A prospective study of opioid use for postoperative pain management after breast operation.

Background: The opioid epidemic has necessitated increased attention to prescribing practices. This study seeks to prospectively quantify postoperative opioid use after breast operation.

Methods: Consecutive patients undergoing breast operation at a single institution in 2018 prospectively tracked each dose of medication and completed a survey of perceptions regarding their opioid prescription.

Risk management decisions in women with BRCA1 and BRCA2 mutations.

Introduction: Pathogenic mutations and variants of uncertain significance (VUS) occur in BRCA1/2 genes.

Methods: Records of women with a pathogenic mutation or VUS in BRCA1/2 treated between 2008 and 2017 were reviewed.

Results: One hundred and ten women were included.

Patients with sentinel lymph node positive melanoma: Who needs completion lymph node dissection?

Introduction: Completion lymph node dissection (CLND) for melanoma after positive sentinel lymph node biopsy (SLNB) was recently shown to improve regional but not overall survival, likely due to the majority of patients harboring no further nodal disease. We sought to determine predictors of non-sentinel node (NSN) positivity.

Methods: Retrospective review of prospectively collected data on melanoma patients undergoing SLNB.

How Beneficial is Follow-Up Mammography in Elderly Breast Cancer Survivors?

Objective: The aim of this study was to determine the rate of non-palpable cancer detection and benign biopsy rates for follow-up mammograms in elderly breast cancer survivors.

Methods: Women 80 years of age and older who underwent operation for ductal carcinoma in situ or invasive breast cancer from 2005 to 2010 and who had at least 6 months of follow-up were identified from a single-institution, prospectively maintained, Health Insurance Portability and Accountability Act (HIPAA)-compliant database. Patients with mammographic, other imaging, or palpable abnormalities were identified, and the results of their imaging studies and biopsies were reviewed.

Octreotide LAR and bolus octreotide are insufficient for preventing intraoperative complications in carcinoid patients.

Background And Objectives: Surgery in carcinoid patients can provoke a carcinoid crisis, which can have serious sequelae, including death. Octreotide prophylaxis is recommended to prevent carcinoid crisis, however there are few reports of outcomes and no large series examining its efficacy. We hypothesized that a 500 µg prophylactic octreotide dose is sufficient to prevent carcinoid crisis.

Laparoscopic surgical exploration is an effective strategy for locating occult primary neuroendocrine tumors.

Background: Many patients with neuroendocrine tumors (NETs) have metastases at diagnosis. Despite extensive metastases the primary tumors remain small and difficult to locate.

Methods: Records of patients diagnosed with metastatic abdominal NETs from 2006 to 2010 were reviewed retrospectively.

Impact of American College of Surgeons Oncology Group Z0011 and National Surgical Adjuvant Breast and Bowel Project B-32 trial results on surgeon practice in the Pacific Northwest.

Background: Recent clinical trials have suggested no survival benefit for completion axillary node dissection (CALND) after sentinel lymph node biopsy (American College of Surgeons Oncology Group Z0011) and no clinically meaningful benefit for the routine use of immunohistochemistry (National Surgical Adjuvant Breast and Bowel Project B-32) in clinically node-negative breast cancer.

Methods: A 12-question electronic survey was distributed to members of 3 Pacific Northwest surgical societies. Surgeons were queried regarding the impact of the trial results on their surgical management of breast cancer.

Safety and efficacy of preoperative right portal vein embolization in patients at risk for postoperative liver failure following major right hepatectomy.

Background: Right portal vein embolization (RPVE) has been utilized with or without segment IV (RPVE + IV) prior to hepatectomy to induce hypertrophy and prevent liver insufficiency in patients with a predicted future liver remnant (FLR) of ≤30% or cirrhosis.

Methods: Records of patients who underwent RPVE during 2006-2010 were retrospectively reviewed. Patient demographics, operative outcomes and complications were analysed.

Fresh surgical specimens yield breast stem/progenitor cells and reveal their oncogenic abnormalities.

Background: The process by which breast cancer stem cells arise is unknown. It may be that the benign stem cells in breast tissue are transformed into malignant stem cells through the acquisition of genetic abnormalities. In this study, we collected and compared benign and malignant breast stem/progenitor cells to determine whether specific genetic abnormalities occur in breast cancer stem/progenitor cells within the human body.

Emergency department utilization by crack-cocaine smokers in Dayton, Ohio.

The objective of this study was to determine the frequency, principal diagnoses, and correlates of emergency department (ED) visits made by persons with a history of crack-cocaine use (n = 333) over a 3-year period. Data were collected from participant self-reports and hospital records. During the study a total of 643 ED visits were made by 211 people, ranging from 53.