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.

scholarly journals Evaluation of result of skin-nipple sparing mastectomy in Baghdad Teaching Hospital and Dijla Private Hospital

2018 ◽  
Vol 5 (9) ◽  
pp. 3002
Author(s):  
Sabah Noori Abdulraheem Al-Khazaali ◽  
Rafea Jasim Hussein Al-Shammari
Keyword(s):  
Local Recurrence ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Clinical Feature ◽  
Characteristic Type ◽  
Aesthetic Result ◽  
Nipple Sparing Mastectomy ◽  
One Year ◽  
Nipple Sparing

Background: Skin-nipple sparing mastectomy and immediate breast reconstruction by silicone implantation has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the results of skin-nipple sparing mastectomy.Methods: Records of twenty-seven patients with operable breast cancer who had skin-nipple sparing mastectomy and immediate breast reconstruction between June 2009 and June 2011 were reviewed. Patients and tumor characteristic, type of reconstruction, post-operative complication, aesthetics, results and incidence of recurrence analyzed.Results: Mean age of 37 patients, aged 25 to 48 years old. Regarding the clinical feature, the size of mass <3 cm in 70%, the site of mass in upper outer quadrant in 62%, no case of skin changes and/or nipple changes. There are two cases of all patients which fixed to underlying tissues about 63% of cases are grade II, stage II and 37% are grade I, stage I. The results of follow up of the procedures are: seroma developed in 14%, infection 3.5%, skin necrosis 7%, local recurrence was zero for follow up for more than one year, about 63% received chemotherapy.Conclusions: S.N.S.M. and immediate breast reconstruction with silicon implantation for selective case of CA breast is associated with low morbidity and low rate of local recurrence and good aesthetic result with patient satisfaction.

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.

Robotic Nipple-sparing Mastectomy and Immediate Breast Reconstruction With Implant

2017 ◽  
Vol 266 (2) ◽  
pp. e28-e30 ◽  
Author(s):  
Antonio Toesca ◽  
Nickolas Peradze ◽  
Viviana Galimberti ◽  
Andrea Manconi ◽  
Mattia Intra ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Gilles Houvenaeghel ◽  
Julien Barrou ◽  
Camille Jauffret ◽  
Sandrine Rua ◽  
Laura Sabiani ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Complication Rate ◽  
Immediate Breast Reconstruction ◽  
Predictive Score ◽  
Patient’S Satisfaction ◽  
Duration Of Surgery ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Complications Rate ◽  
Length Of Hospitalization

BackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost.ResultsWe analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI&gt;=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient’s satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI &gt;=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.

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