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Prophylaxis mastectomy

Frederick L Moffat, Danny Yakoub
The purpose of this study is to assess the consequences for breast cancer patients of the trend away from breast conservation in favor of bilateral and contralateral mastectomy. The methods are followed from the review of the literature from 1991 to 2015. Breast-conserving surgery and sentinel lymph node biopsy, introduced into mainstream practice in the 1980s and 1990s, respectively, are now the standard of care for early-stage breast cancer. Disruptive change has unexpectedly supervened in the guise of bilateral mastectomy for cancer or prophylaxis and contralateral prophylactic mastectomy...
August 2016: Breast Cancer Research and Treatment
Jennifer Sabino, Donald J Lucas, Craig D Shriver, Amy E Vertrees, Ian L Valerio, Devinder P Singh
Immediate reconstruction after the surgical treatment of breast cancer has increased in the last decade. The purpose of this study is to use the National Surgical Quality Improvement Program database to analyze long-term trends in breast reconstruction. Women who underwent mastectomy for invasive or in situ breast cancer or prophylaxis between 2005 and 2011 were selected from the National Surgical Quality Improvement Program database. Trends and predictors for reconstruction were explored. In 44,410 women identified, immediate reconstruction increased from 30...
June 2016: American Surgeon
Manisha Bahl, Irene J Pien, Kate J Buretta, E Shelley Hwang, Rachel A Greenup, Sujata V Ghate, Scott T Hollenbeck
BACKGROUND: Nipple-areola complex (NAC) and skin flap ischemia and necrosis can occur after nipple-sparing mastectomy (NSM). The purpose of this study was to correlate vascular findings on MRI with outcomes in patients who underwent NSM. STUDY DESIGN: Female patients at a single institution who underwent NSM and had a preoperative breast MRI between 2010 and 2014 were identified. Medical records were reviewed for patient demographics, surgical factors, and complications...
August 2016: Journal of the American College of Surgeons
Mark Sisco, Katharine A Yao
Increasing numbers of women are undergoing nipple-sparing mastectomy, and evidence to support its use for cancer treatment and prophylaxis is expanding. An understanding of technical aspects and pitfalls of the procedure is paramount to ensure that the best results are attained. J. Surg. Oncol. 2016;113:883-890. © 2016 Wiley Periodicals, Inc.
June 2016: Journal of Surgical Oncology
Carlos A Martinez, Scott M Reis, Erika A Sato, Sean G Boutros
UNLABELLED: Ischemia of the nipple-areola complex (NAC) and periareolar tissue is commonly seen following tissue-preserving mastectomies for small invasive and noninvasive cancers. The nipple-areola preserving mastectomy is a multistage procedure in which the NAC and central mastectomy flap tissue is surgically delayed to improve the survivability in patients undergoing mastectomies followed by reconstruction. METHODS: We conducted a retrospective chart review of 20 patients undergoing the 2-stage nipple-areola preserving mastectomy: the first stage comprised undermining the NAC and raising the breast skin flaps, with placement of a silicone sheet in the dissected pocket...
October 2015: Plastic and Reconstructive Surgery. Global Open
Nai-Si Huang, Jiong Wu
OBJECTIVE: To evaluate the oncologic safety of nipple-sparing mastectomy (NSM) for breast cancer patients based on current literature. DATA SOURCES: A comprehensive literature search of Medline, Embase databases was conducted for studies published through March 2014. STUDY SELECTION: Our search criteria included English-language studies that focused on NSM at nipple-areola complex (NAC) involvement, patient selection, and recurrence. Prophylaxis NSM, case series or reports that based on very small population were excluded...
August 20, 2015: Chinese Medical Journal
Stephanie L Koonce, Brian Giles, Sarah A McLaughlin, Galen Perdikis, James Waldorf, Valerie Lemaine, Sarvam TerKonda
BACKGROUND: Solid organ transplant patients frequently develop posttransplant malignancies including breast cancer. They may desire breast reconstruction after mastectomy, which could potentially be complicated by their transplant status, immunosuppressive regimen, and previous operations. We review our experience with patients who have undergone solid organ transplant and subsequent breast reconstruction after mastectomy METHODS: After institutional review board approval, we queried our prospective breast reconstruction and solid organ transplant databases for corresponding patients...
September 2015: Annals of Plastic Surgery
Eva Koo, Michael A Henderson, Mary Dwyer, Anita R Skandarajah
BACKGROUND: Women treated with chest irradiation for childhood, adolescent, and young adulthood (CAYA) malignancies, in particular Hodgkin's lymphoma, have an increased risk of developing second cancers of the breast (SCB). However, there are few uniform guidelines regarding surveillance and prevention for this high-risk group. METHODS: A systematic search using PUBMED and OVID MEDLINE was performed. Publications listed under the terms "breast neoplasm", "neoplasm, radiation-induced", "therapeutic radiation-induced breast cancer", "screening", "surveillance", "prevention", and "prophylaxis" between January 1992 and January 2015 were assessed...
December 2015: Annals of Surgical Oncology
Zhong-Ling Wei, Dong-Ping Huang, Gui-Ping Su, Xing-Hong Wang, Yi-Zhi Jiang, Lai-Quan Huang
OBJECTIVE: To explore the clinical features, diagnosis and treatment of primary breast diffuse large B- cell lymphoma (PBDLBCL). METHODS: Clinical records of 9 PBDLBCL patients treated in Department of Hematology of Yijishan Hospital Affiliated to Wannan Medical College from August 2001 to January 2014 were analyzed retrospectively. RESULTS: All of the 9 patients were female, with an average age of 48 years (range 28 to 75), 8 cases had unilateral breast tumors and 1 case had bilateral...
April 2015: Zhongguo Shi Yan Xue Ye Xue za Zhi
Iheoma Nwaogu, Yan Yan, Julie A Margenthaler, Terence M Myckatyn
BACKGROUND: Given the grave consequences of venous thromboembolic (VTE) events, we examined the impact of breast reconstruction on VTE incidence in patients undergoing breast operations and, secondarily, assess the risk factors associated with VTE. STUDY DESIGN: Patients undergoing breast operations were identified in the 2007 to 2011 American College of Surgeons NSQIP database. The patients were divided into the following treatment categories: lumpectomy, mastectomy, mastectomy with reconstruction, and reconstruction...
May 2015: Journal of the American College of Surgeons
K Richards, P Forouhi, A Johnston, C M Malata
UNLABELLED: Thrombotic complications arising during the treatment of breast cancer can impact the breast reconstruction pathway. We set out to review the details of cases of thromboembolism occurring during neoadjuvant chemotherapy and peri-operatively to study the impact of the event and its management on subsequent breast reconstruction. METHODS: We retrospectively reviewed the medical records of seven patients who had experienced a thrombotic event during their treatment of breast cancer between 2008 and 2012, who then proceeded to breast reconstruction...
March 2015: Annals of Medicine and Surgery
Daniel R Butz, Brittany Lapin, Katharine Yao, Edward Wang, David H Song, Donald Johnson, Mark Sisco
BACKGROUND: Older breast cancer patients undergo postmastectomy breast reconstruction infrequently, in part because of a perception of increased surgical risk. This study sought to investigate the effects of age on perioperative complications after postmastectomy breast reconstruction. METHODS: The American College of Surgeons National Surgery Quality Improvement Program Participant Use Files from 2005 to 2012 were used to identify women with breast cancer who underwent unilateral mastectomy alone or with immediate reconstruction...
February 2015: Plastic and Reconstructive Surgery
Pushplata Gupta, Shilpi Jain
BACKGROUND: Post-operative nausea and vomiting (PONV) is commonly seen after modified radical mastectomy (MRM). In this randomized double-blind prospective study we compared the efficacy of ondansetron, granisetron and granisetron and dexamethasone combination for prevention of PONV following MRM in female patients. MATERIALS AND METHODS: A total of 75 patients (20-60 years of age) undergoing elective MRM were randomly allocated to one of the three groups of 25 patients each...
November 2014: Saudi Journal of Anaesthesia
Radu Olariu, Maziar Shafighi, Mihai A Constantinescu
The prophylactic (risk-reducing) mastectomy is a world-wide recognized method for specifically treating the increased breast cancer risk in patients showing a BRCA1 and/or BRCA2 mutation as well as other patient groups at increased breast cancer risk. This option should be offered to all patients having the pertinent risk profile. Breast reconstruction is an integral part of the risk-reducing mastectomy procedure and all possible methods of breast reconstruction, especially autologous tissue reconstruction should be offered to all patients having a medical indication and desiring this surgical treatment...
December 2014: Therapeutische Umschau. Revue Thérapeutique
Amy Alderman, Karol Gutowski, Amy Ahuja, Diedra Gray
LEARNING OBJECTIVES: After reading this article, participants should be able to: 1. Understand the evidence regarding the timing of expander/implant breast reconstruction in the setting of radiation therapy. 2. Discuss the implications of a patient's risk factors for possible outcomes and complications of expander/implant breast reconstruction. 3. Implement proper prophylactic antibiotic protocols. 4. Use the guidelines to improve their own clinical outcomes and reduce complications. SUMMARY: In March of 2013, the Executive Committee of the American Society of Plastic Surgeons approved an evidence-based guideline on breast reconstruction with expanders and implants, as developed by a guideline-specific work group commissioned by the society's Health Policy Committee...
October 2014: Plastic and Reconstructive Surgery
Peter A Felice, Noah S Nelson, Erin E Page, Sagar S Deshpande, Alexis Donneys, José Rodriguez, Steven R Buchman
BACKGROUND: Immediate expander-based breast reconstruction after mastectomy is a prevalent option for many women with breast cancer. When coupled with adjuvant radiation therapy, however, radiation-induced skin and soft-tissue injury diminish the success of this reconstructive technique. The authors hypothesize that prophylactic administration of the cytoprotectant amifostine will reduce soft-tissue complications from irradiation, aiding expander-based reconstruction. METHODS: Sprague-Dawley rats were divided into two groups: operative expander placement (expander group) and operative sham (sham group)...
October 2014: Plastic and Reconstructive Surgery
Corrado Rubino, Sergio Brongo, Domenico Pagliara, Roberto Cuomo, Giulia Abbinante, Nicola Campitiello, Fabio Santanelli, Daniela Chessa
The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries...
September 2014: Journal of Infection in Developing Countries
Katherine E Poruk, Jian Ying, Jeremy R Chidester, Joshua R Olson, Cindy B Matsen, Leigh Neumayer, Jayant Agarwal
BACKGROUND: Nipple-sparing mastectomy (NSM) has been increasingly used to treat women with breast cancer who wish to preserve the overlying breast skin, but concern remains regarding tumor recurrence. We report our experience performing NSM for breast cancer treatment and prophylaxis over a 6-year period. METHODS: A retrospective chart review on patients undergoing NSM or skin-sparing mastectomy (SSM) from 2005 to 2011 was performed. RESULTS: NSM patients were younger (P < ...
January 2015: American Journal of Surgery
Toni Zhong, Kimberly A Fernandes, Refik Saskin, Rinku Sutradhar, Jennica Platt, Brett A Beber, Christine B Novak, David R McCready, Stefan O P Hofer, Jonathan C Irish, Nancy N Baxter
PURPOSE: To describe the population-based rates of immediate breast reconstruction (IBR) for all women undergoing mastectomy for treatment or prophylaxis of breast cancer in the past decade, and to evaluate geographic, institutional, and patient factors that influence use in the publically funded Canadian health care system. METHODS: This population-based retrospective cohort study used administrative data that included 28,176 women who underwent mastectomy (25,141 mastectomy alone and 3,035 IBR) between April 1, 2002, and March 31, 2012, in Ontario, Canada...
July 10, 2014: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Anees B Chagpar
With increasing public awareness of the risk for breast cancer and modern techniques of reconstruction, the option of surgical prophylaxis for risk reduction is becoming increasingly popular. Bilateral prophylactic mastectomy for women at increased risk of developing breast cancer and contralateral prophylactic mastectomy for those with unilateral breast cancer seeking symmetry, risk reduction, and ease of follow-up are acceptable options for many women. However, prophylactic surgery is not an inconsequential decision, and careful consideration should be given to the risks and benefits of such procedures...
July 2014: Surgical Oncology Clinics of North America
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