Publications by authors named "Sarah DeSnyder"
Article Synopsis
- This study investigated factors linked to positive sentinel lymph nodes (SLNs) in cT1-2N0 breast cancer patients who received neoadjuvant chemotherapy (NACT) and how this data might differ from patients who didn't receive NACT.
- Out of 1,930 patients studied, 12.1% had positive SLNs, with specific tumor characteristics (like hormone receptor-positive status and lobular histology) significantly predicting this outcome.
- The findings suggested low axillary recurrence rates in patients with positive SLNs, indicating that certain tumor features and older age could help identify individuals at higher risk for further disease after treatment.
Background: Inflammatory breast cancer (IBC) is rare and biologically aggressive. We sought to assess diagnostic and management strategies among the American Society of Breast Surgeons (ASBrS) membership.
Patients And Methods: An anonymous survey was distributed to ASBrS members from March to May 2023.
Purpose: Dermal backflow visualized on near-infrared fluorescence lymphatic imaging (NIRF-LI) signals preclinical lymphedema that precedes the development of volumetrically defined lymphedema. We sought to evaluate whether dermal backflow correlates with patient-reported lymphedema outcomes (PRLO) surveys in breast cancer patients treated with regional nodal irradiation (RNI).
Methods And Materials: Patients with breast cancer planned for axillary dissection and RNI prospectively underwent perometry, NIRF-LI, and PRLOs (the Lymphedema Symptom Intensity and Distress Survey [LSIDS] and QuickDASH) at baseline, after surgery, and at 6, 12, and 18 months after radiation.
Article Synopsis
- The study focuses on identifying factors that predict involvement of four or more positive axillary lymph nodes (ALNs) in postmenopausal women with early-stage breast cancer that initially shows no lymph node involvement (cN0).
- Researchers analyzed data from 2532 patients who underwent sentinel lymph node biopsy (SLNB) and completion axillary lymph node dissection (cALND) from 1993 to 2007, identifying key predictive factors like tumor size and lymphovascular invasion.
- The findings suggest that postmenopausal women with HR-positive, HER2-negative breast cancer and a single positive SLN have a low risk (5%) of having four or more positive nodes, indicating that aggressive treatments may not be necessary
Background: Clinical evidence suggests that chemotherapeutic agents are associated with neuropathy and peripheral autonomic dysfunction. However, the possible effects of neoadjuvant chemotherapy on intraoperative temperature remain poorly characterised.
Methods: We evaluated patients who underwent a mastectomy for breast cancer between April 2016 and July 2020.
Background: We examined how breast cancer-related lymphedema (BCRL) affects health-related quality of life (HRQOL), productivity, and compliance with therapeutic interventions to guide structuring BCRL screening programs.
Methods: We prospectively followed consecutive breast cancer patients who underwent axillary lymph node dissection (ALND) with arm volume screening and measures assessing patient-reported health-related quality of life (HRQOL) and perceptions of BCRL care. Comparisons by BCRL status were made with Mann-Whitney U, Chi-square, Fisher's exact, or t tests.
Background: Emergency department (ED) overuse is a large contributor to healthcare spending in the USA. We examined the rate of and risk factors for ED visits following outpatient breast cancer surgery.
Patients And Methods: Using linked data from the Surveillance, Epidemiology, and End Results (SEER) program and Medicare, we identified women who underwent curative breast cancer surgery between 2003 and 2015.
Background: Breast cancer-related lymphedema (BCRL) is a debilitating sequela of breast cancer treatment and is becoming a greater concern in light of improved long-term survival. Inflammatory breast cancer (IBC) is a rare and aggressive malignancy for which systemic therapy, surgery, and radiotherapy remain the standard of care, thereby making IBC patients highly susceptible to developing BCRL. This study evaluated BCRL in IBC following trimodal therapy.
View Article and Find Full Text PDFPurpose: Mild breast cancer-related lymphedema (BCRL) is clinically diagnosed as a 5%-10% increase in arm volume, typically measured no earlier than 3-6 months after locoregional treatment. Early BCRL treatment is associated with better outcomes, yet amid increasing evidence that lymphedema exists in a latent form, treatment is typically delayed until arm swelling is obvious. In this study, we investigated whether near-infrared fluorescence lymphatic imaging (NIRF-LI) surveillance could characterize early onset of peripheral lymphatic dysfunction as a predictor of BCRL.
View Article and Find Full Text PDFBackground: Practices regarding recovery after mastectomy vary significantly, including overnight stay versus discharge same day. Expanded use of Enhanced Recovery After Surgery (ERAS) algorithms and the recent COVID pandemic have led to increased number of patients who undergo home recovery after mastectomy (HRAM).
Methods: The Patient Safety Quality Committee of the American Society of Breast Surgeons created a multispecialty working group to review the literature evaluating HRAM after mastectomy with and without implant-based reconstruction.
Article Synopsis
- The study investigates how different treatment options for early breast cancer, specifically breast-conserving surgery with radiation therapy (RT) versus mastectomy with reconstruction without RT, impact long-term quality of life (QOL).
- Researchers used data from the Texas Cancer Registry, analyzing responses from women treated between 2006 and 2008, with survey data collected from 2017-2018.
- The main goal was to compare satisfaction with breasts and various aspects of well-being (physical, psychosocial, and sexual) between the two treatment groups, while considering factors like age and ethnicity.
Background: In 2017, the American Society of Breast Surgeons (ASBrS) published expert panel recommendations for patients at risk for breast cancer-related lymphedema (BCRL) and those affected by BCRL. This study sought to determine BCRL practice patterns.
Methods: A survey was sent to 2975 ASBrS members.
Background: Inflammatory breast cancer (IBC) is a rare breast malignancy with poor outcomes compared with non-IBC. Age-related differences in tumor biology, treatment, and clinical outcomes have been described in non-IBC. This study evaluated age-related differences in IBC.
View Article and Find Full Text PDFBackground: Nearly one-third of patients with inflammatory breast cancer (IBC) present with de novo stage IV disease. There are limited data on frequency and clinical outcomes of contralateral axillary metastasis (CAM) in IBC with no consensus diagnostic and treatment guidelines.
Patients And Methods: Frequency of synchronous CAM was calculated in unilateral IBC patients at a single center (10/2004-6/2019).
Article Synopsis
- A phase IV study evaluated the Magseed system for localizing breast lesions needing surgery, highlighting its effectiveness since FDA approval in 2016.
- 107 women participated, with key metrics including Magseed retrieval rates, surgery duration, and clinician feedback on ease of use.
- Results showed Magseed was effective, with a 91% rate of margin-negative resections, no device-related complications, and favorable clinician ratings, supporting its continued use in breast lesion localization.
Objective: To assess pain severity and interference with life in women after different types of breast cancer surgery and the demographic, treatment-related, and psychosocial variables associated with these pain outcomes.
Summary Of Background Data: Data are conflicting regarding pain outcomes and quality of life (QOL) among women who undergo different types of breast surgery.
Methods: Women with nonhereditary breast cancer completed the brief pain inventory before surgery and at 1, 6, 12, and 18 months postsurgery.
Introduction: The role of modified radical mastectomy (MRM) in patients with de novo stage IV inflammatory breast cancer (IBC) remains controversial. We evaluated the impact of MRM on outcomes in this population.
Methods: Ninety-seven women presenting with stage IV IBC were identified in an institutional database (2007-2016) and were stratified by receipt of MRM or no surgery (non-MRM).
Background: Modified radical mastectomy (MRM), which includes axillary dissection, is the standard of care for inflammatory breast cancer (IBC). While more limited axillary staging after neoadjuvant chemotherapy (NAC) in clinically node-positive non-IBC has been increasingly adopted, the impact of these techniques in IBC is not clear. To inform patient selection for further study of limited axillary surgery, we aimed to describe the frequency and factors associated with pathological node-negativity (ypN0) in IBC.
View Article and Find Full Text PDFArticle Synopsis
- The text outlines a multi-specialty strategy and guidelines from a Case Review Committee aimed at managing oncologic surgery procedures in a cancer center during the ongoing COVID-19 pandemic.
- It emphasizes the importance of strategic rescheduling to reduce COVID-19 exposure risks while conserving healthcare resources, acknowledging a need for continued careful scheduling as society adapts to living with COVID-19.
- The approach involves input from various surgical departments, focusing on the role of cancer surgeons in safely assessing the timing of surgeries based on factors like tumor biology and treatment responses.
Purpose: Study objectives were to examine: (a) biomarker trajectories (change from presurgical baseline values of Lymphedema index (L-Dex) units and arm volume difference) and symptom cluster scores 24 months after breast cancer surgery and (b) associations of these objective biomarkers and symptom cluster scores. Patient/treatment characteristics influencing trajectories were also evaluated.
Methods: A secondary analysis of data from the published interim analysis of a randomized parent study was undertaken using trajectory analysis.
Background: Enhanced recovery after surgery (ERAS) programs are being used increasingly in microvascular breast reconstruction. However, it is unclear as to what extent the benefits outweigh the costs. We hypothesized that an ERAS pathway for microvascular breast reconstruction would be cost-effective relative to the standard of care.
View Article and Find Full Text PDFBackground: The effect of surgeon factors on patient-reported quality-of-life outcomes after breast-conserving therapy (BCT) is unknown and may help patients make informed care decisions.
Methods: We performed a survey study of women aged ≥ 67 years with non-metastatic breast cancer diagnosed in 2009 and treated with guideline-concordant BCT, to determine the association of surgeon factors with patient-reported outcomes. The treating surgeon was identified using Medicare claims, and surgeon factors were identified via the American Medical Association Physician Masterfile.
Article Synopsis
- The study aimed to identify factors influencing opioid use after breast-conserving surgery (BCS) by surveying 316 patients about their postoperative pain management.
- Results indicated that surgical factors such as bilateral oncoplastic surgery and axillary lymph node dissection significantly increased opioid consumption, with those in the highest usage quartile taking over 50 oral morphine equivalents (OME).
- Other associated factors included smoking, preoperative opioid use, high pain scores after surgery, and receiving larger discharge prescriptions, highlighting the need for tailored opioid prescribing strategies.