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https://www.readbyqxmd.com/read/29346711/early-assessment-of-post-surgical-outcomes-with-pre-pectoral-breast-reconstruction-a-literature-review-and-meta-analysis
#1
Abhishek Chatterjee, Maurice Y Nahabedian, Allen Gabriel, David Macarios, Mousam Parekh, Fang Wang, Leah Griffin, Steven Sigalove
BACKGROUND: Pre-pectoral breast reconstruction is an emerging surgical approach. This study provides an early assessment of outcomes with the technique. METHODS: A comprehensive literature review was performed through searches of PubMed® /MEDLINE® to identify studies on pre-pectoral reconstruction. Patient characteristics and outcomes were extracted from studies and pooled. Linear relationships between complication rates and patient characteristics with pre-pectoral reconstruction were analyzed...
January 18, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29342302/determination-of-the-appropriate-physical-density-of-internal-metallic-ports-in-temporary-tissue-expanders-for-the-treatment-planning-of-post-mastectomy-radiation-therapy
#2
Norifumi Mizuno, Haruna Takahashi, Jiro Kawamori, Naoki Nakamura, Mami Ogita, Shogo Hatanaka, Ryouhei Yamauchi, Masatsugu Hariu, Kenji Sekiguchi
Some patients undergoing breast reconstruction require post-mastectomy radiation therapy, but the metallic ports used in temporary tissue expanders attenuate the X-rays. In this study, we evaluated by the film method, the attenuation of 4 MV and 6 MV X-rays after passing through a metallic port, with the aim of identifying a useful method for determining the appropriate density to use in the radiation treatment planning system (RTPS), taking into account the distance between the metallic port and the targets...
January 12, 2018: Journal of Radiation Research
https://www.readbyqxmd.com/read/29341294/topical-nitroglycerin-for-the-treatment-of-intraoperative-microsurgical-vasospasm
#3
Joseph A Ricci, Dhruv Singhal, Eugene Y Fukudome, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. This study aims to analyze the outcomes of this medication on flap complications compared with papaverine. METHODS: All consecutive free flaps performed for breast reconstruction at a single institution were reviewed...
January 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29340798/diagnostic-implications-of-a-small-voxel-reconstruction-for-loco-regional-lymph-node-characterization-in-breast-cancer-patients-using-fdg-pet-ct
#4
Daniëlle Koopman, Jorn A van Dalen, Hester Arkies, Ad H J Oostdijk, Anne Brecht Francken, Jos Bart, Cornelis H Slump, Siert Knollema, Pieter L Jager
BACKGROUND: We evaluated the diagnostic implications of a small-voxel reconstruction for lymph node characterization in breast cancer patients, using state-of-the-art FDG-PET/CT. We included 69 FDG-PET/CT scans from breast cancer patients. PET data were reconstructed using standard 4 × 4 × 4 mm3 and small 2 × 2 × 2 mm3 voxels. Two hundred thirty loco-regional lymph nodes were included, of which 209 nodes were visualised on PET/CT. All nodes were visually scored as benign or malignant, and SUVmax and TBratio(=SUVmax/SUVbackground) were measured...
January 16, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29335394/landscape-of-oncoplastic-breast-surgery-across-poland
#5
Agnieszka Kolacinska, Diana Hodorowicz-Zaniewska, Artur Bocian, Dariusz Michalik, Rafal Matkowski, Andrzej Kurylcio, Pawel Pyka, Michal Charytonowicz, Maciej Berkan
Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29334788/latissimus-dorsi-flap-in-breast-reconstruction-recent-innovations-in-the-workhorse-flap
#6
Rachita Sood, Jeena M Easow, Geoffrey Konopka, Zubin J Panthaki
BACKGROUND: Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap. METHODS: The authors discuss the historical uses and more recent developments in the LDF...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29334363/macrophage-membrane-coated-iron-oxide-nanoparticles-for-enhanced-photothermal-tumor-therapy
#7
Qian-Fang Meng, Lang Rao, Minghui Zan, Ming Chen, Guang-Tao Yu, Xiaoyun Wei, Zhuhao Wu, Yue Sun, Shi Shang Guo, Xing-Zhong Zhao, Fu-Bing Wang, Wei Liu
Nanotechnology possesses the potential to revolutionize the diagnosis and treatment of tumors. The ideal nanoparticles used for in vivo cancer therapy should own long blood circulation and active cancer targeting. Additionally, they should be innoxious and invisible to the immune system. Here, we developed a biomimetic nanoplatform with the above properties for cancer therapy. Macrophage membranes were reconstructed into vesicles and then coated onto magnetic iron oxide nanoparticles (Fe3O4 NPs). Inherited from the Fe3O4 core and the macrophage membrane shell, the resulting Fe3O4@MM NPs exhibited good biocompatibility, immune evasion, cancer targeting, and light-to-heat conversion capabilities...
January 15, 2018: Nanotechnology
https://www.readbyqxmd.com/read/29330268/pelvic-and-buttock-hypoplasia-reconstructed-with-anatomical-breast-implants
#8
Felicity Page, Ayad Harb, Garth Titley
Radiation therapy is used in the management of a number of childhood cancers and can have significant effects on skeletal growth. We present the case of a 35-year-old woman who developed a hypoplastic pelvis and buttocks following radiotherapy for rhabdomyosarcoma of the vagina at the age of 2. At the age of 25, the patient underwent bilateral buttock augmentation with a two-stage reconstruction using tissue expansion followed by definitive augmentation with anatomical breast implant insertion. The patient continues to have a satisfactory outcome 10 years following reconstruction, having undergone a single uplift procedure and exchange of implants through the original incision 9 years postoperatively...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29327777/the-use-of-acellular-dermal-matrices-adm-in-breast-reconstruction-a-review
#9
Christian Eichler, Carolin Schulz, Nadine Vogt, Mathias Warm
The use of acellular dermal matrices (ADM), sometimes referred to as extracellular matrix (ECM), has become an interesting aspect of breast reconstruction. A great deal of literature is available, totaling over 7000 ADM-based reconstructions. Most often, ADMs are used in a skin sparing mastectomy (SSM) scenario, although heterologous breast augmentation with a sub-pectoral fixation may also require an ADM application. Their use has become an attractive, but expensive option. Available data shows head to head comparisons between individual ADMs to be mostly retrospective in nature with only a few prospective trials available...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29327298/the-impact-of-obesity-on-outcomes-for-patients-undergoing-mastectomy-using-the-acs-nsqip-data-set
#10
Mary Garland, Fang-Chi Hsu, Clancy Clark, Akiko Chiba, Marissa Howard-McNatt
PURPOSE: According to the World Health Organization (WHO), 34.7% of females in the United States are obese (BMI ≥ 30) in 2014, compared to 32.5% in 2010. The previous research has demonstrated high BMI as an independent risk factor for surgical complications after breast surgery. As more patients become obese, we sought to examine whether increasing obesity had an effect on outcomes of women who underwent a unilateral mastectomy without breast reconstruction. METHODS: The study reviewed the 2007-2012 ACS-NSQIP database and identified all patients who underwent a unilateral mastectomy without reconstruction...
January 11, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29325808/dutch-breast-reconstruction-guideline
#11
REVIEW
Marc A M Mureau
Treatment of breast cancer is complex and multidisciplinary by nature, with protocols that are updated continuously. During preoperative multidisciplinary team meetings, regularly there is discussion between team members regarding optimal timing and type of breast reconstruction, due to conflicting interests of oncological and reconstructive treatments. Therefore, a multidisciplinary, evidence-based guideline for breast reconstruction in women undergoing breast conserving therapy or mastectomy for breast cancer, or following prophylactic mastectomy was developed by a multidisciplinary working group...
December 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29325422/outcomes-in-deep-inferior-epigastric-perforator-flap-and-implant-based-reconstruction-does-age-really-matter
#12
Lauren V Kuykendall, Angie Zhang, Bugra Tugertimur, Sara Bijan, Corin Agoris, Ambuj Kumar, Deniz Dayicioglu
Despite the growing elderly population, there is limited research specific to this demographic concerning breast reconstruction (BR). Lack of evidence-based BR recommendations in older populations may contribute to misconceptions and subsequent underutilization of BR, especially autologous BR. Patients who received either deep inferior epigastric perforator (DIEP) flap BR or tissue expander/implant (TE/I) BR by a single surgeon between July 2011 and July 2015 were surveyed postoperatively by using the psychometrically validated BREAST-Q questionnaire to determine patient satisfaction...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29324933/brachytherapy-in-soft-tissue-tumours-an-interdisciplinary-challenge
#13
Silvanie Volz, Konstantinos Kalousis, Jung In Song, Tobias Kisch, Eike Wenzel, Peter Mailänder
OBJECTIVE: Interdisciplinary work including surgery and additive radiotherapy is often needed for the therapy of tumours. Beneath this, brachytherapy is an important part of the radiotherapy. It was first used over 100 years ago and is in regular use after the development of afterload technology in the early 1970s. Today it is often used in different tumour therapies, for example in soft tissue sarcoma or breast tumours, in order to decrease the risk of local recurrence. Concerning its benefits, higher doses could be used because of the localized effect with equivalent local control rate and less toxicity of treatment...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29320921/benefits-and-risks-with-acellular-dermal-matrix-adm-and-mesh-support-in-immediate-breast-reconstruction-a-systematic-review-and-meta-analysis
#14
Håkan Hallberg, Svanheidur Rafnsdottir, Gennaro Selvaggi, Annika Strandell, Ola Samuelsson, Ida Stadig, Therese Svanberg, Emma Hansson, Richard Lewin
In modern implant-based immediate breast reconstruction, it has become common to use biological acellular dermal and synthetic matrices in combination with a tissue expander or an implant. The aim of this systematic review was to examine differences in recurrence of cancer, impact on oncological treatment, health related quality of life, complications and aesthetic outcome between matrix and no matrix in immediate breast reconstruction. Systematic searches, data extraction and assessment of methodological quality were performed according to predetermined criteria...
January 10, 2018: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/29319579/how-big-is-too-big-pushing-the-obesity-limits-in-microsurgical-breast-reconstruction
#15
Jamie A Spitz, Perry S Bradford, Frank Aguilar, Sergey Y Turin, Marco F Ellis
PURPOSE: Obesity is a major public health concern in the United States, affecting nearly 79 million people. There have been promising results performing microvascular breast reconstruction in patients with obesity; however, the definition of obesity is often poorly defined or does not extend above a body mass index (BMI) of 35. Our goal was to examine outcomes of microvascular breast reconstruction in this questionably more risky population. METHODS: A retrospective review from 2013 to 2016 was performed of 2 surgeons' experience with abdominally based microvascular breast reconstructions...
February 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29318956/improvement-in-existing-chest-wall-irregularities-during-breast-reconstruction
#16
Katherine M Huber, Amanda Zimmerman, Deniz Dayicioglu
Mastectomies for both cancer resection and risk reduction are becoming more common. Existing chest wall irregularities are found in these women presenting for breast reconstruction after mastectomy and can pose reconstructive challenges. Women who desired breast reconstruction after mastectomy were evaluated preoperatively for existing chest wall irregularities. Case reports were selected to highlight common irregularities and methods for improving cosmetic outcome concurrently with breast reconstruction procedures...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29318171/mobile-web-based-follow-up-for-postoperative-acl-reconstruction-a-single-center-experience
#17
James Higgins, John Semple, Lucas Murnaghan, Sarah Sharpe, John Theodoropoulos
Background: The initial 6 weeks after surgery has been identified as an area for improvement in patient care. During this period, the persistence of symptoms that go unchecked can lead to unscheduled emergency room and clinic visits, calls to surgeons' offices, and readmissions. Purpose: To analyze postoperative data from a previous study examining postoperative outcomes in 2 patient populations following breast reconstruction and anterior cruciate ligament (ACL) reconstruction with use of a patient-centered mobile application...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29316774/how-to-optimize-aesthetic-outcomes-in-implant-based-breast-reconstruction
#18
Maurizio Bruno Nava, Giuseppe Catanuto, Nicola Rocco
The evolution of breast reconstructive surgery keeps pace with the evolution of breast oncologic surgery. The reconstructive choice should always balance the optimal local control of disease and the best cosmetic result, reflecting an informed decision that is shared with the patient, who is always at the center of the decision-making process. Implant-based breast reconstruction following mastectomy represents a complex choice. In order to obtain optimal results, the following considerations are mandatory: thorough preoperative planning, a complete knowledge of the devices that are used, accurately performed surgery, and appropriate follow-up...
January 10, 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29316048/does-response-to-neo-adjuvant-chemotherapy-impact-breast-reconstruction
#19
Michael R Cassidy, Emily C Zabor, Michelle Stempel, Babak Mehrara, Mary L Gemignani
Neo-adjuvant chemotherapy (NAC) is administered in breast cancer treatment for downstaging of disease. Here, we determined the impact of response to NAC on breast reconstruction uptake. A prospective NAC and mastectomy database with or without reconstruction were reviewed with IRB approval. Univariable analyses were conducted using Kruskal-Wallis or Fisher's exact tests. Multivariable logistic regression was used to adjust for potential confounders. We identified 271 patients with unilateral breast cancer receiving NAC and either unilateral or bilateral mastectomy from 9/2013 to 5/2016...
January 8, 2018: Breast Journal
https://www.readbyqxmd.com/read/29315799/preserving-a-patent-diep-pedicle-to-facilitate-salvage-breast-reconstruction-with-a-second-free-flap-a-case-report
#20
Dimitris Reissis, Daniel P Butler, Francis P Henry, Simon H Wood
Surgeons performing free flap breast reconstruction need to have a range of techniques in their armamentarium to successfully salvage cases of flap failure. We present a case of 47-year-old patient who suffered near-total right breast deep inferior epigastric perforator (DIEP) flap failure 3 days post-bilateral immediate breast reconstruction with DIEP flaps. At debridement, the DIEP pedicle was noted to be patent with preserved perfusion to a small segment of tissue around the origin of the pedicle. This tissue and the DIEP pedicle itself were therefore preserved to facilitate subsequent breast reconstruction using stacked transverse upper gracilis flaps anastomosed end-to-end to the original DIEP pedicle...
January 8, 2018: Microsurgery
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