Investigation of Clinical Characteristics of Patients who underwent Toilet Mastectomy for Breast Cancer: 10 Years of Experience

Yıl 2023, Cilt: 1 Sayı: 1, 1 - 4, 28.02.2023

Mehmet Hamdi Sakarya Mesud Fakirullahoğlu Mustafa Yeni

Öz

Aim: To present the diagnosis, treatment, and follow-up processes of patients who
underwent toilet mastectomy for breast cancer.

Material and Method: After the approval of the ethics committee, the data of the
patients who underwent surgery for breast cancer in the general surgery and surgical
oncology clinic of a tertiary hospital between October 2012 and October 2022 were
collected. As a result of the necessary filtering, 11 cases were included in the study.
Preoperative, operative, and postoperative data of the cases were investigated.
Statistical analysis was made with the SPSS ver. 23.0 program; quantitative variables
were expressed as mean ± standard deviation (SD), minimum-maximum, range, and
percent (%).

Results: The mean age of the cases was 62.81±19.98 years (26-93). While the
indication for surgery was bleeding in 8 (72.7%) cases, infection was in 3 cases. In the
preoperative evaluation, regional lymph node metastasis was observed in 5 cases;
the remaining cases had distant organ metastases. The morbidity rate in our study
was 36.4%, and no mortality was observed in any of the cases. In addition, the mean
overall survival was found to be 14.09 months (2-36).

Conclusion: Toilet mastectomy is a surgery performed in advanced breast cancer
cases with skin involvement (infection and/or bleeding). It remains a method
accepted by surgeons because of its reduction in tumor size, easier tumor control,
and positive cosmetic results.

Anahtar Kelimeler

Bleeding, Mastectomies, Morbidities

Meme kanseri nedeniyle tuvalet mastektomi uygulanan hastaların klinik özelliklerinin incelenmesi: 10 yıllık deneyim

Öz

Amaç: Meme kanseri nedeniyle tuvalet mastektomi uygulanan hastaların tanı, tedavi ve takip süreçlerini sunmak.

Gereç ve Yöntem: Etik kurul onayı alındıktan sonra Ekim 2012 ile Ekim 2022 tarihleri arasında üçüncü basamak bir hastanenin genel cerrahi ve cerrahi onkoloji kliniğinde meme kanseri nedeniyle cerrahi uygulanan olguların verileri toplandı. Gerekli filtrelemeler sonucunda 11 olgu çalışmaya dahil edildi. Olguların preoperatif, operatif ve postoperatif verileri araştırıldı. İstatistiksel analizler SPSS ver. 23.0 programı ile yapılmış olup; nicel değişkenler ortalama ± standart sapma (SS), minimum maksimum, aralık ve yüzde (%) olarak ifade edildi.

Bulgular: Olguların yaş ortalaması 62,81±19,98 yıl (26-93) idi. 8 (%72,7) olguda cerrahi endikasyon kanama iken 3 olguda enfeksiyon idi. Preoperatif değerlendirmede 5 olguda bölgesel lenf nodu metastazı görülürken; kalan olgularda uzak organ metastazı mevcuttu. Çalışmamızın morbidite oranı %36,4 olup, hiçbir olguda mortalite görülmedi. Ayrıca genel sağkalım ortalama 14,09 ay (2-36) olarak saptandı.

Sonuç: Tuvalet mastektomi cilt tutulumu (enfeksiyon ve/veya kanama) olan ileri evre meme kanseri olgularında uygulanan bir cerrahidir. Tümör boyutunu azaltması, daha kolay tümör kontrolü sağlaması ve pozitif kozmetik sonuçlar nedeniyle cerrahlar tarafından kabul edilen bir yöntem olmaya devam etmektedir.

Anahtar Kelimeler

Kanama, Mastektomiler, Morbiditeler

Kaynakça

• Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524-541. DOI: 10.3322/caac.21708
• Mandal A, Jana P, Bakshi S, Mandal RK. A comparative clinicopathological study between ultrasonography, mammography, fine needle aspiration cytology and core needle biopsy of breast lump. Int Surg J. 2020;7(7):2325-2331. DOI: 10.18203/2349-2902.isj20202844
• Alkabban FM, Ferguson T. Breast cancer. StatPearls. Accessed Dec 10, 2022. https://www.ncbi. nlm.nih.gov/books/NBK482286/
• Baso AoBSa. Surgical guidelines for the management of breast cancer. Eur J Surg Oncol. 2009;35:1-22. DOI: 10.1016/j.ejso.2009.01.008
• Constantin A, Predescu D, Ciofu R, Achim F, Constantinoiu S. Palliative (“Toilet”) mammectomy, A decision-making dilemma-short review. Chirurgia (Bucur). 2021;116(2):150- 161. DOI: 10.21614/chirurgia.116.2.150
• Radziszewski M, Choromańska E, Nowak A, Kowalewski R, Radziszewski J. Toilet mastectomy as a possible and recommended solution to improve the quality of life of advanced breast cancer patients-case series. Palliative Med. 2021;13(2):97-100. DOI: 10.5114/pm.2021.104059
• Meena PS, Ameta A, Sethi D, Sethi A. A study of locally advanced breast cancer management in patients with rural background. Int J Surg. 2019;3(4):400-404. DOI: 10.33545/surgery.2019. v3.i4g.278
• Soran A, Ozmen V, Ozbas S, et al. A randomized controlled trial evaluating resection of the primary breast tumor in women presenting with de novo stage IV breast cancer: Turkish Study (Protocol MF07-01). J Clin Oncol. 2016;34:1005-1005. DOI: 10.1200/JCO.2016.34.15_ suppl.1005
• Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. DOI: 10.3322/caac.21660
• Özmen V, Özmen T, Doğru V. Breast cancer in Turkey; an analysis of 20.000 patients with breast cancer. Eur J Breast Health. 2019;15(3):141-146. DOI: 10.5152/ejbh.2019.4890
• Manzoor S, Anwer M, Soomro S, Kumar D. Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries? Pak J Med Sci. 2019;35(6):1554-1557. DOI: 10.12669/pjms.35.6.165
• Özşahin H, Yetkin G, Sevim ZK, Çitgez B, Uludağ M, Mihmanlı M. Ülsere dev meme kanseri olgu sunumu. Ş.E.E.H Tıp Bülteni. 2016;50(2):155-158. DOI: 10.5350/SEMB.20150812083852
• Piggin C, Jones V. Malignant fungating wounds: an analysis of the lived experience. Int J Palliat Nurs. 2007;13(8):384-391. DOI: 10.12968/ijpn.2007.13.8.24537
• Nomoto S, Akai T, Nomiyama H, Kuwano H, Kuwabara Y, Yoshimitsu K. A retrospective study of the effectiveness of haemostatic radiotherapy with conventional fractionation in patients with advanced cancer. J Cancer Res Ther. 2015;3(11):124-128. DOI: 10.14312/2052-4994.2015- 18
• Satoh E, Osanai T, Tomi Y, et al. A case report of recurrent bleeding and massive malodorous effusion due to skin invasion of advanced breast cancer successfully treated with Mohs’ paste. Gan to Kagaku Ryoho. 2018;45(13):1997-1999.
• Chirappapha P, Lertsithichai P, Sukarayothin T, Leesombatpaiboon M, Supsamutchai C, Kongdan Y. Oncoplastic techniques in breast surgery for special therapeutic problems. Gland Surg. 2016;5(1):75-82. DOI: 10.3978/j.issn.2227-684X.2015.05.04
• Verma R, Hirachan S, Singh YP. Palliative Toilet Mastectomy for Advanced Breast Cancer in a University Hospital of Nepal. JIOM Nepal. 2020;42(1):71. DOI: https://doi.org/10.3126/jiom. v42i1.37447
• Ahmad HH, Nicolas G, Saliba C, et al. Chest wall reconstruction with a bilayered wound matrix mesh following toilet mastectomy. Am J Case Rep. 2019;20:1736-1739. DOI: 10.12659/ AJCR.915811
• Tukiainen E. Chest wall reconstruction after oncological resections. Scand J Surg. 2013;102(1):9-13. DOI: 10.1177/145749691310200103
• Tham YL, Sexton K, Kramer R, Hilsenbeck S, Elledge R. Primary breast cancer phenotypes associated with propensity for central nervous system metastases. Cancer. 2006;107(10):2521- 2522. DOI: 10.1002/cncr.22270
• Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20):6243s-6249s. DOI: 10.1158/1078-0432.CCR-06-0931
• Kang Y, Siegel PM, Shu W, et al. A multigenic program mediating breast cancer metastasis to bone. Cancer Cell. 2003;3(6):537-549. DOI: 10.1016/s1535-6108(03)00132-6