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https://www.readbyqxmd.com/read/29089810/training-oncoplastic-breast-surgeons-the-canadian-fellowship-experience
#1
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
https://www.readbyqxmd.com/read/29082219/an-update-of-couch-effect-on-the-attenuation-of-megavoltage-radiotherapy-beam-and-the-variation-of-absorbed-dose-in-the-build-up-region
#2
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
https://www.readbyqxmd.com/read/29080656/patient-centered-breast-reconstruction-based-on-health-related-quality-of-life-evidence
#3
REVIEW
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
https://www.readbyqxmd.com/read/29069878/the-effect-of-low-dose-nitroglycerin-ointment-on-skin-flap-necrosis-in-breast-reconstruction-after-skin-sparing-or-nipple-sparing-mastectomy
#4
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
https://www.readbyqxmd.com/read/29062655/prepectoral-implant-based-breast-reconstruction
#5
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
https://www.readbyqxmd.com/read/29062631/immediate-nipple-areolar-complex-reconstruction-for-patients-undergoing-implant-based-reconstruction-or-therapeutic-mammoplasty
#6
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
https://www.readbyqxmd.com/read/29050858/the-inframammary-skin-sparing-mastectomy-technique
#7
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
https://www.readbyqxmd.com/read/28975840/in-the-age-of-breast-augmentation-breast-reconstruction-provides-an-opportunity-to-augment-the-breast
#8
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
https://www.readbyqxmd.com/read/28967564/multidisciplinary-international-survey-of-post-operative-radiation-therapy-practices-after-nipple-sparing-or-skin-sparing-mastectomy
#9
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...
September 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28958980/favorable-outcome-with-close-margins-in-patients-undergoing-nipple-skin-sparing-mastectomy-with-immediate-breast-reconstruction-5-year-follow-up
#10
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
https://www.readbyqxmd.com/read/28929035/porcine-urinary-bladder-matrix-for-management-of-infected-radiation-mastectomy-wound
#11
Yana Puckett, Theophilus Pham, Shirley McReynolds, Catherine A Ronaghan
We present a case report on the successful healing of a Pseudomonas infection wound in a 52-year-old female with morbid obesity, noninsulin dependent diabetes mellitus and a history of tobacco use, who presented with Stage IIIA (T3, N2, Mo) infiltrating ductal carcinoma. The patient received neoadjuvant chemotherapy prior to her bilateral skin-sparing total mastectomies with right axillary sentinel lymphadenectomy. She also had staged reconstruction with temporary breast implants and plans for deep inferior epigastric perforator flaps...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28920659/coding-for-nipple-sparing-and-skin-sparing-mastectomies
#12
Eric Whitacre, Megan McNally, Jan Nagle
No abstract text is available yet for this article.
March 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#13
Norbert Heine, Christoph Koch, Vanessa Brebant, Andreas Kehrer, Alexandra Anker, Lukas Prantl
BACKGROUND: Breast Carcinoma is the most common malign tumor disease in women. 20-30% of these tumors have to be treated by removing all of the breast tissue. After that kind of therapeutic procedure, most of the women are severely traumatized and ask for reconstruction. The goldstandard of breast reconstruction is the free perforator flap from the lower abdomen (DIEAP-flap), which can provide body-own tissue and natural shape for the reconstructed breast.Many studies evaluate the shape of the reconstructed breast but neglect the skin sensitivity...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28854828/laser-assisted-indocyanine-green-angiography-in-implant-based-immediate-breast-reconstruction-a-retrospective-study
#14
Niels Hammer-Hansen, Alexander Andersen Juhl, Tine Engberg Damsgaard
OBJECTIVE: Necrosis in implant-based immediate breast reconstruction is a feared complication. Accurate evaluation of mastectomy skin flaps per-operatively is necessary to decrease this risk. The present study is the first in Scandinavia to review the effects of perioperative evaluation with laser-assisted indocyanine green fluorescence angiography (LA-ICGA). METHOD: A retrospective review was performed using data from the electronic patient record at the Department of Plastic and Breast Surgery at Aarhus University Hospital in Denmark on all patients who underwent implant-based skin-sparing immediate breast reconstruction with ADM in the time period March 2012 to October 2015...
August 30, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28831335/subcutaneously-placed-breast-implants-after-a-skin-sparing-mastectomy-do-we-always-need-adm
#15
Apresh Singla, Animesh Singla, Eric Lai, David Caminer
Immediate breast reconstruction is an acceptable treatment option after mastectomy for prophylaxis of early breast cancer. Different options exist for implant placement, incision technique, patient suitability, and institutional experience. This article is a case series exploring the feasibility and outcomes of patients undergoing immediate breast reconstruction using skin-sparing mastectomy without mesh or acellular dermal matrix (ADM) and with a vertical inframammary incision. METHODS: A single-institution retrospective analysis was performed for all patients who underwent immediate single-stage reconstruction with subcutaneous silicon implants without ADM between 2009 and 2014 inclusive...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28816143/radiation-therapy-versus-no-radiation-therapy-to-the-neo-breast-following-skin-sparing-mastectomy-and-immediate-autologous-free-flap-reconstruction-for-breast-cancer-patient-reported-and-surgical-outcomes-at-1-year-a-mastectomy-reconstruction-outcomes-consortium
#16
MULTICENTER STUDY
Andrew L Cooke, Julian Diaz-Abele, Tom Hayakawa, Ed Buchel, Kimberly Dalke, Pascal Lambert
PURPOSE: To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer. METHODS AND MATERIALS: We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database...
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28766233/prospective-study-comparing-surgeons-pain-and-fatigue-associated-with-nipple-sparing-versus-skin-sparing-mastectomy
#17
Rubie Sue Jackson, Thomas Sanders, Adrian Park, Robert Buras, Wen Liang, Christine Harris, Charles Mylander, Martin Rosman, Luther Holton, Devinder Singh, Laura Martino, Lorraine Tafra
BACKGROUND: Nipple-sparing mastectomy (NSM) is more technically challenging than skin-sparing mastectomy (SSM) but offers quality-of-life and cosmetic advantages. However, surgeon physical symptoms related to NSM workload have not been documented. METHODS: This was a prospective study using questionnaires to compare surgeon-reported physical symptoms before, during, and after NSM versus SSM. Surgeons also answered general questions about each mastectomy. Bilateral cases were performed simultaneously by two surgeons, who completed independent questionnaires...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766219/a-10-year-experience-with-mastectomy-and-tissue-expander-placement-to-facilitate-subsequent-radiation-and-reconstruction
#18
Zeina Ayoub, Eric A Strom, Valentina Ovalle, George H Perkins, Wendy A Woodward, Welela Tereffe, Benjamin D Smith, Simona F Shaitelman, Michael C Stauder, Karen E Hoffman, Sarah M DeSnyder, Patrick B Garvey, Mark W Clemens, Carlos H Barcenas, Henry M Kuerer, Steven Kronowitz
BACKGROUND: An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. METHODS: Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy. Rates and causes of tissue expander explantation before, during, and after radiotherapy, as well as tumor specific outcomes and reconstruction approaches, were collected...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28758229/time-dependent-factors-in-diep-flap-breast-reconstruction
#19
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Vittoria Amorosi, Fabio Santanelli di Pompeo
BACKGROUND: The process of harvesting and performing microsurgical anastomosis may lengthen deep inferior epigastric artery perforator (DIEP) flap breast reconstruction affecting results and patient safety. The aim of the study was to investigate the associations between predictors and operative time (OT). METHODS: Between 2004 and 2016, 336 immediate and 68 delayed unilateral reconstructions were performed in 404 patients. Age, weight, height, body mass index (BMI), nulliparity, or pluriparity condition were collected to determine the impact of patient characteristics on OT...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28742054/laue-lens-for-radiotherapy-applications-through-a-focused-hard-x-ray-beam-a-feasibility-study-on-requirements-and-tolerances
#20
Riccardo Camattari
Focusing a hard x-ray beam would represent an innovative technique for tumour treatment, since such a beam may deliver a dose to a tumour located at a given depth under the skin, sparing the surrounding healthy cells. A detailed study of a focusing system for hard x-ray aimed at radiotherapy is presented here. Such a focusing system, named Laue lens, exploits x-ray diffraction and consists of a series of crystals disposed as concentric rings capable of concentrating a flux of x-rays towards a focusing point...
August 21, 2017: Physics in Medicine and Biology
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