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      The impact of breast‐conserving surgery and modified radical mastectomy on postoperative wound complications in patients with early breast cancer

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          Abstract

          In recent years, breast conservation surgery (BCS) and modified radical mastectomy (MRM) have been widely used in the treatment of early‐stage breast cancer. However, the effects of complications from these two surgical methods are still unclear. The purpose of this study was to evaluate the effects of BCS and MRM on postoperative wound complications in patients with early breast cancer. Eighty‐eight patients with early breast cancer were randomly divided into BCS group ( n = 46) and MRM group ( n = 42). The occurrence of postoperative wound complications was compared between the two groups. The results showed that BCS patients had significantly lower intraoperative surgical times, blood losses, incision lengths, drainage volumes, drainage times and lengths of hospital stays than their MRM counterparts ( p < 0.05). The overall incidence of postoperative wound complications in the BCS group was significantly lower than that in the MRM group at 1 month after surgery, but the difference was not statistically significant ( p < 0.001). The rate of excellent breast cosmetic outcome was significantly higher in the BCS group than in the MRM group ( p < 0.001). Compared to MRM, BCS has a lower incidence of intraoperative and postoperative wound complications, better cosmetic outcomes and higher clinical value in the treatment of early‐stage breast cancer.

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          Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update

          Purpose To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 (HER2) testing in breast cancer guideline. Methods Based on the signals approach, an Expert Panel reviewed published literature and research survey results on the observed frequency of less common in situ hybridization (ISH) patterns to update the recommendations. Recommendations Two recommendations addressed via correspondence in 2015 are included. First, immunohistochemistry (IHC) 2+ is defined as invasive breast cancer with weak to moderate complete membrane staining observed in > 10% of tumor cells. Second, if the initial HER2 test result in a core needle biopsy specimen of a primary breast cancer is negative, a new HER2 test may (not "must") be ordered on the excision specimen based on specific clinical criteria. The HER2 testing algorithm for breast cancer is updated to address the recommended work-up for less common clinical scenarios (approximately 5% of cases) observed when using a dual-probe ISH assay. These scenarios are described as ISH group 2 ( HER2/chromosome enumeration probe 17 [CEP17] ratio ≥ 2.0; average HER2 copy number < 4.0 signals per cell), ISH group 3 ( HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 6.0 signals per cell), and ISH group 4 ( HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 4.0 and < 6.0 signals per cell). The diagnostic approach includes more rigorous interpretation criteria for ISH and requires concomitant IHC review for dual-probe ISH groups 2 to 4 to arrive at the most accurate HER2 status designation (positive or negative) based on combined interpretation of the ISH and IHC assays. The Expert Panel recommends that laboratories using single-probe ISH assays include concomitant IHC review as part of the interpretation of all single-probe ISH assay results. Find additional information at www.asco.org/breast-cancer-guidelines .
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            Breast Cancer: Current Perspectives on the Disease Status.

            Breast cancer is the most frequently diagnosed cancer in women and ranks second among causes for cancer related death in women. Evidence in literature has shown that the past and ongoing research has an enormous implication in improving the clinical outcome in breast cancer. This has been attributed to the progress made in the realm of screening, diagnosis and therapeutic strategies engaged in breast cancer management. However, poor prognosis in TNBC and drug resistance presents major inhibitions which are also current challenges for containing the disease. Similarly, a focal point of concern is the rising rate of breast cancer incidence and mortality among the population of under developed world. In this chapter, an overview of the current practices for the diagnosis and treatment of breast cancer and associated impediments has been provided.
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              Molecular Classification of Breast Cancer.

              Cancer classification aims to provide an accurate diagnosis of the disease and prediction of tumor behavior to facilitate oncologic decision making. Traditional breast cancer classification, mainly based on clinicopathologic features and assessment of routine biomarkers, may not capture the varied clinical courses of individual breast cancers. The underlying biology in cancer development and progression is complicated. Recent findings from high-throughput technologies added important information with regard to the underlying genetic alterations and the biological events in breast cancer. The information provides insights into new treatment strategies and patient stratifications that impact on the management of breast cancer patients. This review provides an overview of recent data on high throughput analysis of breast cancers, and it analyzes the relationship of these findings with traditional breast cancer classification and their clinical potentials.
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                Author and article information

                Contributors
                wqfsci@163.com
                Journal
                Int Wound J
                Int Wound J
                10.1111/(ISSN)1742-481X
                IWJ
                International Wound Journal
                Blackwell Publishing Ltd (Oxford, UK )
                1742-4801
                1742-481X
                07 February 2024
                February 2024
                : 21
                : 2 ( doiID: 10.1111/iwj.v21.2 )
                : e14685
                Affiliations
                [ 1 ] Department of Thyroid and Breast Surgery The First People's Hospital of Wenling City Wenling Zhejiang China
                Author notes
                [*] [* ] Correspondence

                Qunfei Wang, Department of Thyroid and Breast Surgery, The First People's Hospital of Wenling City, No. 333, Chuan'annan Road, Chengxi Street, Wenling 317500, Zhejiang, China.

                Email: wqfsci@ 123456163.com

                Article
                IWJ14685
                10.1111/iwj.14685
                10850612
                0df6024e-f112-412b-b491-df09ecf19c1d
                © 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 04 January 2024
                : 15 December 2023
                : 04 January 2024
                Page count
                Figures: 5, Tables: 3, Pages: 10, Words: 5204
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                February 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:08.02.2024

                Emergency medicine & Trauma
                breast conservation surgery,early breast cancer,modified radical mastectomy,wound complications

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