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Skin sparing

Jacques Bernier
The increasing use of nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM) in the treatment of nonmetastatic breast cancer is justified by considerations linked to their therapeutic index. In selected patients, efficacy results tend to be similar to those observed after radical modified mastectomy and at the same time, subcutaneous mastectomies preserve the patient's body image. Yet the oncologic safety of the two former surgical approaches is still a matter of debate, also in consideration of the almost complete absence of clinical studies directed to prospective, controlled comparisons between subcutaneous and radical modified mastectomies...
2018: Ecancermedicalscience
Sae Byul Lee, Jong Won Lee, Byung Ho Son, Jin Sup Eom, Eun Key Kim, Taik Jong Lee, Sei-Hyun Ahn
BACKGROUNDS: This study aimed to compare the oncologic outcomes of nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM) followed by immediate reconstruction with those of conventional mastectomy (CM) in young patients aged under 35 years old with breast cancer. METHODS: We analyzed retrospectively 2889 patients who underwent mastectomy for breast cancer at Asan Medical Center from January 2003 to December 2008. We compared NSM/SSM followed by immediate reconstruction with CM in patients under 35 years old by analyzing clinicopathologic features, breast cancer specific survival rate (BCSS), distant metastasis free survival rate (DMFS), and local recurrence rate (LRR)...
June 13, 2018: Asian Journal of Surgery
C M White, M K Hanna
OBJECTIVE: The glans penis may show a deep groove (surgically favorable), or may appear flat with an absent sulcus (unfavorable). Glans dehiscence following hypospadias repair, especially after multiple surgeries, frequently results in a scarred, obliterated, or absent urethral plate. The glans penis appears to be flat and grooveless. This study reported on the outcome of a two-stage salvage repair for glans dehiscence in 49 consecutive patients. MATERIALS AND METHODS: Retrospective chart review was performed for all patients who underwent repair for glans dehiscence following hypospadias repair...
May 30, 2018: Journal of Pediatric Urology
Indrakumar Janani, Rachita Lakra, Manikantan Syamala Kiran, Purna Sai Korrapati
Cancer nanomedicine has emerged as a revolution in the last decade opening up promising strides for the cancer treatment. The major challenge in these therapeutic approaches resides in the failure of clinical trials owing to the immunological cancer microenvironment. Therefore, the success of next generation nanomedicine depends on tunable physicochemical nanomaterial design and corresponding clinical trials by integrating targeted delivery with mitigated toxicity. The present study deals with the fabrication of nanofibrous scaffold impregnated with molybdenum nanoparticles for targeted skin cancer therapeutics...
September 2018: Journal of Trace Elements in Medicine and Biology
Zain Husain, Rina M Allawh, Ali Hendi
Treatment of digital skin cancers is challenging due to various functional and cosmetic implications. Traditionally, routine treatment includes radical amputation, but digital skin cancers are increasingly being treated with more conservative, tissue-sparing methods such as Mohs micrographic surgery (MMS), which provides excellent tissue conservation and margin control when used to treat melanoma and nonmelanoma skin cancers (NMSCs). In this study, we conducted a retrospective chart review to evaluate clinical outcomes following MMS for treatment of digital melanoma and NMSCs...
May 2018: Cutis; Cutaneous Medicine for the Practitioner
Elizabeth B Odom, Rajiv P Parikh, Grace Um, Simone W Kantola, Amy E Cyr, Julie A Margenthaler, Marissa M Tenenbaum, Terence M Myckatyn
BACKGROUND: Nipple-sparing mastectomy (NSM) offers several advantages for women seeking post-mastectomy breast reconstruction, but compromised skin and nipple perfusion may lead to skin and nipple necrosis. It is unclear if the incisional approach contributes to these complications; therefore, the purpose of this study was to compare the impact of incision type on outcomes in patients undergoing NSM. METHODS: This is a prospective cohort study of patients undergoing NSM with prosthetic breast reconstruction through an inframammary fold (IMF) versus a lateral radial (LR) incision...
March 26, 2018: Plastic and Reconstructive Surgery
Heather Richardson, Joel A Aronowitz
Patients who don't want or can't have formal breast reconstruction after mastectomy surgery can be considered for a Goldilocks mastectomy, where the breast fullness is recreated from what is left behind after the gland tissue is removed from underneath the skin in a breast reduction pattern. A Goldilocks mastectomy does not require the use of implants or tissue transfer from other parts of the body and may be completed in a single surgery. This is best suited for larger breasted women who are willing to have much smaller breasts as a result...
April 2018: Plastic and Reconstructive Surgery. Global Open
Ines Müller, Dagmar Kulms
Malignant transformation of melanocytes, the pigment cells of human skin, causes formation of melanoma, a highly aggressive cancer with increased metastatic potential. Recently, mono-chemotherapies continue to improve by melanoma specific combination therapies with targeted kinase inhibitors. Still, metastatic melanoma remains a life-threatening disease because tumors exhibit primary resistance or develop resistance to novel therapies, thereby regaining tumorigenic capacity. In order to improve the therapeutic success of malignant melanoma, the determination of molecular mechanisms conferring resistance against conventional treatment approaches is necessary; however, it requires innovative cellular in vitro models...
May 18, 2018: Journal of Visualized Experiments: JoVE
Sung Jae Ahn, Tae Yong Woo, Dong Won Lee, Dae Hyun Lew, Seung Yong Song
INTRODUCTION: Nipple-sparing mastectomy (NSM), combined with immediate breast reconstruction, has become the preferred surgical option to achieve better patient satisfaction and aesthetic outcome. However, nipple-areolar complex (NAC) ischemia and necrosis are common complications following nipple-sparing technique. MATERIALS AND METHODS: We performed a retrospective analysis of 220 breasts that underwent NSM and immediate reconstruction from May 2010 to December 2016 at our institute...
May 18, 2018: European Journal of Surgical Oncology
Ramona Woitek, Georg Pfeiler, Alex Farr, Panagiotis Kapetas, Julia Furtner, Maria Bernathova, Veronika Schöpf, Paola Clauser, Maria A Marino, Katja Pinker, Pascal A Baltzer, Thomas H Helbich
PURPOSE: Skin-sparing and nipple-sparing mastectomies (SSM; NSM) remove the breast's fibroglandular tissue (FGT), thereby reducing breast cancer risk. The postoperative presence of residual FGT (RFGT) is associated with remaining cancer risk. This study evaluated the role of MRI in the quantitative assessment of RFGT and its impact on the estimation of the remaining breast cancer risk. METHODS: The postoperative MRI scans (following EUSOMA recommendations) of 58 patients who had undergone SSM or NSM between 2003 and 2013, as well as preoperative MRI scans that were available in 25 of these patients, were retrospectively evaluated for the presence and location of RFGT by three radiologists...
July 2018: European Journal of Radiology
Chan Hee Jee, Hyun Jee Kim, Kyung-Hwa Kwak
RATIONALE: Tapia's syndrome is a rare and potentially anesthesia-related complication that may cause considerable distress to the patient. Here we describe a case of unilateral Tapia's syndrome in a patient undergoing a skin sparing mastectomy and immediate breast reconstruction which, to the best of our knowledge, has not been reported in the literature. PATIENT CONCERNS: A 41-years old female underwent right skin sparing total mastectomy and breast reconstruction with latissimus dorsi flap under general anesthesia...
June 2018: Medicine (Baltimore)
Victorien M T van Verschuer, Marc A M Mureau, Bernadette A M Heemskerk-Gerritsen, Pravesh S Gadjradj, Cleo Rogier, Cornelis Verhoef, Jessica P Gopie, Caroline Seynaeve, Linetta B Koppert
INTRODUCTION: Challenges of direct-to-implant breast reconstruction (BR) are to achieve sufficient implant coverage and lower pole projection. We assessed reoperation rates, long-term patient satisfaction and aesthetic outcome after direct-to-implant BR without acellular dermal matrix (ADM) in women with high breast cancer risk. METHODS: Women who underwent bilateral skin or nipple-sparing mastectomy and immediate direct-to-implant BR between 1994 and 2006 completed a survey on reoperations and the Breast-Q Reconstruction questionnaire...
May 28, 2018: Journal of Plastic Surgery and Hand Surgery
Panagiotis Kokotis, Nurcan Üçeyler, Christian Werner, Georgios Tsivgoulis, Nektaria Papanikola, Aristeidis H Katsanos, Nikos Karandreas, Claudia Sommer
INTRODUCTION: Hypohidrosis and heat intolerance, frequently reported by men and women with Fabry disease (FD), is thought to be related not only to the deposition of globotriaosylceramide (Gb3) in eccrine sweat glands, but also to reduced sweat gland sympathetic innervation. METHODS: We performed a case-control study to compare the density of sweat gland innervation between patients with FD and healthy controls by examining lower leg skin punch biopsies. We used a standardized grid of circles superimposed upon the immunofluorescent specimen to create a simple pattern of circles over the sweat gland...
July 15, 2018: Journal of the Neurological Sciences
George Spencer Arnould, Martha Matuszak, Avraham Eisbruch
This study aims to demonstrate a specific treatment planning method and its effectiveness of sparing high dose to superficial skin for head and neck volumetric-modulated arc therapy (VMAT) treatments. A total of 10 patients with bilateral disease encompassing superficial neck nodes were planned as VMAT. Standard VMAT plans were created for each patient per written directive from physician, including target prescriptions, normal structure goals, and plan parameters. After these plans were created, low isodose levels were converted into dose structures, which are used to create a new skin sparing (SS) structure...
May 22, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Edward I Chang, Jun Liu
INTRODUCTION: Obesity has been viewed as a relative contraindication against autologous free flap breast reconstruction due to increased risks of complications including flap loss. METHODS: Prospective analysis of obese patients undergoing autologous breast reconstruction. RESULTS: Overall 72 patients (average age: 48.5 years; average 35.7: kg/m2) underwent abdominal free flap breast reconstruction. Forty-three patients underwent bilateral while the remainder had unilateral reconstruction (n=115 flaps)...
May 14, 2018: Plastic and Reconstructive Surgery
Hyung Chul Lee, Hyun Ho Han, Eun Key Kim
BACKGROUND: The use of various latissimus dorsi (LD) flap types in combination with implants is a safe and reliable 1-stage breast reconstruction method. However, 1 or more positional changes are generally required during the procedure. We designed a vertical skin paddle that was centered along the midaxillary line and harvested the required LD muscle amount based on the thoracodorsal artery descending branch, thereby completing flap elevation, inset, and donor-site closure in the supine position following skin-sparing mastectomy...
May 23, 2018: Annals of Plastic Surgery
Wan-Sze Pek, Bien-Keem Tan, Yvonne Ying Ru Ng, Veronique Kiak Mien Tan, Mohamed Zulfikar Rasheed, Benita Kiat Tee Tan, Kong Wee Ong, Yee Siang Ong
BACKGROUND: Nipple-sparing mastectomies (NSMs) are increasingly performed to obtain the best aesthetic and psychological outcomes in breast cancer treatment. However, merely preserving the nipple-areolar complex (NAC) does not guarantee a good outcome. Darkly pigmented NACs and a tendency for poor scarring outcomes are particular challenges when treating Asian patients. Herein, we review the reconstructive outcomes following NSM at Singapore General Hospital. METHODS: All breasts reconstructed following NSM over an 11-year period from 2005 to 2015 were reviewed...
May 2018: Archives of Plastic Surgery
Sergio Santos-Alarcón, Cesar Benavente-Villegas, Isabel García-Briz, Magdalena Moneva-Léniz, Celia Sanchis-Sánchez, Almudena Mateu-Puchades
Dear Editor, Gestational pemphigoid (GP) is a rare autoimmune bullous dermatosis in pregnancy. GP usually occurs during the second or third month of pregnancy. It clinically manifests as the development of either early-onset urticarial lesions or late-onset subepidermal blisters that may linger for weeks or even months. Herein we report the case of a 45-year-old woman with the distinctive clinical onset of GP. A forty-five-year-old woman, gravida I, para 0, at 27 weeks gestation, was referred for evaluation to our Department with an extensive pruritic eruption that had developed over the previous 7 days...
April 2018: Acta Dermatovenerologica Croatica: ADC
Anamaria Balić, Zrinka Bukvić Mokos, Branka Marinović, Daniela Ledić Drvar
Dear Editor, Pitted keratolysis (PK), also known as keratosis plantaris sulcatum, is a non-inflammatory, bacterial, superficial cutaneous infection, characterized by many discrete superficial crateriform ''pits'' and erosions in the thickly keratinized skin of the weight-bearing regions of the soles of the feet (1). The disease often goes unnoticed by the patient, but when it is noticed it is because of the unbearable malodor and hyperhidrosis of the feet, which are socially unacceptable and cause great anxiety to many of the patients...
April 2018: Acta Dermatovenerologica Croatica: ADC
Elena-Daniela Serban, Francesca Farnetani, Giovanni Pellacani, Maria Magdalena Constantin
Worldwide melanoma incidence and mortality are increasing (1). Despite the ongoing research, advanced melanoma is still incurable; therefore, the most appropriate solution seems to be early detection combined with complete surgical excision (2). Since the diagnostic protocol of suspicious lesions includes a complete excision with safety margins (2), the problem of unnecessary scarring is significant. The real challenge in this case is to have a properly formulated diagnosis before acquiring a biopsy. Currently available non-invasive techniques are coherence tomography, digital dermoscopy, and reflectance confocal microscopy...
April 2018: Acta Dermatovenerologica Croatica: ADC
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