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Technique nipple sparing

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https://www.readbyqxmd.com/read/29030030/oncological-safety-of-nipple-sparing-prophylactic-mastectomy-a-review-of-the-literature-on-3716-cases
#1
T Muller, A Baratte, C Bruant-Rodier, F Bodin, C Mathelin
INTRODUCTION: The objective of our study was to evaluate the risk of cancer after prophylactic nipple-sparing mastectomy (PNSM). MATERIAL AND METHODS: The PubMed database was consulted using the following key-words: "nipple-sparing mastectomy", "prophylactic", "locoregional recurrence", "oncological risk". Articles published between January 1995 and December 2016 were searched. RESULTS: Out of the 270 articles found, 19 were included. Overall, 15 studies were retrospective, 2 prospective, 2 prospective and retrospective and 3 were multicentric...
October 10, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28973707/expanding-eligibility-criteria-for-nipple-sparing-mastectomy
#2
Sonia T Orcutt, Cristina O'Donoghue, Paul Smith, Christine Laronga
The use of mastectomy has increased in patients who are high-risk genetic carriers who need or desire mastectomy for prophylactic reasons, as well as for patients who have breast cancer and need or desire mastectomy for treatment of their cancer. Retaining the nipple and skin with a nipple-sparing mastectomy results in improved patient satisfaction as compared with traditional mastectomy, without compromise of oncologic principles. This technique has been performed in patients with small, peripherally located tumors and nonptotic breasts; in recent years, however, consideration has been given to patients with more centrally located, larger tumors, and patients undergoing radiation or with ptotic breasts with the potential for poor cosmetic outcome...
October 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#3
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/28876554/surgical-anatomy-of-reduction-mammaplasty-a-historical-perspective-and-current-concepts
#4
A O Wamalwa, T Stasch, F W Nangole, S O Khainga
Reduction mammaplasty is the volumetric reduction in the bulk of the breast. Techniques have evolved from primarily reducing the breast bulk to reducing with emphasis on functional and aesthetic outcome. The deeper understanding of the surgical anatomy of the breast has guided this development. While Paulus Aegina (sixth century AD), Dieffenbach (1848) and Gaillard-Thomas (1882) set the pace in glandular reduction; Pousson (1897) and Dehner (1908) focused on breast ptosis. It took quite some time before the enigma of the vascularization to the nipple areolar complex could be solved...
March 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28862111/how-can-we-improve-education-of-breast-surgeons-across-europe
#5
Agnieszka Kolacinska
The proposed global curriculum developed by the American Society of Surgical Oncology (SSO) and the European Society of Surgical Oncology (ESSO) and the textbook: provides a state-of- the- art of breast cancer surgery, complements the syllabus and curriculum of the Union Europeenne des Medecins Specialistes (UEMS) examination in breast surgery/ European Board of Surgery Qualification in Breast Surgery (EBSQinBS) administered by ESSO (1) Knowledge and understanding of the principles of breast cancer incidence, aetiology, risk factors, genetics, premalignant and high-risk lesions, pathology, prognostic and predictive factors, risk prediction models, screening, diagnosis and imaging, breast cancer, oncoplastic, reconstructive breast surgery, axillary surgery and future perspective for this, radiation therapy, neoadjuvant and adjuvant systemic treatment- endocrine-, immuno- and chemotherapy, side effects and toxicities of treatment, locoregional recurrence, follow-up, locally advanced breast cancer, metastatic breast cancer, breast cancer in young and elderly patients, survivor issues, lymphedema, palliative care, chroni pain, body image and sexuality, fertility issues, cognitive functions, etc...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28841601/prophylactic-nipple-sparing-mastectomy-and-direct-to-implant-reconstruction-of-the-large-and-ptotic-breast-is-preshaping-of-the-challenging-breast-a-key-to-success
#6
Gudjon L Gunnarsson, Camilla Bille, Laurens C Reitsma, Peter Wamberg, Jørn Bo Thomsen
BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28831365/comparative-study-of-prepectoral-and-subpectoral-expander-based-breast-reconstruction-and-clavien-iiib-score-outcomes
#7
Lynne N Bettinger, Linda M Waters, Stephen W Reese, Susan E Kutner, Daniel I Jacobs
Prepectoral breast reconstruction is increasingly popular. This study compares complications between 2 subpectoral and 1 prepectoral breast reconstruction technique. METHODS: Between 2008 and 2015, 294 two-staged expander breast reconstructions in 213 patients were performed with 1 of 3 surgical techniques: (1) Prepectoral, (2) subpectoral with acellular dermal matrix (ADM) sling ("Classic"), or (3) subpectoral/subserratus expander placement without ADM ("No ADM"). Demographics, comorbidities, radiation therapy, and chemotherapy were assessed for correlation with Clavien IIIb score outcomes...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28831361/reelevating-the-mastectomy-flap-a-safe-technique-for-improving-nipple-areolar-complex-malposition-after-nipple-sparing-mastectomy
#8
Shuhao Zhang, Nadia P Blanchet
Nipple-areolar complex (NAC) malposition is one of the most common complications following nipple-sparing mastectomy with implant-based reconstruction. To maximize perfusion to the NAC, traditional methods of correcting NAC malposition limit undermining below the NAC. We demonstrate a series of cases in which improvement of NAC malposition was safely performed by reelevating the NAC and mastectomy flap to allow redraping of the soft tissue envelope over the implant and the overlying capsule. Thirty-four patients were identified in a span over 4 years where 44 NACs were repositioned using this method...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28692558/robotic-nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-implant-first-report-of-surgical-technique
#9
Antonio Toesca, Nickolas Peradze, Viviana Galimberti, Andrea Manconi, Mattia Intra, Oreste Gentilini, Daniele Sances, Debora Negri, Giulia Veronesi, Mario Rietjens, Stefano Zurrida, Alberto Luini, Umberto Veronesi, Paolo Veronesi
No abstract text is available yet for this article.
August 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28684896/a-technique-of-endoscopic-nipple-sparing-mastectomy-for-breast-cancer
#10
Yu Wang, Ji-Xiang Wu, Shan Guan
BACKGROUND AND OBJECTIVES: Nipple-sparing mastectomy (NSM) is a widely accepted surgical technique for patients with early breast cancer. The technique improves cosmetic outcomes, but a decrease in nipple sensitivity has been observed with NSM because of the incision into the nipple-areola complex (NAC). Endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) removes all breast tissue through the axillary incision used for the sentinel lymph node biopsy, to avoid incision around the NAC area...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28607860/spy-elite-s-ability-to-predict-nipple-necrosis-in-nipple-sparing-mastectomy-and-immediate-tissue-expander-reconstruction
#11
Mark L Venturi, Ali N Mesbahi, Libby R Copeland-Halperin, Victoria Y Suh, Louisa Yemc
BACKGROUND: Nipple-sparing techniques have improved the aesthetics of reconstruction following mastectomy, but nipple necrosis complicates up to 37% of procedures, distressing patients, delaying adjuvant therapy, and compromising outcomes. No method reliably detects nipple necrosis better than clinical assessment of tissue perfusion. We prospectively assessed the accuracy of intraoperative indocyanine green laser angiography to predict nipple necrosis. METHODS: Twenty consecutive women undergoing immediate tissue expander breast reconstruction following 32 nipple-sparing mastectomies underwent indocyanine green fluorescence imaging to assess nipple perfusion immediately before and after intraoperative tissue expansion...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28574950/prepectoral-breast-reconstruction-a-safe-alternative-to-submuscular-prosthetic-reconstruction-following-nipple-sparing-mastectomy
#12
Hani Sbitany, Merisa Piper, Rachel Lentz
BACKGROUND: Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538548/comparison-of-outcomes-with-tissue-expander-immediate-implant-and-autologous-breast-reconstruction-in-greater-than-1000-nipple-sparing-mastectomies
#13
COMPARATIVE STUDY
Jordan D Frey, Mihye Choi, Ara A Salibian, Nolan S Karp
BACKGROUND: Nipple-sparing mastectomy permits complete preservation of the nipple-areola complex with excellent aesthetic results and with oncologic safety similar to that associated with traditional mastectomy techniques. However, outcomes have not been directly compared for tissue expander-, immediate implant-, and autologous tissue-based breast reconstruction after nipple-sparing mastectomy. METHODS: All patients undergoing nipple-sparing mastectomy from 2006 to June of 2016 were identified at a single institution...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28495572/a-tumor-ultrasound-guided-incision-tugi-approach-to-nipple-sparing-mastectomy-balancing-oncologic-safety-and-technical%C3%A2-outcomes
#14
Emil J Fernando, Benjamin R Eskenazi, Risal S Djohan, Stephen R Grobmyer
BACKGROUND: Nipple-sparing mastectomy (NSM) is a prevalent operation for patients with breast cancer. Indications have been limited to tumors accessible via radial, infra-mammary, or periareolar incisions out of concern for oncologic and technical safety. We study an alternative approach to NSM based on tumor ultrasound-guided incisions (TUGI) and report its oncologic and technical outcomes. MATERIALS AND METHODS: A retrospective chart review examined patients who underwent TUGI NSM between 2013 and 2016...
April 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28458973/improved-outcomes-with-pedicled-nipple-sparing-mastectomies-using-a-new-surgical-delay-mastectomy-through-wise-incisions
#15
Jean-Claude D Schwartz, Piotr P Skowronksi
Nipple-sparing mastectomy (NSM) is challenging in patients with significant ptosis and skin excess. We previously described the first use of a surgical delay (a supraareolar incision with undermining off the breast mound) to facilitate a second-stage pedicled NSM and reconstruction. Here, we present an improvement in our surgical delay technique-a total skin and NSM through Wise incisions. This technique obviates concerns regarding delays in cancer care and more aggressively delays the nipple, allowing for more reliable and extreme NAC transpositions...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28369015/nipple-areola-complex-malposition-in-nipple-sparing-mastectomy-a-review-of-risk-factors-and-corrective-techniques-from-greater-than-1000-reconstructions
#16
Mihye Choi, Jordan D Frey, Ara A Salibian, Nolan S Karp
BACKGROUND: Nipple-areola complex malposition after nipple-sparing mastectomy can be a challenging issue to correct. The current literature is largely limited to smaller series and implant-based reconstructions. METHODS: A retrospective review of all nipple-sparing mastectomies from 2006 to 2016 at a single institution was performed. Incidence, risk factors, and corrective techniques of nipple-areola complex malposition were analyzed. RESULTS: One thousand thirty-seven cases of nipple-sparing mastectomy were identified, of which 77 (7...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28210547/nipple-areolar-complex-reconstruction-and-patient-satisfaction-a-systematic-review-and-meta-analysis
#17
Ellen S Satteson, Benjamin J Brown, Maurice Y Nahabedian
BACKGROUND: Nipple-areola complex (NAC) reconstruction transforms a mound of soft tissue into a breast and often marks the final stage of breast reconstruction after mastectomy. METHODS: A systematic review and meta-analysis were conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Articles were classified based on the nipple reconstructive technique-either composite nipple sharing or local flap with nipple-sparing mastectomy (NSM) used as a control...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28162212/-endoscopic-nipple-sparing-mastectomy-with-skin-lifting-system-followed-by-immediate-breast-reconstruction
#18
S Guan, Y Wang, K T Zhang, X Y Li, J X Wu
Objective: To discuss the surgical treatment and efficacy of endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) followed by immediate breast reconstruction. Methods: ENSMSLS was conducted on 21 patients followed by immediate breast reconstruction with implant via axillary incision from August 2014 to January 2016 in Oncology Center, Beijing Tongren Hospital, Capital Medical University. These 21 patients were frequency matched with 21 patients, who received nipple-sparing mastectomy via loop periareolar incision from November 2012 to May 2015 in the same center...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28040452/delay-techniques-for-nipple-sparing-mastectomy-a-systematic-review
#19
REVIEW
Laurel S Karian, Paul J Therattil, Philip D Wey, Kevin T Nini
BACKGROUND: Rare but serious complications of nipple-sparing mastectomy (NSM) include necrosis of the nipple-areolar complex (NAC) and mastectomy skin flaps. NAC and mastectomy flap delay procedures are novel techniques designed to avoid these complications and may be combined with retroareolar biopsy as a first-stage procedure. We performed a systematic review of the literature to evaluate various techniques for NAC and mastectomy flap delay. METHODS: PubMed and Cochrane databases were searched from January 1975 through April 15, 2016...
February 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28032163/transition-from-round-to-shaped-implants-in-immediate-breast-reconstruction-our-preferred-approach-and-clinical-outcomes
#20
Thomas A Imahiyerobo, Kevin H Small, Robyn Sackeyfio, Hannah Hoffman, Mia Talmor
BACKGROUND: Smooth, round, silicone implants predominate device-based breast reconstruction in the USA; despite their prevalence, complications can include bottoming out, superior contour deformity, rippling, and/or lateral malposition. This complication profile increases the need for revision surgery and subsequent patient dissatisfaction. With the resurgence of shaped, textured, silicone implants in the USA, we report the senior author's success with these devices and outline a strategy to optimize outcomes in breast reconstruction surgery...
December 28, 2016: Aesthetic Plastic Surgery
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