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https://www.readbyqxmd.com/read/28466362/treatment-of-implant-exposure-due-to-skin-necroses-after-skin-sparing-mastectomy-initial-experiences-using-a-not-selective-random-epigastric-flap
#1
Estíbaliz Echazarreta-Gallego, Guillermo Pola-Bandrés, María Dolores Arribas-Del Amo, Ismael Gil-Romea, Ramón Sousa-Domínguez, Antonio Güemes-Sánchez
Breast prostheses exposure is probably the most devastating complication after a skin sparing mastectomy (SSM) and implant-based, one-stage, breast reconstruction. This complication may occur in the immediate post-operative period or in the weeks and even months after the procedure. In most cases, the cause is poor skin coverage of the implant due to skin necrosis. PATIENTS AND METHODS: Eight consecutive cases of implant exposure (or risk of exposure) due to skin necrosis in SSM patients over a period of 5 years, all patients were treated using a random epigastric rotation flap, executed by the same medical team...
May 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28452244/efficacy-of-double-mirrored-omega-pattern-for-skin-sparing-mastectomy-to-reduce-ischemic-complications
#2
Fabio Santanelli di Pompeo, Michail Sorotos, Rosaria Laporta, Marco Pagnoni, Benedetto Longo
BACKGROUND: Excellent cosmetic results from skin-sparing mastectomy (SSM) are often impaired by skin flaps' necrosis (SFN), from 8%-25% or worse in smokers. This study prospectively investigated the efficacy of Double-Mirrored Omega Pattern (DMOP-SSM) compared to Wise Pattern SSM (WP-SSM) for immediate reconstruction in moderate/large-breasted smokers. METHODS: From 2008-2010, DMOP-SSM was performed in 51 consecutive immediate breast reconstructions on 41 smokers (mean age = 49...
April 28, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28410984/a-systematic-review-of-complications-associated-with-direct-implants-vs-tissue-expanders-following-wise-pattern-skin-sparing-mastectomy
#3
REVIEW
Jason Corban, Hani Shash, Tyler Safran, Nicolas Sheppard-Jones, Omar Fouda-Neel
INTRODUCTION: With proven oncological safety and improved aesthetic outcomes, the Type IV or "Wise pattern" skin-sparing mastectomy (SSM) is a procedure that is being performed with increasing frequency. Unfortunately, it is also associated with an increased risk of complications. The purpose of this investigation was to determine the complications associated with direct-to-implant and two-step tissue-expander breast reconstruction following Wise pattern SSM. METHODS: Systematic electronic searches were performed using PubMed, MEDLINE, and Embase databases...
March 14, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28341315/initial-clinical-experience-of-postmastectomy-intensity-modulated-proton-therapy-in-patients-with-breast-expanders-with-metallic-ports
#4
Robert W Mutter, Nicholas B Remmes, Mohamed Mh Kahila, Kathy A Hoeft, Deanna H Pafundi, Yan Zhang, Kimberly S Corbin, Sean S Park, Elizabeth S Yan, Valerie Lemaine, Judy C Boughey, Chris J Beltran
PURPOSE: The feasibility of proton postmastectomy radiation therapy in patients reconstructed with expanders has not been previously reported, limiting treatment options. We analyzed the dosimetric impact of the metallic port contained within expanders on intensity modulated proton therapy (IMPT) and report our techniques and quality control for treating patients in this setting. METHODS AND MATERIALS: Twelve patients with the same expander model underwent 2-field IMPT as part of a prospective registry...
December 16, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#5
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28319637/online-patient-reported-reviews-of-mohs-micrographic-surgery-qualitative-analysis-of-positive-and-negative-experiences
#6
Shuai Xu, Zaza Atanelov, Ashish C Bhatia
Mohs micrographic surgery (MMS) is the gold standard for treating high-risk skin cancers and skin cancers in areas where skin sparing is essential. However, relatively little is known about patient-reported satisfaction with this procedure. In this study, we used qualitative research methods to determine themes of patient-reported satisfaction and dissatisfaction with MMS on one popular online resource (RealSelf). Real-world patient feedback provides an opportunity for physicians to explore the patient mind-set and to target areas of potential improvement in MMS patient satisfaction...
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28293497/vertically-set-sombrero-shaped-abdominal-flap-for-asian-breast-reconstruction-after-skin-sparing-mastectomy
#7
Hirokazu Uda, Kotaro Yoshimura, Rintaro Asahi, Syunji Sarukawa, Ataru Sunaga, Hideaki Kamochi, Yasushi Sugawara
BACKGROUND: Immediate autologous breast reconstruction after skin-sparing mastectomy is an esthetically superior method, and a free abdominal flap is often used. However, in Asian patients, little redundant abdominal skin and thin subcutaneous tissue are common, necessitating the development of a more suitable flap design and setting. We devised a narrow flap, the sombrero-shaped flap (S-flap), set vertically, to reduce postoperative abdominal morbidity without sacrificing cosmetic results...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28260139/the-impact-of-mastectomy-type-on-the-female-sexual-function-index-fsfi-satisfaction-with-appearance-and-the-reconstructed-breast-s-role-in-intimacy
#8
K Rojas, M Onstad, C Raker, M A Clark, A Stuckey, J Gass
BACKGROUND: As mastectomy rates increase and overall survival for early breast cancer improves, a better understanding of the long-term consequences of mastectomy is needed. We sought to explore the correlation of specific mastectomy type with the Female Sexual Function Index (FSFI), body image satisfaction, and the reconstructed breast's role in intimacy. METHODS: This study is a secondary analysis of a cross-sectional survey including a retrospective chart review...
June 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28203495/correction-of-polymastia-vera-class-i-with-skin-sparing-mastectomy-and-immediate-rib-sparing-diep-flap-reconstruction
#9
Dominik Duscher, David Kiesl, Matthias Aitzetmüller, Manfred Schmidt, Georg M Huemer
No abstract text is available yet for this article.
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28191788/full-thickness-skin-mesh-graft-vaginoplasty-a-skin-sparing-technique
#10
Guilherme Lang Motta, Patric Machado Tavares, Gabriel Veber Moisés Silva, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
INTRODUCTION: The ideal vaginoplasty method should promote good cosmetic and functional results with low morbidity. We describe a new technique for congenital vaginal agenesis using a full-thickness perforated skin graft. MATERIALS AND METHODS: We report an 18 year old patient with vaginal agenesis (Morris syndrome) that undergone a modified version of McIndoe vaginoplasty. Patient is set in a low lithotomy position and lateral traction sutures are placed in labia and a 16Fr urethral catheter inserted...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28162950/nipple-sparing-mastectomy-for-the-management-of-recurrent-breast-cancer
#11
Brittany L Murphy, Judy C Boughey, Tina J Hieken
INTRODUCTION: For patients who have an ipsilateral breast cancer recurrence following prior breast-conserving surgery and radiation, total mastectomy generally is recommended. However, little is known about the suitability and outcomes of nipple-sparing mastectomy (NSM) with immediate breast reconstruction for the treatment of recurrent breast cancer, prompting this investigation. PATIENTS AND METHODS: From 1008 patients scheduled for NSM for breast cancer treatment at our institution between January 2009 and June 2016, we identified all patients who underwent surgery for ipsilateral recurrent breast cancer...
January 9, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28119943/kaposi-s-sarcoma-of-the-rectum-in-a-homosexual-male-with-hiv-aids
#12
Anand Kumar, Deborah Nautsch
Visceral involvement in AIDS-related Kaposi's sarcoma is common, but it is rarely seen in the absence of cutaneous disease. Most patients with gastrointestinal tract Kaposi's sarcoma remain asymptomatic and are often diagnosed on endoscopy or autopsy. We report a case of a 24-year-old homosexual man who presented with rectal pain and bleeding and was found to have skin-sparing, disseminated Kaposi's sarcoma with rectum, liver, lungs, and lymph node involvement. Despite treatment with highly active anti-retroviral therapy, he developed multiorgan failure resulting in death...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28103903/intraoperative-radiotherapy-iort-as-boost-in-breast-cancer
#13
REVIEW
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28087389/evaluation-of-local-oncologic-safety-in-nipple-areola-complex-sparing-mastectomy-after-primary-chemotherapy-a-propensity-score-matched-study
#14
Roberto Agresti, Marco Sandri, Massimiliano Gennaro, Giulia Bianchi, Ilaria Maugeri, Mario Rampa, Giuseppe Capri, Maria Luisa Carcangiu, Giovanna Trecate, Egidio Riggio, Laura Lozza, Filippo de Braud
BACKGROUND: Nipple-areola complex-sparing mastectomy (NSM), extending the concept of skin-sparing mastectomy, allows for the provision of a better cosmetic result. Large operable T2-T3 breast cancer might theoretically appear suitable for this surgical option as an alternative to conventional mastectomy or breast-conserving surgery, when a good response to primary chemotherapy has been achieved. PATIENTS AND METHODS: From January 2009 to May 2013, 422 patients with invasive breast cancer were progressively accrued to NSM...
December 24, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28065399/oncologic-safety-of-immediate-breast-reconstruction-in-breast-cancer-patients-who-underwent-neoadjuvant-chemotherapy-short-term-outcomes-of-a-matched-case-control-study
#15
Jai Min Ryu, Sungmin Park, Hyun-June Paik, Seok Jin Nam, Seok Won Kim, Se Kyung Lee, Jonghan Yu, Soo Youn Bae, Isaac Kim, Sa Ik Bang, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Jeong Eon Lee
INTRODUCTION: Although the indication for immediate breast reconstruction (IBR) after skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) has been expanded, IBR after neoadjuvant chemotherapy (NACT) is still controversial. We conducted retrospective matched case-control study to analyze oncologic outcomes between patients who underwent TM only and those who underwent IBR after SSM or NSM after NACT. PATIENTS AND METHODS: A retrospective review of breast cancer patients who underwent IBR after SSM or NSM after NACT between 2008 and 2015 at a single center was conducted...
October 27, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28051266/one-stage-breast-reconstruction-techniques-in-elderly-patients-to-preserve-quality-of-life
#16
M Maruccia, M Mazzocchi, L A Dessy, M G Onesti
OBJECTIVE: The aim of this study was to review one-stage breast reconstruction techniques performed in elderly patients at our institution to identify the criteria of selection of each in terms of outcomes and quality of life. PATIENTS AND METHODS: Patients older than 65 years who underwent one-stage breast reconstruction between January 2004 and July 2014 at our hospital were included. Patients and procedure-related data were collected from the medical records...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28048201/su-f-t-646-sbrt-lung-moving-beyond-the-3d-conformal-paradigm-with-an-elekta-versahd-accelerator
#17
A Dalhart, D Hyer, B Allen, R Flynn, H Johnston
PURPOSE: To develop a volumetric modulated arc therapy (VMAT) planning and delivery methodology for lung stereotactic body radiation therapy (SBRT) that addresses the unique geometric challenges presented when using an Elekta VersaHD linear accelerator. METHODS: The Elekta VersaHD imaging panels are fixed at 160cm SID when deployed, limiting the ability to perform non-coplanar treatments due to collisions with the treatment table. The panels can be folded in a stored position for non-coplanar treatments, but in this configuration, longitudinal table travel is restricted by the space required for the folded panels...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047599/su-f-t-515-increased-skin-dose-in-supine-craniospinal-irradiation-due-to-carbon-fiber-couch-and-vacuum-bag-immobilization-device
#18
D Robertson, Z Zhao, X Wang, J Yang
PURPOSE: To measure the surface dose for supine craniospinal irradiation employing posterior beams, treating through an imaging couch and BlueBag immobilization device. METHODS: The percentage depth dose (PDD) in the buildup region of a clinical 6 MV photon beam was measured using an Advanced Markus parallel plate ionization chamber in a solid water phantom. The PDD from a 10×10 cm(2) anterior beam was measured at 100 cm SSD, simulating a traditional prone craniospinal technique...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046470/su-f-t-509-investigation-into-the-impact-of-the-linear-accelerator-treatment-table-on-skin-dose-to-prone-breast-patients
#19
K Pedersen, J Irwin, P Sansourekidou, S Kriminski, D Pavord
PURPOSE: To investigate the impact of the treatment table on skin dose for prone breast patients for which the breast contacts the table and to develop a method to decrease skin dose. METHODS: We used 12cm stack of 15cmx15cm solid water slabs to imitate breast. Calibrated EBT3 radiochromic film was affixed to the bottom of the phantom. Treatments for 32 patients were analyzed to determine typical prone breast beam parameters. Based on the analysis, a field size and a range of gantry angles were chosen for the test beams...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28033508/pathological-complete-response-in-invasive-breast-cancer-treated-by-skin-sparing-mastectomy-and-immediate-reconstruction-following-neoadjuvant-chemotherapy-and-radiation-therapy-comparison-between-immunohistochemical-subtypes
#20
J Barrou, M Bannier, M Cohen, E Lambaudie, A Gonçalves, P Bertrand, M Buttarelli, P Opinel, N Sterkers, A Tallet, C Zinzindohoué, G Houvenaeghel
CONTEXT: Even if neoadjuvant chemotherapy (NACT) and oncoplastic techniques have increased the breast conserving surgery rate, mastectomy is still a standard for multifocal or extensive breast cancers (BC). In the prospect of increasing breast reconstruction, an alternative therapeutic protocol was developed combining NACT with neoadjuvant radiation therapy (NART), followed by mastectomy with immediate breast reconstruction (IBR). The oncological safety of this therapeutic plan still needs further exploration...
April 2017: Breast: Official Journal of the European Society of Mastology
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