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Objective: To explore the effects of ultrasound-guided stellate ganglion block (U-SGB) combined with ultrasound-guided serratus anterior plane block (U-SAPB) on postoperative acute pain and sleep duration in patients undergoing radical mastectomy. Methods: 120 female patients who underwent radical mastectomy were randomly divided into the control group, the U-SAPB group and the combined group (U-SGB combined with U-SAPB), with 40 cases in each group. Patients of the control group received only general anesthesia, patients of the U-SAPB group received U-SAPB, and patients of the combined group received U-SGB and U-SAPB. All patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The visual analogue scale (VAS) of pain intensity, the duration of nocturnal sleep, the time of first pressing the analgesic pump and the number of effective presses were compared among the three groups at different time points after surgery. Results: Compared with the control group, the VAS scores of the combined group were significantly lower at all time points after surgery (P<0.05), the time of first pressing the analgesic pump was significantly delayed, the number of effective presses of the analgesic pump was reduced, and the duration of nocturnal sleep was longer within 3 days after surgery (P<0.05); compared with the U-SAPB group, the VAS scores of the combined group were better at 8 h and later after surgery, and the time of first pressing the analgesic pump was later (P<0.05). Conclusion: Compared with simple general anesthesia and serratus anterior plane block, ultrasound-guided stellate ganglion block combined with serratus anterior plane block can effectively alleviate postoperative acute pain in breast cancer patients, prolong the duration of early nocturnal sleep. [ABSTRACT FROM AUTHOR]

Abstract Purpose We aimed to study the effect of music therapy combined with aerobic exercise on the sleep quality of patients undergoing chemotherapy after a radical mastectomy. Methods A randomized controlled trial was conducted at the Breast Disease Diagnosis and Treatment Center, Shaanxi Province Tumor Hospital, from July 2017 to June 2019. 110 female breast cancer patients who underwent a radical mastectomy were recruited and randomly allocated into an intervention group or a control group. The intervention group completed music therapy combined with aerobic exercise from the first to the sixth admission to the hospital for chemotherapy, while the control group received only routine nursing care. The sleep quality of these patients was measured using the Pittsburgh Sleep Quality Index (PSQI). A linear mixed model was used to adjust the PSQI of patients after controlling for other confounding factors. Results The mean sleep quality score of the breast cancer patients who received chemotherapy after a radical mastectomy (baseline) was 8.86 ± 2.34. The intervention group had a significantly lower mean global PSQI score than the control group from the first test to the third test, with an adjusted mean difference of -1.05 (95%CI: -1.86, -0.24; P = 0.01), -2.89 (95%CI: -3.70, -2.08; P

Objective To investigate the impact of nociceptive level (NOL) index on cellular immunity and HIF-1α in patients with radical breast cancer. Methods A total of 80 patients undergoing radical mastectomy between December 2022 and December 2023 were randomly assigned into an experimental group and a control group using a random number table method. The NOL index in the experimental group was maintained within the range of 30 to 50, with corresponding adjustments made to achieve the target concentration of remifentanil. In contrast, the control group initially received remifentanil at a target controlled infusion rate of 4 ng/mL, which was adjusted based on hemodynamics. The average target concentration of remifentanil was recorded for both groups. Venous blood samples were collected from all participants one day before and one day after surgery to measure CD4+, CD8+ cell counts, NK cell activity, as well as serum levels of HIF-1α. Results There were no significant differences observed in anesthesia time, operation time, intraoperative mean arterial pressure (MAP), heart rate (HR), and postoperative visual analog scale (VAS) scores between the two groups. The average target concentration of remifentanil in the experimental group was significantly lower than that in the control group (P < 0.05). Moreover, the experimental group exhibited higher values of CD4+, CD4+/CD8+ ratio, and NK cells compared to the control group, while demonstrating a lower level of HIF-1α expression (P < 0.05). In addition, within the experimental group, there was a decrease in CD4+ count and CD4+/CD8+ ratio one day after surgery compared to one day before surgery; meanwhile, HIF-1α expression increased significantly after surgery when compared to preoperative levels (P < 0.05). Similarly, within the control group, there was a decrease observed in CD4+, CD8+, CD4+/CD8+ ratio as well as NK cell values one day after surgery when compared to preoperative levels; additionally, HIF-1α expression showed a significant increase after surgery when compared to preoperative levels (P < 0.05). Conclusion The implementation of NOL monitoring during radical mastectomy under general anesthesia can effectively lower the required remifentanil concentration, thereby mitigating its suppressive effects on T lymphocytes, preserving NK cell activity, and reducing elevated levels of HIF-1α. Consequently, this approach exerts minimal impact on the tumor immune microenvironment (TIME) in patients. [ABSTRACT FROM AUTHOR]

This study aims to compare the anesthetic effects of remimazolam tosilate and propofol in patients undergoing radical mastectomy. The study group received remimazolam tosilate in combination with sufentanil and cisatracurium besilate for anesthesia induction, while the control group received propofol with sufentanil and cisatracurium besilate. In the study group, the eyelash reflex disappearance time was longer and the recovery time was shorter compared to the control group (p < 0.05). No significant differences were observed in Post-Anesthesia Care Unit (PACU) retention time and Visual Analogue Scale (VAS) scores at 24 hours post-operation between the groups (p > 0.05). Furthermore, the study group exhibited a lower decrease in Mean Arterial Pressure (MAP) at 1, 3 and 5 minutes after anesthesia induction (p<0.05). After losing consciousness, there was no statistically significant difference in HR decrease between both groups (p > 0.05). The study group also had higher respiratory rate (RR) and Tidal volume (VT) levels, with a lower incidence of apnea compared to the control group (p < 0.05). Thirty minutes before anesthesia, no significant differences were found in the five indicators between the groups (p>0.05). At 24 hours post-operation, the study group showed higher Cluster of Differentiation 3+ (CD3+), CD4+, natural killer (NK) cell levels and CD4+/CD8+ ratios compared to the control group (p < 0.05). However, at 72 hours post-operation, no statistically significant differences were observed in these five indicators between the groups (p > 0.05). Compared with propofol, remimazolam tosilate achieves rapid sedation, maintains adequate sedation, and reduces suppression of the respiratory and circulatory systems. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) following radical mastectomy in breast cancer patients can significantly affect patient recovery and healthcare resources. Identifying and understanding the risk factors for postoperative wound infections (PWIs) are crucial for improving surgical outcomes. This retrospective study was conducted from June 2020 to June 2023, including 23 breast cancer patients who developed PWIs post‐radical mastectomy and a control group of 46 patients without such infections. Comprehensive patient data, including variables such as intraoperative blood loss, hospital stay duration, body mass index (BMI), operation time, anaemia, drainage time, diabetes mellitus, cancer stage, white blood cell (WBC) count, serum albumin levels and preoperative neoadjuvant chemotherapy, were meticulously gathered. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS software (Version 27.0). The univariate analysis identified several factors significantly associated with an increased risk of PWIs, including preoperative neoadjuvant chemotherapy, low serum albumin levels, advanced cancer stage, diabetes mellitus and reduced WBC count. Multivariate logistic regression highlighted anaemia, prolonged drainage time, diabetes mellitus, advanced cancer stage, reduced WBC count, hypoalbuminemia and preoperative neoadjuvant chemotherapy as significant contributors to the increased risk of PWIs. Anaemia, extended drainage time, diabetes mellitus, advanced cancer stage, low WBC count, hypoalbuminemia and preoperative neoadjuvant chemotherapy are key risk factors for SSIs post‐radical mastectomy. Early identification and proactive management of these factors are imperative to reduce the incidence of postoperative infections and enhance recovery outcomes in breast cancer patients. [ABSTRACT FROM AUTHOR]

Background and Aims: Gabapentin (GBP) has been found to decrease the pain scores and analgesic requirements following total abdominal hysterectomy, spinal surgery, and ear, nose, and throat surgery. It has been suggested that central neuronal sensitization may play an important role in postoperative pain. This study compares the effect of two different doses of preemptive GBP on morphine requirement and postoperative pain relief in patients undergoing mastectomy. Methods: This randomized comparative trial included 70 patients scheduled for unilateral mastectomy. They were divided into two groups. Group 1 received 800 mg oral GBP and Group 2 received 1200 mg oral GBP 2 h before surgery. After surgery, we recorded the pain score at different time points using the Visual Analog Scale (VAS) at rest. Patients were also asked about possible side effects of the premedication drug. Patients received morphine 0.1 mg/kg intravenous on demand. The time of first rescue analgesia was recorded along with the total rescue analgesic requirement in the first 24 h. Results: In our study, the mean VAS score, postoperatively at 2, 4, 12, 24 h in Group 2, was less than Group 1 but the difference was not statistically significant (P = 0.9, 0.1, 0.8, 0.4, respectively) Patients of Group 1 demanded rescue analgesia earlier (5.8 ± 3.4 h) than Group 2 (9.6 ± 5.9 h). The total 24 h morphine consumption in Group 1 (10.97 ± 4.01 mg) was higher than Group 2 (6.71 ± 5.02 mg). No significant side effects were observed during the perioperative period. Conclusion: We conclude that GBP in higher doses, when used preemptively, provides a greater degree of analgesia with opioid-sparing effect.

The article provides an overview of the ConSIBreC randomized controlled trial, which aims to evaluate the effectiveness of conserving surgery in patients with inflammatory breast cancer (IBC) who have achieved a clinical complete response after neoadjuvant chemotherapy. IBC is a rare and aggressive subtype of breast cancer, and the standard treatment is radical mastectomy. However, with the increasing rate of complete response to chemotherapy, there is a question of whether breast conserving surgery could be a viable option. The trial will involve 329 patients per arm and will assess local recurrence rates, survival rates, and other outcomes. The study is expected to offer valuable evidence on the potential of conserving surgery in IBC patients. [Extracted from the article]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To report a case of primary neuroendocrine breast cancer (NEBC)，and to provide clinical reference for the diagnosis and treatment of the disease. Methods The diagnosis and treatment process of a 54-year-old female patient with NEBC admitted to Jiangsu Province Hospital of Chinese Medicine on September 13, 2021 was retrospectively reported，and analyzed in combination with relevant literature. Results The patient was admitted due to unilateral painless breast mass. The patient was considered to have a non-special type of breast cancer with neuroendocrine differentiation and underwent surgery. The diagnosis of NEBC was confirmed by pathology and immunohistochemistry after operation. Further comprehensive treatment was given and no local recurrence or distant metastasis was found in the 1-year follow-up. Conclusion NEBC is a rare and special type of breast carcinoma which lacks specific clinical manifestations. Pathology and immunohistochemistry are required for diagnosis. Chromogranin A (CgA) and sunaptophysin (Syn) are generally considered to be reliable markers for the diagnosis of NEBC. The treatment plan has not yet formed a unified standard. Treatment guidelines for general type of breast cancer of the same pathological stage are mostly referred to. There is still no consensus on its prognosis.

ABSTRACTBackground This research work investigated the effect of magnesium sulfate added to bupivacaine in serratus anterior block in cases of modified radical mastectomy.Patients and method A total of 80 female patients of ASA I and II were randomly assigned into two equal groups depending on the adjuvant added to bupivacaine. B group: patients received 20 ml 0.5% bupivacaine with 5 ml 0.9% normal saline. BM group: patients received 20 ml 0.5% bupivacaine+150 mg magnesium sulfate in 0.9% normal saline with a total volume of 25 ml in both groups. Primary aim was to test the effect of magnesium sulfate when added to bupivacaine on pain intensity. Secondary targets were to detect the haemodynamics, safety and any side effects of magnesium sulfate.Results Visual analogue scale measurement showed statistical significant decrease after 4 hours till 24 hours postoperatively in BM group more than in B group. Mean time to first rescue analgesia in BM group was 11.73 ± 1.91 hours versus 8.13 ± 1.38 hours in B group with P value < 0.001. The mean total dose of nalbuphine used was statistically significantly decreased in BM group, as it was 15.50 ± 3.89 mg in B group and 9.63 ± 4.44 mg in BM group with P value < 0.001. Occurrence of complications in both groups showed insignificant statistical difference.Conclusions Magnesium sulfate with bupivacaine in serratus anterior plane block produced prolonged analgesia postoperatively without significant haemodynamic instability with significant decline in the total dose of rescue analgesic with minimal side effects.

Abstract Background Emergency agitation is a common postoperative complication in patients under general anesthesia, which can lead to unpredictable damages such as shedding of drainage tube and bleeding from the wound. The purpose of the study is to investigate whether intraoperative infusion of Magnesium Sulfate reduces the incidence of emergency agitation (EA) in patients undergoing radical mastectomy, and to evaluate its safety and efficacy. Methods A total of 70 patients were randomly assigned to two groups: the Magnesium group (M group) and the control group (C group). After a routine intravenous anesthetic induction, patients in the M group received a 30 mg/kg bolus of intravenous magnesium during the first hour and then a continuous infusion of 10 mg/kg ×h until the end of the surgery, patients in the C group received 0.9% saline at the same volume and rate. The sedation-agitation scale (SAS) and the visual analogue scale were used to assess agitation and pain, respectively. Results Compared to the C group, the M group reduced the incidence of EA significantly (odds ratio 0.26, 95% confidence interval 0.09–0.71, P = 0.009). The postoperative pain score of the magnesium sulfate group(0(0,1)) was lower than that of the control group(2(0,3)) at T0 (P = 0.011). Additionally, the M group required a lower dosage of remifentanil during surgery compared to the C group(300.4 ± 84 versus 559.3 ± 184 µg, respectively, P

Breast cancer is the most common type of malignancy among women in Brazil and worldwide, excluding non-melanoma skin cancers. The purpose of this report is to describe the case of a patient with invasive breast carcinoma, associated with a large extent of skin involvement and nipple-areola complex, whose lesion was unchanged after neoadjuvant chemotherapy. After a Halsted mastectomy, the thoraco-epigastric flap was used to close the thoracic defect, with a favorable evolution of the patient. The use of the thoraco-epigastric flap has been described as a reliable tool because it is characterized as a technique that is easy to perform, safe and with minimal post-surgical complications.

IntroductionAccessory breast cancer (ABC) is an extremely rare condition, particularly the presence of triple-negative ABC with ipsilateral invasive in situ breast cancer. Binary breast tumors are controversial in terms of surgical methods and comprehensive treatment.Case presentationWe share the case of a 64-year-old postmenopausal woman who presented with an underarm mass for 3 months. Ultrasonography and computed tomography suggested possible breast cancer with axillary lymph node metastasis. The patient underwent a left modified radical mastectomy combined with axillary lymph node dissection. The postoperative pathology confirmed a binary tumor, prompting us to initiate comprehensive treatment.ConclusionWe present the treatment approach for a rare case of triple-negative para-breast cancer complicated with carcinoma in situ of the breast, hoping to contribute new therapeutic ideas for the treatment of this disease.

Background: This research work investigated the effect of magnesium sulfate added to bupivacaine in serratus anterior block in cases of modified radical mastectomy. Patients and method: A total of 80 female patients of ASA I and II were randomly assigned into two equal groups depending on the adjuvant added to bupivacaine. B group: patients received 20 ml 0.5% bupivacaine with 5 ml 0.9% normal saline. BM group: patients received 20 ml 0.5% bupivacaine+150 mg magnesium sulfate in 0.9% normal saline with a total volume of 25 ml in both groups. Primary aim was to test the effect of magnesium sulfate when added to bupivacaine on pain intensity. Secondary targets were to detect the haemodynamics, safety and any side effects of magnesium sulfate. Results: Visual analogue scale measurement showed statistical significant decrease after 4 hours till 24 hours postoperatively in BM group more than in B group. Mean time to first rescue analgesia in BM group was 11.73 ± 1.91 hours versus 8.13 ± 1.38 hours in B group with P value < 0.001. The mean total dose of nalbuphine used was statistically significantly decreased in BM group, as it was 15.50 ± 3.89 mg in B group and 9.63 ± 4.44 mg in BM group with P value < 0.001. Occurrence of complications in both groups showed insignificant statistical difference. Conclusions: Magnesium sulfate with bupivacaine in serratus anterior plane block produced prolonged analgesia postoperatively without significant haemodynamic instability with significant decline in the total dose of rescue analgesic with minimal side effects. [ABSTRACT FROM AUTHOR]

Background: Emergency agitation is a common postoperative complication in patients under general anesthesia, which can lead to unpredictable damages such as shedding of drainage tube and bleeding from the wound. The purpose of the study is to investigate whether intraoperative infusion of Magnesium Sulfate reduces the incidence of emergency agitation (EA) in patients undergoing radical mastectomy, and to evaluate its safety and efficacy. Methods: A total of 70 patients were randomly assigned to two groups: the Magnesium group (M group) and the control group (C group). After a routine intravenous anesthetic induction, patients in the M group received a 30 mg/kg bolus of intravenous magnesium during the first hour and then a continuous infusion of 10 mg/kg ×h until the end of the surgery, patients in the C group received 0.9% saline at the same volume and rate. The sedation-agitation scale (SAS) and the visual analogue scale were used to assess agitation and pain, respectively. Results: Compared to the C group, the M group reduced the incidence of EA significantly (odds ratio 0.26, 95% confidence interval 0.09–0.71, P = 0.009). The postoperative pain score of the magnesium sulfate group(0(0,1)) was lower than that of the control group(2(0,3)) at T0 (P = 0.011). Additionally, the M group required a lower dosage of remifentanil during surgery compared to the C group(300.4 ± 84 versus 559.3 ± 184 µg, respectively, P<0.001). Conclusions: the intraoperative infusion of magnesium sulfate is a safe and effective method for reducing the incidence of emergency agitation in patients undergoing radical mastectomy. Trail registration: The study was registered in Chictr.org with the identifier: ChiCTR2300070595 on 18/04/2023. [ABSTRACT FROM AUTHOR]

Objective: To analyze the influencing factors of preoperative anxiety in patients undergoing radical mastectomy, and to explore the effects of preoperative anxiety on postoperative recovery, cellular immune function and quality of life. Methods: 120 patients who planned to undergo radical mastectomy in our hospital from March 2020 to December 2021 were selected as research objects. Anxiety status of all patients was assessed by self-rating anxiety Scale (SAS) at 1d before surgery, and they were divided into anxious group and non-anxious group according to whether there was preoperative anxiety. The influencing factors of preoperative anxiety in patients undergoing radical mastectomy were analyzed by multivariate Logistic regression. Postoperative recovery, cellular immune function and quality of life were compared between the anxious group and non-anxious group. Results: Among 120 patients undergoing radical mastectomy, 31 patients had no preoperative anxiety, and 89 patients had anxiety symptoms. They were divided into the anxious group (n=89) and the non-anxious group (n=31) according to whether there was preoperative anxiety. The preoperative anxiety of patients with radical mastectomy were correlated with age, education level, family per capita monthly income, payment method, marital status, family support, previous history of general anesthesia, length of hospital stay before operation and regular physical examination (P＜0. 05). Multivariate Logistic regression analysis showed that age＜60 years, education level of primary school or below, family per capita monthly income＜3000 yuan, marital status unmarried, no family support, no previous history of general anesthesia, length of hospital stay before operation＞1 d were risk factors for preoperative anxiety in patients with radical mastectomy (P＜0. 05). The postoperative first anal exhaust time, the first time to get out of bed and the postoperative length of hospital stay in the anxious group were all longer than those in the non-anxious group (P＜0. 05). The levels of CD3+, CD4+and CD4+/CD8+in the two groups were increased at 1 month after operation, and the non-anxious group was higher than the anxious group (P＜0. 05). The levels of CD8+in the two groups were decreased at 1 month after operation, and the non-anxious group was lower than the anxious group (P＜0. 05). 1 month after operation, physiological status, emotional status, social/family status, functional status, additional attention score and total score in the two groups decreased, and the non-anxious group was lower than the anxious group (P＜0. 05). Conclusion: The incidence of preoperative anxiety in patients undergoing radical mastectomy is high, and its occurrence is affected by many factors such as age, education level, monthly income per capita in the family, marital status, family support, history of general anesthesia, length of hospital stay before operation, which can lead to prolonged recovery time and decreased cellular immune function and quality of life. [ABSTRACT FROM AUTHOR]

Purpose. To compare the incidence of breast cancer (BC) relapse after subcutaneous mastectomy and Madden radical mastectomy.Patients and methods. The study included 102 patients diagnosed with BC with stages IIB – III, who underwent neoadjuvant drug therapy with a subsequent surgical stage of treatment on the basis of the Tver Regional Clinical Oncology Dispensary from 2017 to 2020. The main group included 50 patients who underwent subcutaneous mastectomy with simultaneous installation of an endoprosthesis: stage IIB – 31 (62 %) patients; stage III – 19 (38 %) patients. The comparison group included 52 patients who underwent surgical treatment in volume – radical mastectomy according to Madden (RME): Stage IIB – 34 (65.4 %) patients; stage III – 18 (34.6 %) patients. Depending on the subtype of the tumor, patients received neoadjuvant drug therapy.Results. During the three-year follow-up period, the progression of the disease after subcutaneous RME was detected in 7 (14 %) patients. Locoregional relapses accounted for 4 cases (8 %), progression to distant organs 3 cases (6 %). After the Madden RME, disease progression was detected in 6 (11.5 %) patients. Locoregional relapses accounted for 3 cases (5.7 %), progression to distant organs 3 cases (5.7 %). The detected foci did not always coincide with the primary subtype of the tumor: in 5 cases the subtype was different (38.5 %), in 8 cases it coincided (61.5 %).Conclusion. The frequency of development of locoregional and distant metastases did not statistically depend on the volume of surgical intervention (p > 0.05). It is reasonable to conduct a histological examination in case of progression to determine the tactics of treatment.

Min Zhu, Siqi Xu, Xia Ju, Shengbin Wang, Xitong Yu Department of Anesthesiology, The Anqing Medical Center of Anhui Medical University, The Fifth Clinical Medical College of Anhui Medical University, Anqing, People’s Republic of ChinaCorrespondence: Xia Ju, Department of Anesthesiology, The Anqing Medical Center of Anhui Medical University, The Fifth Clinical Medical College of Anhui Medical University, Anqing, 246003, People’s Republic of China, Tel +86 13685563136, Email alcon2006@126.comPurpose: This study aims to investigate the effects of the different doses of esketamine on postoperative quality of recovery in patients undergoing modified radical mastectomy.Methods: Ninety-nine female patients were randomly allocated to three groups: the low-dose esketamine group (group E1) (0.5 mg/kg loading, 2 μg/kg/h infusion), the high-dose esketamine group (group E2) (0.5 mg/kg loading, 4 μg/kg/h infusion), the control group (group C) (received normal saline). The primary outcome was the quality of recovery-15 (QoR-15) scores on postoperative day 1 (POD1) and days 3 (POD3). The secondary outcomes were the sleep quality scores on POD1, bispectral index (BIS) value at 10, 30, and 60 min after operation, numeric rating scale (NRS) pain scores within 24 h after surgery, nausea, vomiting, drowsiness, nightmare, and intraoperative awareness.Results: The total QoR-15 scores were higher in group E1 and group E2 than in group C on POD1 and POD3 (P< 0.05). The sleep quality scores on POD1 and BIS value at 10, 30, and 60 min after operation were higher in group E1 and group E2 than in group C (P< 0.05). The NRS pain scores at 2, 4 and 6 h after surgery in group E1 and at 2, 4, 6, 12 and 24 h after surgery in group E2 were lower than in group C (P< 0.05). The NRS pain scores at 6, 12 and 24 h after surgery in group E2 were lower than in group E1 (P< 0.05). The incidence of drowsiness was higher in group E1 and group E2 than in group C (P< 0.05).Conclusion: Esketamine infusion improved to some extent the quality of recovery on POD1 and POD3 in patients undergoing modified radical mastectomy, especially 4 μg/kg/h esketamine was better, but the BIS value and incidence of drowsiness were significantly increased.Keywords: esketamine, postoperative quality of recovery, radical mastectomy

Aim to find the main causes of the lateral conical defects formation in obese patients after radical mastectomy for breast cancer. Material and methods. We analysed prospectively 82 breast cancer patients with various degrees of obesity. The patients were randomized into two groups. In the main group (43 patients), the original RME method (RU patent No. 2748639, dated May 28, 2021) was used; in the control group (39 patients), the standard RME method was applied. Results. The use of a standard elliptical incision for RME in obese patients leads to the formation of lateral conical defects, the frequency of which reaches 74%. There is a high correlation between the frequency of formation of lateral conical defects in radical mastectomy with expansion of the breast base (Spearman index 0.85 (p0.05), chest circumference (Spearman index 0.92(p0.05), fat pedicle thickness (Spearman index 0.94 (p 0.05) and degree of mammoptosis (Spearman index 0.98 (p 0.05).

Background & Objective: Erector Spinae Plane block (ESPB) is used in patients subjected to modified radical mastectomy (MRM) as a part of balanced anesthesia technique, and to offer prolonged postoperative analgesia. Local anesthetic agents are usually combined with various adjuvants to augment the effect. We compared dexmedetomidine (Dex) versus dexamethasone as adjuvants to ESPB in patients undergoing MRM. Methodology: This randomized controlled study involved 90 patients subjected to MRM under general anesthesia with preoperative ESPB using 30 ml levobupivacaine 0.25%. They were randomly assigned into three equal groups according to the adjuvants used. Dex Group (n = 30) received 1 μg/kg dexmedetomidine, Dexa Group (n = 30) received 10 mg dexamethasone, and ESPB Group (n = 30) received no adjuvants. Patients were monitored for pain using VAS scores and vital signs. The primary outcome measure was total morphine consumption. The secondary outcomes were intraoperative fentanyl consumption, pain intensity, and analgesia duration. Results: The postoperative analgesia duration was significantly longer in the Dex group compared with the ESPB group (P = 0.029) but not in the dexamethasone group. Intraoperative fentanyl and postoperative morphine consumption were significantly lower in the Dex group than in the ESPB group. VAS scores were significantly lower in the Dex group than in the ESPB group at rest and movement. VAS scores of the Dexamethasone group were similar to that of the ESPB group at rest and movement. Conclusion: As an adjuvant to levobupivacaine in erector spinae plane block, dexmedetomidine reduces pain at rest and with movement, reduces intraoperative fentanyl and postoperative morphine consumption, and prolongs the analgesia duration. It is superior to dexamethasone in pain reduction and duration of analgesia. [ABSTRACT FROM AUTHOR]

Introduction. The use of preoperative magnetic resonance imaging (PMR) in patients with breast cancer is debatable, with little agreement on its usefulness above routine scans. The goal of this study was to assess comparative studies of individuals with non-advanced breast cancer who were treated with or without PMR. Methods. A search was conducted in MEDLINE/PUBMED, LILACS, and SCIELO for medical literature published between January 1, 2000 and March 31, 2021, and publications that satisfied the inclusion criteria were included. Results. There were 3,828 publications, 53 of which matched the inclusion requirements; the papers were examined, and the findings were summarized in tables. There were 46 single or multicenter retrospective and comparative investigations, three prospective, randomized, controlled trials, and four meta-analyses including patients with infiltrating ductal or lobular carcinoma or ductal carcinoma in situ. The comparative results were antagonistic and debatable; however, in the most relevant studies, it was demonstrated that PMR delays surgery; increases mastectomies and additional biopsies; increases detection of ipsilateral/contralateral disease that is not necessarily malignant; and no significant difference in the rate of loco-regional or distant recurrence was established. Conclusion. Conclusions. PMR in non-advanced breast cancer has debatable outcomes in terms of surgery type, reoperations, and progression-free survival, and it is still being studied.

Abstract Background The primary goal of modified radical mastectomy is to remove cancerous cells and reduce the risk of breast cancer spreading. This operation is associated with considerable acute postoperative pain and restricted shoulder movement. If this acute pain is neglected most patients will develop chronic post-mastectomy pain, which reduces the quality of life. Regional anesthesia using ultrasound-guided paravertebral nerve block or pectoral nerve block has become an ideal addition to general anesthesia for providing analgesia after breast cancer surgery. This was a randomized clinical trial conducted between February 2018 and February 2019. This study compared between the two nerve blocks regarding the efficacy in terms of analgesic consumption. Results The study included 30 female patients who were undergoing modified radical mastectomy under general anesthesia and randomly divided into 2 groups of 15 patients in each. This study showed there was a statistically significant increase in the amount of total fentanyl used intraoperatively in TPVB group than PECs group with p value = 0.008. Less VAS score in PECS group with statistically significant difference between groups at 4 h, 5 h, 6 h, and 8 h. More time needed for 1st requested rescue analgesia in PECS group with P value = 0.013. Patients in PECS group received a less total dose of fentanyl in the first 24 h postoperative with P value = 0.040. There was no statistically significant difference found between groups regarding postoperative complications. Conclusions In female patients undergoing breast surgeries, the PECs block can be used efficiently and safely, providing better pain relief than the TPVB and reducing intraoperative and postoperative opioids use.

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Background: Radical mastectomy often causes acute and chronic pain. One aimed to explore whether unilateral, ultrasound-guided, single-injection modified intercostal nerve block (MINB) could improve postoperative analgesia compared with no-MINB (Control group) in patients undergoing radical mastectomy., Methods: Sixty-five patients were randomly assigned to receive no-MINB (Control group) or MINB (MINB group) with 0.33 % ropivacaine (30 ml). The primary outcome was Visual Analogue Scale (VAS) scores at rest 6 h postoperatively. Secondary outcomes included VAS scores at rest and during movement at 0 h, 12h, 24h, 48h, and 90 days postoperatively; use of intraoperative opioids; postoperative rescue analgesia; time of first ambulation; complications; and score of China version of the Quality of recovery-15 (QoR-15) questionnaire (0 = extremely poor QoR; 150 = excellent QoR) at 24 h after surgery., Results: The MINB group showed lower resting VAS (resting) pain score at 6 h postoperatively (median [interquartile], 1 (0-2), vs 2 (2-3), 95 % CI difference in medians 1-2; P < 0.001), and significantly lower scores at resting and during movement at 0-24 h postoperatively. The MINB group showed lower intraoperative opioid use, a better quality of recovery on the QoR-15 scale, and more patients needed rescue analgesia in control group compared to those in MINB group. None of the MINB subjects showed MINB-related complications., Conclusion: Preoperative ultrasound-guided MINB markedly improved analgesia and concurrently reduced rescue analgesia demands and better recovery in patients undergoing radical mastectomy., Competing Interests: Declaration of competing interest No potential conflict of interest relevant to this article was reported., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)

Objective To investigate the influence of thoracic paravertebral block(TPVB) and serratus anterior plane block(SAPB) on postoperative analgesia and stress response in patients with breast cancer. Methods A total of 92 patients who planned to receive radical mastectomy from January 2020 to December 2021 in Huizhou Municipal Central Hospital were selected as study objects. All the patients were divided into SAPB group(SAPB + laryngeal mask general anesthesia, n=31), TPVB group(TPVB + laryngeal mask general anesthesia, n=31) and general anesthesia group(laryngeal mask general anesthesia, n=30) according to random number method. The postoperative pain and analgesic effect were compared among the three groups. The stress response indexes ［interleukin(IL)-10, IL-6 and malondialdehyde(MDA)］before and 24 hours after operation were compared among the three groups. The adverse reactions of the three groups were recorded. Results The VAS scores at 12 h, 24 h, 48 h and 72 h after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). The dosage of sufentanil and the effective press times of patient-controlled intravenous analgesia(PCIA) within 48 hours after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). The levels of serum IL-10, IL-6 and MDA at 24 h after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). Conclusion TPVB is superior to SAPB in postoperative analgesia for breast cancer, which can effectively relieve postoperative pain of patients, prolong the effective duration of analgesia, reduce the dose of analgesic drugs, and alleviate the stress reaction of the body.

ObjectiveTo study the analgesic effect of breast cancer patients undergoing modified radical mastectomy (MRM) and the influence of perioperative T lymphocyte subsets by remifentanil combined with dexmedetomidine.Methods80 breast patients were divided into control group and research group based on the anesthesia protocol. Patients in control group was given remifentanil for anesthesia induction and maintenance, and patients in research group was given remifentanil and dexmedetomidine for anesthesia induction and maintenance. We compared the anesthesia time, operation time, surgical blood loss, postoperative wake-up time, extubation time, incidence of adverse reactions, VAS score and T lymphocyte subsets in peripheral blood in the two groups of patients.ResultsThe baseline data including age, height, weight and BMI, ASA classification, stage of breast cancer, frequency of neoadjuvant therapy, and surgical characteristics including anesthesia time, operation time and bleeding volume all have no significant difference between two groups (P > 0.05). Compared to control group, the time of wake up and extubation in patients of research group were all significantly decreased (P 0.05). At 1 h during operation and 24 h after operation, the ratio of CD4+ and CD4+/CD8+ cells in the research group was significantly higher than these of the control group (P

OBJECTIVE: To investigate clinical utility of a new immobilization method in image-guided intensity-modulated radiotherapy (IMRT) for breast cancer patients after radical mastectomy. MATERIALS AND METHODS: Forty patients with breast cancer who underwent radical mastectomy and postoperative IMRT were prospectively enrolled. The patients were randomly and equally divided into two groups using both a carbon-fiber support board and a hollowed-out cervicothoracic thermoplastic mask (Group A) and using only the board (Group B). An iSCOUT image-guided system was used for acquiring and correcting pretreatment setup errors for each treatment fraction. Initial setup errors and residual errors were obtained by aligning iSCOUT images with digitally reconstructed radiograph (DRR) images generated from planning CT. Totally 600 initial and residual errors were compared and analyzed between two groups, and the planning target volume (PTV) margins before and after the image-guided correction were calculated. RESULTS: The initial setup errors of Group A and Group B were (3.14±3.07), (2.21±1.92), (2.45±1.92) mm and (3.14±2.97), (2.94±3.35), (2.80±2.47) mm in the left-right (LAT), superior-inferior (LONG), anterior-posterior (VERT) directions, respectively. The initial errors in Group A were smaller than those in Group B in the LONG direction (P < 0.05). No significant difference was found in the distribution of three initial error ranges (≤3 mm, 3–5 mm and > 5 mm) in each of the three translational directions for the two groups (P > 0.05). The residual errors of Group A and Group B were (1.74±1.03), (1.62±0.92), (1.66±0.91) mm and (1.70±0.97), (1.68±1.18), (1.58±0.98) mm in the three translational directions, respectively. No significant difference was found in the residual errors between two groups (P > 0.05). With the image-guided correction, PTV margins were reduced from 8.01, 5.44, 5.45 mm to 3.54, 2.99, 2.89 mm in three translational directions of Group A, respectively, and from 8.14, 10.89, 6.29 mm to 2.67, 3.64, 2.74 mm in those of Group B, respectively. CONCLUSION: The use of hollowed-out cervicothoracic thermoplastic masks combined with a carbon-fiber support board showed better inter-fraction immobilization than the single use of the board in reducing longitudinal setup errors for breast cancer patients after radical mastectomy during IMRT treatment course, which has potential to reduce setup errors and improve the pretreatment immobilization accuracy for breast cancer IMRT after radical mastectomy. [ABSTRACT FROM AUTHOR]

The aim of the study is to improve the quality of life of women with breast cancer (BC) and a high risk of its development by performing one-stage or delayed reconstruction of the lost breast.The objectives of the study were: to clarify the criteria for selecting patients for prophylactic mastectomy; development of surgical tactics in the treatment of breast cancer and a high risk of its development; assessment of oncological safety of LME; clarification of the methods of reconstruction of the breast; analysis of postoperative complications, including the effect of neoadjuvant PCT during simultaneous breast reconstruction on their frequency, and determination of possible ways to prevent them.Material and methods. The prospective controlled study included 258 patients who underwent surgical treatment in our department between 2007 and 2016. The criteria for the inclusion of patients in the study were: carrying out radical surgical treatment for breast cancer, both in isolation and in combination with the reconstruction of the lost breast; carriage of germline mutations in the tumor suppressor genes BRCA1 and BRCA2, the presence of first-degree relatives suffering from breast cancer, previous BRCA-associated breast cancer; the desire of patients with multiple recurrent proliferative benign breast diseases that are not amenable to conservative and surgical treatment to use the surgical method of breast cancer prophylaxis with immediate restoration of the breast.Results. According to the Beck Depression Questionnaire, 72 % of patients in the first group of patients had a critical and high level of depression, while patients who underwent CME with one-stage reconstruction did not have such levels of depression. At the same time, a relatively favorable psychological state of patients with a low level of depression was observed in 17 of 21 patients in the RME + delayed reconstruction group (which amounted to 81% of the group), in 21 of 22 patients in the RME + simultaneous reconstruction group (95% of the group), and only in 5 of 43 patients in the RME group (12% of the group) (χ2 = 51.6; critical value 9.2 at p ≤ 0.01).Conclusions. When analyzing the results obtained, we once again became convinced of the oncological safety of LME with a one-stage reconstruction of the breast, subject to certain requirements. In the presence of appropriate conditions, it is possible to preserve the SAC during the LME. Preventive LME with simultaneous breast reconstruction is the method of choice in patients with a high risk of developing breast cancer, subject to the appropriate selection criteria and the patient's desire.

Keywords: Erector spinae plane block; Dexmedetomidine; Postoperative analgesia; Radical mastectomy EN Erector spinae plane block Dexmedetomidine Postoperative analgesia Radical mastectomy 731 734 4 05/16/22 20220601 NES 220601 This letter to the editor refers to article available at https://doi.org/10.1007/s40122-020-00234-9. Erector spinae plane block, Dexmedetomidine, Postoperative analgesia, Radical mastectomy. [Extracted from the article]

Breast cancer (BC) remains one of the most common diseases of the female population. According to statistics, breast cancer is detected in every eighth woman. Approximately 20‑24% of breast cancer patients are diagnosed with triple negative breast cancer. Triple‑negative breast cancer is characterized by an aggressive clinical course, a higher relapse rate, and low overall survival. According to statistics, the median survival rate for women with metastatic triple‑negative breast cancer is less than one year. We demonstrate a successful case of treatment of a 60‑year‑old woman diagnosed with triple negative breast cancer on the right, edematous‑infiltrative form, St IIIC cT4bN3M0 on the background of metabolic syndrome. Antitumor treatment lasted 1 year and consisted of three stages: systemic chemotherapy, surgical treatment (radical mastectomy), and adjuvant radiation therapy. After the treatment, remission was achieved. The patient is alive and has a relapse‑free period of 3 years. Conclusion. Despite the severe concomitant pathology in the observed patient, we received a positive result of multi‑ stage therapy, where cytotoxic chemotherapy was the basic treatment for a woman with triple negative breast cancer.

Background and Purpose: The low rate of internal mammary node (IMN) recurrence was attributed to systemic therapy and internal mammary chain (IMC) coverage by the tangential fields of irradiation. This study aimed to evaluate the incidental irradiation dose to the IMC in breast cancer patients after surgery and to estimate the clinical predictive parameters affecting the magnitude of the IMC. Materials and Methods: A total of 138 patients treated with postmastectomy radiotherapy and 210 patients undergoing radiotherapy after breast-conserving surgery (BCS) in our hospital were retrospectively analyzed. The mean dose (Dmean) to the IMC and the first to third intercostal spaces of IMC levels (ICS1–3) were evaluated. We evaluated the IMC coverage according to the type of surgery and whether the ipsilateral supraclavicular fossa (SCF) was included in the irradiation field. Results: The incidental radiation dose to the IMC was 29.69 Gy, and the dose delivered to the IMC, ICS1, and ICS2 showed a greater coverage in the modified radical mastectomy (MRM) group when compared with the BCS group (32.85 vs. 27.1 Gy, 26.6 vs. 12.5 Gy, 34.63 vs. 30.42 Gy). The dose delivered to ICS3 showed no difference between the MRM and BCS groups (37.41 vs. 36.24 Gy). Furthermore, 131 patients (37.64%) received radiotherapy to the chest wall and ipsilateral SCF. In the univariate analysis, both surgery type and SCF irradiation were parameters affecting the Dmean of incidental radiation to the IMC (r = −0.179, P = 0.001; r = −0.175, P = 0.001). In the multivariate analysis, surgery type was the only correlative factor that affected incidental radiation dose to the IMC (r = –3.534, P = 0.000). Conclusion: The real influencing factor of incidental dose to the IMC was the surgery form rather than the accession of SCF irradiation. [ABSTRACT FROM AUTHOR]

Objective: To compare the postoperative analgesia effect between erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) guided by ultrasound after radical mastectomy. Methods: From May 2015 to December 2019, 64 patients who underwent radical mastectomy in The Second Hospital of Shanxi Medical University were randomly divided into ESPB group and TPVB group, 32 cases in each group. On the basis of general anesthesia, ESPB group was given EspB, TPVB group was given TPVB, and patient-controlled intravenous analgesia (PCIA) was given after operation. The visual analogue scale (VAS) scores at rest and coughing at 2 h, 6 h, 12 h, 24 h and 48 h after operation were compared between the two groups. The first pressing time of PCIA, PCIA analgesia pump pressing times and dosage of PCIA sufentanil 24 h after operation, rescue analgesia and incidence of adverse reactions were compared between the two groups. Results: There was no significant difference in VAS scores between the two groups at rest and coughing at different time points after operation (P>0.05); There was no significant difference in first pressing time of PCIA, PCIA sufentanil 24 h after operation and the incidence of rescue analgesia between the two groups (P>0.05); The PCIA analgesia pump pressing times 24 h after operation in ESPB group were lower than those in TPVB group, the difference was statistically significant (P<0.05); There was no significant difference in the incidence of postoperative nausea and vomiting, skin itching, respiratory depression and dizziness between ESPB group and TPVB group (P>0.05). Conclusion: Compared with TPVB, ESPB guided by ultrasound has similar analgesic effect in patients with radical mastectomy, and it does not increase the incidence of adverse reactions. It has higher safety and can replace TPVB to provide good postoperative analgesia for patients with radical mastectomy. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer in women and the most common cause of death in working-age women. According to the results of immunohistochemical studies, 10-20% of cases revealed a triple-negative type of breast cancer. This subtype is characterized by significant proliferative activity and growth rate, aggressive clinical course, and early metastasis. This leads to a suspicious prognosis and, accordingly, encourages an increase of surgical treatment radicalism and aggressive systemic treatment. This review briefly analyzes existing treatment strategies for triple-negative breast cancer with a focus on surgical treatment. Surgical treatment is an integral part of complex therapy. Currently, the attention of researchers is focused not only on the radicalism of the operation, ensuring long-term survival, but also on achieving a good cosmetic result that determines the quality of life of patients. In this aspect, organ-preserving and prosthetic methods of operations are promising, the feasibility and effectiveness of which are being discussed. The relevance of choosing the optimal method of operation is evidenced by the lack of generally accepted approaches based on informative markers for the prognosis of the course of the disease. Therefore, the choice of the optimal method of surgical treatment taking into account the individual characteristics of the patient and the tumor, indications for chemotherapy, and radiation therapy remains an unresolved issue and requires further research. [ABSTRACT FROM AUTHOR]

Background: The primary goal of modified radical mastectomy is to remove cancerous cells and reduce the risk of breast cancer spreading. This operation is associated with considerable acute postoperative pain and restricted shoulder movement. If this acute pain is neglected most patients will develop chronic post-mastectomy pain, which reduces the quality of life. Regional anesthesia using ultrasound-guided paravertebral nerve block or pectoral nerve block has become an ideal addition to general anesthesia for providing analgesia after breast cancer surgery. This was a randomized clinical trial conducted between February 2018 and February 2019. This study compared between the two nerve blocks regarding the efficacy in terms of analgesic consumption. Results: The study included 30 female patients who were undergoing modified radical mastectomy under general anesthesia and randomly divided into 2 groups of 15 patients in each. This study showed there was a statistically significant increase in the amount of total fentanyl used intraoperatively in TPVB group than PECs group with p value = 0.008. Less VAS score in PECS group with statistically significant difference between groups at 4 h, 5 h, 6 h, and 8 h. More time needed for 1st requested rescue analgesia in PECS group with P value = 0.013. Patients in PECS group received a less total dose of fentanyl in the first 24 h postoperative with P value = 0.040. There was no statistically significant difference found between groups regarding postoperative complications. Conclusions: In female patients undergoing breast surgeries, the PECs block can be used efficiently and safely, providing better pain relief than the TPVB and reducing intraoperative and postoperative opioids use. [ABSTRACT FROM AUTHOR]

Abstract Background Thoracic paravertebral block may be used for analgesia after breast surgery. Ultrasound can be used during the whole technique of paravertebral block to increase success rate and decrease its complications. As well, pectoral nerve block is now used for pain relief after modified radical mastectomy with or without axillary clearance. Objective To compare thoracic paravertebral block and pectoral nerve block for postoperative analgesia after modified radical mastectomy Methods The study was performed over 30 female patients that were randomly divided into 2 groups with 15 patients in group A for thoracic paravertebral block (TPVB) and 15 in group B for pectoral nerve block (PECS) with injection of total 20 ml bupivacaine 0.25% in each block. Outcome measures of the study are postoperative analgesia duration (time to first rescue analgesia (0.5 mg/kg pethidine) after administration of block) and total analgesic dose in 24 h after surgery and postoperative pain which will be assessed using a visual analog scale (VAS, 0–10 as 0 = no pain and 10 = worst imaginable pain). The vital signs and pain score will be recorded at 0, 1, 2, 4, 6, 8, 12, 18, and 24 h after surgery. Results Our study showed decrease in systolic blood in PVB group immediately postoperative and in the first 6 h postoperative with p value

Background and PurposeThe low rate of internal mammary node (IMN) recurrence was attributed to systemic therapy and internal mammary chain (IMC) coverage by the tangential fields of irradiation. This study aimed to evaluate the incidental irradiation dose to the IMC in breast cancer patients after surgery and to estimate the clinical predictive parameters affecting the magnitude of the IMC.Materials and MethodsA total of 138 patients treated with postmastectomy radiotherapy and 210 patients undergoing radiotherapy after breast-conserving surgery (BCS) in our hospital were retrospectively analyzed. The mean dose (Dmean) to the IMC and the first to third intercostal spaces of IMC levels (ICS1–3) were evaluated. We evaluated the IMC coverage according to the type of surgery and whether the ipsilateral supraclavicular fossa (SCF) was included in the irradiation field.ResultsThe incidental radiation dose to the IMC was 29.69 Gy, and the dose delivered to the IMC, ICS1, and ICS2 showed a greater coverage in the modified radical mastectomy (MRM) group when compared with the BCS group (32.85 vs. 27.1 Gy, 26.6 vs. 12.5 Gy, 34.63 vs. 30.42 Gy). The dose delivered to ICS3 showed no difference between the MRM and BCS groups (37.41 vs. 36.24 Gy). Furthermore, 131 patients (37.64%) received radiotherapy to the chest wall and ipsilateral SCF. In the univariate analysis, both surgery type and SCF irradiation were parameters affecting the Dmean of incidental radiation to the IMC (r = −0.179, P = 0.001; r = −0.175, P = 0.001). In the multivariate analysis, surgery type was the only correlative factor that affected incidental radiation dose to the IMC (r = –3.534, P = 0.000).ConclusionThe real influencing factor of incidental dose to the IMC was the surgery form rather than the accession of SCF irradiation.

Objectives: To establish a nomogram incorporating clinical characteristics to predict the risk of breast cancer-related lymphedema (BCRL)., Methods: In this retrospective study, we included 200 consecutive patients with breast cancer undergoing radical mastectomy from January 2022 to December 2023. Of these, 98 patients diagnosed with BCRL were designated as the experimental group, while 102 patients served as the control group. Logistic regression analyses were conducted to explore factors associated with clinical prognosis and to construct and validate a nomogram for predicting the risk of BCRL using R language version 4.1.2., Results: Univariate and multivariate logistic regression analyses identified six independent risk factors: the number of lymph node dissections (95% CI: 1.425-8.956, P < 0.01), radiotherapy (95% CI: 1.134-2.341, P < 0.01), lack of functional exercise (95% CI: 4.908-19.064, P = 0.001), adjuvant and neoadjuvant chemotherapy (95% CI: 1.763-4.287, P = 0.001), BMI (95% CI: 1.075-2.897, P < 0.05), and hypertension (95% CI: 1.077-2.999, P < 0.05). Using these variables, we developed a nomogram to predict the incidence of BCRL. The AUC value for the model was 0.74 (95% CI: 0.675-0.887), indicating acceptable agreement between predicted and observed outcomes. Decision curve analysis demonstrated good positive net benefits for the model., Conclusion: The number of lymph node dissections, radiotherapy, lack of functional exercise, adjuvant and neoadjuvant chemotherapy, BMI, and hypertension are independent risk factors for BCRL. Moreover, the nomogram prediction model showed good predictive performance, high accuracy, and clinical applicability., Competing Interests: None., (AJTR Copyright © 2024.)