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Breast reconstruction

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https://www.readbyqxmd.com/read/28088591/specific-agreement-on-dichotomous-outcomes-in-the-situation-of-more-than-two-raters
#1
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
#2
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
#3
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
#4
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
#5
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...
January 10, 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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28065399/oncologic-safety-of-immediate-breast-reconstruction-in-breast-cancer-patients-who-underwent-neoadjuvant-chemotherapy-short-term-outcomes-of-a-matched-case-control-study
#10
Jai Min Ryu, Sungmin Park, Hyun-June Paik, Seok Jin Nam, Seok Won Kim, Se Kyung Lee, Jonghan Yu, Soo Youn Bae, Isaac Kim, Sa Ik Bang, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Jeong Eon Lee
INTRODUCTION: Although the indication for immediate breast reconstruction (IBR) after skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) has been expanded, IBR after neoadjuvant chemotherapy (NACT) is still controversial. We conducted retrospective matched case-control study to analyze oncologic outcomes between patients who underwent TM only and those who underwent IBR after SSM or NSM after NACT. PATIENTS AND METHODS: A retrospective review of breast cancer patients who underwent IBR after SSM or NSM after NACT between 2008 and 2015 at a single center was conducted...
October 27, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28064435/3d-volume-reconstruction-from-serial-breast-specimen-radiographs-for-mapping-between-histology-and-3d-whole-specimen-imaging
#11
Thomy Mertzanidou, John H Hipwell, Sara Reis, David J Hawkes, Babak Ehteshami Bejnordi, Mehmet Dalmis, Suzan Vreemann, Bram Platel, Jeroen van der Laak, Nico Karssemeijer, Meyke Hermsen, Peter Bult, Ritse Mann
PURPOSE: In breast imaging, radiological in-vivo images, such as X-ray mammography and Magnetic Resonance Imaging (MRI), are used for tumour detection, diagnosis and size determination. After excision, the specimen is typically sliced into slabs and a small subset is sampled. Histopathological imaging of the stained samples is used as the gold standard for characterisation of the tumour microenvironment. A 3D volume reconstruction of the whole specimen from the 2D slabs could facilitate bridging the gap between histology and in-vivo radiological imaging...
January 8, 2017: Medical Physics
https://www.readbyqxmd.com/read/28062965/patient-satisfaction-and-clinical-outcomes-following-414-breast-reductions-application-of-breast-q
#12
A Cogliandro, M Barone, G Cassotta, S Tenna, B Cagli, P Persichetti
BACKGROUND: The aim of this study was to measure breast satisfaction and quality of life using the BREAST-Q Reduction Module in a large sample of postoperative patients having breast reduction using the inverted T technique. METHODS: With due approval from the ethics committee of our university, 414 patients who were seen in consultation for breast reduction surgery between 2005 and 2015 performed by the same team were asked to fill out BREAST-Q surveys. The patient factors collected for all those undergoing breast reduction included age, body mass index, incision pattern, areola complex pedicle used, amount of tissue resected, concurrent procedures, and complications...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28062432/epirubicin-extravasation-consequences-of-delayed-management
#13
Olivia Hale, Peter George Deutsch, Anindya Lahiri
Epirubicin is an anthracycline chemotherapy agent used for treatment of several cancers including oesophageal, breast and gastric. Extravasation is a well-recognised and serious complication of any intravenous therapies but especially chemotherapeutic agents. Signs of the injury can be subtle and without prompt recognition and treatment there can be extensive tissue damage and depending on location of injury this can result in significant functional loss. In this article, a case of delayed management of epirubicin extravasation from a cannula situated at the dorsum of the hand is discussed...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28061518/breast-reconstruction-in-elderly-patients-risk-factors-clinical-outcomes-and-aesthetic-results
#14
Rosaria Laporta, Sorotos Michail, Longo Benedetto, Santanelli di Pompeo Fabio
Background Correlation among age, clinical, and aesthetic outcomes in implant-based and autologous breast reconstructions was investigated. Methods Between 2004 and 2014, a retrospective study was performed on patients who underwent reconstruction following mastectomy. Patients were divided in group A (< 50 years), group B (≥ 50-59 years), group C (≥ 60-69 years), and group D (≥ 70 years). Demographics, comorbidities, American Society of Anesthesiologists (ASA) class, and length of stay were assessed using chi-square and Kruskal-Wallis H analysis considering p ≤ 0...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28059961/use-of-quantile-regression-to-determine-the-impact-on-total-health-care-costs-of-surgical-site-infections-following-common-ambulatory-procedures
#15
Margaret A Olsen, Fang Tian, Anna E Wallace, Katelin B Nickel, David K Warren, Victoria J Fraser, Nandini Selvam, Barton H Hamilton
OBJECTIVE: To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. BACKGROUND: Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. METHODS: We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28058719/segmented-separable-footprint-projector-for-digital-breast-tomosynthesis-and-its-application-for-subpixel-reconstruction
#16
Jiabei Zheng, Jeffrey A Fessler, Heang-Ping Chan
PURPOSE: Digital forward and back projectors play a significant role in iterative image reconstruction. The accuracy of the projector affects the quality of the reconstructed images. Digital breast tomosynthesis (DBT) often uses the ray-tracing (RT) projector that ignores finite detector element size. This paper proposes a modified version of the separable footprint (SF) projector, called the segmented separable footprint (SG) projector, that calculates efficiently the Radon transform mean value over each detector element...
January 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28058563/long-term-satisfaction-and-body-image-after-contralateral-prophylactic-mastectomy
#17
Chelsea Anderson, Jessica Y Islam, M Elizabeth Hodgson, Susan A Sabatino, Juan L Rodriguez, Clara N Lee, Dale P Sandler, Hazel B Nichols
BACKGROUND: Contralateral prophylactic mastectomy (CPM) rates have been increasing in the US, and although high levels of satisfaction with CPM have been reported, few studies have evaluated the long-term effects on body image, comparing CPM with breast-conserving surgery (BCS) and unilateral mastectomy (UM). METHODS: We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n = 1176)...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28055246/validation-of-a-semi-automated-technique-to-accurately-measure-abdominal-fat-distribution-using-ct-and-mri-for-clinical-risk-stratification
#18
Mohammed Abdul Waduud, Amal Sharaf, Iain Roy, Rosario Lopez-Gonzalez, Andrew Hart, David McGill, Giles Roditi, John Biddlestone
OBJECTIVES: A valid method for accurate quantification of abdominal fat distribution (AFD) using both computer tomography (CT) and magnetic resonance imaging (MRI) is described. This method will be primarily useful in the prospective risk stratification of patients undergoing reconstructive breast surgery. Secondary applications in many other clinical specialities are foreseen. METHODS: 15 sequential patients who had undergone breast reconstruction following both CT and MRI imaging (30 scans) were retrospectively identified at our single centre...
January 5, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28054926/a-literature-review-of-burns-in-reconstructed-breasts-after-mastectomy
#19
Marie Jaeger, Yonathan Wagman, Alon Liran, Moti Harats, Eyal Winkler, Josef Haik, Ariel Tessone
OBJECTIVE: The goal of this literature review is to review and combine case studies of accidental burns to the breast, following mastectomy and immediate breast reconstruction with autologous tissue, implants, or tissue expanders. METHODS: The authors searched PubMed and Cochrane Library and reviewed cases of burns of reconstructed breasts after mastectomy from July 1985 to May 2015. Only studies in the English language were included in their search. They also report 5 new cases of burns in patients with burns to the breast, which were either reconstructed with implants or tissue expanders at Sheba Medical Center (Ramat Gan, Israel)...
December 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28053634/persistent-pain-after-breast-cancer-treatment-a-questionnaire-based-study-on-the-prevalence-associated-treatment-variables-and-pain-type
#20
Alexander Andersen Juhl, Peer Christiansen, Tine Engberg Damsgaard
PURPOSE: Persistent pain is a common side effect of breast cancer treatment. The present study aimed to assess the prevalence, associated treatment-related factors, and the type of pain (neuropathic or nociceptive) in patients who had undergone a unilateral mastectomy. METHODS: All women who underwent a unilateral mastectomy at a University Hospital between 2009 and 2013 were eligible for inclusion. Women with breast reconstruction or active cancer were excluded...
December 2016: Journal of Breast Cancer
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