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Cancer Control : Journal of the Moffitt... 2001The techniques of breast reconstruction have evolved and matured over the past 25 years. Recent studies have proven the benefit of breast reconstruction for breast... (Review)
Review
BACKGROUND
The techniques of breast reconstruction have evolved and matured over the past 25 years. Recent studies have proven the benefit of breast reconstruction for breast cancer patients.
METHODS
The authors reviewed the recent literature on the techniques of breast reconstruction and the effects of reconstruction on patients following surgery for breast cancer. The findings in recent studies are correlated with the experience of the authors.
RESULTS
A better understanding has been gained regarding surgical techniques of breast reconstruction as well as the proper indications for the various methods. The criteria of patient benefit have been defined by recent long-term studies.
CONCLUSIONS
Breast reconstruction following mastectomy has been proven to be a safe and beneficial procedure.
Topics: Breast; Breast Implants; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Time Factors; Transplantation, Autologous
PubMed: 11579338
DOI: 10.1177/107327480100800505 -
Missouri Medicine 2010The principle subdivisions of aesthetic breast surgery are: breast augmentation, mastopexy (breast lift), and reduction mammoplasty (breast reduction). In each of these... (Review)
Review
The principle subdivisions of aesthetic breast surgery are: breast augmentation, mastopexy (breast lift), and reduction mammoplasty (breast reduction). In each of these subdivisions, emerging new technologies and trends have potential to change the management of specific aesthetic problems of the breast. Given the continued increasing popularity of aesthetic breast surgery, an understanding of these newer developments will assist all practitioners in communicating with their patients and colleagues.
Topics: Breast; Breast Implantation; Breast Implants; Esthetics; Humans; Lipectomy; Mammaplasty
PubMed: 20629290
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Jun 2020This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. This analysis used the...
This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. This analysis used the Florida Inpatient Discharge Dataset from 1 January 2013 to 30 September 2017, which contains deidentified patient-level administrative data from all acute care hospitals in the state of Florida. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ test and logistic regression in this analysis. On the multivariable analysis, we found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received. Our results show that African American (odds ratio (OR): 0.68, 95%CI: 0.58-0.78, < 0.001) and Hispanic or Latino (OR: 0.82, 95%CI: 0.72-0.93, = 0.003) patients have significantly lower odds of receiving implant reconstruction when compared to white patients. Patients with Medicare (OR: 1.57, 95%CI: 1.33-1.86, < 0.001) had significantly higher odds and patients with Medicaid (OR: 0.61, 95%CI: 0.51-0.74, < 0.001) had significantly lower odds of getting autologous reconstruction when compared to patients with commercial insurance. Our study demonstrated that, in the state of Florida over the past years, variables, such as race, region, insurance, and comorbidities, play an important role in choosing the reconstruction modality. More efforts are needed to eradicate disparities and give all patients, despite their race, insurance payer, or region, equal access to health care.
Topics: Adult; Aged; Aged, 80 and over; Female; Florida; Health Services Accessibility; Humans; Male; Mammaplasty; Middle Aged; Multivariate Analysis; Odds Ratio; Transplantation, Autologous
PubMed: 32521732
DOI: 10.3390/medicina56060281 -
Tidsskrift For Den Norske Laegeforening... Jun 2004Breast cancer is the most common cancer in women, many of whom feel less feminine after the loss of a breast. Breast reconstruction can strengthen their self image,... (Review)
Review
BACKGROUND
Breast cancer is the most common cancer in women, many of whom feel less feminine after the loss of a breast. Breast reconstruction can strengthen their self image, hence it is an excellent treatment option for those who have had a mastectomy.
MATERIAL AND METHODS
This review is based on information retrieved from Medline and on clinical experience. We have also asked all departments of plastic surgery in Norway which methods of breast reconstruction they are using.
RESULTS AND INTERPRETATION
Breast reconstruction following mastectomy is performed by plastic surgeons and if necessary in cooperation with breast surgeons. The missing breast can be reconstructed with an implant, autologous tissue or by combining the two methods. Many years of experience have resulted in high standards within reconstructive breast surgery. In Norway breast reconstruction is performed in every department of plastic surgery.
Topics: Breast Implants; Breast Neoplasms; Contraindications; Female; Humans; Mammaplasty; Mastectomy; Patient Selection
PubMed: 15229707
DOI: No ID Found -
Magyar Onkologia Mar 2011Breast screening programs along with advances in diagnostic methods and oncologic treatment have resulted in full recovery for a decisive number of patients diagnosed... (Review)
Review
Breast screening programs along with advances in diagnostic methods and oncologic treatment have resulted in full recovery for a decisive number of patients diagnosed with early-stage breast cancer. The results of the ultra-radical-, followed by the breast conserving era pose new opportunities and challenges for the oncologic breast surgeon. The focus of oncoplastic surgery is not only on the tumor, but also on the female patient, allowing for individualized immediate breast reconstruction with acceptable esthetic result following radical tumor exstirpation. Modern procedures differ both in concept and technique from that of traditional breast surgery. This paper provides a comprehensive and detailed overview of reconstructive and oncoplastic breast surgery.
Topics: Breast Implants; Breast Neoplasms; Female; Free Tissue Flaps; Humans; Mammaplasty; Mastectomy; Mastectomy, Segmental; Practice Guidelines as Topic; Surgical Flaps
PubMed: 21617790
DOI: No ID Found -
Medicine Aug 2023We aimed to present our 20-year experience of using the deep inferior epigastric vessels as recipient vessels for free scapular flaps phalloplasty and evaluate the...
We aimed to present our 20-year experience of using the deep inferior epigastric vessels as recipient vessels for free scapular flaps phalloplasty and evaluate the outcomes. Penile reconstruction was performed using a free scapular flap between 2000 and 2020 by the same surgical team. Deep inferior epigastric vessels were used in all the cases. The surgical techniques and outcomes were described. Overall, 73 patients used the deep inferior epigastric artery (DIEA) as the recipient artery. Regarding the recipient veins, 2 veins were anastomosed in 72 (98.6%) patients, 1 deep inferior epigastric vein (DIEV) was used in 1 patient, 2 DIEV in 14, 1 DIEV + superficial inferior epigastric vein (SIEV) in 13, 1 DIEV + superficial circumflex iliac vein (SCIV) in 38, great saphenous vein (GSV) + SCIV in 4, and GSV + SIEV in 3. The mean age and body mass index of the study cohort was 28 years and 24.3 kg/m2, respectively. The shortest follow-up time was 7 months. Eleven patients had flap-related complications. Three patients were readmitted to the operating room within 24 hours, and 2 of them underwent salvage procedures with venous revision. Two patients lost the entire flap. One patient with 3-cm distal portion necrosis required surgical intervention. Three patients experienced urethral necrosis. DIEA is a suitable receptor artery for inflow. The DIEV, SIEV, and SCIV are available options for venous drainage according to the patient anatomical characteristics. The GSV can be an excellent backup for outflow and salvage procedures.
Topics: Humans; Phalloplasty; Mammaplasty; Surgical Flaps; Iliac Vein; Epigastric Arteries
PubMed: 37543758
DOI: 10.1097/MD.0000000000034603 -
JPMA. the Journal of the Pakistan... Apr 2023To establish a clinical score for morbidity prediction based on patient-related risk factors after breast reduction surgery.
OBJECTIVES
To establish a clinical score for morbidity prediction based on patient-related risk factors after breast reduction surgery.
METHOD
The retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, Kafrelsheikh University Hospital, Egypt, and comprised data of female patients with bilateral macromastia who underwent breast reduction, using the inferior pedicle invertedT technique between February 2019 and June 2020. After data retrieval, risk factors and complications were documented and related to the patients'risk factors Data was analysed using SPSS 20.
RESULTS
Of the 30 cases, 20(66.7%) were aged ≥35 years, 16(53.3%) had body massindex ≥37kg/m2 and 27(90%) were non-smokers. The mean preoperative haemoglobin level was 12.15±1.115g/dL and the mean weight of tissue resected on both sides was 2074.17±696.12gm. Factors significantly associated with complications included smoking, suprasternal notch to nipple distance ≥38cm, haemoglobin <12.5g/dL, the weight of excised tissue ≥2000gm and a positive family history of macromastia. The total score of the morbidity prediction scale ranged 2-190, with the best cut-off value being ≥93. The scale had 100% sensitivity,specificity, positive predictive value, negative predictive value and 100 percent accuracy.
CONCLUSIONS
Ability to predict postoperative surgical-site morbidity may optimise safety as well as outcome after reduction mammaplasty.
Topics: Female; Humans; Retrospective Studies; Mammaplasty; Nipples; Hypertrophy; Treatment Outcome
PubMed: 37482836
DOI: 10.47391/JPMA.EGY-S4-18 -
Modern Pathology : An Official Journal... Jul 2018Oncoplastic surgery provides breast cancer patients with greater aesthetic satisfaction without compromising disease-free survival or overall survival rate. Large volume... (Review)
Review
Oncoplastic surgery provides breast cancer patients with greater aesthetic satisfaction without compromising disease-free survival or overall survival rate. Large volume displacement oncoplastic surgical techniques have become increasingly popular as a strategy for improving aesthetic outcomes and extending the option of breast conservation therapy. They often involve breast reduction or mastopexy reconstructive techniques to facilitate resection of large breast volumes on the side of the breast cancer and accompanied with symmetry contralateral breast reductions or mastopexies. However, dissection of large volume displacement oncoplastic surgical specimens presents unique challenges. Compared with traditional mastectomy specimens, they are relatively complicated, which requires the pathologist to understand the surgical procedure and the anatomy of the specimens. Given this, we introduce the standard anatomical and terminological description for the breast pathologic specimens of five large volume displacement oncoplastic surgical techniques commonly performed in our institution for breast cancer management. The individual surgical specimen is composed of one or several components, which include lateral wall, superior keyhole, medial wall, lateral wing, inferior pole, and medial wing. We also present specimen documentation and sectioning procedures used in our institution. The advantages for the patient provided by large volume reduction oncoplastic surgery must be supported by proper evaluation of the surgical pathology specimen. Therefore, we recommend that each section taken from the oncoplastic specimen be labeled as to its specific location in the specimen components. Standardized nomenclature and technique will assist pathologists in accurately evaluating the surgical margins.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy, Segmental; Medical Oncology; Specimen Handling; Surgery, Plastic; Terminology as Topic
PubMed: 29449682
DOI: 10.1038/s41379-018-0020-z -
World Journal of Surgical Oncology Apr 2023Cell-assisted lipotransfer (CAL), a technique of autologous adipose transplantation enriched with adipose-derived stem cells (ADSCs), has the potential to improve... (Review)
Review
BACKGROUND
Cell-assisted lipotransfer (CAL), a technique of autologous adipose transplantation enriched with adipose-derived stem cells (ADSCs), has the potential to improve cosmetic outcomes at irradiated sites. However, many concerns have been raised about the possibility of ADSCs increasing oncological risk in cancer patients. With the increasing demand for CAL reconstruction, there is an urgent need to determine whether CAL treatment could compromise oncological safety after radiotherapy, as well as to evaluate its efficacy in guiding clinical decisions.
METHODS
A PRISMA-compliant systematic review of the safety and efficacy of CAL in breast cancer patients after radiotherapy was conducted. The PubMed, Ovid, Cochrane Library, and ClinicalTrials.gov databases were comprehensively searched from inception to 31 December 2021.
RESULTS
The search initially yielded 1185 unique studies. Ultimately, seven studies were eligible. Based on the limited outcome evidence, CAL did not increase recurrence risk in breast cancer patients but presented aesthetic improvement and higher volumetric persistence in a long-term follow-up. Although breast reconstruction with CAL also had oncological safety after radiotherapy, these patients needed more adipose tissue and had relatively lower fat graft retention than the non-irradiated patients (P < 0.05).
CONCLUSIONS
CAL has oncological safety and does not increase recurrence risk in irradiated patients. Since CAL doubles the amount of adipose required without significantly improving volumetric persistence, clinical decisions for irradiated patients should be made more cautiously to account for the potential costs and aesthetic outcomes. There is limited evidence at present; thus, higher-quality, evidence-based studies are required to establish a consensus on breast reconstruction with CAL after radiotherapy.
Topics: Humans; Female; Breast Neoplasms; Neoplasm Recurrence, Local; Adipose Tissue; Adipocytes; Mammaplasty
PubMed: 37069583
DOI: 10.1186/s12957-023-03010-z -
Aesthetic Plastic Surgery May 2009Mammaplasty for breast enhancement and correction of ptosis augmentation is described. Between 2002 and 2007, autoaugmentation mammaplasty was performed for 27 patients...
Mammaplasty for breast enhancement and correction of ptosis augmentation is described. Between 2002 and 2007, autoaugmentation mammaplasty was performed for 27 patients (age, 48 +/- 7.3 years) using an inferior-based flap of deepithelialized dermoglandular tissue inserted beneath the breast parenchyma of a superior-based nipple-areolar complex pedicle. The results confirmed that autoaugmentation mammaplasty corrects ptosis while increasing the projection and apparent volume of the breast. The degree of inframammary fold (IMF) descent 6 months after surgery generally paralleled that of the nipple. The mean level of the IMF was below the mean level of the nipple. Postoperatively, the optimum distance had been largely achieved. The advantage of the technique is that it optimizes the shape and volume of the breast without the use of an implant.
Topics: Adult; Female; Humans; Mammaplasty; Middle Aged; Sutures
PubMed: 19225831
DOI: 10.1007/s00266-009-9310-7