Perioperative Management of Breast Cancer Surgery
Breast cancer (BC) is the most common invasive cancer affecting women worldwide. Therefore, early prevention and detection by self-breast examination (SBE) remains a strong recommendation by the American Cancer Society. Upon diagnosing, additional tests are performed to identify the stage and appropriate treatments. Survival rate of BC depends on the age and time of diagnosis, tumor size at advanced stage, and positive lymph node. Several risk factors include female sex, obesity, sedentary activities, drinking alcohol, hormone replacement during menopause, ionizing radiation, early age of first menstruation and old age. Perioperative management will vary based on preexisting conditions/comorbidities of each patient. Ongoing global research efforts and investigations focus into the causes, treatment of metastatic BC, risk reduction techniques, management, new laboratory and imaging tests, and supportive care of the patient/survivor. Enhanced recovery after surgery (ERAS) pathways for BC surgery and interprofessional collaboration are critical to address the emotional, physical, and spiritual needs of the patient effectively. As new therapies and more aggressive treatment measures are adopted for BC, we must be cognizant of the particular complications in this population and remain vigilant in our efforts to minimize the risk.
KeywordsBreast cancer Risk factors Complications Enhanced recovery after surgery (ERAS) Interprofessional Collaboration
- 1.American Cancer Society. What’s new in breast cancer research? 2018a. https://www.cancer.org/cancer/breast-cancer/about/whats-new-in-breast-cancer-research.html. Accessed 11 Aug 2018.
- 2.American Cancer Society. How does breast cancer start? 2018b. https://www.cancer.org/cancer/breast-cancer/about/how-does-breast-cancer-form.html. Accessed 11 Aug 2018.
- 3.Astanehe A, Temple-Oberle C, Nielsen M, de Haas W, Lindsay R, Matthews J, et al.. An enhanced recovery after surgery pathway for microvascular breast. 2018Google Scholar
- 6.Buntic R. An atlas of microsurgery techniques & principles. 2018. http://www.microsurgery.org. Accessed 9 Sept 2018.
- 7.Chen W. Factors that modify breast cancer risk in women. 2018. Up-To-Date. Retrieved 31 Dec 2018 from www.uptodate.com
- 9.Destrebecq V, Lieveke A. Are intensive cares worthwhile for breast cancer patients: the experience of an oncological ICU. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086595/pdf/fmed-03-00050.pdf. Accessed 22 Dec 2018.
- 11.Evans DG, Graham J, O’Connell S, Arnold S, Fitzsimmons D. Familial breast cancer: summary of updated NICE guidance. Bmj, 2013;346:f3829.Google Scholar
- 15.Harlow S. Sentinel lymph node biopsy in breast cancer: techniques. 2017. Up-To-Date. Retrieved 1 Jan 2019 from www.uptodate.com
- 16.Kabel AM, Baali FH. Breast cancer: insights into risk factors, pathogenesis, diagnosis and management. J Cancer Res Treat. 2015;3(2):28–33.Google Scholar
- 17.Lee B, Agarwal J, Ascherman J, Caterson S, Gray D, Hollenbeck S, Khan S, Loeding L, Mahabir R, Miller A, Perdikis G, Schwartz J, Sieling B, Thoma A, Wolfman J, Wright J. Evidence-based clinical practice guideline: autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps. Plast Reconstr Surg. 2017;140(5):651–64.CrossRefGoogle Scholar
- 20.Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, Horton J, … Johnson PL. Society of surgical Oncology-American Society for radiation oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. Annals of surgical oncology, 2014;21(3):704–716Google Scholar
- 21.Nahabedian M. Overview of breast reconstruction. 2018. Up-To-Date. Retrieved 22 Dec 2018 from www.uptodate.com
- 23.Sebai ME, Siotos C, Payne RM, Stone JP, Seal SM, Habibi M, … Rosson GD. Enhanced recovery after surgery pathway for microsurgical breast reconstruction: a systematic review and meta-analysis. Plastic and reconstructive surgery, 2019;143(3):655–666Google Scholar
- 25.Sindali K, Harries V, Borges A, Simione S, Patel S, Vorster T, et al.. Improved patient outcomes using the enhanced recovery pathway in breast microsurgical reconstruction: a UK experience. JPRAS Open. 2018.Google Scholar
- 27.Temple-Oberle C, Shea-Budgell M, Tan M, Semple J, Schrag C, et al. Consensus review of optimal perioperative care in breast reconstruction: Enhanced Recovery after Surgery (ERAS) society recommendations. Am Soc Plast Surg. 2017;139:1056–71. https://doi.org/10.1097/PRS.0000000000003212.CrossRefGoogle Scholar
- 28.Wahab TA, Uwakwe H, Jumah M, Aransi R, Khan HK. A modified Enhanced Recovery after Surgery (ERAS): use and surgical outcome in breast cancer patients. J Biosci Med. 2018;6(03):15.Google Scholar
- 29.Wilkins EG, Hamill JB, Kim HM, Kim JY, Greco RJ, Qi J, Pusic AL. Complications in postmastectomy breast reconstruction one-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) Study. Annals of surgery, 2018;267(1):164Google Scholar
- 30.Wöckel A, Wolters R, Wiegel T, Novopashenny I, Jannni W, Kreienberg R, … BRENDA study group. The impact of adjuvant radiotherapy on the survival of primary breast cancer patients: a retrospective multicenter cohort study of 8935 subjects. Annals of oncology, 2014;25(3):628–632Google Scholar