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https://www.readbyqxmd.com/read/28106627/outcomes-after-elevation-of-serratus-anterior-fascia-during-prosthetic-breast-reconstruction
#1
Akhil K Seth, Elliot M Hirsch, John Y S Kim, Neil A Fine
BACKGROUND: Achieving optimal inferolateral coverage is critical to successful prosthetic breast reconstruction. Serratus anterior fascia (SF) elevation, a promising alternative to muscle flaps and acellular dermis (ADM), has not been rigorously studied. This study evaluates complication rates after mastectomy and immediate tissue expander (TE) coverage using SF, relative to other existing methods of reconstruction. METHODS: Retrospective review of consecutive patients undergoing mastectomy with immediate TE reconstruction over 10 years at 1 institution was performed...
January 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28104033/-impact-of-immediate-breast-reconstruction-on-the-onset-of-adjuvant-chemotherapy-and-on-the-postoperative-complications
#2
W S Liu, L Mu, X C Tang, Y Yu, X C Cao, X Wang
Objective: To explore the impact of immediate breast reconstruction on the onset of adjuvant chemotherapy and on the postoperative complications. Methods: We retrospectively analyzed the clinical data from female breast cancer patients treated by either modified radical mastectomy with immediate breast reconstruction(IBR) ( n=108) or modified radical mastectomy alone(n=115), followed by adjuvant chemotherapy at our department between January 2011 and December 2012. Results: There was no significant difference in the overall complication rates between the IBR group and modified radical mastectomy group (49...
January 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28103903/intraoperative-radiotherapy-iort-as-boost-in-breast-cancer
#3
REVIEW
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28099173/surgical-approach-for-ulcerated-locally-advanced-breast-cancer-a-single-center-experience-a-retrospective-study
#4
Rita Laforgia, Clelia Punzo, Annunziata Panebianco, Annalisa Volpi, Marina Minafra, Maria Grazia Sederino
AIM: The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable for a neoadjuvant chemotherapy step and to consider various reconstruction techniques. MATERIAL OF STUDY: Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps...
January 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28097499/automating-perforator-flap-mra-and-cta-reporting
#5
Christopher J Lange, Nanda Deepa Thimmappa, Srikanth R Boddu, Silvina P Dutruel, Mengchao Pei, Zerwa Farooq, Ashkan Heshmatzadeh Behzadi, Yi Wang, Ramin Zabih, Martin R Prince
Surgical breast reconstruction after mastectomy requires precise perforator coordinates/dimensions, perforator course, and fat volume in a radiology report. Automatic perforator reporting software was implemented as an OsiriX Digital Imaging and Communications in Medicine (DICOM) viewer plugin. For perforator analysis, the user identifies a reference point (e.g., umbilicus) and marks each perforating artery/vein bundle with multiple region of interest (ROI) points along its course beginning at the muscle-fat interface...
January 17, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28095769/pcm-sabre-a-platform-for-benchmarking-and-comparing-outcome-prediction-methods-in-precision-cancer-medicine
#6
Noah Eyal-Altman, Mark Last, Eitan Rubin
BACKGROUND: Numerous publications attempt to predict cancer survival outcome from gene expression data using machine-learning methods. A direct comparison of these works is challenging for the following reasons: (1) inconsistent measures used to evaluate the performance of different models, and (2) incomplete specification of critical stages in the process of knowledge discovery. There is a need for a platform that would allow researchers to replicate previous works and to test the impact of changes in the knowledge discovery process on the accuracy of the induced models...
January 17, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/28094211/likelihood-of-unacceptable-normal-tissue-doses-in-breast-cancer-patients-undergoing-regional-nodal-irradiation-in-routine-clinical-practice
#7
Jose Bazan, Dominic DiCostanzo, Karla Kuhn, Lonika Majithia, Allison Quick, Nilendu Gupta, Julia White
PURPOSE: As indications for regional nodal irradiation (RNI) for breast cancer have expanded, so too has scrutiny over potential late toxicity from radiotherapy. This emphasizes the need for careful radiation treatment planning to maximize the therapeutic ratio. We sought to evaluate how often unacceptable doses (UDs) to organs at risk (OARs) occur and the associated factors for patients receiving RNI in daily practice. METHODS AND MATERIALS: Treatment records of patients who received RNI from February 2012 to May 2015 were studied...
October 19, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28093897/presence-of-early-stage-cancer-does-not-impair-the-early-protein-metabolic-response-to-major-surgery
#8
Mariëlle P K J Engelen, V Suzanne Klimberg, Arianna Allasia, Nicolaas Ep Deutz
BACKGROUND: Combined bilateral mastectomy and reconstruction is a common major surgical procedure in women with breast cancer and in those with a family history of breast cancer. As this large surgical procedure induces muscle protein loss, a preserved anabolic response to nutrition is warranted for optimal recovery. It is unclear whether the presence of early stage cancer negatively affects the protein metabolic response to major surgery as this would mandate perioperative nutritional support...
January 16, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28092637/non-invasive-classification-of-breast-microcalcifications-using-x-ray-coherent-scatter-computed-tomography
#9
Bahaa Ghammraoui, Lucretiu M Popescu
We investigate the use of energy dispersive x-ray coherent scatter computed tomography (ED-CSCT) as a non-invasive diagnostic method to differentiate between type I and type II breast calcifications. This approach is sensitive to the differences of composition and internal crystal structure of different types of microcalcifications. The study is carried out by simulating a CSCT system with a scanning pencil beam, considering a polychromatic x-ray source and an energy-resolving photon counting detector. In a first step, the multidimensional angle and energy distributed CSCT data is reduced to the projection-space distributions of only a few components, corresponding to the expected target composition: adipose, glandular tissue, weddellite (calcium oxalate) for type I calcifications, and hydroxyapatite for type II calcifications...
February 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#10
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28089230/metastatic-fractures-of-long-limb-bones
#11
REVIEW
P Anract, D Biau, P Boudou-Rouquette
The diagnosis of pathological fracture should be considered routinely in patients with long limb-bone fractures. Investigations must be performed to establish the diagnosis of pathological fracture then to determine that the bone lesion is a metastasis. In over 85% of cases, the clinical evaluation combined with a detailed analysis of the radiographs is sufficient to determine that the fracture occurred at a tumour site. Aetiological investigations establish that the tumour is a metastasis. In some patients, the diagnosis of metastatic cancer antedates the fracture...
January 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28088591/specific-agreement-on-dichotomous-outcomes-in-the-situation-of-more-than-two-raters
#12
Henrica C W de Vet, Rieky E Dikmans, Iris Eekhout
OBJECTIVE: For assessing inter-rater agreement the concepts of observed agreement and specific agreement have been proposed. The situation of two raters and dichotomous outcomes has been described, whereas often times multiple raters are involved. We aim to extend it for more than two raters and examine how to calculate agreement estimates and 95% confidence intervals (CIs). STUDY DESIGN AND SETTING: As an illustration we used a reliability study that includes the scores of 4 plastic surgeons classifying photographs of breasts of 50 women, after breast reconstruction into 'satisfied' or 'not satisfied'...
January 11, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28079697/infectious-loss-of-tissue-expanders-in-breast-reconstruction-are-we-treating-the-right-organisms
#13
Gabriel M Klein, Brett T Phillips, Alexander B Dagum, Duc T Bui, Sami U Khan
BACKGROUND: Postoperative infections following tissue expander-based breast reconstruction represent a significant threat to the reconstructive process. Studies have found the incidence to be as high as 29%. There has been abundant research into the risk factors associated with these infections, although very few studies have focused on the causative organisms. The purpose of this study was to investigate the bacterial flora associated with tissue expander infections after breast reconstruction...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#14
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28077836/-decision-making-experience-on-breast-reconstruction-for-women-with-breast-cancer
#15
Myungsun Yi, Woo Joung Joung, Eun Young Park, Eun Jin Kwon, Haejin Kim, Ji Young Seo
PURPOSE: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. METHODS: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. RESULTS: Five theme clusters emerged...
December 2016: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28072582/the-effect-of-system-geometry-and-dose-on-the-threshold-detectable-calcification-diameter-in-2d-mammography-and-digital-breast-tomosynthesis
#16
Andria Hadjipanteli, Premkumar Elangovan, Alistair Mackenzie, Padraig T Looney, Kevin Wells, David R Dance, Kenneth C Young
Digital breast tomosynthesis (DBT) is under consideration to replace or to be used in combination with 2D-mammography in breast screening. The aim of this study was the comparison of the detection of microcalcification clusters by human observers in simulated breast images using 2D-mammography, narrow angle (15°/15 projections) and wide angle (50°/25 projections) DBT. The effects of the cluster height in the breast and the dose to the breast on calcification detection were also tested. Simulated images of 6 cm thick compressed breasts were produced with and without microcalcification clusters inserted, using a set of image modelling tools for 2D-mammography and DBT...
February 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28072394/three-dimensional-cascaded-system-analysis-of-a-50-%C3%A2%C2%B5m-pixel-pitch-wafer-scale-cmos-active-pixel-sensor-x-ray-detector-for-digital-breast-tomosynthesis
#17
Chumin Zhao, Nikita Vassiljev, Anastasios Konstantinidis, Robert Speller, Jerzy Kanicki
High-resolution, low-noise x-ray detectors based on the complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been developed and proposed for digital breast tomosynthesis (DBT). In this study, we evaluated the three-dimensional (3D) imaging performance of a 50 ��m pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). The two-dimensional (2D) angle-dependent modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were experimentally characterized and modeled using the cascaded system analysis at oblique incident angles up to 30��...
January 10, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28069398/objective-decision-making-between-conventional-and-oncoplastic-breast-conserving-surgery-or-mastectomy-an-aesthetic-and-functional-prospective-cohort-study
#18
D Pukancsik, P Kelemen, M Újhelyi, E Kovács, N Udvarhelyi, N Mészáros, I Kenessey, T Kovács, M Kásler, Z Mátrai
BACKGROUND: Breast-conserving surgery (BCS) is considered the standard treatment for early-stage breast cancer. However, fair to poor cosmetic outcomes following conventional BCS have been observed in as many as one-third of cases. The aim of this study was to determine the critical tumor-to-breast volume ratio for each quadrant of the breast beyond which conventional BCS would no longer offer acceptable cosmetic and functional results or satisfactory quality of life for the patient. METHODS: A prospective cohort study was performed between December 2011 and December 2013 involving 350 patients younger than 70 years with early-stage unifocal (T ≤ 30 mm) breast cancer who underwent wide excision and axillary sentinel lymph node biopsy followed by whole-breast irradiation...
December 5, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28068732/-concept-for-a-national-implant-registry-to-improve-patient-safety
#19
L Prantl, U von Fritschen, J Liebau, J von Hassel, E M Baur, P M Vogt, R E Giunta, R E Horch
Since the introduction of silicone implants, several events have led to considerable uncertainty among the patients, public, and users. So far, however, the necessary steps to significantly improving patient safety have not been taken in any of these cases. Requiring stricter approvals for medical devices, improving monitoring by the regulatory authorities and the revision of the Medical Devices Directive are all initial steps in the right direction towards a change in policy, but are insufficient as an early warning system...
December 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28066801/cell-assisted-lipotransfer-in-breast-augmentation-and-reconstruction-a-systematic-review-of-safety-efficacy-use%C3%A2-of%C3%A2-patient-reported-outcomes-and-study-quality
#20
Zeeshaan Arshad, Lindsey Karmen, Rajan Choudhary, James A Smith, Olivier A Branford, David A Brindley, David Pettitt, Benjamin M Davies
BACKGROUND: Cell assisted lipotransfer serves as a novel technique for both breast reconstruction and breast augmentation. This systematic review assesses the efficacy, safety and use of patient reported outcome measures in studies involving cell assisted lipotransfer. We also carry out an objective assessment of study quality focussing on recruitment, follow-up and provide an up-to-date clinical trial landscaping analysis. METHODS: Key electronic databases were searched according to PRISMA guidelines and pre-defined inclusion and exclusion criteria...
December 2016: JPRAS Open
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