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https://www.readbyqxmd.com/read/28716116/catching-and-monitoring-clinical-innovation-through-performance-indicators-the-case-of-the-breast-conserving-surgery-indicator
#1
Anna Maria Murante, Silvio Candelori, Paola Rucci, Sabina Nuti, Manuela Roncella, Matteo Ghilli, Andrea Mercatelli, Maria Pia Fantini
BACKGROUND: The evolution in the surgical and diagnostic procedures, the attention to women's preferences, the case mix, and differences in professional practices may lead to a variability in the quality of breast cancer clinical pathway. To catch and manage this variability it is important to use valid measures. The aim of this paper is to examine the concurrent validity of the breast-conserving surgery (BCS) indicator and to provide evidence to guide the quality improvement process...
July 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28709454/comparison-of-skin-sparing-mastectomy-using-ligasure%C3%A2-small-jaw-and-electrocautery
#2
Young Woo Chang, Hwan Soo Kim, Seung Pil Jung, Sang Uk Woo, Jae Bok Lee, Jeoung Won Bae, Gil Soo Son
BACKGROUND: Skin-sparing mastectomy (SSM) is increasingly used in patients with breast cancer. We compared the differences between use of electrocautery and LigaSure™ Small Jaw in patients with breast cancer who underwent SSM. METHODS: Between January 2012 and December 2015, 81 patients with breast cancer who underwent SSM were selected and were divided into the electrocautery group and the LigaSure™ Small Jaw group based on the devices that were used. Clinicopathological characteristics, body mass index, operative time, and weight of removed breast were obtained from medical records...
July 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28699269/determinants-of-short-and-long-term-outcomes-in-patients-undergoing-immediate-breast-reconstruction-following-neoadjuvant-chemotherapy
#3
Craig A Wengler, Stephanie A Valente, Zahraa AlHilli, Neil M Woody, Julia H Muntean, Jame Abraham, Rahul D Tendulkar, Risal Djohan, Colin O'Rourke, Joseph P Crowe, Stephen R Grobmyer
BACKGROUND: We evaluated oncologic outcomes and complications of skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate reconstruction (IR) after neoadjuvant chemotherapy (NAC) in patients with early-stage and locally advanced breast cancer (BC). METHODS: BC patients from 2000 to 2014 treated with NAC followed by SSM/NSM and IR were reviewed. Patient demographics, tumor characteristics, NAC response, complications, and recurrence were analyzed...
July 11, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28690051/nipple-sparing-mastectomy-for-breast-cancer-and-implant-reconstruction-is-associated-with-high-patients-satisfaction-and-safe-oncological-outcomes
#4
Violette Mesdag, Claudia Régis, Emmanuelle Tresch, Marie-Pierre Chauvet, Loïc Boulanger, Pierre Collinet, Sylvia Giard
BACKGROUND: The preservation of the nipple areolar complex (NAC) for cancer treatment is still a matter of debate because of suspected increase of local recurrence and surgery-specific complications. The aim of the study was to investigate both the relapse risk associated with Nipple Sparing Mastectomy (NSM) for breast cancer and women's satisfaction with preservation of the NAC. METHODS: We included retrospectively all patients who had skin-sparing mastectomy (SSM) or NSM from 2007 to 2012 for breast cancer or ductal carcinoma in situ (DCIS)...
July 6, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28673535/nipple-sparing-and-skin-sparing-mastectomy-review-of-aims-oncological-safety-and-contraindications
#5
Viviana Galimberti, Elisa Vicini, Giovanni Corso, Consuelo Morigi, Sabrina Fontana, Virgilio Sacchini, Paolo Veronesi
Skin-sparing (SSM) and nipple-sparing (NSM) mastectomies are relatively new conservative surgical approaches to breast cancer. In SSM most of the breast skin is conserved to create a pocket that facilitates immediate breast reconstruction with implant or autologous graft to achieve a quality cosmetic outcome. NSM is closely similar except that the nipple-areola complex (NAC) is also conserved. Meta-analyses indicate that outcomes for SSM and NSM do not differ from those for non-conservative mastectomies. Recurrence rates in the NAC after NSM are acceptably low (0-3...
June 30, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28671888/complications-after-total-skin-sparing-mastectomy-and-expander-implant-reconstruction-effects-of-radiation-therapy-on-the-stages-of-reconstruction
#6
Anne Warren Peled, Marie Sears, Frederick Wang, Robert D Foster, Michael Alvarado, Jasmine Wong, Cheryl A Ewing, Hani Sbitany, Laura J Esserman, Barbara Fowble
BACKGROUND: Many patients undergoing total-skin sparing mastectomy (TSSM) and 2-staged expander-implant (TE-I) reconstruction require postmastectomy radiation therapy (PMRT). Additionally, many patients undergoing TSSM for recurrent cancer have a history of lumpectomy and radiation therapy (XRT). Few studies have looked at the impact of XRT on the stages of TE-I reconstruction. METHODS: Patients undergoing TSSM and immediate TE-I reconstruction between 2006 and 2013 were identified from a prospectively maintained database...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28666767/towards-breast-cancer-rotational-radiotherapy-with-synchrotron-radiation
#7
Francesca Di Lillo, Giovanni Mettivier, Antonio Sarno, Roberta Castriconi, Paolo Russo
PURPOSE: We performed the first investigations, via measurements and Monte Carlo simulations on phantoms, of the feasibility of a new technique for synchrotron radiation rotational radiotherapy for breast cancer (SR(3)T). METHODS: A Monte Carlo (MC) code based on Geant4 toolkit was developed in order to simulate the irradiation with the SR(3)T technique and to evaluate the skin sparing effect in terms of centre-to-periphery dose ratio at different energies in the range 60-175keV...
June 27, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28664306/axillary-advancement-suture-to-minimize-post-implantation-deformity-in-implant-based-breast-reconstruction
#8
Jun Ho Lee, Chi-Ho Yeo, Kyu-Jin Chung, Taegon Kim
Patients who have undergone implant-based breast reconstruction after skin-sparing mastectomy often complain about bulging on the upper flank or inferior axillary area. This is most likely because the subcutaneous tissue layer of the upper flank, which is continuous with the breast tissue, tends to show inferolateral drooping once the subcutaneous tissue becomes loose after eliminating the breast parenchyma. In addition, one of the weaknesses of implant surgery is that implants cannot completely replace the tissue removed during skin-sparing mastectomy (SSM)...
June 29, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28621194/-breast-reconstruction-surgery-with-endoscopic-assisted-latissimus-dorsi-muscle-flap
#9
Gábor Bognár, András Novák, György Ledniczky, Gábor István
The results obtaining with breast reconstruction surgery are not always satisfactory for the patients. Reconstruction with pure latissimus dorsi flap is useful option and due to endoscopic harvest large scar on the back can be avoided. The skin sparing mastectomy and even the sentinel lymph node biopsy or lymphadenectomy can be performed using a single incision in the axilla. Also the immediate reconstruction with endoscopically assisted harvest of the latissimus dorsi muscle flap in selective cases can be done using the same incision...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28605205/analysis-of-factors-influencing-drain-amount-time-to-drain-removal-and-seroma-formation-in-patients-undergoing-immediate-expander-implant-breast-reconstruction
#10
Kyong-Je Woo, Joo Myong Paik, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Sa Ik Bang
BACKGROUND: Placement of a closed suction drain is a common cause of patient complaints, such as postoperative pain or discomfort following immediate expander-implant breast reconstruction. This study aims to identify factors that affect drainage volume, time to drain removal, and seroma formation. METHODS: A retrospective chart review of prospectively collected data was conducted on patients who underwent immediate expander-implant breast reconstructions following nipple-sparing or skin-sparing mastectomy without skin excision (nipple areolar complex excision only) between February 2010 and April 2015...
June 12, 2017: Journal of Plastic Surgery and Hand Surgery
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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