The THAI Journal of SURGERY 2009; 30:75-134. Official Publication of the Royal College of Surgeons of Thailand Abstracts of the 34th Annual Scientific Meeting of the Royal College of Surgeons of Thailand,4-7 July 2009, Ambassador Jontien Hotel, Pattaya, Thailand BREAST SURGERY COMPARATIVE STUDY OF CYTOLOGICAL ANALYSIS Conclusion: Cytological analysis is a useful method VERSUS FROZEN SECTION FOR DETECTION OF and at least as accurate as frozen section for evaluating SENTINEL LYMPH NODE METASTASES IN BREAST sentinel lymph node metastasis in breast cancer patients. CANCER Wichitra Asanprakit1, Phibul Punyarit2, Sukchai Satthaporn1, A COMPARATIVE STUDY BETWEEN COMPRESSIBLE Wichai Vassanasiri1, Surapong Supaporn1 BRASSIERE AND CONVENTIONAL PRESSURE 1Department of Surgery, Phramongkutklao Hospital and College of DRESSING FOR SEROMA PREVENTION AFTER Medicine, Bangkok, Thailand, 2Army institute of Pathology, MASTECTOMY IN BREAST CANCER Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand Wisit Kasertsermwiriya, Suphakarn Techapongsatorn, Background: Sentinel lymph node biopsy has become Anan Manomaiphiboon, Pong Karnchanasuthiruk, the standard procedure for axillary lymph node evaluation Sathis Srimunthayamatr in breast cancer patients. Frozen section is the common General Surgery Unit, Department of Surgery, BMA Medical College and technique that often used for intraoperative examination Vajira Hospital, Bangkok, Thailand of sentinel lymph node but it has some disadvantages. Cytology is another analysis technique that has been Background: Seroma is a common complication after evaluated during operation for several types of cancer and mastectomy in breast cancer. Its incidence is about 30- it has advantage over frozen section. 53%. Various techniques to prevent seroma such as fibrin Objectives: Aims of this study were to compare glue, sclerosing agents, dissection instruments, shoulder usefulness of frozen section and cytological analysis for exercise did not show the advantage. From previous diagnosis of sentinel lymph node metastases of breast studies, conventional pressure dressing could not maintain cancer. the pressure at surgical wound. Then, newly developed Materials and Methods: During January 2007 to compressible brassiere was selected for comparative study December 2007, 84 breast cancer patients underwent after pressure and acceptable testing. sentinel lymph node biopsy by blue dye technique alone. Materials and Methods: A total of 56 patients with After dissection and removal of lymph nodes, cytological stage I-III breast cancer who underwent modified radical analysis, frozen section and permanent section of sentinel mastectomy in Vajira Hospital were randomly allocated lymph nodes were performed. into 2 groups. Compressible brassiere and conventional Results: A total of 166 sentinel lymph nodes were pressure dressing after surgery were applied to 27 and 29 harvested and sent for cytological analysis, frozen section patients. The surgeons did not know the type of dressing and permanent section. 32 lymph nodes were positive by until finished the operation. The demographic data, total permanent section. The sensitivity, specificity and accuracy volume of drainage, drainage period and occurrence of of cytological analysis were 93.75%, 100% and 98.79% the seroma were recorded and compared between two respectively that equal to frozen section method. groups. 75 76 Abstracts Thai J Surg Jul. - Dec. 2009 Results: The drainage volume in compressible QUALITY OF LIFE IN BREAST CANCER PATIENTS brassiere group and conventional group were not different Suphakan Techapongsatorn, Supada Techapongsatorn, statistically (774.3 ml and 725.5 ml, p = 0.73). The drainage Wisit Kasetsermviriya, Satit Srimantayamas, period between two group were not different too (11.1 days Anan Manomaipiboon and 9.3 days, p = 0.19). Seroma occurred in 6/27 and 4/29 General Surgery Unit, Department of Surgery, Bangkok Metropolitan cases (p = 0.49). Skin complications from adhesive dressing Administration Medical College and Vajira Hospital, Bangkok, Thailand especially excoriation or bleb formation occurred in only conventional group (8/29). Objective: To study quality of life in breast cancer Conclusion: The incidence of seroma after patient stage 1-3 and factors that effect the quality of life in mastectomy in breast cancer were not different statistically vajira hospital. significant between compressible brassiere and conven- Materials and Methods: One hundred and five stage tional pressure dressing. However, surrounding skin 1-3 breast cancer patients who follow up at the Outpatient complications from adhesive dressing were not found in Department of Vajira Hospital between December 2004 - compressible brassiere. November 2005. The patients answered the WHOQOL- BREF (Thai version) and the Quality of Life score was calculated to find the mean of score and standard deviation. KNOWLEDGE, ATTITUDE AND BEHAVIOR OF THAI The socioeconomic status and treatment factors were WOMEN TOWARD BREAST CANCER SCREENING analyzed effect to the quality of life. Results: The mean quality of life is 87.8286 (medium Suphakarn Techapongsatorn1, Cherdchai Kittipovanon2 quality of life) and the standard deviation is 8.58. The 1General Surgery Unit, Department of Surgery, Bangkok Metropolitan income and education factors were statistical significant Administration Medical College and Vajira Hospital, Bangkok, Thailand, effect to the quality of life score (p <0.05). 2General Surgery unit, Somdej Prayupraraj Kranuan Khon Kaen Hospital, Conclusion: The mean quality of life in breast cancer Khon Kaen, Thailand patient stage 1-3 was in medium range. Income and Objective: To study the knowledge, attitude and education had effect on the quality of life in breast cancer behavior of Thai women toward breast cancer screening patients. Materials and Methods: A total of 200 women attending OPD or visiting surgical ward at BMA Medical College and Vajira hospital and Somdej Prayupraraj QUALITY OF LIFE IN BREAST CANCER SURGERY: Kranuan Khon Kaen during August 2007-December 2007 COMPARATIVE STUDY OF MASTECTOMY, MASTEC- were enrolled. Self administer questionnaires about TOMY WITH IMMEDIATE BREAST RECONSTRUC- knowledge, attitude and behavior toward breast cancer TION AND BREAST CONSERVING SURGERY screening were distributed to the subjects. Percentage of Satit Srimontayamas, Adune Ratanawichitrasin, knowledge, attitude and behavior toward breast cancer Kris Bhothisuwan, Supakorn Rojananin, screening were analyzed. Poramaporn Prasarttong-Osoth, Pradit Rushatamukayanunt, Results: The good knowledge toward breast cancer Waraporn Imruthaichareonchok, Visnu Lohsiriwat, screening such as self breast examination was 70% and Suebwong Juthapisit, Pornchai O-charoenrat examination by medical personnel was 75%. The good Division of Head-Neck and Breast Surgery, Department of Surgery, attitude toward breast cancer screening such as self breast Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand examination was 93%, examination by medical personnel was 70%, and mammography was 70%. The barrier of Background: Breast conserving surgery (BCS) and breast cancer screening was the male physician who mastectomy with immediate breast reconstruction (MIBR) performed breast physical examination and cost of are the treatment of breast cancer with advantages in terms mammography. The behavior toward breast cancer of cosmetic outcome. The procedures do not affect survival screening was limited, self breast examination was 70%, outcome and local recurrence, but may improve quality of examination by medical personnel and performed life (QoL). Previous studies failed to demonstrate a better mammography was only 30% QoL in women who undergone BCS and MIBR, compared Conclusion: The good knowledge and attitude toward with women who undergone mastectomy (MT). Therefore breast cancer screening by medical personnel was 70 % and we aimed to study QoL amongst women who underwent 93 % respectively. But the behavior toward breast cancer mastectomy, BCS and mastectomy with IBR. screening was only 30%. Material and Methods: Two hundred and sixty five Vol. 30 No. 3-4 Abstracts 77 Thai women who had breast cancer surgery at Siriraj and TRAM groups received adjuvant chemotherapy more Hospital were included in the study. These included 113 than women in the BCS group. All three groups had same women who had mastectomy (MT group), 109 women who follow up period. Based on the FACT-G and FACT-B score, had breast conserving surgery (BCS group) and 43 women there was no significant difference in overall QoL amongst who had mastectomy with transverse rectus abdominis three studied groups (p=0.056 for FACT-G and p=0.275 for muscle flap (TRAM group). Functional Assessment for FACT-B, ANOVA test.). However, the difference was Cancer Therapy-G and B (FACT-G and FACT-B) demonstrated in the emotional well-being subsection questionnaires were used to assess QoL. ANOVA test was (p=0.09) that the women in TRAM group had better used for statistic analysis. emotional well-being comparing the women in BCS and Results: There was no difference in age, occupation, MT groups. graduate, marital and menopausal status of patient amongst Conclusion: Women who underwent mastectomy with the three groups. However, women in the BCS group IBR had no significant difference in FACT-G and FACT-B presented at earlier stage than the MT and TRAM group. score, however the women in the TRAM group had better Axillary lymph node dissection (ALND)