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Forequarter amputation for recurrent breast cancer

INTRODUCTION: Localized excision combined with radiation and chemotherapy represents the current standard of care for recurrent breast cancer. However, in certain conditions a forequarter amputation may be employed for these patients. PRESENTATION OF CASE: We present a patient with recurrent breast...

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Autores principales: Pundi, Krishna N., AlJamal, Yazan N., Ruparel, Raaj K., Farley, David R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446684/
https://www.ncbi.nlm.nih.gov/pubmed/25898339
http://dx.doi.org/10.1016/j.ijscr.2015.04.018
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author Pundi, Krishna N.
AlJamal, Yazan N.
Ruparel, Raaj K.
Farley, David R.
author_facet Pundi, Krishna N.
AlJamal, Yazan N.
Ruparel, Raaj K.
Farley, David R.
author_sort Pundi, Krishna N.
collection PubMed
description INTRODUCTION: Localized excision combined with radiation and chemotherapy represents the current standard of care for recurrent breast cancer. However, in certain conditions a forequarter amputation may be employed for these patients. PRESENTATION OF CASE: We present a patient with recurrent breast cancer who had a complicated treatment history including multiple courses of chemotherapy, radiation, and local surgical excision. With diminishing treatment options, she opted for a forequarter amputation in an attempt to limit the spread of cancer. DISCUSSION: In our patient the forequarter amputation was utilized as a last resort to slow disease progression after she had failed multiple rounds of chemotherapy and received maximal radiation. Unfortunately, while she had symptomatic relief in the short-term, she had cutaneous recurrence of metastatic adenocarcinoma within 2 months of the procedure. In comparing this case with other reported forequarter amputations, patients with non-metastatic disease showed a mean survival of approximately two years. Furthermore, among patients who had significant pain prior to surgery, all patients reported pain relief, indicating a significant palliative benefit. This seems to indicate that our patient’s unfortunate outcome was anomalous compared to that of most patients undergoing forequarter amputation for recurrent breast cancer. CONCLUSION: Forequarter amputation can be judiciously used for patients with recurrent or metastatic breast cancer. Patients with recurrent disease without evidence of distant metastases may be considered for curative amputation, while others may receive palliative benefit; disappointingly our patient achieved neither of these outcomes. In the long term, these patients may still have significant psychological problems.
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spelling pubmed-44466842015-05-29 Forequarter amputation for recurrent breast cancer Pundi, Krishna N. AlJamal, Yazan N. Ruparel, Raaj K. Farley, David R. Int J Surg Case Rep Case Report INTRODUCTION: Localized excision combined with radiation and chemotherapy represents the current standard of care for recurrent breast cancer. However, in certain conditions a forequarter amputation may be employed for these patients. PRESENTATION OF CASE: We present a patient with recurrent breast cancer who had a complicated treatment history including multiple courses of chemotherapy, radiation, and local surgical excision. With diminishing treatment options, she opted for a forequarter amputation in an attempt to limit the spread of cancer. DISCUSSION: In our patient the forequarter amputation was utilized as a last resort to slow disease progression after she had failed multiple rounds of chemotherapy and received maximal radiation. Unfortunately, while she had symptomatic relief in the short-term, she had cutaneous recurrence of metastatic adenocarcinoma within 2 months of the procedure. In comparing this case with other reported forequarter amputations, patients with non-metastatic disease showed a mean survival of approximately two years. Furthermore, among patients who had significant pain prior to surgery, all patients reported pain relief, indicating a significant palliative benefit. This seems to indicate that our patient’s unfortunate outcome was anomalous compared to that of most patients undergoing forequarter amputation for recurrent breast cancer. CONCLUSION: Forequarter amputation can be judiciously used for patients with recurrent or metastatic breast cancer. Patients with recurrent disease without evidence of distant metastases may be considered for curative amputation, while others may receive palliative benefit; disappointingly our patient achieved neither of these outcomes. In the long term, these patients may still have significant psychological problems. Elsevier 2015-04-15 /pmc/articles/PMC4446684/ /pubmed/25898339 http://dx.doi.org/10.1016/j.ijscr.2015.04.018 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Pundi, Krishna N.
AlJamal, Yazan N.
Ruparel, Raaj K.
Farley, David R.
Forequarter amputation for recurrent breast cancer
title Forequarter amputation for recurrent breast cancer
title_full Forequarter amputation for recurrent breast cancer
title_fullStr Forequarter amputation for recurrent breast cancer
title_full_unstemmed Forequarter amputation for recurrent breast cancer
title_short Forequarter amputation for recurrent breast cancer
title_sort forequarter amputation for recurrent breast cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446684/
https://www.ncbi.nlm.nih.gov/pubmed/25898339
http://dx.doi.org/10.1016/j.ijscr.2015.04.018
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