scholarly journals Understanding Preoperative Breast Satisfaction among Patients Undergoing Mastectomy and Immediate Reconstruction: BREAST-Q Insights

2021 ◽  
Vol 148 (6) ◽  
pp. 891e-902e
Author(s):  
Meghana G. Shamsunder ◽  
Thais O. Polanco ◽  
Colleen M. McCarthy ◽  
Robert J. Allen ◽  
Evan Matros ◽  
...  
Keyword(s):  
Immediate Reconstruction

Exit-surface wave reconstruction using a focal series

1992 ◽  
Vol 50 (2) ◽  
pp. 988-989
Author(s):  
W.J. de Ruijter ◽  
M.R. McCartney ◽  
David J. Smith ◽  
J.K. Weiss
Keyword(s):  
Surface Wave ◽  
Spherical Aberration ◽  
Data Extraction ◽  
High Sensitivity ◽  
Geometric Distortion ◽  
Variation Method ◽  
Objective Lens ◽  
Immediate Reconstruction ◽  
Exit Surface ◽  
Electron Microscopes

Further advances in resolution enhancement of transmission electron microscopes can be expected from digital processing of image data recorded with slow-scan CCD cameras. Image recording with these new cameras is essential because of their high sensitivity, extreme linearity and negligible geometric distortion. Furthermore, digital image acquisition allows for on-line processing which yields virtually immediate reconstruction results. At present, the most promising techniques for exit-surface wave reconstruction are electron holography and the recently proposed focal variation method. The latter method is based on image processing applied to a series of images recorded at equally spaced defocus.Exit-surface wave reconstruction using the focal variation method as proposed by Van Dyck and Op de Beeck proceeds in two stages. First, the complex image wave is retrieved by data extraction from a parabola situated in three-dimensional Fourier space. Then the objective lens spherical aberration, astigmatism and defocus are corrected by simply dividing the image wave by the wave aberration function calculated with the appropriate objective lens aberration coefficients which yields the exit-surface wave.

Intraoperative, postoperative and long-term oncosurgical safety of therapeutic mammaplasty

2013 ◽  
Vol 154 (33) ◽  
pp. 1291-1296 ◽  
Author(s):  
László Romics Jr. ◽  
Sophie Barrett ◽  
Sheila Stallard ◽  
Eva Weiler-Mithoff
Keyword(s):  
Recurrence Rate ◽  
Tumour Size ◽  
Breast Conservation ◽  
Malignant Lesion ◽  
Surgical Techniques ◽  
Incomplete Resection ◽  
Immediate Reconstruction ◽  
Oncological Safety

Introduction: (Pre)malignant lesion in the breast requiring mastectomy conventionally may be treated with breast conservation by using oncoplastic breast surgical techniques, which is called therapeutic mammaplasty. However, no reliable data has been published so far as regards the oncological safety of this method. Aim: The aim of the authors was to analyse the oncological safety of therapeutic mammaplasty in a series of patients. Method: 99 patients were treated with therapeutic mammaplasty and data were collected in a breast surgical database prospectively. Results were analysed with respect to intraoperative, postoperative and long-term oncological safety. Results: Incomplete resection rate was 14.1%, which correlated with tumour size (p = 0.023), and multifocality (p = 0.012). Time between surgery (therapeutic mammaplasty) and chemotherapy was similar to time between conventional breast surgeries (wide excision, mastectomy, mastectomy with immediate reconstruction) and chemotherapy (mean 29–31 days; p<0.05). Overall recurrence rate was 6.1%, locoregional recurrence rate was 2% during 27 month (1–88) mean follow-up. Conclusions: Since literature data are based on relatively short follow-up and low patient number, it is highly important that all data on therapeutic mammaplasty is collected in a prospectively maintained breast surgical database in order to determine true recurrence after long-follow-up. Orv. Hetil., 2013, 154, 1291–1296.

Is There a Bias Against Obese Patients in the Treatment of Breast Cancer?

2020 ◽  
pp. 000313482098487
Author(s):  
Melinda Wang ◽  
Julian Huang ◽  
Anees B. Chagpar
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Prophylactic Mastectomy ◽  
Implicit Bias ◽  
Treatment Decision ◽  
Obese Patients ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Immediate Reconstruction

Background Patient and tumor characteristics often coincide with obesity, potentially affecting treatment decision-making in obese breast cancer patients. Independent of all of these factors, however, it is unclear whether obesity itself impacts the decision to offer patients undergoing mastectomy breast reconstruction, postmastectomy radiation therapy (PMRT), or neoadjuvant chemotherapy. We sought to determine whether implicit bias against obese breast cancer patients undergoing mastectomy plays a role in their treatment. Methods Medical records of breast cancer patients undergoing mastectomy from January 2010 to April 2018 from a single institution were retrospectively reviewed, separated into obese (BMI ≥30) and nonobese (BMI <30) categories, and compared using nonparametric statistical analyses. Results Of 972 patients, 291 (31.2%) were obese. Obese patients were more likely to have node-positive, triple-negative breast cancers ( P = .026) and were also more likely to have other comorbidities such as a history of smoking ( P = .026), hypertension ( P < .001), and diabetes ( P < .001). Receipt of immediate reconstruction and contralateral prophylactic mastectomy did not vary between obese and nonobese patients. While obese patients were more likely to undergo neoadjuvant chemotherapy (26.5% vs. 18.1%, P = .004) and PMRT (33.0% vs. 23.4%, P = .003), this did not remain significant when controlling for comorbidities and clinicopathologic confounders. Conclusion Obese patients present with more aggressive tumors and often have concomitant comorbidities. Independent of these factors, however, differences in the treatment of patients undergoing mastectomy do not seem to be affected by an implicit bias against obese patients.

scholarly journals A Protocol for the Use of a Combined Microvascular Free Flap with Custom-Made 3D-Printed Total Temporomandibular Joint (TMJ) Prosthesis for Mandible Reconstruction in Children

2021 ◽  
Vol 11 (5) ◽  
pp. 2176
Author(s):  
Krzysztof Dowgierd ◽  
Rafal Pokrowiecki ◽  
Maciej Borowiec ◽  
Marcin Kozakiewicz ◽  
Dominika Smyczek ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Soft Tissues ◽  
Total Joint Replacement ◽  
Speech Development ◽  
Functional Requirements ◽  
Immediate Reconstruction ◽  
Congenital Deformities ◽  
Custom Made ◽  
Masticatory System

Extended postoperative mandibular reconstructions due to orofacial disease involving the temporomandibular joint (TMJ) in immature patients remain a challenge as a result of ongoing growth, which is usually affected by the disease and treatment. Current reconstructive techniques based fully on alloplastic total joint replacement fail to meet fully the anatomical and functional requirements for the masticatory system and speech development. Fourteen children aged 12.6 ± 2.6 with tumors or congenital deformities affecting the mandible and TMJ were included in the study. Radical surgical treatment according to our own protocol was performed through microvascular anastomotic flap reconstruction of the soft tissues and bones, together with total TMJ custom replacements. Follow-up lasted 2–6 years. During the follow-up, increases in the mandible body (13% growth) and ramus (12% growth) were observed, both of which were related (p < 0.001). This is the first report concerning the immediate reconstruction of the mandible with ramus and total TMJ in children and adolescents that combines a free vascularized graft and total individual prosthesis of the TMJ. The presented technique enabled optimal function of the TMJ, growth of the mandible, and further rehabilitation of the patients. The technique was demonstrated to be safe, reliable, and provide good functional and cosmetic outcomes.

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