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Koichi Tomita, Kenji Yano, Akimitsu Nishibayashi, Shien Seike, Ko Hosokawa
BACKGROUND: When the inframammary fold (IMF) is excised in mastectomy procedures for oncologic reasons, it must be recreated to restore a natural breast shape. Despite refinements in surgical techniques, postoperative loss of a well-defined IMF can occur. This study aimed to assess the outcomes of IMF recreation after two-stage, implant-based breast reconstruction. METHODS: We retrospectively reviewed 75 consecutive patients who underwent unilateral, two-stage, implant-based breast reconstruction between 2013 and 2015 at the authors' institution...
2016: SpringerPlus
Brittany L Murphy, Tanya L Hoskin, Judy C Boughey, Amy C Degnim, James W Jakub, Adam C Krajewski, Steven R Jacobson, Tina J Hieken
BACKGROUND: While nipple-sparing mastectomy (NSM) is gaining acceptance for risk reduction and for treatment of early stage breast cancer, node-positive disease remains a relative contraindication. Our aim was to evaluate the use and outcomes of NSM in node-positive breast cancer patients. METHODS: We identified 240 cancers in 226 patients (14 bilateral) scheduled for NSM and operated on between 1/2009 and 6/2014. We compared outcomes for 58 node-positive vs 182 node-negative patients...
September 3, 2016: American Journal of Surgery
B S Abdulkarim, K Joseph, L Vos, H K Warkentin, Z Gabos, N Pervez, K Tankel, S Ghosh, S M J Chafe, M B Parliament
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
S Yuce Sari, A Kotek, M Gultekin, B Akkus Yildirim, C Onal, G Ozyigit, M Gurkaynak, F Yildiz
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Wendy K Y Ng, Amy Chesney, Forough Farrokhyar, Nicole Hodgson, Arianna Dal Cin
With the advent of the skin sparing mastectomy, immediate breast reconstruction with placement of the definitive prosthesis at the time of mastectomy is possible. The question remains: does single-stage prosthetic reconstruction result in greater numbers of complications or rates of re-operation, compared to two-stage tissue expander reconstruction? A retrospective cohort study of a single centre?s experience with these techniques was carried out. From 2004 to 2012, 54 cases of immediate breast reconstruction with implant were identified, and 108 cases of immediate breast reconstruction using a tissue expander were identified...
September 27, 2016: Journal of Plastic Surgery and Hand Surgery
Mark Sisco, Alexandra M Kyrillos, Brittany R Lapin, Chihsiung E Wang, Katharine A Yao
PURPOSE: For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use. METHODS: Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (n = 114,849)...
November 2016: Breast Cancer Research and Treatment
Gustavo Nader Marta, Philip M Poortmans, Thomas A Buchholz, Tarek Hijal
Skin sparing mastectomy, a surgical procedure sparing a large portion of the overlying skin of the breast, and nipple-sparing mastectomy, sparing the whole nipple-areolar complex, are increasingly used, although their oncologic efficacy remains unclear. The aim of this study was to assess the radiation oncologists' opinions regarding the indications of radiation therapy (RT) after skin-sparing mastectomy and nipple-sparing mastectomy. Radiation oncology members of four national and international societies were invited to complete a questionnaire comprising of 22 questions to assess their opinions regarding RT indications in the context of skin-sparing and nipple-sparing mastectomy...
September 9, 2016: Breast Journal
Peirong Yu
The introduction of the transverse rectus abdominis myocutaneous flap in the 1970s marks the beginning of modern breast reconstruction although implants were available even earlier mainly for breast augmentation. Mastectomy techniques have evolved from the early Halsted radical mastectomy to the modern skin sparing mastectomy. The latter made possible using implants for breast reconstruction. Although prosthetic reconstruction provides a simpler procedure with quick recovery, autologous reconstruction offers more natural and long-lasting results especially in the setting of radiotherapy...
August 2016: Gland Surgery
Magali S Rüfenacht, Ernesto Montaruli, Eléonore Chappuis, Klara M Posfay-Barbe, Giorgio C La Scala
BACKGROUND: Necrotizing fasciitis is a serious soft-tissue infection associated with sepsis and tissue destruction. Surgical management usually requires extensive débridement of necrotic fascia and overlying skin, with significant aesthetic and functional consequences. The authors review the outcome of all recent cases of necrotizing fasciitis treated with skin-sparing débridement at their institution. METHODS: The authors conducted a retrospective review of all of their cases of necrotizing fasciitis treated with skin-sparing débridement...
September 2016: Plastic and Reconstructive Surgery
Naveen M Krishnan, John P Fischer, Marten N Basta, Maurice Y Nahabedian
BACKGROUND: Prosthetic breast reconstruction is most commonly performed using the two-stage (expander-implant) technique. However, with the advent of skin-sparing mastectomy and the use of acellular dermal matrices, one-stage prosthetic reconstruction has become more feasible. Prior studies have suggested that one-stage reconstruction has economic advantages relative to two-stage reconstruction despite a higher revision rate. This is the first cost-utility analysis to compare the cost and quality of life of both procedures to guide patient care...
September 2016: Plastic and Reconstructive Surgery
Allen Gabriel, Steven R Sigalove, G Patrick Maxwell
Although immediate postmastectomy breast reconstruction is favored over delayed reconstruction, it remains associated with high complication rates. Potential complications include seroma formation, dehiscence, infection, and tissue necrosis along incision edges. Closed incision negative pressure therapy (ciNPT; Prevena Incision Management System, KCI, an Acelity company, San Antonio, Tex.) has been reported to help hold incision edges together, protect incisions from external contamination, and remove fluid and infectious material...
July 2016: Plastic and Reconstructive Surgery. Global Open
Brittany L Murphy, Tanya L Hoskin, Judy C Boughey, Amy C Degnim, Jodi M Carter, Katrina N Glazebrook, Tina J Hieken
BACKGROUND: Guidelines advise modified radical mastectomy following neoadjuvant systemic therapy for T4 breast cancer. We studied the influence of current systemic therapy and tumor subtype on pathologic stage and practice patterns to identify patients for whom less aggressive operative treatment might be considered. METHODS: We identified 98 clinical T4 M0 cases operated on at our institution from October 2008-July 2015. Patient, tumor, and treatment variables were analyzed...
October 2016: Surgery
Nadine Döge, Stefan Hönzke, Fabian Schumacher, Benjamin Balzus, Miriam Colombo, Sabrina Hadam, Fiorenza Rancan, Ulrike Blume-Peytavi, Monika Schäfer-Korting, Anke Schindler, Eckart Rühl, Per Stahl Skov, Martin Church, Sarah Hedtrich, Burkhard Kleuser, Roland Bodmeier, Annika Vogt
Understanding penetration not only in intact, but also in lesional skin with impaired skin barrier function is important, in order to explore the surplus value of nanoparticle-based drug delivery for anti-inflammatory dermatotherapy. Herein, short-term ex vivo cultures of (i) intact human skin, (ii) skin pretreated with tape-strippings and (iii) skin pre-exposed to sodium lauryl sulfate (SLS) were used to assess the penetration of dexamethasone (Dex). Intradermal microdialysis was utilized for up to 24h after drug application as commercial cream, nanocrystals or ethyl cellulose nanocarriers applied at the therapeutic concentration of 0...
July 6, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Yurina Maeshima, Kumiko Oseto, Ryohei Katsuragi, Yukiko Yoshimoto, Sachiko Takahara, Akira Yamauchi
Women with BRCA1/2 mutations have a high risk of breast cancer and may opt for risk-reducing mastectomy (RRM). We report a 38-year-old Japanese woman who was diagnosed as a BRCA2 mutation carrier. She underwent prophylactic bilateral skin-sparing mastectomy (SSM) with excision of the nipple and preservation of the areola skin. It is unclear whether a bilateral RRM leads to better survival compared with intensive surveillance. The oncological risk associated with the presence of remnant breast glandular tissue after SSM or nipple-sparing mastectomy has been obscure...
June 2016: Journal of Breast Cancer
Karen E Mooney, Michael B Altman, Sharbacha Edward, Jose Garcia-Ramirez, Maria A Thomas, Imran Zoberi, Todd DeWees, Daniel Mullen, Jacqueline E Zoberi
PURPOSE: Current guidelines for high-dose-rate accelerated partial breast irradiation using single-entry implants are based on the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 protocol, which assumed a balloon implant geometry. We have developed robust plan evaluation criteria specifically for the strut-adjusted volume implant (SAVI). METHODS AND MATERIALS: Plan evaluation criteria were established using a "training data set" of 62 SAVI treatment plans and included the percentage volume of target receiving 90%, 95%, and 100% of the prescription dose (V90, V95, and V100), the absolute volume of target receiving 150% and 200% of prescription (V150 and V200), and the maximum doses to skin (Dskin max) and ribs (Drib max)...
September 2016: Brachytherapy
Gennaya L Mattison, Priya G Lewis, Subhas C Gupta, Hahns Y Kim
BACKGROUND: SPY Elite imaging uses an injectable fluorescing agent to intraoperatively assess the perfusion and viability of tissue, including skin flaps, during postmastectomy reconstruction for breast cancer patients. In this study, the authors sought to compare the surgeon's assessment of flap viability with that of SPY imaging perfusion, analyzing the clinical outcomes postoperatively. METHODS: In this study, the intraoperative difference between the plastic surgeon's assessment of skin viability and the SPY imaging assessment was analyzed by the skin flap area preserved in patients undergoing skin-sparing mastectomy...
July 2016: Plastic and Reconstructive 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
S Al-Himdani, S Timbrell, K T Tan, J Morris, N J Bundred
UNLABELLED: Skin-sparing mastectomy (SSM) facilitates immediate breast reconstruction. We investigated locoregional recurrence rates after SSM compared with simple mastectomy and the factors predicting oncological failure. METHODS: Patients with early breast cancer that underwent mastectomy between 2000 and 2005 at a single institution were studied to ascertain local and systemic recurrence rates between groups. Kaplan-Meier curves and log-rank test were used to evaluate disease-free survival...
July 2016: European Journal of Surgical Oncology
Ilaria Baldelli, Gaia Cardoni, Simonetta Franchelli, Piero Fregatti, Daniele Friedman, Marianna Pesce, Erica Ponte, Gregorio Santori, Pierluigi Santi
BACKGROUND: Although the introduction of acellular dermal matrices is considered one of the most important advancements in alloplastic breast reconstruction, costs and local policy limit their use in Italy. The purpose of this study was to assess short-term outcomes following Surgimesh-PET-based breast reconstruction. METHODS: A single-center, retrospective, case-control study was performed from January 1, 2012, to December 31, 2013, by enrolling 206 breast reconstructions performed in 196 patients after oncologic (n = 200) or prophylactic (n = 6) mastectomy...
June 2016: Plastic and Reconstructive Surgery
A De Puysseleyr, W De Neve, C De Wagter
PURPOSE: To assess the dosimetric impact of a patient positioning device for prone breast radiotherapy and assess the accuracy of a treatment planning system (TPS) in predicting this impact. METHODS: Beam attenuation and build-up dose perturbations, quantified by ionization chamber and radiochromic film dosimetry, were evaluated for 3 components of the patient positioning device: the carbon fiber baseplate, the support cushions and the support wedge for the contralateral breast...
June 2016: Physica Medica: PM
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