Batwing mammoplasty: a safe oncoplastic technique for breast conservation in breast cancer patients with gigantomastia

Background Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. Materials and methods Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. Results All patients had a body mass index above 30kg/m2 with a mean of 36.7kg/m2 (range 31.6–44.9kg/m2). The mean distance from midclavicular point to nipple was 42cm (range 38–50cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2kg (ranging from 1.035–1.63kg). Postoperative complications occurred in 14.2% of patients. Nipple–areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61–74). The mean score for physiological wellbeing was 77.3 (range 64–84) and the mean score for physical wellbeing was 35 (range 31–40). Conclusion Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.

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Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v14i1.10 ◽

2018 ◽

Vol 14 (1) ◽

pp. 18-23

Author(s):

Kurdo Akram Qradaghi

Keyword(s):

Patient Satisfaction ◽

Retrospective Study ◽

Operative Time ◽

Surgical Techniques ◽

Satisfaction Rate ◽

Areola Complex ◽

Different Types ◽

Aesthetic Results ◽

The Mean ◽

Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

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Skin Sparing Mastectomy with Preservation of Nipple Areola Complex and Immediate Breast Reconstruction in Patients with Breast Cancer: A Single Centre Prospective Study

Plastic Surgery International ◽

10.1155/2014/589068 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Debarati Chattopadhyay ◽

Souradip Gupta ◽

Prabir Kumar Jash ◽

Marang Buru Murmu ◽

Sandipan Gupta

Keyword(s):

Breast Cancer ◽

Patient Satisfaction ◽

Local Recurrence ◽

Breast Reconstruction ◽

Frozen Section ◽

Immediate Breast Reconstruction ◽

Breast Cancer Patients ◽

Nipple Areola Complex ◽

Areola Complex ◽

The Aesthetic

Background. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. Methods. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. The criteria for inclusion were core biopsy-proven, peripherally located breast cancer of any tumor size and with any “N” status, with documented negative intraoperative frozen section biopsy of retroareolar tissue, and distance from the nipple to tumor margin >2 cm on mammography. Results. The median age of the patients was 45 years. The majority had either stage II or stage III breast cancer. The median mammographic distance of tumor from nipple areola complex (NAC) was 3.8 cm. The overall operative morbidity was minimal. The NAC could be preserved in all the patients. There was no local recurrence of tumor at median follow-up of 28.5 months. The aesthetic outcomes were satisfactory. Conclusion. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction.

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Long-Term Oncologic Safety of Immediate Reconstructive Surgery in Patients with Invasive Breast Cancer: A Retrospective Matched-Cohort Study

10.21203/rs.3.rs-786631/v1 ◽

2021 ◽

Author(s):

Yanni Song ◽

Shanshan Sun ◽

Dalin Li ◽

Jiguang Han ◽

Ming Niu ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Patient Satisfaction ◽

Cancer Patients ◽

Breast Conservation ◽

Well Being ◽

Secondary Outcome ◽

Matched Cohort ◽

Breast Cancer Patients ◽

Matched Cohort Study

Abstract Objective Immediate reconstruction (IR) is a safe and effective surgical treatment for patients with breast cancer. We aimed to assess the prognosis, aesthetic outcomes, and patient satisfaction of IR compared with breast conservation surgery (BCS) and total mastectomy (TM).Methods In this retrospective matched-cohort study, we established two cohorts according to the tumor (T) size of breast cancer. In the T≤3cm group, cases (IR) and controls (BCS or TM) were matched for age, pathological tumor size and pathologic nodal status in a 1:1:1 ratio. In the T>3cm group, cases (IR) and controls (TM) were matched with the same factors and ratio. The primary outcome was the 5-year disease-free survival (DFS). The secondary outcome was patient satisfaction and quality of life.Results Between May, 2005 and December, 2014, total 12,678 breast cancer patients were assessed, of which 587 were included (T≤3 cm group: 155 IR vs 155 BCS vs 155 TM; T>3cm group: 61 IR vs 61 TM). In the T≤3 cm cohort, patients underwent IR had no difference compared with those underwent BCS or TM regarding the 5-year DFS (P=0.539); however, an improved aesthetic satisfaction, psychosocial and sexual well-being were achieved in the IR group (P＜0.001). In the T>3 cm cohort, IR group had a worse median 5-year DFS (P=0.044), especially for Her2+ or triple-negative breast carcinoma (TNBC) subtypes compared with TM group. Conclusions IR improves aesthetic satisfaction, psychosocial and sexual well-being for breast cancer patients with T≤3 cm. However, Her2+ or TNBC predict a worse 5-year DFS in the T>3 cm group.

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CHANGES IN THE NIPPLE-AREOLA COMPLEX IN PATIENTS WITH BREAST CANCER

Problems in oncology ◽

10.37469/0507-3758-2017-63-4-593-597 ◽

2017 ◽

Vol 63 (4) ◽

pp. 593-597

Author(s):

Aziz Zikiryakhodzhaev ◽

Nadezhda Volchenko ◽

Erik Saribekyan ◽

Yelena Rasskazova

Keyword(s):

Breast Cancer ◽

Surgical Treatment ◽

Cancer Patients ◽

Molecular Subtypes ◽

Breast Cancer Patients ◽

Nipple Areola Complex ◽

Histological Types ◽

Areola Complex

The article presents data about the lesion of the nipple-areola complex in breast cancer. In 2015-2016 surgical treatment was performed in 101 breast cancer patients, different in size but with the mandatory removal of the nipple-areola complex. There are analyzed the dependence of the lesion of the nipple-areola complex from histological types of breast cancer, molecular subtypes, multicentricity, the location of tumor in the breast. The most significant criterion was the dependence of the lesion of the nipple-areola complex from the distance between tumor node and the nipple.

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Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

Breast Disease ◽

10.3233/bd-219015 ◽

2021 ◽

pp. 1-5

Author(s):

David Samuel Kereh ◽

John Pieter ◽

William Hamdani ◽

Haryasena Haryasena ◽

Daniel Sampepajung ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Mean Value ◽

Rank Test ◽

Luminal Breast Cancer ◽

P Value ◽

Strong Positive Correlation ◽

Breast Cancer Patients ◽

The Mean ◽

Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

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Comparison of metabolic changes after neoadjuvant endocrine and chemotherapy in ER-positive, HER2-negative breast cancer

Scientific Reports ◽

10.1038/s41598-021-89651-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ho Hyun Ryu ◽

Sei Hyun Ahn ◽

Seon Ok Kim ◽

Jeong Eun Kim ◽

Ji sun Kim ◽

...

Keyword(s):

Breast Cancer ◽

Metabolic Profile ◽

Fasting Glucose ◽

Medical Center ◽

Mean Value ◽

Metabolic Changes ◽

Phase Iii ◽

Breast Cancer Patients ◽

Neoadjuvant Endocrine Therapy ◽

The Mean

AbstractSurvival of breast cancer patients has improved, and treatment-related changes regarding metabolic profile deterioration after neoadjuvant systemic treatment (NST) become important issues in cancer survivors. We sought to compare metabolic profile changes and the neutrophil-to-lymphocyte ratio (NLR) between patients undergoing neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET) 3 years after the treatment. In a prospective, randomized, phase III trial which compared 24 weeks of NCT with adriamycin and cyclophosphamide followed by docetaxel and NET with goserelin and tamoxifen (NEST), 123 patients in the Asan Medical Center were retrospectively reviewed to evaluate metabolic changes, such as body mass index (BMI), blood pressure (BP), total cholesterol (TC), fasting glucose, and the NLR. The mean age of patients was 42 years. The changes in BMI, serum glucose, and TC during NST and after 3 years were significantly different between NCT and NET. The proportion of overweight + obese group and the mean BMI were significantly increased during NCT (26.6% to 37.5%, 22.84 kg/m2 to 23.87 kg/m2, p < 0.05), and these attributes found to have normalized at the 3-year follow-up. In the NET group, BMI changes were not observed (p > 0.05, all). There were no differences in changes over time among in the Hypertension group during NCT and NET (p = 0.96). The mean value of serum TC and fasting glucose significantly increased (< 0.05, both) during NCT and decreased 3 years after NCT (p < 0.05); however, no significant changes were observed in the NET group. The NLR was increased from 1.83 to 3.18 after NCT (p < 0.05) and decreased from 1.98 to 1.43 (p < 0.05) after NET. Compared with minimal metabolic effect of NET, NCT worsens metabolic profiles, which were recovered over 3 years. The NLR was increased after NCT but decreased after NET.

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Lesion-Based Bone Metastasis Detection in Chest Bone Scintigraphy Images of Prostate Cancer Patients Using Pre-Train, Negative Mining, and Deep Learning

Diagnostics ◽

10.3390/diagnostics11030518 ◽

2021 ◽

Vol 11 (3) ◽

pp. 518

Author(s):

Da-Chuan Cheng ◽

Te-Chun Hsieh ◽

Kuo-Yang Yen ◽

Chia-Hung Kao

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Deep Learning ◽

Bone Metastasis ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Breast Cancer Patients ◽

Location Detection ◽

The Mean ◽

Mean Sensitivity

This study aimed to explore efficient ways to diagnose bone metastasis early using bone scintigraphy images through negative mining, pre-training, the convolutional neural network, and deep learning. We studied 205 prostate cancer patients and 371 breast cancer patients and used bone scintigraphy data from breast cancer patients to pre-train a YOLO v4 with a false-positive reduction strategy. With the pre-trained model, transferred learning was applied to prostate cancer patients to build a model to detect and identify metastasis locations using bone scintigraphy. Ten-fold cross validation was conducted. The mean sensitivity and precision rates for bone metastasis location detection and classification (lesion-based) in the chests of prostate patients were 0.72 ± 0.04 and 0.90 ± 0.04, respectively. The mean sensitivity and specificity rates for bone metastasis classification (patient-based) in the chests of prostate patients were 0.94 ± 0.09 and 0.92 ± 0.09, respectively. The developed system has the potential to provide pre-diagnostic reports to aid in physicians’ final decisions.

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Aesthetic outcome and patient’s quality of life in breast cancer patients undergoing mastectomy with or without immediate reconstruction.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12587 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12587-e12587

Author(s):

Sidra Afzal ◽

Asad Parvaiz ◽

Nida Javed

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Well Being ◽

Mean Difference ◽

Breast Cancer Patients ◽

Immediate Reconstruction ◽

Patient’S Satisfaction ◽

Group A ◽

The Mean ◽

Group B

e12587 Background: : Although post mastectomy Immediate breast reconstruction has shown to improve physical and psychosocial well-being of breast cancer patients, this is not a usual procedure in Pakistan due to limited resources and lack of awareness. The aim of our study is to evaluate patient’s satisfaction/ aesthetic outcomes between the patients undergoing mastectomy alone (Group A) and the ones undergoing mastectomy followed by immediate reconstruction (Group B). Methods: This is a prospective study conducted at Shaukat Khanum Hospital Pakistan comparing aesthetic outcome, patient’s satisfaction and Quality of life between two groups using Breast Q module. All patients undergoing mastectomy with and without reconstruction between April 2017 to July 2019 are included. Sample size of 84 was calculated (42 in each group). Results: The mean Q score of satisfaction with the breast in group B is 82.64 and in group A is 35.82 (P = 0.001). The mean Q score of Psychosocial well-being in group B is 89 vs 44.95 in group A (P = 0.001). The mean Q score of Physical well-being in group B is 98.23 vs 90.41 in group A (P = 0.002). The mean Q score of sexual well-being in group B is 81.93 vs 43 in Group A (P = 0.001). [Mean difference in score of 5-10 - little change, 10-20 - moderate change, > 20 - significant change].The mean difference between two groups in satisfaction with breast , psychosocial well-being and sexual well-being is more than 20 with a statistically significant p-value, while in physical well-being the mean difference is 7.8 which falls in little change group. Conclusions: Our study shows that reconstruction helps breast cancer patients in providing comprehensive care in a manner that they achieve a higher satisfaction with their appearance, psychological and sexual well-being without compromising oncological safety and this should be practiced more in our country. Also patients education about these procedures should be raised to help them fighting against this disease

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