scholarly journals Partial Breast Reconstruction with Lateral Chest Wall Perforator Flap to Facilitate Breast Conservation in Breast Cancer: First 100 Cases with Cancer Outcomes at 8 Years Follow-Up and the Lessons Learned

2021 ◽  
Vol Volume 13 ◽  
pp. 9453-9466
Author(s):  
Pankaj Gupta Roy ◽  
Laura Mustata ◽  
Jesse Hu ◽  
Ben Phillips ◽  
Vaishali Parulekar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Breast Conservation ◽  
Perforator Flap ◽  
Lessons Learned ◽  
Cancer Outcomes ◽  
Lateral Chest

scholarly journals Breast reconstruction after breast cancer surgery – persistent pain and quality of life 1–8 years after breast reconstruction

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nina Honkanen ◽  
Laura Mustonen ◽  
Eija Kalso ◽  
Tuomo Meretoja ◽  
Hanna Harno
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Perforator Flap ◽  
Persistent Pain ◽  
Rectus Abdominis ◽  
Preoperative Pain ◽  
Significant Difference

Abstract Objectives To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Methods A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p=0.40), mood (BDI-II, p=0.41 and HADS A, p=0.54) or sleep (p=0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusions Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Breast Reconstruction

2018 ◽  
Author(s):  
Graham S Schwarz ◽  
Eliana F R Duraes
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Breast Implant ◽  
Breast Conservation ◽  
Perforator Flap ◽  
Multidisciplinary Care ◽  
Functional Results ◽  
Well Being ◽  
Autologous Reconstruction ◽  
Breast Cancer Patients

Breast reconstruction is an essential component of breast cancer multidisciplinary care. Restoring the breast form has repeatedly been shown to improve self-image, psychological well-being, and overall quality of life. Excellent aesthetic and functional results may be obtained with close collaboration between the breast surgical oncology and reconstructive plastic surgery teams. Plastic surgical consultation should be obtained for all women undergoing mastectomy and in selected women with anticipated contour deformity following breast conservation therapy. Most breast cancer patients will undergo reconstruction in stages coordinated with the individual’s multimodal oncologic therapy. In the majority of patients undergoing mastectomy, this reconstructive process may begin immediately at the time of breast tissue removal. Implant-based and autologous reconstructive approaches may both yield excellent results but need to be matched with patients’ goals, lifestyle, anatomy, and medical comorbidities.      This review contains 15 figures, 7 tables and 55 references Key words: autologous reconstruction, breast implant, breast reconstruction, flap, microsurgical breast reconstruction, nipple-sparing mastectomy, oncoplastic, perforator flap, single stage

Breast Reconstruction

2018 ◽  
Author(s):  
Graham S Schwarz ◽  
Eliana F R Duraes
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Breast Implant ◽  
Breast Conservation ◽  
Perforator Flap ◽  
Multidisciplinary Care ◽  
Functional Results ◽  
Well Being ◽  
Autologous Reconstruction ◽  
Breast Cancer Patients

Breast reconstruction is an essential component of breast cancer multidisciplinary care. Restoring the breast form has repeatedly been shown to improve self-image, psychological well-being, and overall quality of life. Excellent aesthetic and functional results may be obtained with close collaboration between the breast surgical oncology and reconstructive plastic surgery teams. Plastic surgical consultation should be obtained for all women undergoing mastectomy and in selected women with anticipated contour deformity following breast conservation therapy. Most breast cancer patients will undergo reconstruction in stages coordinated with the individual’s multimodal oncologic therapy. In the majority of patients undergoing mastectomy, this reconstructive process may begin immediately at the time of breast tissue removal. Implant-based and autologous reconstructive approaches may both yield excellent results but need to be matched with patients’ goals, lifestyle, anatomy, and medical comorbidities.      This review contains 15 figures, 7 tables and 55 references Key words: autologous reconstruction, breast implant, breast reconstruction, flap, microsurgical breast reconstruction, nipple-sparing mastectomy, oncoplastic, perforator flap, single stage

Simultaneous Breast Reconstruction with Transverse Rectus Abdominal Myocutaneous (Tram) Flaps

1998 ◽  
Vol 6 (3) ◽  
pp. 146-148
Author(s):  
Sv Sidorov ◽  
Kv Vardosanidze ◽  
Sp Shevchenko
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Radical Mastectomy ◽  
Individual Approach ◽  
Cosmetic Effect ◽  
The Aesthetic

Breast reconstruction with transverse rectus abdominal myocutaneous (TRAM) flaps on pedicles was performed simultaneously with radical mastectomy in 73 patients with breast cancer. In the case of the tumour exceeding the breast borders, or edemo-infiltrative form of cancer, radical mastectomy was accomplished, and the wound defect on the chest wall was closed without technical difficulties, while simultaneously solving the aesthetic part of the operation. Complications were noted in 13 patients (17.8%), and with revision, complications were eliminated without impairing cosmetic effect. Recurrence of the breast cancer was noted in 9.6% of patients, which is explained by the presence of hidden separate metastases not located during the preoperational period or operation. An individual approach in solving the task of simultaneous breast reconstruction with radical mastectomy is necessary in each patient.

scholarly journals Analysis on the Effect of Application of the DIEP Flap in Breast Reconstruction Surgery

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Tan Jia Liang
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Early Stage ◽  
Developed Countries ◽  
Breast Cancer Surgery ◽  
Sex Reassignment Surgery ◽  
Diep Flap ◽  
Breast Reduction Surgery ◽  
Reconstruction Surgery

Breast reconstruction surgery means using autologous tissue grafts and breast prosthesis to rebuild chest wall deformities and the absence of breast caused by post mastectomy, which are possibly due to burns, trauma, infections, congenital dysplasia and sex reassignment surgery etc., with the prevalence of unilateral breast reconstruction. After attempting to carry out breast reconstruction with latissimus dorsi, many surgeons constantly improved, designed, and modified multiple forms of operation programs and thus promote increasing improvement in repair and reconstruction of the breast after breast reduction surgery and mastectomy for breast cancer [1] Currently, breast reconstruction after breast cancer surgery is just in the early stage while it has occupied an important position in developed countries,therefore, the knowledge of breast reconstruction needs to be enhanced and publicized in our country. Some data show the quality of life in patients following breast reconstruction surgery is significantly higher than that in patients undergoing lumpectomy plus radiotherapy or simple mastectomy. More and more patients pursue breast reconstruction after mastectomy for breast cancer. Breast reconstruction is roughly divided into lost chest wall skin repair, hemispherical breast reconstruction, anterior axillary fold repair, plastic surgery for subclavian depression, nipple and areola reconstruction and asymmetrical breast repair. In the reconstruction of breasts, it is necessary to endeavor to make the rebuilt breast symmetrical to the healthy side so that future adjustment will be simple and easily feasible.

scholarly journals Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India

2019 ◽  
Vol 29 (3) ◽  
pp. 683-692
Author(s):  
K. V. Deepa ◽  
A. Gadgil ◽  
Jenny Löfgren ◽  
S. Mehare ◽  
Prashant Bhandarkar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Breast Conservation Surgery ◽  
Breast Cancer Surgery ◽  
Significant Difference ◽  
Domain Scores

Abstract Purpose Breast cancer is the commonest cancer in women worldwide. Surgery is a central part of the treatment. Modified radical mastectomy (MRM) is often replaced by breast conserving therapy (BCT) in high-income countries. MRM is still the standard choice, in low- and middle-income countries (LMICs) as radiotherapy, a mandatory component of BCT is not widely available. It is important to understand whether quality of life (QOL) after MRM is comparable to that after BCT. This has not been studied well in LMICs. We present, 5-year follow-up of QOL scores in breast cancer patients from India. Methods We interviewed women undergoing breast cancer surgery preoperatively, at 6 months after surgery, and at 1 year and 5 years, postoperatively. QOL scores were evaluated using FACT B questionnaire. Average QOL scores of women undergoing BCT were compared with those undergoing MRM. Total scores, domain scores and trends of scores over time were analyzed. Results We interviewed 54 women with a mean age of 53 years (SD 9 ± years). QOL scores in all the women, dipped during the treatment period, in all subscales but improved thereafter and even surpassed the baseline in physical, emotional and breast-specific domains (p < 0.05) at 5 years. At the end of 5 years, there was no statistically significant difference between the MRM and BCT groups in any of the total or domain scores. Conclusion QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.

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