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R Di Micco, R L O'Connell, P A Barry, N Roche, F A MacNeill, J E Rusby
INTRODUCTION: Bilateral mammoplasty (BM) can optimise oncological safety and aesthetic outcomes in women with large or ptotic breasts whose tumour to breast volume ratio or tumour location pose a challenge to standard breast-conserving therapy (BCT) and for whom mastectomy (with or without reconstruction) may be the only alternative. METHODS: We undertook a comprehensive analysis of surgical outcomes (complications according to the Clavien Dindo classification), acute radiation morbidity (Radiation Therapy Oncology Group classification), oncological outcomes, and patient satisfaction (BREAST-Q questionnaire) in women who underwent BM for breast cancer (BC) from June 2009-November 2014...
September 9, 2016: European Journal of Surgical Oncology
Toni Zhong, Jiayi Hu, Shaghayegh Bagher, Anthony Vo, Anne C OʼNeill, Kate Butler, Christine B Novak, Stefan O P Hofer, Kelly A Metcalfe
BACKGROUND: This is the first study to use generic distress, cancer-specific, and procedure-specific measures to prospectively evaluate psychological responses, body image, sexuality, and health-related quality of life in immediate compared with delayed breast reconstruction. METHODS: Consecutive patients undergoing autologous immediate and delayed breast reconstruction (June of 2009 to December of 2010) completed the Hospital Anxiety and Depression Scale, Body Image Scale, Sexuality Scale, and BREAST-Q preoperatively and postoperatively (6, 12, and 18 months)...
October 2016: Plastic and Reconstructive Surgery
Eliana F R Duraes, Paul Durand, Leonardo C Duraes, Susan Orra, Andrea Moreira-Gonzalez, Joao Batista de Sousa, Risal S Djohan, James Zins, Steven Bernard, Graham S Schwarz
A breast cancer diagnosis imposes significant emotional and psychological duress. The purpose of this study is to assess the baseline quality of life (QOL) of immediate, delayed, and secondary breast reconstruction patients, comparing these results with QOL in women seeking plastic surgery for cosmetic breast, and non-breast procedures. From 2012 through 2013, immediate (group 1), delayed (group 2), and secondary (Group 3) reconstruction patients, aesthetic breast (group 4) and non-breast plastic surgery patients (group 5) answered Breast-Q questionnaires...
September 7, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Nicola R Dean, Tamara Crittenden
OBJECTIVE: To assess the clinical effectiveness of breast reconstruction and the utility of the BREAST-Q patient-reported outcomes measure for routine patient care. METHODS: The BREAST-Q was administered to all patients attending a breast reconstructive service (n = 343) at a University Hospital at each visit. RESULTS: The BREAST-Q was easy to administer in a clinic setting, with a high participation rate (64.2% completing the minimum dataset of three BREAST-Qs)...
September 6, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Rachel L O'Connell, Rosa DiMicco, Komel Khabra, Elizabeth A O'Flynn, Nandita deSouza, Nicola Roche, Peter A Barry, Anna M Kirby, Jennifer E Rusby
PURPOSE: The most recently developed module of the BREAST-Q, a validated patient outcome measure, is for patients who have undergone breast-conserving therapy (BCT) for cancer. This aim of this study was to assess patient satisfaction and quality of life after BCT using BREAST-Q, investigate clinical risk factors for lower satisfaction and explore the relationship between patient satisfaction with the appearance of their breasts and the other domains of the BREAST-Q. METHODS: Women who had undergone unilateral BCT in the preceding 1-6 years were invited to participate at the time of their annual surveillance mammogram...
November 2016: Breast Cancer Research and Treatment
Meagan E Brennan, Kathy Flitcroft, Sanjay Warrier, Kylie Snook, Andrew J Spillane
BACKGROUND: Immediate tissue expander/implant-based breast reconstruction (BR) is often avoided when post-mastectomy radiotherapy (PMRT) is planned due to concerns about high complication rates and poor aesthetic outcomes. This study evaluated surgical, aesthetic and quality of life (QoL) outcomes in women undergoing immediate implant-based BR (IIBR) followed by PMRT. METHODS: Participants were recruited at least six months after completing the final stage of BR...
September 6, 2016: Breast: Official Journal of the European Society of Mastology
Hiba El Hage Chehade, Hannah Headon, Umar Wazir, Amtul R Carmaichael, Christina Choy, Abdul Kasem, Kefah Mokbel
BACKGROUND: Nipple-sparing mastectomy (NSM) is becoming a viable oncoplastic option. There is debate regarding the best approach that balances oncological safety with aesthetics. In this study, we describe an approach involving a hemi-periareolar incision and evaluate its safety and outcomes. METHODS: Patients treated at single center between 2012 and 2015 were observed prospectively. After a histologically negative subareolar biopsy, immediate reconstruction with implant and acellular dermal matrix was performed after NSM...
July 21, 2016: American Journal of Surgery
Jakob Nedomansky, Stefanie Nickl, Bernhard Maier, Peter Dubsky, Werner Haslik, Klaus F Schroegendorfer
BACKGROUND: Management of the nipple-areola complex is an important issue in primary breast reconstruction. When nipple-sparing mastectomy is not suitable, alternatives are immediate nipple-areola complex replantation and delayed reconstruction. The aim of this study was to examine whether patients benefit more from nipple-areola complex preservation by immediate replantation or delayed nipple-areola complex reconstruction. METHODS: Postoperative results and patient satisfaction after 54 primary breast reconstructions with immediate nipple-areola complex replantation or delayed nipple-areola complex reconstruction were retrospectively evaluated...
August 8, 2016: Annals of Plastic Surgery
Benjamin H L Howes, David I Watson, Chris Xu, Beverley Fosh, Maximiliano Canepa, Nicola R Dean
BACKGROUND: Patient-reported outcomes and quality of life following mastectomy are not well understood. This study evaluates the quality of life following surgery for breast cancer and compares outcomes following breast-conserving surgery versus total mastectomy with or without reconstruction. METHODS: A case-controlled cross-sectional study was conducted using the validated BREAST-Q™ questionnaire and a study-specific questionnaire to determine patient's views about surgical outcomes...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Catherine de Blacam, Claragh Healy, Lorraine Quinn, Carol Spillane, Terence Boyle, Patricia A Eadie, Elizabeth M Connolly, David O'Donovan
BACKGROUND: Patient reported outcomes are increasingly being taken into account in planning health service provision. Few studies have examined how the process of care influences patients' perception of outcome. The aim of the current study was to quantify patient satisfaction with breast reconstruction and to examine the demographic, disease and process-of-care variables that contributed to satisfaction with breasts and overall outcome. METHODS: A cross-sectional study was designed and the BREAST-Q outcomes assessment instrument was used to evaluate patient-reported psychosocial, physical and sexual well-being, as well as satisfaction with breasts, overall outcome and process of care...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Michael A Howard, Mark Sisco, Katharine Yao, David J Winchester, Ermilo Barrera, Jeremy Warner, Jennifer Jaffe, Peter Hulick, Kristine Kuchta, Andrea L Pusic, Stephen F Sener
BACKGROUND AND OBJECTIVES: The authors sought to study patient-reported outcomes following nipple-sparing mastectomy (NSM). METHODS: From 2008 to 2011, the BREAST-Q was administered to women undergoing NSM surgery for cancer treatment or risk-reduction prior to surgery and at 2 years after completion of reconstruction. The change in score over time and the impact of surgical indication, complication occurrence, and laterality on scores were analyzed. RESULTS: The BREAST-Q was prospectively administered to 39 women undergoing NSM for cancer treatment (n = 17) or risk-reduction (RR) (n = 22)...
September 2016: Journal of Surgical Oncology
Apresh Singla
BACKGROUND: For women undergoing breast conservative surgery or lumpectomy for early stage breast carcinoma, there are limited options for reconstruction. Options include the use of flap surgery and/or implants, and have a significant associated morbidity and cost. Autologous fat grafting is a new alternative that can achieve a good cosmetic result, while reducing patient morbidity and cost by avoiding more extensive surgery. OBJECTIVE: The primary objectives are to assess patient satisfaction using the Breast-Q questionnaire and to evaluate fat graft volume...
2016: JMIR Research Protocols
Patrick J Buchanan, Mariam Abdulghani, Jennifer F Waljee, Jeffrey H Kozlow, Michael S Sabel, Lisa A Newman, Kevin C Chung, Adeyiza O Momoh
BACKGROUND: Little is known about the role breast reconstruction plays in decisions made for contralateral prophylactic mastectomy. This study explores factors critical to patient medical decision-making for contralateral prophylactic mastectomy and reconstruction among women with early stage, unilateral breast cancer. METHODS: A mixed methods approach was used to gain an understanding of patients' choices and experiences. Patients with stage 0 to III unilateral breast cancer who underwent reconstruction were recruited, and semistructured interviews were conducted...
July 2016: Plastic and Reconstructive Surgery
Jenny Heiman Ullmark, Christina Sahlin, Håkan Hallberg, Roger Olofsson Bagge
BACKGROUND: Breast-conserving surgery is an established alternative for the majority of women with early stage breast cancer. Consensus on negative margins (no ink on tumour) for invasive cancer makes mutilating extensive lumpectomies unnecessary. Several breast-conserving surgical methods are described in the literature. The aim of this study was to describe and evaluate a technique using the inframammary fold incision. METHODS: Twenty-seven patients with suspected breast cancer (stage I-II) underwent breast-conserving surgery using the inframammary fold incision...
June 22, 2016: Journal of Plastic Surgery and Hand Surgery
Hannah Headon, Abdul Kasem, Aisling Manson, Christina Choy, Amtul R Carmichael, Kefah Mokbel
INTRODUCTION: The advent of acellular dermal matrix devices (ADMs) has enhanced both the scope of implant-based immediate breast reconstruction (IBR) following skin sparing mastectomy (SSM) for the treatment or risk reduction of breast cancer. Currently, there are a wide range of options available for the use of ADMs. METHODS: This is a prospective observational single institution study of 118 consecutive patients undergoing a total of 164 SSM and IBR procedures either for treatment for breast cancer or for risk reduction, between 2012 and 2014...
June 2016: Surgical Oncology
Baoguo Chen, Huifeng Song
BACKGROUND: Polyacrylamide hydrogel (PAAG), once used as an injection for breast augmentation, has been banned in the medical field for cosmetic purposes for more than 10 years in China. But a large number of breasts have characteristic deformities due to the gel's feature of erosion. Our aim is to explore a retrospective study on PAAG's long-term effects on women, ensuing breast deformity and the strategy for breast plasticity after removing the gel in our center from 2007 to 2014. METHODS: From 2007 to 2014, 200 patients, whose breasts were injected with PAAG, underwent the operation to remove the injectable material...
August 2016: Aesthetic Plastic Surgery
Amy Alderman, Andrea Pusic, Diane K Murphy
BACKGROUND: The Breast Implant Follow-up Study is a large, ongoing observational study of women who received Natrelle round silicone-filled or saline-filled breast implants. This analysis describes patient-reported outcomes in the cohort who underwent breast augmentation. METHODS: Subjects prospectively completed two validated scales of the BREAST-Q (satisfaction with breasts and psychosocial well-being) preoperatively and at 1 and 4 years postoperatively. Effect size and z tests were used to compare differences between preoperative versus postoperative scores; multivariate mixed models were used to compare differences in scores between silicone-filled and saline-filled implants...
June 2016: Plastic and Reconstructive Surgery
Miho Saiga, Naruto Taira, Yoshihiro Kimata, Satoko Watanabe, Yuko Mukai, Kojiro Shimozuma, Taeko Mizoo, Tomohiro Nogami, Takayuki Iwamoto, Takayuki Motoki, Tadahiko Shien, Junji Matsuoka, Hiroyoshi Doihara
BACKGROUND: An understanding of health-related quality of life (HRQOL) is of utmost importance in both oncological and esthetic breast surgery. The BREAST-Q is a patient-reported outcome (PRO) measure that investigates HRQOL and patient satisfaction before and after breast surgery. The aim of this study was to develop a Japanese version of the BREAST-Q including the mastectomy module, the reconstruction module, the augmentation module and the reduction/mastopexy module, and to assess the psychometric properties of the mastectomy module among Japanese women...
May 14, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Marco Klinger, Silvia Giannasi, Francesco Klinger, Fabio Caviggioli, Valeria Bandi, Barbara Banzatti, Davide Forcellini, Luca Maione, Barbara Catania, Valeriano Vinci, Andrea Lisa, Guido Cornegliani, Mattia Siliprandi, Corrado Tinterri
Breast cancer represents the most frequent cancer in female population. Nowadays breast conservative surgery (BCS) is an accepted option for breast malignancies, and its indications has been extended thanks to the advent of oncoplastic surgery, reducing both mastectomy and re-excision rate, avoiding at the same time breast deformities. From January 2008 to November 2011, 84 women underwent BCS with periareolar approach for oncoplastic volume replacement. We divided patients into four groups analyzing breast size and resection volume (Group 1: small-moderate sized breast with resection <20%; Group 2: small-moderate sized breast with resection >20%; Group 3: big sized breast with resection <20%; Group 4: big sized breast with resection >20%)...
July 2016: Breast Journal
Anna Luan, Kenneth J Hui, Austin C Remington, Xiangxia Liu, Gordon K Lee
INTRODUCTION: The choice to undergo mastectomy and breast reconstruction is a highly personal decision with profound psychosocial effects, and ultimately, the decision between implant- and autologous tissue-based reconstruction should be made based on a combination of factual information and the patient's personal values and preferences. Unfortunately, patients undergoing breast reconstruction surgery may experience decision regret. Decision aids promote patient involvement in decision making by not only providing standard information about options, but also emphasizing comparative risks, benefits, and alternatives, and most importantly by providing clarification exercises regarding personal values to guide patients toward an individualized decision...
May 2016: Annals of Plastic Surgery
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