Assessment of local tissue water in the arms and trunk of breast cancer survivors with and without upper extremity lymphoedema.

Given the paucity of information on local tissue water (LTW) in the upper extremity and trunk of women after breast cancer surgery, the purpose of this study was to compare tissue dielectric constant (TDC) values between the affected and unaffected sides of breast cancer survivors with and without upper extremity lymphoedema (LE). Differences in LTW were assessed using the TDC method for three sites in the upper limbs, three sites in the lateral thorax and two sites on the back. Additional measures included demographic and clinical characteristics, arm circumference and bioimpedance analysis.

Menopausal-Related Symptoms in Women One Year After Breast Cancer Surgery.

Context: Approximately 60% to 100% of women with breast cancer experience at least one menopausal-related symptom. Little is known about associations between menopausal status and symptoms in women 12 months after breast cancer surgery.

Objectives: The purpose of this study was to evaluate for differences in occurrence, severity, and distress of symptoms between pre- and postmenopausal women 12 months after breast cancer surgery.

Predictors of Altered Upper Extremity Function During the First Year After Breast Cancer Treatment.

Objective: The purpose of this study was to evaluate trajectories of and predictors for changes in upper extremity (UE) function in women (n = 396) during the first year after breast cancer treatment.

Design: Prospective, longitudinal assessments of shoulder range of motion (ROM), grip strength, and perceived interference of function were performed before and for 1 year after surgery. Demographic, clinical, and treatment characteristics were evaluated as predictors of postoperative function.

Polymorphisms in Tumor Necrosis Factor-α Are Associated With Higher Anxiety Levels in Women After Breast Cancer Surgery.

Introduction: Before and after breast cancer surgery, women have reported varying anxiety levels. Recent evidence has suggested that anxiety has a genetic basis and is associated with inflammation. The purposes of the present study were to identify the subgroups of women with distinct anxiety trajectories; to evaluate for differences in the phenotypic characteristics between these subgroups; and to evaluate for associations between polymorphisms in cytokine genes and subgroup membership.

Preoperative Breast Pain Predicts Persistent Breast Pain and Disability After Breast Cancer Surgery.

Context: Approximately 30% of the women report pain in the affected breast before breast cancer surgery.

Objectives: The purpose of this secondary analysis of our prospective study was to determine how women who experienced both preoperative and persistent postsurgical breast pain (n=107) differed from women who did not report preoperative breast pain and did (n=158) or did not (n=122) experience persistent postsurgical breast pain.

Methods: Differences in demographic and clinical characteristics were evaluated.

Persistent arm pain is distinct from persistent breast pain following breast cancer surgery.

Unlabelled: Persistent pain following breast cancer surgery is well documented. However, it is not well characterized in terms of the anatomic site affected (ie, breast, arm). In 2 separate growth mixture modeling analyses, we identified subgroups of women (N = 398) with distinct breast pain and arm pain trajectories.

Persistent breast pain following breast cancer surgery is associated with persistent sensory changes, pain interference, and functional impairments.

Unlabelled: Interindividual variability exists in persistent breast pain following breast cancer surgery. Recently, we used growth mixture modeling to identify 3 subgroups of women (N = 398) with distinct persistent breast pain trajectories (ie, mild, moderate, severe) over 6 months following surgery. The purposes of this study were to identify demographic and clinical characteristics that differed among the breast pain classes and, using linear mixed effects modeling, to examine how changes over time and in sensitivity in the breast scar area, pain qualities, pain interference, and hand and arm function differed among these classes.

Trajectories of Depressive Symptoms in Women Prior to and for Six Months After Breast Cancer Surgery.

Depressive symptoms are common in women with breast cancer. This study evaluated how ratings of depressive symptoms changed from the time of the preoperative assessment to 6 months after surgery and investigated whether specific demographic, clinical, and symptom characteristics predicted preoperative levels of and/or characteristics of the trajectories of depressive symptoms. Characteristics that predicted higher preoperative levels of depressive symptoms included being married/partnered; receipt of adjuvant chemotherapy; more fear of metastasis; higher levels of trait anxiety, state anxiety, sleep disturbance, problems with changes in appetite; more hours per day in pain; and lower levels of attentional function.

Associations between cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression in patients prior to breast cancer surgery.

Pain, fatigue, sleep disturbance, and depression are common and frequently co-occurring symptoms in oncology patients. This symptom cluster is often attributed to the release of proinflammatory cytokines. The purposes of this study were to determine whether distinct latent classes of patients with breast cancer (n = 398) could be identified based on their experience with this symptom cluster, whether patients in these latent classes differed on demographic and clinical characteristics and whether variations in cytokine genes were associated with latent class membership.

Side of cancer does not influence limb volumes in women prior to breast cancer surgery.

Background: Understanding normal volume asymmetry is essential for accurate assessment of limb volume changes following breast cancer (BC) treatment in which lymphatic function is disrupted. The purposes of this study were to evaluate for differences in dominant and nondominant limb volumes and to evaluate for interactions between the effects of dominance and side of cancer on limb volume.

Methods And Results: This study evaluated preoperative limb volumes of 397 women enrolled in a prospective, longitudinal study of neuropathic pain and lymphedema.

Cytokine gene variations associated with subsyndromal depressive symptoms in patients with breast cancer.

Purpose: This study explored the relationships between variations in cytokines genes and depressive symptoms in a sample of patients who were assessed prior to and for six months following breast cancer surgery. Phenotypic differences between Resilient (n = 155) and Subsyndromal (n = 180) depressive symptom classes, as well as variations in cytokine genes were evaluated.

Method: Patients were recruited prior to surgery and followed for six months.

Cytokine candidate genes predict the development of secondary lymphedema following breast cancer surgery.

Background: Lymphedema (LE) is a frequent complication following breast cancer treatment. While progress is being made in the identification of phenotypic risk factors for the development of LE, little information is available on the molecular characterization of LE. The purpose of this study was to determine if variations in pro- and anti-inflammatory cytokine genes were associated with LE following breast cancer treatment.

Identification of patient subgroups and risk factors for persistent arm/shoulder pain following breast cancer surgery.

Purpose: In this prospective, longitudinal study, we extend our findings on persistent breast pain in patients (n = 398) following breast cancer surgery and evaluate the prevalence and characteristics of persistent pain in the arm/shoulder. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the arm pain classes, were evaluated.

Methods And Sample: Patients were recruited from Breast Care Centers located in a Comprehensive Cancer Center, two public hospitals, and four community practices.

Associations between cytokine gene variations and severe persistent breast pain in women following breast cancer surgery.

Unlabelled: Persistent pain following breast cancer surgery is a significant clinical problem. Although immune mechanisms may play a role in the development and maintenance of persistent pain, few studies have evaluated for associations between persistent breast pain following breast cancer surgery and variations in cytokine genes. In this study, associations between previously identified extreme persistent breast pain phenotypes (ie, no pain vs severe pain) and single nucleotide polymorphisms (SNPs) spanning 15 cytokine genes were evaluated.

Variations in potassium channel genes are associated with breast pain in women prior to breast cancer surgery.

Preoperative breast pain in women with breast cancer may result from a number of causes. Previous work from our team found that breast pain occurred in 28.2% of women (n = 398) who were about to undergo breast cancer surgery.

Association between an interleukin 1 receptor, type I promoter polymorphism and self-reported attentional function in women with breast cancer.

Subgroups of patients with breast cancer may be at greater risk for cytokine-induced changes in cognitive function after diagnosis and during treatment. The purposes of this study were to identify subgroups of patients with distinct trajectories of attentional function and evaluate for phenotypic and genotypic (i.e.

Associations between cytokine gene variations and self-reported sleep disturbance in women following breast cancer surgery.

Purpose Of The Research: To attempt to replicate the associations found in our previous study of patients and family caregivers between interleukin 6 (IL6) and nuclear factor kappa beta 2 (NFKB2) and sleep disturbance and to identify additional genetic associations in a larger sample of patients with breast cancer.

Methods And Sample: Patients with breast cancer (n = 398) were recruited prior to surgery and followed for six months. Patients completed a self-report measure of sleep disturbance and provided a blood sample for genomic analyses.

Lymphatic and angiogenic candidate genes predict the development of secondary lymphedema following breast cancer surgery.

The purposes of this study were to evaluate for differences in phenotypic and genotypic characteristics in women who did and did not develop lymphedema (LE) following breast cancer treatment. Breast cancer patients completed a number of self-report questionnaires. LE was evaluated using bioimpedance spectroscopy.

Associations between pro- and anti-inflammatory cytokine genes and breast pain in women prior to breast cancer surgery.

Unlabelled: The purposes of this study were to determine the occurrence rate for preoperative breast pain; describe the characteristics of this pain; evaluate for differences in demographic and clinical characteristics; and evaluate for variations in pro- and anti-inflammatory cytokine genes between women who did and did not report pain. Patients (n = 398) were recruited prior to surgery and completed self-report questionnaires on a number of pain characteristics. Genotyping was done using a custom genotyping array.

Expanding the role of technology: stereotactic breast biopsy in the mobile environment.

The sharing of expensive minimally-invasive breast biopsy technology is now allowing women in small cities and towns in the United States to receive the same quality of care as their counterparts living near major medical centers. By placing digital stereotactic and ultrasound systems in mobile coaches, entrepreneurs have filled a niche in the healthcare system which affects the lives of hundreds of thousands of women yearly.

Gastrointestinal complications associated with intramuscular ketorolac tromethamine therapy in the elderly.

Objective: To report 3 cases of gastrointestinal (GI) complications associated with the use of intramuscular ketorolac tromethamine therapy in elderly patients.

Case Summaries: In case 1, an 88-year-old woman was taken to surgery for the management of an acute abdomen and repair of a 2+ cm perforated prepyloric gastric ulcer. The patient had received a total 16 doses of ketorolac 30 mg im.

Computed tomographic and ultrasound appearances of a solitary intrahepatic choledochal cyst.

A pregnant patient presenting with acute abdominal pain was found to have an intrahepatic mass, the features of which, on computed tomography and ultrasound examination, suggested a solid lesion. At surgery this proved to be a solitary intrahepatic choledochal cyst (Todani Type 5) with areas of malignant degeneration.

Radiographic assessment of anomalous bile ducts.

We report 5 radiologically documented cases of anomalous bile duct drainage of a segment of the right lobe of the liver and/or the cystic duct. These anomalies may be suspected on preoperative, intraoperative, or postoperative cholangiograms by the lack of visualization of the bile ducts draining a focal portion of the right lobe of the liver ("naked segment"). They may also be diagnosed definitively by direct duct opacification.

Significance of post-cholecystectomy subhepatic fluid collections.

A prospective ultrasound study of the right upper quadrant in 105 patients who had undergone cholecystectomy showed the incidence of fluid collection in the gall bladder fossa to be 24% 2 to 4 days after operation. In all but two patients, these fluid collections were of no clinical significance. The relationship between the presence of fluid and several other variables, such as use of drains and surgical techniques, are discussed.