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Ralph Verstappen, Gabriel Djedovic, Evi Maria Morandi, Dietmar Heiser, Ulrich Michael Rieger, Thomas Bauer
Background: A persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time...
March 5, 2018: Archives of Plastic Surgery
Ryo Miyake, Satoki Kinoshita, Naoko Shimada, Ken Uchida, Hiroshi Takeyama, Toshiaki Morikawa
PURPOSE: Skin-sparing mastectomy (SSM) enables a radical cure of breast cancer while overcoming the cosmetic issues related to surgery. We review our experience of performing SSMs and assess whether preservation of the nipple-areola complex (NAC) could have been an option for some patients who underwent SSM. METHODS: The subjects of this retrospective study were women who underwent SSM that utilized four incision types; namely, the so-called tennis racket incision, a periareolar and midaxillary incision, an areola-sparing and midaxillary incision, and a small transverse elliptical incision...
February 21, 2018: Surgery Today
Arjen A W M van Turnhout, Charlotte J J Franke, Eline J C Vriens-Nieuwenhuis, Wouter B van der Sluis
INTRODUCTION: Little is reported on surgical outcomes of SERI Surgical Scaffold, a bioresorbable silk-derived surgical scaffold, developed to provide soft-tissue support and repair, in implant/expander breast reconstruction. METHODS: A retrospective chart study was conducted of all patients who underwent direct-to-implant reconstruction with a SERI surgical scaffold after skin-sparing mastectomy, recording surgical characteristics, perioperative complications and reoperations...
February 1, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Umar Wazir, Kefah Mokbel
INTRODUCTION: The increasing use of acellular dermal matrix (ADM) and fat transfer in the context of breast reconstruction, following skin sparing mastectomy (SSM) for therapeutic and risk reducing purposes, combined with the need to eliminate animation deformities, reduce post-operative dysfunctional pain and the risk of capsular contracture, has prompted surgeons to investigate the possibility of placing the mammary implant over the pectoralis major muscle with complete coverage with ADM thus reviving the pre-pectoral approach which was previously abandoned due to high complications rates and poor aesthetics in the pre-ADM era...
February 2, 2018: American Journal of Surgery
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
Fatma Umit Malya, Huseyin Kadioglu, Huseyin Kazim Bektasoglu, Zuhal Gucin, Seyma Yildiz, Mehmet Guzel, Ezgi Basak Erdogan, Serap Yucel, Yeliz Emine Ersoy
Objective To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study...
January 1, 2018: Journal of International Medical Research
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
Sadaf Jafferbhoy, Mihir Chandarana, Maria Houlihan, Rishikesh Parmeshwar, Sankaran Narayanan, Soni Soumian, Simon Harries, Lucie Jones, Dayalan Clarke
Background: The last two decades have seen significant changes in surgical management of breast cancer. The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice. Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options. Prepectoral implant placement and complete coverage of implant with acellular dermal matrix (ADM) eliminates the need to detach the muscle from underlying chest wall in contrast to the subpectoral technique...
December 2017: Gland Surgery
Moshe Giladi, Mijal Munster, Rosa S Schneiderman, Tali Voloshin, Yaara Porat, Roni Blat, Katarzyna Zielinska-Chomej, Petra Hååg, Ze'ev Bomzon, Eilon D Kirson, Uri Weinberg, Kristina Viktorsson, Rolf Lewensohn, Yoram Palti
BACKGROUND: Tumor Treating Fields (TTFields) are an anti-neoplastic treatment modality delivered via application of alternating electric fields using insulated transducer arrays placed directly on the skin in the region surrounding the tumor. A Phase 3 clinical trial has demonstrated the effectiveness of continuous TTFields application in patients with glioblastoma during maintenance treatment with Temozolomide. The goal of this study was to evaluate the efficacy of combining TTFields with radiation treatment (RT) in glioma cells...
December 29, 2017: Radiation Oncology
Taylan Tuğrul
Aim: In this study, at different fields, energies and gantry angles, treatment couch and rails dose absorption ratio and treatment couch effect on surface and build-up region doses were examined. Background: It is assumed that radiation attenuation is minimal because the carbon fiber couches have low density and it is not generally accounted for during treatment planning. Consequently, it leads to a major dosimetric mistake. Materials and methods: Solid water phantom was used for relative dose measurement...
January 2018: Reports of Practical Oncology and Radiotherapy
J Maxwell, A Arnaout, R Hanrahan, M Brackstone
BACKGROUND: Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops...
October 2017: Current Oncology
T Sedaghatian, M Momennezhad, S H Rasta, Y Makhdoomi, S Abdollahian
PURPOSE: Fiber carbon is the most common material used in treating couch as it causes less beam attenuation than other materials. Beam attenuation replaces build-up region, reduces skin-sparing effect and causes target volume under dosage. In this study, we aimed to evaluate beam attenuation and variation of build-up region in 550 TxT radiotherapy couch. MATERIALS AND METHODS: In this study, we utilized cylindrical PMMA Farmer chamber, DOSE-1 electrometer and set PMMA phantom in isocenter of gantry and the Farmer chamber on the phantom...
September 2017: Journal of Biomedical Physics & Engineering
Jennica Platt, Toni Zhong
The article summarizes the available evidence regarding clinical decision making in breast reconstruction from the patient perspective of satisfaction and health-related quality of life. A review of generic and specific patient reported outcome measures is provided. Important components of breast reconstruction care are compared, such as timing of reconstruction, autologous and implant-based reconstruction, and the use of nipple-sparing and skin-sparing mastectomy. This evidence-based summary will be useful to guide clinicians when discussing breast reconstruction with their patients...
January 2018: Clinics in Plastic Surgery
Min Ho Yun, Eul Sik Yoon, Byung-Il Lee, Seung-Ha Park
BACKGROUND: Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy...
November 2017: Archives of Plastic Surgery
Lyndsey Highton, Richard Johnson, Cliona Kirwan, John Murphy
BACKGROUND: The development of acellular dermal matrices (ADMs) has facilitated single-stage implant breast reconstruction (IBR) following skin-sparing mastectomy. The conventional approach of postpectoral implant placement with lower pole ADM confers a good cosmetic result by improving lower pole projection and control, while minimizing issues of implant visibility, palpability, and rippling. This is balanced with potential disadvantages including pain, disruption of pectoral muscle function, and animation...
September 2017: Plastic and Reconstructive Surgery. Global Open
Lyndsey R Highton, John A Murphy
BACKGROUND: We report a technique of immediate nipple-areolar complex (NAC) reconstruction for patients undergoing skin-sparing mastectomy and implant-based breast reconstruction or therapeutic mammoplasty with central excision. METHODS: Immediate nipple reconstruction is performed using a modified C-V flap planned along the edge of the incision. The areola is reconstructed using a full-thickness skin graft taken from skin usually discarded during the procedure...
September 2017: Plastic and Reconstructive Surgery. Global Open
G-T Lam, J-G Feron, P Mallon, A Roulot, B Couturaud
Skin-sparing mastectomy and immediate implant-based breast reconstruction is technically a challenging procedures for women with large, ptotic breasts. This is usually performed using the Wise pattern incision resulting in an inverted T scar, which is associated with postoperative complications. The other challenge is obtaining adequate coverage of the prosthesis. We describe a technique that avoids the inverted T scar and provides a single horizontal scar with a double dermo-muscular layer coverage of the prosthesis...
October 16, 2017: Annales de Chirurgie Plastique et Esthétique
Amanda L Zimmerman, Bugra Tugertimur, Paul D Smith, Ambuj Kumar, Deniz Dayicioglu
BACKGROUND: Augmentation mammoplasty remains the most common cosmetic surgery procedure performed. The objective of this article is to evaluate the impact of augmented volume of the reconstructed breast in patients that undergo nipple-sparing mastectomy and patients previously augmented who undergo mastectomy with tissue expander/implant-based reconstruction. METHODS: Patients undergoing skin-sparing mastectomy, nipple-sparing mastectomy, and mastectomy after previous augmentation followed by tissue expander/implant-based reconstruction between June 2011 and April 2015 by 2 surgeons at the same institution were included...
October 2017: Cancer Control: Journal of the Moffitt Cancer Center
Gustavo Nader Marta, Philip Poortmans, Alfredo C de Barros, José Roberto Filassi, Ruffo Freitas Junior, Riccardo A Audisio, Max Senna Mano, Sarkis Meterissian, Sarah M DeSnyder, Thomas A Buchholz, Tarek Hijal
PURPOSE/OBJECTIVE(S): Skin sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) have entered routine surgical practice for breast cancer, though their oncologic safety has not been established in randomized controlled trials. The aim of this study was to evaluate and compare radiation oncologists' and breast surgeons' opinions concerning the indications of post-operative radiation therapy (PORT) after SSM and NSM. MATERIALS/METHODS: Radiation oncologists and breast surgeons from North America, South America and Europe were invited to contribute in this study...
November 2017: European Journal of Surgical Oncology
Enver Özkurt, Mustafa Tükenmez, Erdem Güven, Burcu Çelet Özden, Gizem Öner, Mahmut Müslümanoğlu, Abdullah İğci, Vahit Özmen, Seden Küçücük, Neslihan Cabioğlu
BACKGROUND: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast specific surgeons and plastic surgeons. AIMS: The aim of this study is to explore the significant clinicopathological factors associated with long term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction (IBR) with tissue expander (TE) or implant after mastectomy. STUDY DESIGN: Retrospective cohort Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent IBR with TE or implant were retrospectively analyzed...
September 29, 2017: Balkan Medical Journal
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