Browsing by Subject "Breast Neoplasms"
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Item Advances in molecular classification and targeted therapy for breast cancer(2005-07-28) Tripathy, Debasish (Debu)Item Analysis of Neurocognitive Elements of Attention Following Chemotherapy Treatment(2013-01-16) Grosch, Maria Catherine; Cullum, C. MunroBreast cancer affects approximately 123 out of 100,000 women per year in the United States, with 207,090 new cases estimated each year (Altekruse et al., 2010). Adjuvant chemotherapy has become a staple of care to improve long-term outcomes for several types of breast cancers (de Boer, Taskila, Ojajärvi, van Dijk, & Verbeek, 2009). Because of advances in treatment, the overall 5-year survival rate for breast cancer patients is now estimated at 89% (Altekruse et al., 2010). With increased survival comes a greater concern for issues related to quality of life, including cognitive function. Unfortunately, cancer treatments may result in cognitive changes or impairment, with deficits ranging from minor to debilitating (Argyriou, Assimakopoulos, Iconomou, Giannakopoulou, & Kalofonos, 2011). The phenomenon of cognitive dysfunction following cancer treatment is often called “chemo-brain” by patients and in the media. Despite an increase in the number of published studies in recent years, many aspects of chemotherapy-related cognitive dysfunction remain poorly understood. The pattern of cognitive impairment and neurological damage (as seen on neuroimaging) is reflective of disruption of frontal subcortical networks (Meyers, 2008). Because attention and related constructs are of central importance in this so-called “subcortical profile,” it is important to have a thorough understanding of how these domains are impacted by chemotherapy. However, available literature is difficult to interpret, in part because of various methodological factors, including the use of singular or otherwise limited neuropsychological tests, inconsistent use of tests across studies, and variability in the conceptualization of domains believed to be affected by chemotherapy (such as attention and related constructs). Thus, conclusions regarding attentional impairment in women treated for breast cancer are limited, and its role in the clinical syndrome known as chemo-brain remains poorly understood.Item Aspirin Use Is Associated with Improved Outcomes in Inflammatory Breast Cancer Patients(2023-05-01T05:00:00.000Z) Johns, Christopher Lee; Kim, D. W. Nathan; Alluri, Prasanna; Liu, Yu-LunPURPOSE: Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer and has a high propensity for distant metastases. Our previous data suggested that aspirin (ASA) use may be associated with reduced risk of distant metastases in aggressive BC; however, there are no reported studies on the potential benefit of ASA use in patients with IBC. METHODS: Data from patients with non-metastatic IBC treated between 2000-2017 at two institutions, were reviewed. Overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS) were performed using Kaplan-Meier analysis. Univariate and multivariable logistic regression models were used to identify significant associated factors. RESULTS: Of 59 patients meeting the criteria for analysis and available for review, 14 ASA users were identified. ASA users demonstrated increased OS (p=.03) and DMFS (p=.02), with 5-year OS and DMFS of 92% (p=.01) and 85% (p=.01) compared to 51% and 43%, respectively, for non-aspirin users. In univariate analysis, pT stage, pN stage, and aspirin use were significantly correlated (p < .05) with OS and DFS. On multivariable analysis, ASA use (HR=.11, CI 0.01- 0.8) and lymph node stage (HR=5.9, CI 1.4-25.9) remained significant for OS and DFS (aspirin use (HR =0.13, CI 0.03-0.56) and lymph node stage (HR=5.6, CI 1.9-16.4). CONCLUSION: ASA use during remission was associated with significantly improved OS and DMFS in patients with IBC. These results suggest that ASA may provide survival benefits to patients with IBC. Prospective clinical trials of ASA use in patients with high-risk IBC in remission should be considered.Item The biological therapy of breast cancer: Molecular targets and monoclonal antibodies HER2 and herceptin(2003-05-08) Haley, Barbara B.Item BRCA1 and BRCA2: genes with frequent mutations that predispose to breast and ovarian cancer(1997-07-03) Taurog, Joel D.Item Breast cancer prevention myths versus facts(2011-12-02) Klemow, DawnItem Can breast cancer be prevented?(1999-09-16) Yardley, Denise A.Item A case for onco-cardiology: late cardiac effects after treatment for breast cancer(2013-07-12) Andrews, Thomas C.Item Characterization of the Role of the PP2A-AB Gene, a Putative Tumor Suppressor, in Cell Growth and Tumorigenesis(2005-05-11) Esplin, Edward D.; Mumby, Marc C.The PP2A-Aβ gene (PPP2R1B) encodes the β isoform of the A subunit of serine/threonine protein phosphatase 2A. Mutations in PP2A-Aβ have been identified in a wide variety of human cancers. The important role of protein phosphatase 2A in down regulating cell growth suggests these mutations may contribute to cancer susceptibility and tumorigenesis by compromising the function of PP2A-Aβ and that PP2A-Aβ may act as a tumor suppressor. Screening of cancer patient DNAs revealed an association between a germline alteration of the PP2A-Aβ and breast carcinoma and identified alterations of PP2A-Aβ in lung carcinoma and ALL patient genomic DNAs. The biochemical consequences of these PP2A-Aβ mutations on PP2A function were investigated by in vitro and in vivo coimmunoprecipitations between the PP2A-Aβ subunit and the B and C subunits of PP2A. These studies showed mutations in PP2A-Aβ confer a loss of function by reducing its ability to bind the B and C subunits, destabilizing the PP2A-Aβ containing PP2A complex. The affect of the PP2A-Aβ gene on cell growth was analyzed by transfecting the PP2A-Aβ gene into cancer cell line deficient for wild type PP2A-Aβ and deriving stable cell lines. The PP2A-Aβ gene appeared to confer a relative disadvantage to transfected cells, resulting in a lower fraction of derived stable lines compared to controls. These cell lines were tested for proliferation and colony formation in soft agar. No significant difference was observed in the growth rate of PP2A-Aβ cell lines compared to controls. One of the PP2A-Aβ stable cell lines demonstrated dramatic suppression of colony formation in soft agar, but this was not confirmed in any additional PP2A-Aβ stable cell lines, leaving this finding inconclusive. The stable cell lines were also analyzed by Western blotting for changes in the Wnt signaling cascade. Cell lines expressing exogenous PP2A-Aβ are found to have lower levels of β-catenin compared to control cell lines. This suggests that the PP2A-Aβ gene is involved in regulating the Wnt signaling pathway, which is shown to be involved in cell growth control and is similarly affected by known tumor suppressor genes.Item Clinical issues in breast cancer(1976-09-02) Frenkel, Eugene P.Item Comparison of Bioluminescence and Fluorescence Imaging as Tools for Evaluating Growth of MCF7 and 4T1 Mammary Tumors(2017-01-17) Lin, Elisa B.; Winters, Alex; Gerberich, Jeni; Campbell, Trey; Liu, Li; O'Kelly, Devin; Mason, Ralph P.INTRODUCTION: Tumor growth can be assessed by a variety of small animal imaging modalities which are cheap, easy, and efficient. In particular, bioluminescence imaging (BLI) and fluorescence imaging (FLI) have received attention for their ability to measure tumor growth and response to treatment. Both imaging modalities are accurate and well established, however, each method has its own unique advantages and limitations. This study compared the use of BLI and FLI to characterize and monitor growth of mammary 4T1-luc and MCF7-luc-GFP-mCherry tumors in nude mice. Strong correlations were established between BLI, FLI, and tumor volume, providing evidence that each method could be used to validate the other and reduce overall error. METHODS: BLI and FLI image sequences were performed with the IVIS(r) Spectrum. BLI was used for 4T1 (n = 8) and MCF7 (n = 6) tumors. FLI was only used for MCF7 tumors. Tumor volume was measured with calipers. RESULTS: Evaluating the area under each BLI and FLI curve (the AUC method) proved to be more accurate than only evaluating at one time point or wavelength. For both BLI and FLI, the AUC method greatly simplified the imaging workflow and removed the need for perfect temporal accuracy, since all times and wavelengths were considered. BLI and FLI both showed strong correlation with tumor volume (R2 = 0.91 and 0.87, respectively). The BLI and FLI signals were also correlated (R2 = 0.79). Experimental difficulties like tumor scarring and a mid-experiment C. bovis infection compromised data quality. DISCUSSION: The strong correlations between each measurement are very reassuring. Each offers specific benefits, e.g., BLI and FLI allow detection of sub-palpable volumes and additional metastases in some cases. BLI offers particularly strong contrast to noise, but requires the administration of luciferin substrate. FLI signal is subject to background auto fluorescence; this became a particular problem when the C. bovis infection occurred. Caliper measurements are simple for subcutaneous tumors, but the optical imaging can also reveal deeper tumors. The investigations to date largely confirm growth characteristics and the utility of available imaging methods matching the extant literature. The correlations had not been examined for 4T1-luc at UTSW previously. Furthermore, these methods provide a foundation for my forthcoming medical school research activity. Notably, future plans include continued investigation of metastases and utilizing Multispectral Optoacoustic Tomography (MSOT) for integrated hypoxia studies.Item Cooperative Invasion Between Tumor Cell Subpopulations(2013-01-17) Prechtl, Amanda Miya; Pearson, Gray W.Breast cancer is responsible for over 40,000 deaths each year in the United States. The majority of these deaths are not attributable to the primary breast tumor, but to metastases in vital organs. Tumor cell invasion is an early step in the metastatic cascade which can occur collectively by multiple cells cooperatively invading into the surrounding stroma. Primary patient breast tumors and patient-derived breast cancer cells can collectively invade yet how cells collectively invade is still largely unknown. It is well known that tumors contain heterogenous populations of cells yet traditional metastasis models focus on the ability of a rare population of neoplastic cells to autonomously invade past the basement membrane surrounding the tumor, intravasate into blood vessels and disseminate throughout the body to colonize foreign tissues. We hypothesized that there is a stable subpopulation of tumor cells that is capable of initiating the invasion of another population. Using organotypic culture models, which provide a three dimensional environment that models stromal conditions, and real-time imaging, a technique in which cell behavior can be imaged in real time at a single cell resolution, we determined that breast cancer cell lines can contain populations of cells with differential invasive potential. Furthermore, we concluded that one population of invasvie cells is sufficient to induce the invasion of other noninvasvie cells. This suggests a new mechanism for breast cancer metastasis, in which subpopulations of cells can cooperate with each other as opposed to competing against each other, to invade and potentially metastasize. Future studies will focus on determining the requirements for the leader cells to induce invasion and the follower cells to migrate behind the leader cells, with the eventual goal of targeting specific tumor populations for diagnostic and therapeutic treatment.Item Effect of Physical Activity on Community Participation among Breast Cancer Patients(2015-08-31) Dean, Victoria Nicole; Casenave, Gerald W.; Chiu, Chung-Yi; Rose, LindseyBACKGROUND: Breast cancer patients who engage in physical activity are shown to have a reduction in difficulties during daily living as a result of treatment side effects; however, it is unknown if participation in physical activity will reduce the limitations experienced by these individuals while participating in community activities. SUBJECTS: Female breast cancer patients, with a mean age of 51.81(SD = 7.88, range 30-64), diagnosed with stage 1 (n = 16, 21.3%), stage II (n = 37, 49.3%), stage III (n = 15, 20.0%) cancer who have completed chemotherapy (n = 63, 84.0%), are undergoing chemotherapy (n = 9, 12.0%), or have not yet started chemotherapy (n = 1, 1.3%). The majority of the participants were individuals were employed full time (n = 39, 52.0%), employed part time (n = 13, 17.3%). The majority of these women were married (n = 49) or divorced (n = 11). These women were college graduates (n = 30) or finished some graduate school (n = 20). These participants were European American (n = 34, 45.3%) and African American (n = 13, 17.3%). The BMI of these participants had a mean of 27.28 with a range from 16.30 to 44.81(SD = 5.35). Some of these individuals (n = 53) reported co-occuring medical conditions such as high cholesterol, high blood pressure, diabetes, and being overweight. METHOD: We recruited female breast cancer patients between the age of 18-66, with stage I, II, or III cancer, who are starting, in the process of, or have completed chemotherapy. Participants who met the inclusion criteria were selected to participate. Research assistants invited these patients to volunteer the survey study. For the current study purpose, we analyzed the association between the International Physical Activity Questionnaire (IPAQ) and the World Health Organization Disability Assessment Scale version 2.0 (WHODAS 2.0), using the Pearson product-moment correlation at the level of statistical significance at .05. The survey packages were sent to the participants through the United States Postal Service. Once the surveys were returned by mail the participants received a $10 gift card for compensation. RESULTS: A significant negative association was observed between limitations in participation in society (r = -.31, p =.004, medium effect size) and walking. Significant negative associations were also discovered between the limitations in life activities and vigorous activity (r = -.24, p = .023, small to medium effect size), along with walking (r = -.23, p = 0.25, small to medium effect size). Lastly, a significant negative association was seen between the limitations in communication and understanding and walking (r = -.20, p = .046, small to medium effect size). DISCUSSION: Engaging in physical activity decreases the limitations in understanding and communication, life activities, and participation in society an individual encounters. Vigorous activity is not required to experience reductions in community limitations. Simply engaging in light physical activity, like walking, produces results.Item Efficacy of Botswana's National Cancer Treatment Strategy: A Preliminary Analysis of Radiation Therapy in Breast Cancer Patients(2021-05-01T05:00:00.000Z) Shah, Sidrah Mariam; Grover, Surbhi; Chang, Mary; Nwachukwu, ChikaBACKGROUND: Breast cancer is a significant threat to public health in low- and middle-income countries (LMIC) globally, with the observation of an alarming increase in incidence in sub-Saharan Africa. Radiation Therapy (RT) is an essential component of breast cancer treatment and many LMIC currently lack access to RT. In Botswana, cancer care for citizens is paid for by the government, which has resulted in a unique investment in RT compared to other countries in the region. However, breast cancer mortality remains high, warranting further investigation into patient access to and receipt of RT. OBJECTIVE: This project seeks to investigate and present preliminary data on the percentage of breast cancer patients in Botswana qualifying for RT who actually went on to initiate RT. Demographic and clinical characteristics of breast cancer patients in Botswana are also presented. METHODS: Demographic, clinical, and treatment information was collected prospectively on all breast cancer patients presenting to the Breast Multidisciplinary Team (MDT) clinic at Princess Marina Hospital (PMH) in Gaborone, Botswana from January 2015 to October 2020. Patients with incomplete treatment information were excluded from the analysis. Patients who should have received RT were identified based on National Comprehensive Cancer Network (NCCN) guidelines. RESULTS: A total of 131 patients were included in the analysis. Of these, 29.8% were HIV-positive and 77.5% presented with advanced-stage disease. The vast majority of patients underwent mastectomy, and only 35% received chemotherapy. Based on NCCN guidelines, 121 patients qualified for receipt of radiation. In this population of breast cancer patients in Botswana, 92.6% of patients who needed RT received it. CONCLUSION: Based on this preliminary analysis, the investment of Botswana's Ministry of Health in RT for its citizens is seeing encouraging success among breast cancer patients. This analysis was limited by incomplete treatment information on the majority of breast cancer patients in this cohort, limiting the sample size in the final analysis. Further study is needed to characterize completion of RT in this population and factors that affect this.Item Endocrine aspects of breast cancer(1976-12-09) Smith, R. GrahamItem Free Flap Breast Reconstruction in Cancer Patients: Effect of BMI on Outcomes of the Deep Inferior Epigastric Perforator (DIEP) Flap(2016-01-19) Reddy, Nikitha; Cullins, Madeline; Kayfan, Samar; Pezeshk, Ronnie A.; Teotia, Sumeet S.; Haddock, Nicholas T.BACKGROUND: The Deep Inferior Epigastric (DIEP) flap has achieved marked acceptance in free flap breast reconstruction, yet the effect of body mass index (BMI) on the procedural outcome can vary depending on the literature. This study aims to evaluate the effect of BMI on flap and donor-site complications in patients undergoing DIEP flap reconstruction. METHODS: A retrospective analysis of 233 DIEP flaps in 135 patients was performed, and the patients were stratified as three groups based on BMI: Normal (BMI<25), Overweight (BMI 25-29.9), and Obese (BMI>30). Data with regard to age, smoking history, comorbid conditions, preoperative radiation, preoperative chemotherapy, and complications post-DIEP flap reconstruction at the flap and donor-sites was analyzed and compared among groups. RESULTS: Overweight patients had statistically higher rates of overall complications (p=0.001), umbilical wound (p=0.03), and return visits to the operating room during same hospital stay (p=0.004) compared to normal weight patients. Obese patients experienced statistically higher rates of overall complications (p=0.000023), return visits to operating room during same hospital stay (p=0.02), abdominal necrosis (p=0.0008), breast wound (p=0.019), umbilical wound (p=0.0053), and vacuum-assisted closure wound therapy (p=0.0006) compared to normal weight patients. There were no significant differences between the groups in regards to infection of the abdominal, breast, and umbilical sites, abdominal wound, abdominal seroma, breast necrosis, breast seroma, breast hematoma, umbilical necrosis, blood transfusion, pulmonary embolism, average OR time, average hospital length of stay, or loss of flap viability (p>0.05). Age distribution and preoperative radiation were not statistically different. Compared to normal-weight patients, overweight patients had significantly lower rates of smoking history and higher rates of hypertension, diabetes, and preoperative chemotherapy. Obese patients had statistically higher rates of preoperative chemotherapy compared to normal weight patients. These confounding factors between the groups are a limitation to the BMI control. CONCLUSION: Overweight and obese patients undergoing DIEP flap breast reconstruction are predisposed to statistically higher risk for the aforementioned complications than normal weight patients. However, there was no significant difference in loss of flap viability between the groups. Therefore, DIEP flap breast reconstruction is an appropriate option.Item Hereditary breast cancer: the basics of BRCA and beyond(2016-04-08) Haley, Barbara B.Item Immediate vs Delayed Breast Reconstruction: A Single Institution Experience(2017-01-17) Zhou, Michael; Kayfan, Samar; Wang, Jenny; Haddock, Nicholas T.; Teotia, Sumeet S.BACKGROUND: Deep inferior epigastric perforator (DIEP), superficial inferior epigastric artery (SIEA), and profunda artery perforator (PAP) flaps are acceptable options for autologous breast reconstruction. This study comprehensively evaluates the differences in outcomes between patients receiving immediate, delayed/immediate (staged with the use of tissue expanders), and delayed breast reconstructions (without the use of tissue expanders). METHODS: 547 free flaps (DIEP, SIEA, or PAP) on 331 patients were performed. Patients were grouped based on reconstruction timing: immediate (n=175 flaps), delayed-immediate (n=247 flaps), and delayed (n= 125 flaps). Comorbidities, preoperative radiation, neoadjuvant/postoperative chemotherapy, length of hospital stay, number of subsequent revision surgeries, and breast and donor site complications were analyzed among the groups. RESULTS: Immediate reconstructions, when compared to delayed-immediate reconstructions, encountered more infections (p<0.01), more wound occurrences (p = <0.01), longer lengths of stay (5.2 versus 4.1 days), longer procedure times (p = <0.01), and larger number of revision surgeries (2.4 vs 1.4 revisions) in patients receiving a single unilateral flap. Between outcomes of single flap immediate and delayed reconstructions, immediate reconstruction resulted in longer lengths of stay (5.2 vs 4.0 days), longer procedure time (p = <0.01), larger number of revision surgeries (2.4 vs 1.7 revisions), and higher chance of wound necrosis (p = <0.01). In patients receiving 2 free flaps (bilateral or double-pedicle unilateral reconstruction), immediate reconstructions encountered larger numbers of subsequent revision surgeries (1.7 versus 1.1 revisions) and no other significant differences compared to delayed-immediate reconstructions. There were no significant differences between delayed and delayed-immediate reconstructions. CONCLUSION: Immediate, delayed-immediate, and delayed reconstructions are all reasonably safe options for breast reconstruction. However, higher rates of complications among immediate reconstructions imply delayed-immediate and delayed reconstructions may be superior options to immediate reconstructions, not only in bilateral reconstructions, but especially in single free flap reconstructions. These results should be considered between the surgeon and patient when deciding an appropriate reconstruction plan based on the risks, benefits, and potential costs associated with different breast reconstruction timings.Item The Impact of Pleiotrophin on Breast Cancer Progression(2019-03-12) Sorrelle, Noah Bruce; Cobb, Melanie H.; Brekken, Rolf A.; Scherer, Philipp; Sternweis, Paul C.Breast cancer is the most frequent type of cancer, despite being largely restricted to women. Over the past few decades, cancer biologists have made great strides in understanding the factors that drive breast cancer tumorigenesis and progression. However, the significance of many factors, such as Pleiotrophin, remain uncharacterized. Pleiotrophin (Ptn), a neurite outgrowth factor and a heparin-binding cytokine, is reportedly expressed in many types of cancer, including breast cancer. Despite being identified as a secreted factor produced by breast cancer cells in 1991, its functional significance in breast cancer is uncertain. Previous studies into this question were limited by available tools for specifically perturbing or knocking out Ptn genetically. Further, they were also limited in scope, focusing only on select characteristics of the tumor progression and the microenvironment. Curiously, research into Ptn's impact in breast cancer came to a halt in 2007, leaving the very question of Ptn's functional significance unanswered. Using pharmacologic and genetic methods, I tested the impact of Ptn perturbation in multiple preclinical models of breast cancer. Ptn perturbation only impacted primary tumor growth in a single model. In contrast, Ptn perturbation resulted in reduced pulmonary metastatic burden in every model tested thus far. This effect does not appear to be due to Ptn's direct impact on cancer cell phenotype, growth, or migration. Anti-Ptn therapy did not affect epithelial-tomesenchymal transition of cancer cells, nor did Ptn directly promote cancer cell proliferation or migration in vitro. These results suggest that Ptn's effects are through changes in the tumor microenvironment. By immunohistochemistry and flow cytometry, I observed that there was less neutrophil infiltration and macrophage/metastatic lesion coupling in vivo. This result was interesting as both neutrophils and macrophages are implicated in promoting pulmonary metastasis in preclinical models of breast cancer. Using a cytokine/chemokine array, I observed that Ptn perturbation resulted in the reduction of macrophage and neutrophil chemokines, including MCP-1 and CXCL5, respectively. In contrast to previous reports, Ptn perturbation did not result in changes in angiogenesis, epithelial-to-mesenchymal transition, or markers of cell proliferation or apoptosis. Some of these reported activities may have resulted from off-target effects of the tools used at the time. Overall, the experimental strategies and specificity of the tools used in my thesis work have provided more accurate insights into the activity of Ptn. Additionally, the results suggest that Ptn is a potent driver of pulmonary metastasis in breast cancer and that targeting Ptn may an effective therapeutic strategy to treat metastatic breast cancer.Item The Impact of Radiation and Chemotherapy on Outcomes in Patients Who Complete Implant-Based Breast Reconstruction(2018-01-23) Jayaraman, Avinash P.; Hampton, Savannah N.; Nair, Lekshmi A.; Venutolo, Christopher; Haddock, Nicholas T.; Teotia, Sumeet S.INTRODUCTION: Treatments for breast cancer include neoadjuvant chemotherapy (NACT), adjuvant chemotherapy (ACT), radiation (RAD), and combinations of these therapies. Many of these patients will choose to pursue implant-based breast reconstruction concurrently with these treatments. Effects of these therapies on the outcomes of implant-based reconstructions have not been studied fully. METHODS: From January 2012 to December 2016 two surgeons performed 542 breast reconstructions using tissue expanders (TE). The number of patients choosing implants who completed reconstruction was n=272. They were split into 8 groups based on therapy received: Group 1 (no treatment, n=139), Group 2 (NACT, n=32), Group 3 (ACT, n=44), Group 4 (NACT+ACT, n=14), Group 5 (NACT+RAD, n=17), Group 6 (ACT+RAD, n=13), Group 7 (RAD, n=12), Group 8 (ACT+NACT+RAD, n=1). Group 8 was excluded because it had only one patient, leaving n=271. ANOVA (df between groups = 6, df within groups = 264) and Tukey HSD were run to compare differences in the percentages of patients with infections requiring IV antibiotics, necrosis requiring operation, seroma, and TE exchange for new TE. Numbers of different surgeries were also counted. RESULTS: Comorbidities and age were equivalent across groups, except for Group 7 (55.7 yr) and Group 4 (41.6 yr), p=.03. There were no significant differences in percentages of patients with infection requiring IV antibiotics (p=.32), necrosis requiring operation (p=.09), or seroma (p=.40). For patients who required replacement of TE with another TE due to complication, only Group 1 (1.4%) vs Group 6 (15.4%) had a significant difference, p=.04. There were no differences in the mean numbers of complication-related surgeries before implant placement (p=.07), complication-related surgeries after implant placement (p=.30), revision surgeries (p=.98), or total surgeries (p=.29). There were no significant differences in the percentages of patients receiving at least one complication-related surgery before implant (p=.16), at least one complication-related surgery after implant (p=.85), or at least one revision surgery (p=.94). CONCLUSION: Among most patients who choose to undergo implant-based reconstruction in an academic practice, we found no significant differences in complication rates, mean numbers of surgeries per patient, and percentages of patients undergoing different types of surgeries. Although patients with combined adjuvant chemotherapy and radiation had a higher rate of TE exchange for new TE due to complication, the rates of other complications and surgeries were comparable. Given these results, practice trends in breast reconstruction can remain cautiously optimistic for patients choosing implant-based reconstruction concurrently with cancer treatments.
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