Expanding the use of internal mammary artery perforators as a recipient vessel in free tissue transfer: An anatomical analysis by computed tomography angiography in breast cancer patients

Microsurgery ◽  
2019 ◽  
Vol 39 (6) ◽  
pp. 509-514 ◽  
Author(s):  
Dongwoo Shin ◽  
Ki Wook Sung ◽  
Kenneth L. Fan ◽  
Tae Hwan Park ◽  
Seung Yong Song ◽  
...  
2015 ◽  
Vol 9 ◽  
pp. BCBCR.S25782 ◽  
Author(s):  
Sarah L. Savaridas ◽  
Jonathan D. Spratt ◽  
Julie Cox

Introduction The importance of internal mammary nodes (IMNs) in the staging and treatment of breast cancer patients is controversial. Methods A retrospective cohort of patients diagnosed with primary breast cancer over a 4-year period (January 2009 to December 2012) was assessed. The number and size of any IMNs visible on spiral computed tomography (CT) were recorded. Results A total of 830 patients were diagnosed with primary breast cancer within the identified time frame, of which 150 patients met the inclusion criteria. Of these 42% (63) had IMNs present, although the majority were small (<5 mm). However, 16% (25) had larger nodes, greater than 5 mm in short axis, present on CT. Significantly more patients with the presence of large (>5 mm) IMNs had more advanced disease with CT evidence of other distant spread. Conclusion We have demonstrated that IMNs are present in a substantial number of our primary breast cancer patients. We suggest that further histological research is required to establish reliable CT size criterion for pathological IMNs. In addition, routine imaging of the IM chain, as well as axilla, should be considered in the staging of breast cancer.


Breast Care ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. 635-641
Author(s):  
Gamze Durhan ◽  
Ahmet Gürkan Erdemir ◽  
Sezin Yuce Sari ◽  
Melis Gultekin ◽  
Jale Karakaya ◽  
...  

<b><i>Objective:</i></b> Lymphatic irradiation in breast cancer improves locoregional control and has been shown to decrease distant metastasis. However, irradiation also accelerates the formation of atherosclerosis and can cause stenosis, not only in the coronary arteries but also in the internal mammary artery (IMA). The aim of this study was to investigate the effects of radiation on IMAs via computed tomography (CT). <b><i>Methods:</i></b> We reviewed the data of 3,612 patients with breast cancer treated with radiotherapy (RT) between January 2010 and December 2016. We included 239 patients with appropriate imaging and nodal irradiation in the study. All patients were treated with lymphatic irradiation of 46–50 Gy, and a boost dose (6–10 Gy) to the involved internal mammary nodes (IMNs) when imaging studies demonstrated pathological enlargement. Bilateral IMA diameter and the presence of calcification were assessed via thin contrast-enhanced CT and those of ipsilateral irradiated IMAs were compared with those of contralateral nonirradiated IMAs. <b><i>Results:</i></b> The mean diameter of<b><i></i></b>irradiated IMAs was significantly shorter than that of nonirradiated IMAs, regardless of laterality. All vascular calcifications were determined on the irradiated side. A boost dose of radiation to the IMNs and radiation technique did not significantly affect the IMA diameter or the presence of calcification. <b><i>Conclusions:</i></b> The diameter of the IMA is decreased due to RT regardless of laterality, radiation technique, and administration of a boost dose. Evaluation of vessels on CT before coronary artery bypass graft or flap reconstruction can help the surgeon select the most appropriate vessel.


2003 ◽  
Vol 10 (8) ◽  
pp. 935-941 ◽  
Author(s):  
Susanne H. Estourgie ◽  
Pieter J. Tanis ◽  
Omgo E. Nieweg ◽  
Renato A. Valdés Olmos ◽  
Emiel J. Th. Rutgers ◽  
...  

2018 ◽  
Vol 26 (4) ◽  
pp. 945-953 ◽  
Author(s):  
Ariane A. van Loevezijn ◽  
Sanne A. L. Bartels ◽  
Frederieke H. van Duijnhoven ◽  
Wilma D. Heemsbergen ◽  
Sophie C. J. Bosma ◽  
...  

2020 ◽  
Author(s):  
Ramaiah Vinay Kumar

Abstract Background: Automatic Cone-beam computed tomography (CBCT) based image matching for set-up verification is recommended as compared to 2-D match for post-operative local / loco-regional radiotherapy of breast cancer patients by Volumetric Modulated Arc Therapy (VMAT) technique. However, in supine position, off-midline peripheral body Clinical Target Volume (CTV) of unilateral breast cancer patients immobilized on Breast and Lung board of All-in-One (AIO) positioning systemmay necessitate augmented movement of couch in ‘x’ and ‘z’ axis thereby raising the risk of collusion of x-ray sources / detectors system with couch. Methods and Materials: VMAT was planned by a pair of partial arc for whole target volume for seven consecutive post-operative breast cancer patients (five post-mastectomy and two post-breast conservation patients). Tattoo based set-up by shift of treatment table in x-, y- and z-axis as determined by Treatment Planning System followed by X-rays with planar image acquisition and online 2-D imaging matching was performed for set-up verification. In-room 360°rotation of x-ray source and detector system of linear accelerator (linac) was performed before x-ray planar image acquisition. Results: Completion of 360°rotation in-room of x-ray source and detector system of linacaround the machine iso-centre was not possible in six out of seven patients due to possibility of collusion of gantry with contralateral side of the couch. Conclusion: Performing CBCT for generating 3D images for computed tomography (CT) reconstruction may not be practical for patient set-up verification of post-operative radiotherapy of unilateral breast cancer patients positioned supine on breast and lung board.


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