Abstract:
:The management of PABC is very difficult. The incidence of PABC is low, but may be increasing because of the number of women who are becoming pregnant at a later age. More investigation is needed to understand whether the biology of PABC is different from that of breast cancer in nonpregnant women. One exciting area of further research is the potential relationship between mutations in known breast cancer susceptibility genes and breast cancer development during pregnancy. Diagnosis or PABC remains challenging because of the anatomic and physiologic changes that occur in the breast during pregnancy. Understanding the generic influences on PABC may help physicians in diagnosing this disease earlier, and understanding the tumor-receptor characteristics of PABC can help physicians deliver effective treatment. The various modalities available for treatment of PABC and their risks and benefits must be discussed openly with patients and their families. Abortion is not usually recommended. Modified radical mastectomy is the recommended treatment for PABC diagnosed during the first trimester. Neoadjuvant or adjuvant chemotherapy can be given with minimal risks to the fetus during the second or third trimester. Radiation therapy is contraindicated during pregnancy because of the potential for injury to the fetus. Breast conservation therapy, with radiation treatments given after delivery or after neoadjuvant chemotherapy, is an option for women with PABC diagnosed late in pregnancy. Once the appropriate treatment modality is chosen, its implementation must not be delayed because of the pregnancy. Most of the literature shows that women with PABC have the same survival stage for stage as nonpregnant women with breast cancer. But some studies suggest that the prognosis is worse for patients who present with advanced-stage PABC. Finally, recurrence and survival in most patients previously treated for breast cancer do not appear to be adversely affected by subsequent pregnancy. Above all, the patient with breast cancer diagnosed during pregnancy is best served by early and continued involvement of a multidisciplinary cancer treatment team.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Keleher AJ,Theriault RL,Gwyn KM,Hunt KK,Stelling CB,Singletary SE,Ames FC,Buchholz TA,Sahin AA,Kuerer HMdoi
10.1016/s1072-7515(01)01105-xkeywords:
subject
Has Abstractpub_date
2002-01-01 00:00:00pages
54-64issue
1eissn
1072-7515issn
1879-1190pii
S1072-7515(01)01105-Xjournal_volume
194pub_type
杂志文章,评审abstract:BACKGROUND:Neoadjuvant chemotherapy has been shown to increase the rate of breast conservation in clinical trials and small institutional series, but it has never been studied on a national level. STUDY DESIGN:We performed a retrospective review of the National Cancer Database (NCDB). The NCDB is a joint project of th...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established. STUDY DESIGN:A retrospective review of the NSQIP database was performed on patients undergoing elective laparosco...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2016.03.041
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Cirrhosis as an independent predictor of poor outcomes in trauma patients was identified in 1990. We hypothesized that the degree of preinjury hepatic dysfunction is, by itself, an independent predictor of mortality. STUDY DESIGN:The trauma registry at our Level I trauma center was queried for all ICD-9 cod...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2006.08.001
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Laparoscopic appendectomy is typically associated with inpatient hospitalization averaging between 1 and 2 days. In July 2010, a prospective protocol for outpatient laparoscopic appendectomy was adopted at our institution. Patients were dismissed from the post-anesthesia recovery room or day surgery if they ...
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更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Infarction of the optic nerve posterior to the lamina cribrosa, called posterior ischemic optic neuropathy (PION), is a condition that can result in profound bilateral blindness. Cases of PION treated at this institution and those described in the literature were analyzed to identify clinical features that p...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,评审
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更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Obesity, like multiple trauma, is associated with an inflammatory condition that leads to an immunodeficient state. Obese trauma patients are thus thought to be at higher risk of infection compared to patients of normal body mass. Despite this risk, studies to date have not defined obesity as an independent ...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2010.03.002
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Appendiceal cancer (AC) patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) often demonstrate an unpredictable variability in their survival outcomes. Biomarkers predictive of CRS/HIPEC efficacy could better guide treatment decisions. We hypothesized that v...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.12.012
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Thyroid surgery is performed using general anesthesia by the majority of surgeons in current practice. This study was conducted to analyze the utility and safety of local anesthesia for thyroid surgery. STUDY DESIGN:Prospective data were collected for 1,025 consecutive patients undergoing thyroidectomy usin...
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更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Clinicians must choose a treatment strategy for patients with symptomatic cholelithiasis without knowing whether common bile duct (CBD) stones are present. The purpose of this study was to determine the most cost-effective treatment strategy for patients with symptomatic cholelithiasis and possible CBD stone...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2011.02.017
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Nonelective colorectal surgery is associated with substantial patient morbidity and mortality. This study sought to describe the practice of emergency colorectal surgery in the United Kingdom during an 11-year period using the Hospital Episode Statistics (HES) database. STUDY DESIGN:All nonelective admissio...
journal_title:Journal of the American College of Surgeons
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更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:The Tennessee Surgical Quality Collaborative analyzes NSQIP data from 21 participating hospitals. The Tennessee Surgical Quality Collaborative has reduced surgical complications, but causative factors are unclear. We sought to correlate surgical duration with complications to reveal mitigating strategies. S...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Hepatic resection for metastatic colorectal cancer provides excellent longterm results in a substantial proportion of patients. Although various prognostic risk factors have been identified, there has been no dependable staging or prognostic scoring system for metastatic hepatic tumors. STUDY DESIGN:Various...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(99)00089-7
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:We examine the technique of combining percutaneous transluminal angioplasty and secondary intravascular stent deployment with femorofemoral bypass graft in patients with bilateral aortoiliac occlusive disease. STUDY DESIGN:Retrospective review. RESULTS:During the 5-year period from June 1988 to October 199...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract:UNLABELLED:Some of the concepts contained here have been discussed and incorporated in another publication, but the data are entirely unique to this manuscript. (See: Transforming the Surgical "Time-Out" Into a Comprehensive "Preparatory Pause." Backster A, Teo A, Swift M, MD, Polk HC Jr, MD, FACS, Harken AH, MD, FACS....
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.01.009
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Injury is the leading cause of childhood morbidity and mortality in the US. The associated costs exceed $20 billion annually. This study examined disparities in disadvantaged populations of critically injured pediatric patients admitted to a level 1 pediatric trauma center. STUDY DESIGN:A retrospective stud...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2013.02.032
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Classic emergency surgical management of complicated perforated sigmoid diverticulitis is based on the principle of a two-stage operation, with colon resection and temporary stoma (Hartmann's procedure). But the later second-stage operation can be technically difficult and can be associated with a significan...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.11.018
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Severe secondary hyperparathyroidism, which is associated with life-threatening complications, can develop in dialysis-dependent end-stage renal disease patients. The aim of this study was to compare short- and long-term mortality in dialysis patients who underwent near-total parathyroidectomy (NTPTX) and ma...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.12.046
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Several surgical treatment options for morbid obesity exist. Currently, there are no studies that objectively compare complication rates after laparoscopic bariatric operations performed at a single institution. We objectively classify and compare complications resulting from laparoscopic adjustable gastric ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2005.10.003
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Controversy exists over the relative advantages of open mesh repair compared with open stitching methods and the laparoscopic approach. STUDY DESIGN:Two thousand nine hundred six (2,906) consecutive unselected adult patients underwent 3,175 primary inguinal hernia repairs using polypropylene mesh, under loc...
journal_title:Journal of the American College of Surgeons
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更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Pancreatic resection can be performed to ameliorate the sequelae of chronic pancreatitis in selected patients. The perceived risk of pancreatectomy may limit its use. Using a national database, this study compared mortality after pancreatic resections for chronic pancreatitis with those performed for neoplas...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.05.030
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:In the western literature, controversy exists regarding the operative management of carcinoma of the stomach. Still debated are the extent of gastric resection, the role of splenectomy, and the significance of lymphadenectomy. STUDY DESIGN:We performed a retrospective study of 646 consecutive patients who u...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Rib fractures are common among trauma patients and analgesia remains the cornerstone of treatment. Intercostal nerve blocks provide analgesia but are limited by the duration of the anesthetic. This study compares outcomes of epidural analgesia with intercostal nerve block using liposomal bupivacaine for the ...
journal_title:Journal of the American College of Surgeons
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更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The prediction of postoperative liver function remains a largely subjective practice based on CT volumetric analysis. However, future liver volume after a hepatectomy is not the only factor that contributes to postoperative liver function and outcomes. STUDY DESIGN:In this prospective trial, 185 consecutive...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
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更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:It has been suggested that laparoscopic antireflux surgery has been associated with an increased incidence of postoperative paraesophageal hiatus herniation, and that this comes (at least in part) from not performing an esophageal lengthening procedure in patients with preoperative esophageal shortening. Thi...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experience and aimed to identify unique preoperative predictors of early graft and patient survival for primary transplantation (1°-pLTx)...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Urinary-vaginal fistula is one of the most common and dreaded complications of obstetric trauma in developing countries. Management of these fistulas is complicated by the presence of substantial urethral loss and the tendency of the repair to break down. STUDY DESIGN:We retrospectively studied 46 patients ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(00)00351-3
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The optimal method for classifying lymph node (LN) status in breast cancer patients is unknown. We sought to determine if LN ratio (LNR) improves axillary staging. STUDY DESIGN:Kentucky Cancer Registry data (1996 to 2007) were used to compare LN categorization schemas. Overall survival (OS) was evaluated us...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.04.024
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Determining the negative predictive value of benign large-core needle biopsy of nonpalpable mammographically detected breast abnormalities has been difficult because benign results generally preclude surgical excision. Longterm followup of these patients is important to ensure timely diagnosis of new abnorma...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Thyroid surgery is associated with low mortality and morbidity and often is performed in an ambulatory setting. The majority of patients undergoing thyroidectomy have an uncomplicated outcome, but common comorbidities may increase mortality and morbidity. Due to low complication rates, studies using single s...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The number of patients requiring hemodialysis increases each year, with a large cohort of patients still requiring prosthetic grafts for hemodialysis. All available prosthetic vascular access grafts have predictable failure rates, leading to a large group of patients with multiple failed access grafts. This ...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2005-08-01 00:00:00