scholarly journals Contemporary issues and prospects of skin-sparing mastectomy performance in patients with breast cancer

2015 ◽  
Vol 96 (6) ◽  
pp. 1021-1027
Author(s):  
A Kh Ismagilov ◽  
A S Vanesyan ◽  
A R Khamitov
Keyword(s):  
Breast Reconstruction ◽  
Disease Free Survival ◽  
Reconstruction Method ◽  
Biometric Data ◽  
Minimal Impact ◽  
Areola Complex ◽  
Aesthetic Results ◽  
Disease Free Survival Rate ◽  
The One ◽  
Breast Reconstructive Surgery

For breast reconstructive surgery oncological requirements are imposed, which include the principle of radicality, ablastics, antiblastics and minimal impact on the general and disease-free survival rate, as well as aesthetical requirements - excised breast volume replacement, recovery of tactile sensitivity and shape most closely resembling the natural one. The mastectomy technique determines the breast reconstruction aesthetic results. In 1991 skin-sparing mastectomy combined with the one-stage breast reconstruction, which allows to preserve the organ skin, was described by B.A. Toth and P. Lappert. In 1997, G. Carlson proposed the classification of incisions for skin-sparing mastectomy, which considers both aesthetic and oncological aspects of the surgery, thereby it is successfully used to the present day. In 2003, R.M. Simmons published his incision classification in skin-sparing mastectomy, which differs from the G. Carlson classification only by type III incision. Determinant factors for skin-sparing mastectomy type choice are the presence of scars from previous biopsies, tumor topographic and anatomical parameters and planned reconstruction method. Selection of the appropriate incision type for skin-sparing mastectomy depends on the location and the tumor invasion depth in the breast tissue, the distance of the tumor from the nipple-areola complex and aesthetically favorable zones, as well as biometric data (the areola diameter, breast hypertrophy and ptosis) and the patient desires. Thus skin-sparing mastectomy is aimed to the closest possible to the preoperative level result achievement.

Robot-Asssisted Laparoscopic Radical Prostatectomy (Ralp). Oncological and Functional Findings after 90 Cases

2009 ◽  
Vol 76 (2) ◽  
pp. 87-89 ◽  
Author(s):  
C. Giberti ◽  
M. Schenone ◽  
P. Cortese ◽  
F. Gallo ◽  
E Gastaldi ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Functional Results ◽  
Modern Technology ◽  
Nerve Sparing ◽  
Number Of Patients ◽  
Before And After ◽  
Disease Free Survival Rate ◽  
One Year ◽  
The One

The RALP is the most modern technology available for the treatment of intracapsular prostate cancer (CaP), which can produce a shorter learning curve and better results than the traditional techniques. Methods Between March 2005 and March 2008, 90 patients (64.3 ys, range 52–71) with intracapsular CaP underwent RALP at our institute. Before surgery the patients underwent routine examinations and filled in IIEF, IPSS and EORTC-QLQC30/PR 25 questionnaires. Patients were followed up with PSA assay, physical examination and compilation of the questionnaires. Median follow-up was 12.5 months (range 1–35 months). Results Mean operative time was 230 min. Discharge and catheter removal were at day 7.4 and 8.2, respectively, after surgery. Pathological staging reported pT2 and pT3 in 57 (63%) and 33 patients (37%), respectively. Positive surgical margins were assessed in 30 patients (33%), particularly 8.7% in pT2 tumors. The one-year biochemical disease-free survival rate was 90%. Regarding the functional results, 81 patients (90%) were perfectly continent while a mild and a moderate incontinence were reported in 7 (8%) and 2 (2%) patients, respectively. Mean IPSS score decreased from 8 to 4; among the patients who underwent bilateral nerve sparing RALP and no adjuvant therapy, 31 (70.4%) reported satisfactory sexual intercourses. Concerning postoperative quality of life, mean EORTC-QLQC30/PR 25 questionnaires scores were very similar before and after RALP. Conclusions After 90 cases of RALP the oncological and functional results are definitely promising. However, a wider number of patients and a greater follow-up are needed to confirm these data particularly as regards the functional results.

Nipple-sparing mastectomy and immediate breast reconstruction: Critical appraisal of five-year, single-center outcomes.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 99-99
Author(s):  
D. Westbroek ◽  
K. Mann ◽  
M. Ho ◽  
I. Gukas ◽  
I. Karat ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Selection ◽  
Disease Free Survival ◽  
Immediate Breast Reconstruction ◽  
Tissue Loss ◽  
Free Survival ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Disease Free

99 Background: Approximately 5,000 patients undergo breast reconstruction annually in the United Kingdom (2:1 ratio of immediate versus delayed respectively). Preservation of the breast envelope, i.e., skin and nipple areola complex (NAC) improves cosmesis. While skin-sparing mastectomy is an accepted modality for local control in appropriately selected patients, nipple-sparing mastectomy (NSM) remains controversial. In over 1,800 published NSM cases, the local event rate attributable to NAC preservation following NSM (therapeutic and prophylactic) is 0.16% with no evidence of deleterious impact on disease-free survival. In our cohort, patient selection criteria included: preoperative lesion characterisation; 5-mm margin acceptance; submission of separate nipple core specimens for paraffin block histological assessment and re-excision of all involved margins. This study is intended to evaluate the efficacy of loco-regional control in a consecutive cohort of patients, under uniform conditions undergoing nipple-sparing mastectomy and immediate breast reconstruction. We highlight the surgical technique used and propose in/exclusion criteria for appropriate patient selection. Methods: 84 consecutive patients underwent NSM and IBR at Frimley Park Hospital, Surrey, UK (IJL, RD) between January 2004 and December 2008. Data was accrued retrospectively from the institution’s clinical coding, electronic records, and WinPath database. Endpoints recorded include: the incidence of (occult) malignancy at the nipple margins; NAC subcutaneous tissue loss; local (NAC) recurrence rates and disease free survival. Results: The mean age was 51.1 years and follow-up 4.9 years. There was one case of local recurrence in a patient who declined re-excision of close/involved margins. The immediate peri-operative complication rate was within the national mastectomy breast reconstruction audit outcome guidelines. Conclusions: In appropriately selected patients, our findings support nipple preservation at the time of mastectomy and immediate reconstruction as this enhances the cosmetic outcome without compromising oncologic safety.

scholarly journals The Public’s Perception on Breast and Nipple Reconstruction: A Crowdsourcing-Based Assessment

2018 ◽  
Vol 39 (9) ◽  
pp. NP370-NP376 ◽  
Author(s):  
Beina Azadgoli ◽  
Daniel J Gould ◽  
Emma Vartanian ◽  
Ketan M Patel
Keyword(s):  
Breast Reconstruction ◽  
Personal Experience ◽  
Amazon Mechanical Turk ◽  
Nipple Reconstruction ◽  
Chi Square ◽  
Areola Complex ◽  
Aesthetic Results ◽  
Chi Square Test ◽  
The Aesthetic ◽  
Nipple Sparing

Abstract Background Breast reconstruction outcomes have traditionally been measured by evaluating the opinions of patients and surgeons. Objectives Our goal was to assess the views of the general public. Methods A survey was designed and distributed through a crowdsourcing website called Amazon Mechanical Turk. Questions assessed participant demographics, personal experience with breast reconstruction, perceptions on breast reconstruction, and opinions regarding aesthetics results. Responses were analyzed using chi-square test. Results A total of 992 responses were collected. Most participants were female (56.1%), white (32.1%), aged 30 to 39 years (40.4%), and had a bachelor’s degree (42.0%). A total of 44.2% had personal experience with breast reconstruction and 25.8% with nipple reconstruction. Several aesthetic and reconstructive factors were significantly favored over others across sex, ethnicity, age group, education level, and personal experience with breast reconstruction. For instance, women were more likely to prefer reconstructed nipples (P < 0.0001), view a breast without a nipple as complete (P = 0.024) and place less importance on nipple shape (P = 0.002). Additionally, those who personally experienced nipple reconstruction were willing to undergo more procedures for a complete nipple-areola complex (P < 0.0001), to increase aesthetic results (P = 0.018), and to increase chances of nipple survival (P = 0.002). Conclusions Crowdsourcing can be useful in plastic surgery and has helped identify several key findings. The importance of the nipple in reconstruction has been validated; almost three-quarters of respondents did not view a breast without a nipple as complete. The aesthetic preferences seem to support bilateral nipple-sparing reconstruction when possible. Most importantly, the respondents helped elucidate key differences in perception of aesthetic outcomes.

scholarly journals Breast reconstruction with deep inferior epigastric artery perforator flap (DIEP-flap). History of development

2021 ◽  
Vol 8 (3) ◽  
pp. 108-117
Author(s):  
I. S. Duadze ◽  
A. D. Zikiryakhodzhaev ◽  
A. S. Sukhotko ◽  
M. V. Starkova ◽  
F. N. Usov ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Perforator Flap ◽  
Free Flaps ◽  
Diep Flap ◽  
Tram Flap ◽  
Reconstruction Method ◽  
Epigastric Artery ◽  
Rehabilitation Period ◽  
Deep Inferior Epigastric Artery ◽  
Breast Reconstructive Surgery

The article is devoted to the actual topic of breast reconstruction with autologous tissues. The article discusses the key stages in the development of breast reconstructive surgery using free flaps using microsurgical techniques. A flap of the anterior abdominal wall, among other techniques, is the method of choice for breast reconstruction today, also because it allows you to achieve the most "natural" result. The authors compares different variants of autologous flaps, describes the advantages of the DIEP flap in comparison with the TRAM flap. Also, special attention is paid to the choice of breast reconstruction method depending on age, constitutional characteristics and the presence of risk factors such as smoking, diabetes mellitus and excess BMI. Analyzing the advantages of breast reconstruction with autograft flaps, the author concludes that there is a higher quality of life and improved outcomes in these patients than in patients who underwent implant-based reconstruction. Based on the literature review, it was found that breast reconstruction with the help of perforating flaps is still an area of innovation and constant progress: research in this area to date is mainly aimed at reducing the morbidity of the donor area and methods for isolating recipient vessels, shortening the rehabilitation period and developing reproducible reconstruction method.

790: Ten-Year Disease Free Survival Rate Calculated with PSA Cutpoint 0.2 NG/ML in Men After Brachytherapy for T1C Prostate Cancer

2004 ◽  
Vol 171 (4S) ◽  
pp. 209-209
Author(s):  
James B. Benton ◽  
Frank A. Critz ◽  
W. Hamilton Williams ◽  
Clinton T. Holladay ◽  
Philip D. Shrake
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free Survival Rate ◽  
Disease Free

Simple anchoring suture to minimise asymmetric nipple-areola complex (NAC) in immediate unilateral breast reconstruction with implant

2015 ◽  
Vol 68 (2) ◽  
pp. 273-275
Author(s):  
Jun Ho Lee ◽  
Su Won Hur ◽  
Yong-Ha Kim ◽  
Tae Gon Kim ◽  
Soo Jung Lee ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Nipple Areola Complex ◽  
Areola Complex

scholarly journals Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian
Keyword(s):  
Hepatocellular Carcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Curative Therapy ◽  
B Virus ◽  
Effect Of Treatment ◽  
Long Term Prognosis ◽  
One Year ◽  
The One ◽  
The Impact

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.

scholarly journals Adjuvant Gemcitabine-Oxaliplatin (GeMOX) after Curative Surgery in High-risk Patients with Cholangiocarcinoma

2009 ◽  
Vol 3 ◽  
pp. CMO.S3360
Author(s):  
Bernard Paule ◽  
Paola Andreani ◽  
Marie-Pierre Bralet ◽  
Catherine Guettier ◽  
René Adam ◽  
...  
Keyword(s):  
Survival Rate ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
High Risk Factors ◽  
Risk Patients ◽  
Disease Free Survival Rate ◽  
Disease Free

Background There is no standard adjuvant chemotherapy to prevent recurrent cholangiocarcinoma (CCA), a rare cancer with poor prognosis. We assessed the efficacy and safety of GEMOX on intrahepatic and hilar CCA with high-risk factors after curative surgery. Patients and Methods Twenty two patients (mean age: 57 years old) with CCA received 6 cycles of GEMOX: gemcitabine 1,000 mg/m2 on day 1 and oxaliplatin 85 mg/m2 on day 2, q3w after a curative surgery. Results All patients completed 6 cycles of GEMOX. EGFR membranous expression was present in 20 CCA. The 5-year survival rate was 56% (CI 95%: 25.7–85.4); 2-year disease free survival rate was 28% (CI 95%: 3.4–52.6). Median time to progression was 15 months. The rate of recurrence after surgery and chemotherapy was 63% (14/22). Two patients died of disease progression. Twelve patients received cetuximab/GEMOX at the time of relapse. Six died after 12 months (9–48 months), three are still alive suggesting a clinical applicability of EGFR inhibitors in CCA. Conclusion Adjuvant chemotherapy with GEMOX alone seems ineffective in intrahepatic and hilar CCA with a high risk of relapse. Additional studies including targeted therapies to circumvent such poor chemosensitivity are needed.

scholarly journals Abstract P4. Impact of Physician Payment Variation on Breast Reconstruction Method

2017 ◽  
Vol 5 ◽  
pp. 2
Author(s):  
Shantanu N. Razdan ◽  
Hina J. Panchal ◽  
Day Yi ◽  
Joseph J. Disa ◽  
Babak Mehrara ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Reconstruction Method ◽  
Physician Payment
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