Whereas the National Comprehensive Cancer Network (NCCN) criteria restrict germline-genetic testing (GGT) to a subset of breast cancer (BC) patients, the American Society of Breast Surgeons recommends universal GGT. Although the yield of pathogenic germline variants (PGV) in unselected BC patients has been studied, the practicality and utility of incorporating universal GGT into routine cancer care in community and rural settings is understudied. This study reports real-world implementation of universal GGT for patients with breast cancer and genetics-informed, treatment decision-making in a rural, community practice with limited resources.From 2019 to 2022, all patients with breast cancer at a small, rural hospital were offered GGT, using a genetics-extender model. Statistical analyses included Fisher's exact test, t-tests, and calculation of odds ratios. Significance was set at p < 0.05.Of 210 patients with breast cancer who were offered GGT, 192 (91.4%) underwent testing with 104 (54.2%) in-criteria (IC) and 88 (45.8%) out-of-criteria (OOC) with NCCN guidelines. Pathogenic germline variants were identified in 25 patients (13.0%), with PGV frequencies of 15 of 104 (14.4%) in IC and ten of 88 (11.4%) in OOC patients (p = 0.495). GGT informed treatment for 129 of 185 (69.7%) patients.Universal GGT was successfully implemented in a rural, community practice with > 90% uptake. Treatment was enhanced or de-escalated in those with and without clinically actionable PGVs, respectively. Universal GGT for patients with breast cancer is feasible within rural populations, enabling optimization of clinical care to patients' genetic profile, and may reduce unnecessary healthcare, resource utilization. 

Universal Germline-Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision-Making.

Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014 to 2017

BACKGROUND
In 2021, breast cancer was one of the most commonly diagnosed cancer in Australia (Health AIo, Welfare. Cancer in Australia 2021. Canberra: AIHW, 2021). While a mastectomy remains a treatment of choice, only a small percentage of women have access to a breast reconstruction after (Group AAtBRC. Position statement on access to post-mastectomy breast reconstruction information and services in Australia, 2021). Women living in a rural area are less likely to have a breast reconstruction; compared to their metropolitan counterparts (Bhat D, Heiman AJ, Talwar AA, Dunne M, Amanjee K, Ricci JA. Access to breast cancer treatment and reconstruction in rural populations: do women have a choice? J. Surg. Res. 2020; 254:223-31). This study analyses the impact of single breast reconstruction service on a Modified Monash 3 (MM3) region and informs consumers and providers of the importance of a breast reconstruction unit embedded in a rural health network.


METHODS
Following ethics approval, all 64 patients who had undergone a breast reconstruction with this service between 2017 and 2021 were contacted. Patient reported outcomes were recorded through phone interviews, using a standardized questionnaire. For each patient that presented to the rural centre, cost of travel and productivity loss were also calculated, and compared to the closest metropolitan centre.


RESULT
Ninety-seven percent of the 38 participants strongly valued having a breast reconstruction service within their community. Eighty percent of participants were satisfied with their result. Patients were estimated to save on average $8478, by attending the rural breast reconstruction service.


CONCLUSION
Access to a breast reconstruction is significantly impacted by geographical barriers. A rural breast reconstruction service can improve patient access and satisfaction, while also reducing the financial burden on patients.

The development of a rural breast reconstruction service: patient reported outcomes and benefits.

Objectives In this study, we analyzed the effect and prognosis of combinative implantation of autologous-fat granule and prosthesis for breast reconstruction after radical mastectomy. Methods 73 cases of breast cancer patients hospitalized from March 2015 to March 2017 were chosen and separated into observation group (n=41) and control group (n=32) on the basis of the surgical methods. Both the two groups underwent modified radical mastectomy. In addition, the control group received prosthesis implantation for breast reconstruction, and the observation group was implanted with combination of prosthesis and autologous-fat granule transplantation. Thereafter, the surgical indexes, postoperative complications, aesthetic effects of breast reconstruction and prognosis of the two groups of patients were evaluated. Results The surgical duration of the observation group was obviously longer than that of the control group (P 0.05). FACT-B score of both groups of patients one year after surgery was dramatically higher than that before surgery (P 0.05). Conclusion The combinative implantation of both prosthesis and autologous-fat granule for breast reconstruction after radical mastectomy is simple in operation procedure, and has better aesthetic outcome and safety. It satisfies the aesthetic demand of patients while having lesions resection, and does not affect the surgical effect of modified radical mastectomy, which is worthy of clinical promotion.

The effect and prognosis of combinative implantation by autologous-fat granule and prosthesis for breast reconstruction after radical mastectomy.

Resumo O objetivo do estudo foi compreender como agentes comunitarios de saude percebem a organizacao da Atencao Primaria a Saude (APS) para o cuidado a saude de populacoes rurais em municipios de pequeno porte do estado de Minas Gerais. Estudo qualitativo, realizado em seis municipios de pequeno porte das regioes Norte e Nordeste de Minas Gerais. Foram realizados seis grupos focais, entre julho e dezembro de 2019. Os resultados evidenciaram diferentes estrategias para ampliar o acesso da populacao rural a acoes ofertadas na APS, como a construcao de pontos de apoio e a organizacao das equipes para ofertarem consultas, visitas domiciliares e determinados procedimentos nos proprios territorios rurais. Entretanto, a organizacao do cuidado a populacao rural parece estar mais orientada por criterios clinicos e pela capacidade de deslocamento das equipes e dos usuarios do que pelas necessidades de saude da populacao rural. Espera-se que os dados obtidos em diferentes realidades de territorios rurais possam contribuir para o desenvolvimento de estrategias que buscam ampliar e consolidar politicas publicas de saude para a populacao rural brasileira.

/pdf/cuidado-em-saude-as-populacoes-rurais-perspectivas-e-dnpp0gvcx9.pdf

Cuidado em saúde às populações rurais: perspectivas e práticas de agentes comunitários de saúde

Access to Breast Cancer Treatment and Reconstruction in Rural Populations: Do Women Have a Choice?

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Kritika Amanjee

Author Tools

Chat about Author

Papers

Access to Breast Cancer Treatment and Reconstruction in Rural Populations: Do Women Have a Choice?