scholarly journals Giant phyllodes tumor occupying the whole breast in a young female: feasibility of mastectomy and immediate reconstruction

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
Aikaterini K Kolia ◽  
Vasileios Kalles ◽  
Constantinos G Zografos ◽  
Alexandros Chamzin ◽  
Nikolaos V Michalopoulos
Keyword(s):  
Breast Reconstruction ◽  
Breast Tissue ◽  
Tissue Expander ◽  
Breast Implants ◽  
Phyllodes Tumor ◽  
Young Female ◽  
Immediate Breast Reconstruction ◽  
Immediate Reconstruction ◽  
Phyllodes Tumors ◽  
Appropriate Therapy

Abstract Giant phyllodes tumors are rare fibroepithelial breast neoplasms typically >10 cm by definition. The best investigation for preoperative diagnosis is core biopsy, although it is often difficult for the pathologist to distinguish fibroadenomas from phyllodes tumors and determine the level of malignant potential. The wide excision is the appropriate therapy for phyllodes tumors taking into consideration that mastectomy may be required for huge phyllodes tumors. In the modern era of breast tissue expanders and breast implants, immediate breast reconstruction is feasible. We present a case report of a patient with a giant phyllodes tumor of 24 cm diameter who underwent mastectomy and immediate breast reconstruction with breast tissue expander.

Does Immediate Tissue Expander Placement Increase Immediate Postoperative Complications in Patients with Breast Cancer?

2015 ◽  
Vol 81 (2) ◽  
pp. 143-149
Author(s):  
Hossein Masoomi ◽  
Keyianoosh Z. Paydar ◽  
Gregory R. D. Evans ◽  
Emily Tan ◽  
Karen T. Lane ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Hospital Mortality ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Tissue Expander ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Perioperative Outcomes ◽  
Immediate Reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

scholarly journals Comparison between Immediate and Delayed Prosthetic Breast Reconstruction Following Mastectomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B A Wassef ◽  
W H Hassan ◽  
R M Ahmed ◽  
E S Shebl
Keyword(s):  
Quality Of Life ◽  
Breast Reconstruction ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
University Hospital ◽  
University Hospitals ◽  
Immediate Reconstruction ◽  
Safe Alternative ◽  
Group A

Abstract Purpose to compare the outcomes of Immediate versus Delayed prosthetic breast reconstruction. Together with highlighting the importance of immediate reconstruction when it is feasible. Materials and methods This was a prospective study that was held at ain shams university hospitals and Helwan university hospital. The study included 20 patients who were planned to undergo a mastectomy either unilateral or bilateral, patients were divided equally in to 2 groups, (Group A) had an immediate breast reconstruction using mammary implants, while (Group B) had a delayed breast reconstruction using tissue expander then replacing it after a few months with a mammary implant, and the post operative complications were compared against each other. Results Although the number of complications were more in (Group A), but statistically it was found that the rate of complications after immediate reconstruction was non significant from after delayed reconstruction. Conclusion both immediate and delayed mastectomy reconstruction provide substantial safety and quality of life benefits for women choosing these procedures. Furthermore, patients who postpone reconstruction after mastectomy due to personal preference or by medical necessity can be reassured that this approach is a safe alternative to immediate reconstruction and can provide equivalent quality of life and body image benefits.

scholarly journals A case of recurrent malignant phyllodes tumor undergoing nipple-sparing mastectomy with immediate breast reconstruction

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Emi Morioka ◽  
Masakuni Noguchi ◽  
Miki Noguchi ◽  
Masafumi Inokuchi ◽  
Ken-ichi Shimada ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Radiation Treatment ◽  
Tissue Expander ◽  
Phyllodes Tumor ◽  
Left Breast ◽  
Immediate Breast Reconstruction ◽  
Malignant Phyllodes Tumor ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Background Although the primary treatment for malignant phyllodes tumor (PT) is complete surgical excision with either breast-conserving surgery or total mastectomy, recent technical advances have led to the adoption of nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR). Case presentation A 28-year-old woman noticed a mass in her left breast that was rapidly increasing in size. She underwent tumor excision and a histological diagnosis of marked degenerative and necrotic induration suggested benign PT. One year later, however, she was found to have recurrent masses in the left breast on follow-up mammography and sonography. Needle biopsy was performed and the tumor was diagnosed as borderline or malignant PT. She underwent NSM and sentinel lymph-node biopsy with IBR using a tissue expander. Histological examination of the mastectomy specimen showed multiple fibroepithelial tumors with marked stromal overgrowth, focal necrosis, and hemorrhage. Stromal cells showed pleomorphism and a maximal mitotic rate of approximately 25 per 10 high-power fields. The tumor was diagnosed as malignant PT. She did not receive adjuvant chemotherapy or radiation treatment. At 3-year follow-up, the patient remains free of disease and highly satisfied with the cosmetic results. Conclusions NSM with IBR is not a contraindication for malignant PT. It is both curative and can offer an appealing cosmetic option for localized malignant PT.

Emotional expectations reported by hospitalized women in southeastern Brazil before being submitted to mastectomy with immediate breast reconstruction: A clinical-qualitative study

2017 ◽  
Vol 41 (S1) ◽  
pp. s507-s507
Author(s):  
G.L. Almeida ◽  
R.M.C. Sena ◽  
V.L.P. Alves ◽  
C. Cardoso-Filho ◽  
E.R. Turato
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
University Hospital ◽  
Southeastern Brazil ◽  
Immediate Reconstruction ◽  
Female Population ◽  
Competing Interest ◽  
Health Assistant ◽  
The Aesthetic

IntroductionBreast cancer is a type that more affects female population in the world. Surgical indication, present in most cases, is a mutilating procedure and mentally traumatic for majority of women subjected. Thus, immediate breast reconstruction, which is the choice to rebuild the breast during the mastectomy surgery, is an alternative to reduce discomforts associated with loss of the breast, in addition to being associated potentially with improved emotional and psychosocial quality of life.ObjectiveTo discuss, from psychological viewpoint, the emotional expectations about surgical results of a planned mastectomy with immediate breast reconstruction, reported by women with breast cancer treated in a university hospital in Campinas, state of São Paulo.MethodQualitative design, particularized in the clinical-qualitative method, adequate to health assistant settings, using the semi-directed interview with open-ended questions in-depth, fully transcribed and after submitted to content clinical-qualitative analysis. Intentional sample closed by criterion of information theoretical saturation with 12 sequential participants.ResultsAmongst the emergent categories from free-floating readings, we have chosen the following to presentation:.–The desire of healing above expectations of the aesthetic aspects;–The perception of the surgical approach predominantly with aesthetic effects;–The desire of a contra-lateral healthy breast withdrawal, too.ConclusionsFace the proposal of mastectomy with immediate reconstruction, days before the surgery, women reported to be well emotionally organized for the procedure, although in different ways. This occurs probably due to emotional meanings built by many experiences from their psychological histories, as well as from values provided by the socio-cultural environments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prosthetic-Based Breast Reconstruction

2020 ◽  
Author(s):  
Jonathan Nguyen ◽  
Justin Williams ◽  
Albert Losken
Keyword(s):  
Breast Reconstruction ◽  
Breast Implant ◽  
Tissue Expander ◽  
Acellular Dermal Matrix ◽  
Large Cell ◽  
Fat Grafting ◽  
Immediate Reconstruction ◽  
Dermal Matrix ◽  
Prosthetic Reconstruction ◽  
Acellular Dermal

Prosthetic reconstruction is the most popular option for breast reconstruction after mastectomy. There are several different techniques, such as prepectoral versus subpectoral placement, and delayed versus immediate reconstruction, each with their own sets of risks and benefits. With the advent of improved implant technology, acellular dermal matrix, and fat grafting, prepectoral direct to implant has become an accepted and increasingly popular method of reconstruction, with similar to improved complication rates and outcomes as traditional staged tissue expander reconstruction. Prosthetic reconstruction has had some recent controversies, including breast implant associated anaplastic large cell lymphoma and breast implant illness, and many future studies are being directed towards these topics. This review contains 5 figures, and 53 references. Keywords: breast reconstruction, breast implant, acellular dermal matrix, prepectoral reconstruction, tissue expander, fat grafting, capsular contracture, immediate reconstruction, breast implant associated anaplastic large cell lymphoma, breast implant illness

A Case of a Giant Borderline Phyllodes Tumor Early in Pregnancy Treated with Mastectomy and Immediate Breast Reconstruction

2016 ◽  
Vol 22 (6) ◽  
pp. 683-687 ◽  
Author(s):  
Lori F. Gentile ◽  
William Foster Gaillard ◽  
Jodi-Ann Wallace ◽  
Lisa R. P. Spiguel ◽  
Layla Alizadeh ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Phyllodes Tumor ◽  
Immediate Breast Reconstruction ◽  
In Pregnancy

Clinical outcomes following immediate reconstruction and post-mastectomy radiation therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10560-10560
Author(s):  
J. D. Jhaveri ◽  
I. Savetsky ◽  
J. L. Bosworth ◽  
S. C. Rush
Keyword(s):  
Radiation Therapy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tissue Expander ◽  
Muscle Flap ◽  
Complete Removal ◽  
Immediate Breast Reconstruction ◽  
Surgical Revision ◽  
Immediate Reconstruction

10560 Background: Post-mastectomy radiation therapy (PMRT) is an important component of the treatment for locally advanced breast cancer. Some patients opt for immediate breast reconstruction (IR) to cope with the aesthetic consequences of mastectomy. A small number of series have reported mixed results with IR using a tissue expander/implant (TE/I) followed by PMRT. We sought to determine the outcome of patients receiving PMRT after IR with either TE/I or autologous tissue reconstruction (ATR), with respect to both complications and cosmesis. Methods: We retrospectively reviewed the charts of 47 women who underwent PMRT in our practice after IR. All follow-up information was obtained by reexamination or by telephone interview. Contracture/fibrosis results were scored on a scale as follows: 0- no complaints, 1- mild discomfort, not affecting activities of daily life (ADLs), 2- moderate discomfort, affecting ADLs, or biopsy-proven fat necrosis, 3- complications requiring surgical revision, 4- reconstruction failure, requiring removal. For cosmesis, results were recorded as: 1- acceptable, 2- unacceptable. Results: A total of 47 patients were identified as having undergone PMRT after IR. 35 underwent TE/I and 12 underwent ATR, most commonly transverse rectus abdominus muscle flap reconstruction. Median follow-up was 36 months (range: 26 - 96 months). All patients were treated with 50.4 Gy in 25 fractions to the chest wall, and seven patients received an additional electron boost to high risk areas. All patients received 45 Gy in 25 fractions to a supraclavicular field. Of the patients who underwent TE/I and PRMT, twenty-one of 35 (60%) described unacceptable cosmesis, as opposed to two of 12 ATR patients (17%) (p = .02). Similarly, 13 patients in the TE/I (37%) group required either surgical revision (n = 3) or complete removal of their implant (n = 10), as compared to none of the patients in the ATR group (p = .02). Conclusion: Immediate TE/I reconstruction with PMRT was associated with high rates of complications and poor cosmetic results in our experience. ATR resulted in significantly higher rates of functional and cosmetic success. Thus, if IR is planned in the setting of PMRT, ATR should be recommended. No significant financial relationships to disclose.

scholarly journals Role of fat grafting in late breast reconstruction after failure of immediate breast reconstruction with implants – experience of hospital de clínicas in porto alegre

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Andréa Pires Souto Damin ◽  
Gabriela Dinnebier Tomazzoni ◽  
Angela Erguy Zucatto ◽  
Maira Zancan ◽  
Jorge Villanova Biazús
Keyword(s):  
Breast Reconstruction ◽  
Surgical Techniques ◽  
Muscle Flap ◽  
Immediate Breast Reconstruction ◽  
Fat Grafting ◽  
Individual Risk ◽  
Silicone Implants ◽  
Immediate Reconstruction ◽  
Latissimus Dorsi Muscle Flap ◽  
Local Conditions

Introduction: The breast reconstruction techniques with tissue expanders and silicone implants were the most used ones in the past decade. Immediate post-mastectomy reconstruction can evolve to loss of implants, causing significant morbidity to the patients. The knowledge of techniques that use fat grafting has allowed the use of more late reconstruction techniques. Objectives: To assess the application of fat grafting in late breast reconstruction in patients submitted to mastectomy with immediate reconstruction, who presented loss of implant (expanders and prostheses). Method: Cross-sectional study carried out through data collection in electronic medical records. We selected patients from the Mastology Service in HCPA, submitted to immediate breast reconstruction with expanders/prostheses in the period from May/2000 to May/2019. Results: We analyzed 241 cases of mastectomy with immediate breast reconstruction based on implants – 127 (52.7%) expanders and 114 (42.3%) direct prosthesis. In 24 cases (10.0%), there was loss of implants. Among these 24 patients, 20 (83.3%) had not undergone radiotherapy before mastectomy, and 4 (16.7%) had been submitted to previous radiotherapy. Of these, in 18 cases (75.0%), late reconstruction was performed: 3 cases (20.8%) of reconstruction with rectus abdominis flap (TRAM), 4 cases (23.4%) of reconstruction with latissimus dorsi muscle flap (LD), 1 case (5.5%) of fat grafting with flap planning, 6 cases (33.6%) of exclusive flap grafting, and 4 cases (23.4%) of expander/prosthesis after the plastron fat grafting. Conclusions: Breast reconstruction after the loss of expanders/prosthesis can be carried out through several surgical techniques. The knowledge of the mastologist about the different techniques aims at providing the best choice to be used, according to the individual risk profile of each patient. Plastron fat grafting after loss of implant is an important ally in late reconstruction, improving the local conditions and allowing, in our sample, the prevention of the indication of flaps 57% of the time.

scholarly journals Capsular Flap for Implant Coverage in Breast Reconstruction Following Nipple-Sparing Mastectomy in Women With Previous Breast Augmentation

2019 ◽  
Vol 5 ◽  
pp. 2513826X1982879
Author(s):  
Miguel Sabino Neto ◽  
Luiz Henrique Gebrim
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Breast Augmentation ◽  
Prophylactic Mastectomy ◽  
Breast Implants ◽  
Immediate Breast Reconstruction ◽  
Silicone Implants ◽  
Capsular Flap ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

An increased incidence of breast cancer has been observed in women, including in those with silicone breast implants. We describe here the use of a flap made of fibrous capsule to complete the coverage of breast implants in patients undergoing nipple-sparing mastectomy with immediate breast reconstruction, who previously had undergone breast augmentation with silicone implants. All patients underwent ipsilateral therapeutic mastectomy and contralateral prophylactic mastectomy for breast cancer risk reduction and breast symmetrization. The capsular flap was successfully used in 16 patients. No postoperative complications occurred. This is a simple and safe technique and an additional option for this procedure.

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