The nature and importance of women's goals for immediate and delayed breast reconstruction

2021 ◽  
Author(s):  
E. Guest ◽  
N. Paraskeva ◽  
C. Griffiths ◽  
E. Hansen ◽  
A. Clarke ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Delayed Breast Reconstruction

scholarly journals Breast softness in patients randomised to postmastectomy breast reconstruction with an expander prosthesis or DIEP flap

2021 ◽  
Author(s):  
Linda Tallroth ◽  
Håkan Brorson ◽  
Nathalie Mobargha ◽  
Patrik Velander ◽  
Stina Klasson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Subjective Evaluation ◽  
Objective Evaluation ◽  
Applanation Tonometry ◽  
Diep Flap ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Delayed Breast Reconstruction ◽  
Level I ◽  
Therapeutic Study

Abstract Background Objectively measured breast softness in reconstructed breasts and its relation to patients’ subjective satisfaction with breast softness has not yet been investigated. The aim of this study was to evaluate breast softness in patients 1 year following delayed breast reconstruction with an expander prosthesis (EP) or deep inferior epigastric perforator (DIEP) flap, using objective and subjective methods. Methods Seventy-three patients were randomised to breast reconstruction with an EP or DIEP flap between 2012 and 2018. Of these, 69 completed objective evaluation at a mean of 25 (standard deviation, SD 9.4) months following breast reconstruction. Objective evaluation included measurements of breast volume, jugulum-nipple distance, clavicular-submammary fold distance, ptosis and Baker scale grading. Breast softness was assessed with applanation tonometry. Subjective evaluation was performed using the BREAST-Q questionnaire. Results Objectively, DIEP flaps were significantly softer than EP breast reconstructions. Non-operated contralateral breasts were significantly softer compared with reconstructed breasts. In the subjective evaluation, the median score on the question (labelled 1.h) “How satisfied or dissatisfied have you been with the softness of your reconstructed breast (s)?” was higher in the DIEP flap group corresponding to greater satisfaction in this group. A fair correlation was found between the applanation tonometry and the patient-reported satisfaction with the reconstructed breast’s softness (rs = 0.37). Conclusions In terms of breast softness, breast reconstructions with DIEP flaps result in more satisfied patients. Concerning applanation tonometry as an objective tool for softness assessment, future studies on interobserver agreement are warranted. Level of evidence: Level I, therapeutic study

scholarly journals A Qualitative Assessment of the Journey to Delayed Breast Reconstruction

2017 ◽  
Vol 25 (3) ◽  
pp. 157-162 ◽  
Author(s):  
Ho Man Cheng ◽  
Catherine McMillan ◽  
Joan E. Lipa ◽  
Laura Snell
Keyword(s):  
Breast Reconstruction ◽  
Plastic Surgery ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Tertiary Care ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Qualitative Assessment ◽  
Tertiary Care Centre ◽  
Delayed Breast Reconstruction

Background: Canada has low immediate breast reconstruction (IBR) rates compared to the United States and Europe. Breast cancer survivors live with mastectomy defects sometimes for years, and this represents an area for improvement in cancer care. Purpose: This study qualitatively assessed (1) information provided about breast reconstruction at the time of cancer diagnosis among women seeking delayed breast reconstruction (DBR) and (2) referral practices for plastic surgery consultation for DBR. Methods: Fifty-two consecutive patients seen in consultation for DBR at a single Canadian tertiary care centre completed questionnaires regarding their experience in seeking breast reconstruction. Seven semi-structured interviews were conducted to further explore themes identified through questionnaires. Questionnaire responses and interview transcripts were analyzed for recurring themes using standard qualitative techniques. Results: A significant portion of women (43%) was interested in reconstruction prior to mastectomy, yet IBR was infrequently discussed (14%) or discouraged by their oncologic surgeons (33%). Common patient reasons for not pursuing IBR were referring physician objection and not having adequate knowledge. Women expressed wanting to discuss reconstruction at the time of cancer diagnosis. Half of the patients had attended another consultation, but the initial plastic surgeon either did not offer procedures for which these women were candidates or had prohibitively long surgical wait times. Conclusion: Lack of information about reconstructive options at the time of cancer diagnosis and perceived access barriers to plastic surgeons may contribute to underutilization of IBR in Canada. Access to breast reconstruction can be improved by reducing inefficiencies in plastic surgery referrals.

scholarly journals TWO-STAGE DELAYED RECONSTRUCTION IN PATIENTS WITH BREAST CANCER AFTER MASTECTOMY

2018 ◽  
Vol 8 (2) ◽  
pp. 43-49
Author(s):  
A. D. Zikiryahodzhaev ◽  
E. A. Rasskazova
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Radical Mastectomy ◽  
Underlying Disease ◽  
Breast Size ◽  
Cancer Breast ◽  
Small Breast ◽  
Delayed Breast Reconstruction ◽  
Observation Period

Delayed breast reconstruction after performing radical mastectomy for cancer is a surgical method of rehabilitation of patients. Breast reconstruction is performed to improve the quality of life of patients with breast cancer. Breast restoration using expander is used in women with a small breast size, as well as in patients who refuse to use patchwork techniques of breast restoration. In P. A. Herzen MORI 27 patients with a diagnosis of breast cancer was performed in delayed breast reconstruction after radical mastectomy.To achieve symmetry in 51,9 % of cases the operations were also performed on the healthy breast. During the observation period up to 4 years, no signs of progression of the underlying disease were found in this group.

Short-Scar Latissimus Dorsi (SSLD) With a Lateral Approach: A Game Changer in Breast Reconstruction?

2021 ◽  
Author(s):  
Simon Perez ◽  
Emmanuel Delay ◽  
Raphaël Sinna ◽  
Traian Savu ◽  
Richard Vaucher ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Skin Necrosis ◽  
Lateral Approach ◽  
Advancement Flap ◽  
Autologous Reconstruction ◽  
Skin Paddle ◽  
Cutaneous Tissue ◽  
Delayed Breast Reconstruction ◽  
Short Scar

Abstract Background In delayed breast reconstruction, the thoraco-mammary cutaneous tissue often shows residual damage from radiotherapy. The fragility of this tissue is associated with a risk of skin necroses of about 8% when dissection is performed by reopening of the mastectomy scar. Objectives The objective of our study was to adapt the technique of short-scar latissimus dorsi flap surgery with an abdominal advancement flap using a lateral approach only avoiding re-incision of the mastectomy scar. Methods In this retrospective study, we performed 150 reconstructions in 146 patients to assess the safety and effectiveness of the SSLD technique with lateral approach. The primary outcome was the occurrence of postoperative skin necrosis of the thoraco-mammary area. Results Of the 150 delayed breast reconstruction procedures performed, none showed skin necrosis of the thoraco-mammary area, and a positive effect on skin trophicity of this area was observed. The resulting patient and surgical team satisfaction were very favorable. Conclusions In our practice, this technique changed our paradigm because of good skin safety and effectiveness. It allows reconstruction without a patch-effect in patients with very poor skin quality in whom the thoraco-mammary skin would have been replaced in the past by a skin paddle. Reconstruction would have even be contraindicated. It could also be an alternative to many other more complex and longer techniques of autologous reconstruction.

scholarly journals Restoring wholeness: Women’s embodied experiences in considering post-mastectomy delayed breast reconstruction

2018 ◽  
Vol 4 (1) ◽  
pp. 1479478
Author(s):  
Terry Cheng ◽  
Natalie Causarano ◽  
Jennica Platt ◽  
Jennifer M. Jones ◽  
Stefan O.P. Hofer ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Embodied Experiences ◽  
Delayed Breast Reconstruction
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