prepectoral breast reconstruction: do we need to use the chest wall muscle at all?

Abstract Objective To investigate the potential contribution of accessory respiratory muscle atrophy to the decline of forced vital capacity (FVC) in patients with SSc-associated interstitial lung disease (ILD). Methods This single-centre, retrospective study enrolled 36 patients with SSc-ILD who underwent serial pulmonary function tests and chest high-resolution CT (HRCT) simultaneously at an interval of 1–3 years. The total extent of ILD and chest wall muscle area at the level of the ninth thoracic vertebra on CT images were evaluated by two independent evaluators blinded to the patient information. Changes in the FVC, ILD extent, and chest wall muscle area between the two measurements were assessed in terms of their correlations. Multiple regression analysis was conducted to identify the independent contributors to FVC decline. Results Interval changes in FVC and total ILD extent were variable among patients, whereas chest wall muscle area decreased significantly with time (P=0.0008). The FVC change was negatively correlated with the change in ILD extent (r=−0.48, P=0.003) and was positively correlated with the change in the chest wall muscle area (r = 0.53, P=0.001). Multivariate analysis revealed that changes in total ILD extent and chest wall muscle area were independent contributors to FVC decline. Conclusion In patients with SSc-ILD, FVC decline is attributable not only to the progression of ILD but also to the atrophy of accessory respiratory muscles. Our findings call attention to the interpretation of FVC changes in patients with SSc-ILD.

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O-74 Comparison of the incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 Gy in 15 fractions

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(07)71764-0 ◽

2007 ◽

Vol 5 (3) ◽

pp. 23 ◽

Cited By ~ 1

Author(s):

G.A. Whitfield ◽

G. Horan ◽

M.S. Irwin ◽

C.M. Malata ◽

G.C. Wishart ◽

...

Keyword(s):

Breast Reconstruction ◽

Chest Wall ◽

Capsular Contracture ◽

Immediate Breast Reconstruction

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Simultaneous Breast Reconstruction with Transverse Rectus Abdominal Myocutaneous (Tram) Flaps

Canadian Journal of Plastic Surgery ◽

10.1177/229255039800600308 ◽

1998 ◽

Vol 6 (3) ◽

pp. 146-148

Author(s):

Sv Sidorov ◽

Kv Vardosanidze ◽

Sp Shevchenko

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Chest Wall ◽

Radical Mastectomy ◽

Individual Approach ◽

Cosmetic Effect ◽

The Aesthetic

Breast reconstruction with transverse rectus abdominal myocutaneous (TRAM) flaps on pedicles was performed simultaneously with radical mastectomy in 73 patients with breast cancer. In the case of the tumour exceeding the breast borders, or edemo-infiltrative form of cancer, radical mastectomy was accomplished, and the wound defect on the chest wall was closed without technical difficulties, while simultaneously solving the aesthetic part of the operation. Complications were noted in 13 patients (17.8%), and with revision, complications were eliminated without impairing cosmetic effect. Recurrence of the breast cancer was noted in 9.6% of patients, which is explained by the presence of hidden separate metastases not located during the preoperational period or operation. An individual approach in solving the task of simultaneous breast reconstruction with radical mastectomy is necessary in each patient.

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Analysis on the Effect of Application of the DIEP Flap in Breast Reconstruction Surgery

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v2i1.268 ◽

2018 ◽

Vol 2 (1) ◽

Author(s):

Tan Jia Liang

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Chest Wall ◽

Early Stage ◽

Developed Countries ◽

Breast Cancer Surgery ◽

Sex Reassignment Surgery ◽

Diep Flap ◽

Breast Reduction Surgery ◽

Reconstruction Surgery

Breast reconstruction surgery means using autologous tissue graftsÂ and breast prosthesis to rebuild chest wall deformities and theÂ absence of breast caused by post mastectomy, which are possiblyÂ due to burns, trauma, infections, congenital dysplasia and sex reassignment surgery etc., with the prevalence of unilateral breastÂ reconstruction. After attempting to carry out breast reconstructionÂ with latissimus dorsi, many surgeons constantly improved,Â designed, and modified multiple forms of operation programs andÂ thus promote increasing improvement in repair and reconstruction of the breast after breast reduction surgery and mastectomy forÂ breast cancerÂ [1] Currently, breast reconstruction after breast cancer surgery is just in the early stage while it has occupied an importantÂ position in developed countries,therefore, the knowledge of breastÂ reconstruction needs to be enhanced and publicized in our country.Â Some data show the quality of life in patients following breast reconstruction surgery is significantly higher than that in patientsÂ undergoing lumpectomy plus radiotherapy or simple mastectomy.Â More and more patients pursue breast reconstruction afterÂ mastectomy for breast cancer. Breast reconstruction is roughlyÂ divided into lost chest wall skin repair, hemispherical breast reconstruction, anterior axillary fold repair, plastic surgery forÂ subclavian depression, nipple and areola reconstruction andÂ asymmetrical breast repair. In the reconstruction of breasts, it isÂ necessary to endeavor to make the rebuilt breast symmetrical to theÂ healthy side so that future adjustment will be simple and easily feasible.

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Improvement in Existing Chest Wall Irregularities During Breast Reconstruction

Cancer Control ◽

10.1177/1073274817744461 ◽

2018 ◽

Vol 25 (1) ◽

pp. 107327481774446

Author(s):

Katherine M. Huber ◽

Amanda Zimmerman ◽

Deniz Dayicioglu

Keyword(s):

Patient Satisfaction ◽

Breast Reconstruction ◽

Risk Reduction ◽

Chest Wall ◽

Pectus Excavatum ◽

Case Reports ◽

Cosmetic Outcome ◽

Cancer Resection

Mastectomies for both cancer resection and risk reduction are becoming more common. Existing chest wall irregularities are found in these women presenting for breast reconstruction after mastectomy and can pose reconstructive challenges. Women who desired breast reconstruction after mastectomy were evaluated preoperatively for existing chest wall irregularities. Case reports were selected to highlight common irregularities and methods for improving cosmetic outcome concurrently with breast reconstruction procedures. Muscular anomalies, pectus excavatum, scoliosis, polythelia case reports are discussed. Relevant data from the literature are presented. Chest wall irregularities are occasionally encountered in women who request breast reconstruction. Correction of these deformities is possible and safe during breast reconstruction and can lead to improved cosmetic outcome and patient satisfaction.

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