of group 1: treatment by oral diclofenac sodium 100 mg once daily for 3 weeks. Group 2: treatment by diclofenac sodium patches for 8 hours twice daily (morning and evening) for 1 week. The patients were instructed to document the time as soon as pain relief is achieved following the patch application and the intake of the oral dose. The incidence rate was 2.49%. Diclofenac sodium patch was statistically found to be significantly better in subsiding the inflammatory process of the veins, relieving the pain, and enhancing faster healing rate. We conclude that diclofenac sodium patch showed a promising role in the treatment of Mondor's disease of the breast by significantly decreasing the inflammatory process due to its transdermal migration action within a short period and the ability to reach a high local concentration. It achieved the best results for rapid relief of pain and disease regression compared to the oral capsules. Therefore, our protocol was changed to implement diclofenac sodium patch as the first choice in treating Mondor's disease of the breast.
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Affiliation(s)
- Bader Hamza Shirah
- King Abdullah International Medical Research Center/King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hamza Assad Shirah
- Department of General Surgery, Al Ansar General Hospital, Medina, Saudi Arabia
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9
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Pasta V, D'Orazi V, Merola R, Frusone F, Amabile MI, De Luca A, Buè R, Monti M. Oncoplastic central quadrantectomies. Gland Surg 2016; 5:422-6. [PMID: 27563564 DOI: 10.21037/gs.2016.04.01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Tumors localized in the central quadrant (centrally located breast tumors) have always represented a challenge for the surgeon because of the critical aesthetical matters related to the nipple-areola complex (NAC). Many years of experience with breast cancer patients treated by using various oncoplastic techniques, has allowed us to develop the modified hemibatwing for the treatment of central breast tumors, where the NAC is involved. Modified hemibatwing-along with the removal of the NAC-is a useful oncoplastic technique and it represents an ideal option for the treatment of central tumors because it assures oncological safety, a reduced surgical timetable and greater aesthetical results.
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Affiliation(s)
- Vittorio Pasta
- Department of General Surgery, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy;; Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Valerio D'Orazi
- Department of General Microsurgery and Hand Surgery, Fabia Mater Hospital, I-00171 Rome, Italy
| | - Raffaele Merola
- Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Federico Frusone
- Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Alessandro De Luca
- Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Rosanna Buè
- Department of Surgical Science, Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - Marco Monti
- Department of Gynecology and Obstetrics, Sapienza University of Rome, 00161 Rome, Italy
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10
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Follacchio GA, Monteleone F, Anibaldi P, De Vincentis G, Iacobelli S, Merola R, D'Orazi V, Monti M, Pasta V. A modified sentinel node and occult lesion localization (SNOLL) technique in non-palpable breast cancer: a pilot study. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2015; 34:113. [PMID: 26445493 PMCID: PMC4596463 DOI: 10.1186/s13046-015-0230-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/29/2015] [Indexed: 12/30/2022]
Abstract
Background The spread of mammographic screening programs has allowed an increasing amount of early breast cancer diagnosis. A modern approach to non-palpable breast lesions requires an accurate intraoperative localization, in order to achieve a complete surgical resection. In addiction, the assessment of lymph node status is mandatory as it represents a major prognostic factor in these patients. The aim of this study is to evaluate the reliability of a modified technical approach using a single nanocolloidal radiotracer to localize both sentinel node and breast occult lesion. Methods Twenty-five patients with a single non-palpable breast lesions and clinically negative axilla were enrolled. In the same day of surgery, patients underwent intratumoral and peritumoral administration of 99mTc-labeled nanocolloid tracer under sonographic guidance. A lymphoscintigraphy was performed to localize the sentinel lymph node and its cutaneous projection was marked on the skin in order to guide the surgeon to an optimal incision. During surgery an hand-held gamma-detection probe was used to select the best surgical access route and to guide localization of both occult breast lesion and sentinel lymph node. After specimen excision, the surgical field was checked with the gamma-probe to verify the absence of residual sources of significant radioactivity, thereby ensuring a radical treatment in a single surgical session and minimizing normal tissue excision. Results Both targeted breast lesion and sentinel lymph node were localized and removed at the first attempt in every patients and histopathological diagnosis of malignancy was confirmed in 25/26 samples. Non-palpable lesions were included within the surgical margins in all patients and in all samples surgical margins were free from neoplastic infiltration thus avoiding any further reintervention. Only two patients showed metastatic involvement of sentinel lymph node. Conclusions The modified sentinel node and occult lesion localization (SNOLL) technique performed with a single injection of nanocolloidal radiotracer has shown an excellent intraoperative identification rate of both non-palpable lesion and sentinel lymph node. This procedure offers, as opposed to standard techniques, an accurate, simple and reliable approach to the management of non-palpable breast cancer.
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Affiliation(s)
- Giulia Anna Follacchio
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Nuclear Medicine Unit, "Sapienza" University of Rome, Rome, Italy.
| | - Francesco Monteleone
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Nuclear Medicine Unit, "Sapienza" University of Rome, Rome, Italy.
| | - Paolo Anibaldi
- Breast Unit, Department of General Surgery, "San Camillo de Lellis" Hospital, Rieti, Italy.
| | - Giuseppe De Vincentis
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Nuclear Medicine Unit, "Sapienza" University of Rome, Rome, Italy.
| | - Silvia Iacobelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Nuclear Medicine Unit, "Sapienza" University of Rome, Rome, Italy.
| | - Raffaele Merola
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
| | - Valerio D'Orazi
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy. .,Department of General Microsurgery and Hand Surgery, "Fabia Mater" Hospital, Via Olevano Romano 25, 00171, Rome, Italy.
| | - Massimo Monti
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
| | - Vittorio Pasta
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
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