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.

scholarly journals Early postoperative complications and local relapses after nipple sparing mastectomy and immediate breast reconstruction using silicone implants

2019 ◽  
Vol 25 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Vladimir Selakovic ◽  
Milan Ranisavljevic ◽  
Zoran Radovanovic ◽  
Ferenc Vicko ◽  
Dejan Lukic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Silicone Implants ◽  
Breast Cancer Patients ◽  
Early Complications ◽  
Total Percentage ◽  
Reconstruction Methods ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Purpose: Purpose of this study was to evaluate early complications and risk factors associated with nipple sparing mastectomy and immediate breast reconstruction. Methods: This retrospective study was made using data from 246 breast cancer patients treated at the Oncology Institute of Vojvodina in the period from January 2010 to December 2015. In all patients nipple sparing mastectomy was performed along with primary breast reconstruction. Results: The mean indication for nipple sparing mastectomy was multicentricity of the tumor (114 patients; 46.3%). The majority of surgically treated patients were in stage II of the disease. The total percentage of local relapses after the nipple sparing mastectomy was 1.6% (4 patients). Total percentage of early complications was 15% (37 patients). Median follow-up after nipple sparing mastectomy was 260 weeks (ranging from 417 to 104 weeks). Conclusion: Primary reconstruction of the breasts using heterologous implants is standard surgical procedure for breast cancer that does not lead to increased number of complications, nor to increased percentage of the local recurrence.

scholarly journals Robot-assisted Nipple-sparing Mastectomy with Immediate Breast Reconstruction: An Initial Experience

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hyung Seok Park ◽  
Jeea Lee ◽  
Dong Won Lee ◽  
Seung Yong Song ◽  
Dae Hyun Lew ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Learning Curve ◽  
Operation Time ◽  
Immediate Breast Reconstruction ◽  
Robot Assisted ◽  
Open Conversion ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Seeking smaller and indistinct incisions, physicians have attempted endoscopic breast surgery in breast cancer patients. Unfortunately, there are some limitations in the range of movement and visualization of the operation field. Potentially addressing these limitations, we investigated the outcomes of gas and gasless robot-assisted nipple-sparing mastectomy (RANSM) with immediate breast reconstruction (IBR). Ten patients underwent 12 RANSM with IBR between November 2016 and April 2018. Patients with tumors measuring >5 cm in diameter, tumor invasion of the skin or nipple-areolar complex, proven metastatic lymph nodes, or planned radiotherapy were excluded. Age, breast weight, diagnosis, tumor size, hormone receptor status, and operation time were retrospectively collected. Postoperative outcomes including postoperative complications and final margin status of resected were analyzed. The median total operation time and console time were 351 min (267–480 min) and 51 min (18–143 min), respectively. The learning curve presented as a cumulative sum graph showed that the console time decreased and then stabilized at the eighth case. There was no open conversion or major postoperative complication. One patient had self-resolved partial nipple ischemia, and two patients experienced partial skin ischemia. We deemed that RANSM with IBR is safe and feasible for early breast cancer, benign disease of the breast, and BRCA 1/2 mutation carriers. RANSM is an advanced surgical method with a short learning curve.

scholarly journals Trends in bilateral mastectomy for cases of unilateral breast cancer in a Brazilian institute over a 10-year period

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Francisco Pimentel Cavalcante ◽  
Paulo Goberlâneo de Barros Silva ◽  
Marcos Venicio Alves Lima
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Bilateral Mastectomy ◽  
Contributing Factors ◽  
Unilateral Breast Cancer ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Unilateral Mastectomy ◽  
Type Of Surgery

Introduction: There has been a substantial increase worldwide in the number of women with unilateral breast cancer who undergo bilateral mastectomy. Possible contributing factors include the advent of nipple-sparing mastectomy (NSM) and an improvement in breast reconstruction techniques. This study evaluated the trend in bilateral mastectomy at the Ceará Cancer Institute in Brazil. Methods: Patients with unilateral breast cancer who underwent mastectomy and immediate breast reconstruction were evaluated retrospectively between 2009 and 2018. Clinical, pathological and surgical factors were analyzed to determine their possible effects on the type of surgery performed. Results: Of 121 patients, 77 (63.6%) were submitted to unilateral mastectomy, while 44 (36.4%) underwent bilateral mastectomy. Most were treated with NSM (n = 66; 54.5%), with this technique being significantly associated with bilateral mastectomy (p < 0.001). Bilateral mastectomy increased significantly over the period (p = 0.009; r2 = 0.592), but unilateral mastectomy did not (p = 0.417; r2 = 0.084). Age < 45 years (p = 0.007) and negative axilla (p = 0.003) were also associated with bilateral mastectomy, while axillary dissection was associated with unilateral mastectomy (p = 0.028). Multivariate analysis showed the 2016-2018 period to be an independent factor associated with bilateral mastectomy. Conclusions: These results corroborate the international literature. From 2010 onwards, there was a trend towards an increase in bilateral mastectomy with breast reconstruction. These data may contribute to multidisciplinary debates, facilitating the establishment of guidelines. Further studies are required to improve understanding of this phenomenon in Brazil.

scholarly journals Oncological safety of immediate breast reconstruction with skin- or nipple-sparing mastectomy: the value of tumor-to-dermis distance measured by preoperative ultrasonography

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Takaaki Fujii ◽  
Yuko Nakazawa ◽  
Misato Ogino ◽  
Sayaka Obayashi ◽  
Reina Yajima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Skin Flap ◽  
Immediate Breast Reconstruction ◽  
Common Procedure ◽  
Data Set ◽  
Oncological Safety ◽  
Ultrasound Evaluation ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Background Immediate breast reconstruction with skin-sparing (SSM) or nipple-sparing mastectomy (NSM) has become a common procedure. In this study, we evaluated the distance between breast tumor and skin in a series of patients undergoing IBR as it relates to oncologic safety, namely, the incidence of recurrence. Methods The distance of the tumor to the dermis, rather than the outer layer of skin, was the key parameter of our preoperative ultrasound measurements. Our data set comprised the cases of 171 patients and 181 breasts with breast cancer that had undergone two-stage breast reconstruction by expander. The median age of the patients was 47 years (25–75 years). The overall median follow-up period was 47.1 months (8.8–125.3 months). Eighty-five breasts underwent IBR with SSM/NSM; the others underwent conventional mastectomy. Results Among the total of 181 reconstructed breast mounds, the locoregional recurrence rate was 1.1% (2 breasts) with no cases of skin flap recurrence or skin flap necrosis. The tumor-to-dermis distance of cases with skin preservation (NSM/SSM) was significantly less than that of cases with conventional mastectomy (3.8 ± 2.7 mm vs 5.2 ± 2.4 mm). In cases with invasive carcinoma, all cases whose tumor-to-dermis distance was less than 2 mm underwent resection of the skin immediately overlying the tumor. Conclusions Our results suggested that a 2-mm distance between the dermis and tumor on ultrasound evaluation is sufficient for the use of this tissue as a skin flap in SSM/NSM procedures. Our study indicated that immediate breast reconstruction with SSM/NSM can be an oncologically safe surgical option for breast cancer. However, we recommend that resection of the skin overlying the tumor be performed in cases with invasive breast cancer in which the tumor-to-dermis distance is less than 2 mm. Trial registration Patients in this study were retrospectively registered. This study design was approved by our Clinical Ethics Committee (No 1297) (http://ciru.dept.showa.gunma-u.ac.jp/guidance/storage-sample/list.html).

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