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Nicholas L Berlin, Jennifer B Hamill, Ji Qi, Hyungjin M Kim, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Survey-based research is essential for evaluating the outcomes of health care in an era of patient-centered care. However, many such studies are hampered by poor response rates in completion of study questionnaires, thus limiting the generalizability of any findings. The objectives of this analysis were to identify independent variables associated with nonresponse to surveys following breast reconstruction to improve future patient-reported outcomes research. MATERIALS AND METHODS: The Mastectomy Reconstruction Outcomes Consortium is a prospective cohort study involving 11 leading medical centers from the United States and Canada...
April 2018: Journal of Surgical Research
Cameron W Swanick, Xiudong Lei, Ying Xu, Yu Shen, Nathan A Goodwin, Grace L Smith, Sharon H Giordano, Kelly K Hunt, Reshma Jagsi, Simona F Shaitelman, Susan K Peterson, Benjamin D Smith
PURPOSE: For older women with breast cancer, local therapy options may include lumpectomy plus whole-breast irradiation (Lump + WBI), lumpectomy plus brachytherapy (Lump + Brachy), lumpectomy alone (Lump alone), mastectomy without radiation therapy (Mast alone), and mastectomy plus radiation therapy (Mast + RT). We surveyed a population-based cohort of older breast cancer survivors to assess the association of local therapy with long-term quality-of-life outcomes. METHODS AND MATERIALS: We used nationally comprehensive Medicare claims to identify women aged ≥67 years in whom nonmetastatic breast cancer was diagnosed in 2009, who were treated with 1 of the 5 aforementioned treatment options, and who were still alive in 2015...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Chris Devulapalli, Ricardo J Bello, Emily Moin, James Alsobrooks, Pablo Baltodano Fallas, Rika Ohkuma, Michele A Manahan, Justin M Sacks, Carisa M Cooney, Gedge D Rosson
BACKGROUND: Despite well-established correlation of postmastectomy radiotherapy and surgical complications in breast reconstruction, its impact on patient reported outcomes is less clear. We sought to determine the effect of postmastectomy radiotherapy on patient reported outcomes throughout the breast reconstruction process. METHODS: Patients undergoing prosthetic and autologous breast reconstruction from November 2010 to June 2013 were prospectively followed with BREAST-Q surveys (preoperatively, after expander placement, and 6 and 12 months after final reconstruction)...
March 2018: Plastic and Reconstructive Surgery
D Casella, G Di Taranto, M Marcasciano, S Sordi, A Kothari, T Kovacs, F Lo Torto, E Cigna, D Ribuffo, C Calabrese
BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our institutions. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop® )...
February 15, 2018: Breast: Official Journal of the European Society of Mastology
R C Killaars, J Hommes, R R van der Hulst, H J Tielemans, V L Negenborn, A Piatkowski
INTRODUCTION: Breast reconstruction using implants is still the main breast reconstruction technique worldwide. Current debate within implant-based breast reconstruction is whether to perform a 1-stage (direct implant) or 2-stage (tissue expander/implant) reconstruction. Volume differences between a woman's native breast and changes in volume after breast reconstruction might be an important factor for a patient's choice between these types of reconstruction. Three-dimensional imaging facilitates objective breast volume estimates...
February 13, 2018: Annals of Plastic Surgery
Cori A Agarwal, Melody F Scheefer, Lindsey N Wright, Norelle K Walzer, Andy Rivera
BACKGROUND: Chest reconstruction in many female-to-male (FTM) transgender individuals is an essential element of treatment for their gender dysphoria. In existing literature, there are very few longitudinal studies utilizing validated survey tools to evaluate patient reported outcomes surrounding this surgery. The purpose of our study is to prospectively evaluate patient reported satisfaction, improvement in body image, and quality of life following FTM chest wall reconstruction. METHODS: Our study was a prospective analysis of FTM patients who underwent chest reconstruction by a single surgeon (C...
January 31, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
C Cereijo-Garea, S Pita-Fernández, B Acea-Nebril, R Rey-Villar, A García-Novoa, C Varela-Lamas, S Builes-Ramirez, T Seoane-Pillado, V Balboa-Barreiro
AIMS AND OBJECTIVES: To analyze quality of life and satisfaction after immediate breast reconstruction due to cancer and its determining factors. BACKGROUND: Studying breast reconstruction is important because of its frequency and variability. In addition to the surgical results, it is necessary to analyze the quality of life and patient satisfaction using a specific tool. DESIGN-METHODS: An ambispective design was used (n=101;α=0.05;precision=10%), studying anthropometric, socio-cultural data, Fagerström test, and the BREAST-Q© questionnaire...
February 3, 2018: Journal of Clinical Nursing
Henry Wilson, Adam Varnadore
BACKGROUND: As technology advances, surgical practice evolves over time. The author assesses a new approach to implant-based breast reconstruction and the impact of two changes implemented over several years. METHODS: A series of tissue-expander reconstructions performed early in the author's experience were retrospectively compared with a similar number of cases prospectively performed. Demographics, perioperative characteristics, and postoperative outcomes were assessed...
January 31, 2018: Annals of Plastic Surgery
M Barone, A Cogliandro, M Signoretti, P Persichetti
INTRODUCTION: This study aimed to analyse the long-term outcomes following breast reconstruction and contralateral management to evaluate the stability of breast symmetry and patient satisfaction. MATERIALS AND METHODS: The study population consisted of women who had undergone implant-based monolateral breast reconstruction and contralateral management. Patients answered the BREAST-Q reconstruction module. Two reviewers analysed the post-operative outcomes of the patients included and compiled the Kroll Scale...
January 22, 2018: Aesthetic Plastic Surgery
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
Mirelle Lagendijk, Elvira L Vos, Daan Nieboer, Cornelis Verhoef, Evelien M L Corten, Linetta B Koppert
Cosmetic outcome is an important quality of life-related end point following breast-conserving therapy (BCT). To advise on a gold standard, we compare cosmetic outcome evaluated by panel and an objective evaluation (BCCT.core software). Second, patient-reported outcome measures (PROMs) are compared to cosmetic outcome evaluation by panel and BCCT.core. Sixty-eight breast cancer patients were included following BCT between 2007 and 2012. Two independent 6-member panels and two observers using the BCCT.core evaluated cosmetic outcome...
January 8, 2018: Breast Journal
Francesco Ciancio, Dario Melita, Alessandro Innocenti
No abstract text is available yet for this article.
January 4, 2018: Aesthetic Plastic Surgery
John F Diaz
Background: Breast augmentation continues to be one of the most common surgical procedures performed by plastic surgeons. As implant options expand, controlling the numerous variables required for a successful result will prove increasingly challenging. The purpose of this study was to outline specific steps that can be taken during the patient consultation and during surgery to decrease complications and improve overall patient satisfaction and patient outcomes. Methods: A retrospective review of 494 consecutive patients who underwent primary augmentation mammaplasty performed by a single surgeon was undertaken...
October 2017: Plastic and Reconstructive Surgery. Global Open
Ankur Khajuria, Oliver J Smith, Maxim Prokopenko, Maximillian Greenfield, Afshin Mosahebi
BACKGROUND: Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman's self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP) flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness...
November 22, 2017: Systematic Reviews
Isaias Vieira Cabral, Edgard da Silva Garcia, Rebecca Neponucena Sobrinho, Natália Lana Larcher Pinto, Yara Juliano, Joel Veiga-Filho, Lydia Masako Ferreira, Daniela Francescato Veiga
INTRODUCTION: BREAST-Q™ is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. MATERIALS AND METHODS: Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m(2), who were already scheduled for reduction mammaplasty, were included in the study...
November 9, 2017: Aesthetic Plastic Surgery
Alfred P Yoon, Ji Qi, David L Brown, Hyungjin M Kim, Jennifer B Hamill, Jessica Erdmann-Sager, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Previous studies suggest that immediate reconstruction following mastectomy produces superior results over delayed procedures. However, for medical or oncological reasons, some patients may be poor candidates for immediate reconstruction. We compared complications and patient-reported outcomes between immediate and delayed breast reconstructions in a prospective, multicenter study. METHODS: 1957 patients (1806 immediate, 151 delayed) met eligibility criteria...
February 2018: Breast: Official Journal of the European Society of Mastology
Anouk J M Cornelissen, Jop Beugels, Sander M J van Kuijk, Esther M Heuts, Shai M Rozen, Aldona J Spiegel, René R W J van der Hulst, Stefania M H Tuinder
PURPOSE: The number of breast cancer survivors continues to grow. Due to refinements in operating techniques, autologous breast reconstruction has become part of standard care. Impaired sensation remains a debilitating side effect with a significant impact on the quality of life. Microsurgical nerve coaptation of a sensory nerve has the potential to improve sensation of the reconstructed breast. This study investigates the effect of improved sensation of the reconstructed breast on the quality of life in breast cancer survivors...
October 25, 2017: Breast Cancer Research and Treatment
Dhivya R Srinivasa, Patrick B Garvey, Ji Qi, Jennifer B Hamill, Hyungjin M Kim, Andrea L Pusic, Steven J Kronowitz, Edwin G Wilkins, Charles E Butler, Mark W Clemens
BACKGROUND: Direct-to-implant breast reconstruction offers time-saving advantages over two-stage techniques. However, use of direct-to-implant reconstruction remains limited, in part, because of concerns over complication rates., The authors' aim was to compare 2-year complications and patient-reported outcomes for direct-to-implant versus tissue expander/implant reconstruction. METHODS: Patients undergoing immediate direct-to-implant or tissue expander/implant reconstruction were enrolled in the Mastectomy Reconstruction Outcomes Consortium, an 11-center prospective cohort study...
November 2017: Plastic and Reconstructive Surgery
Jessica Erdmann-Sager, Edwin G Wilkins, Andrea L Pusic, Ji Qi, Jennifer B Hamill, Hyungjin Myra Kim, Gretchen E Guldbrandsen, Yoon S Chun
BACKGROUND: Abdominal flap reconstruction is the most popular form of autologous breast reconstruction. The current study compared complications and patient-reported outcomes (PROs) after pedicled transverse rectus abdominis myocutaneous (PTRAM), free TRAM (FTRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps. METHODS: Patients having abdominal-based breast reconstruction at 11 centers were prospectively evaluated for abdominal donor-site and breast complications...
October 10, 2017: Plastic and Reconstructive Surgery
Diana Harcourt, Nicole Paraskeva, Paul White, Jane Powell, Alex Clarke
BACKGROUND: Increasingly, women elect breast reconstruction after mastectomy. However, their expectations of surgery are often not met, and dissatisfaction with outcome and ongoing psychosocial concerns and distress are common. We developed a patient-centered intervention, PEGASUS:(Patients' Expectations and Goals: Assisting Shared Understanding of Surgery) which supports shared decision making by helping women clarify their own, individual goals about reconstruction so that they can discuss these with their surgeon...
October 2, 2017: BMC Medical Informatics and Decision Making
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