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

scholarly journals Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 374-377 ◽  
Author(s):  
Anne-Sophie Heimes ◽  
Kathrin Stewen ◽  
Annette Hasenburg
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Well Being ◽  
Psychological Outcomes ◽  
Psychosocial Aspects ◽  
Breast Cancer Patients ◽  
Immediate Reconstruction ◽  
Delayed Breast Reconstruction ◽  
Delayed Reconstruction

Background: Only little is known about the psychosocial aspects of breast cancer patients after mastectomy with immediate versus delayed breast reconstruction. Methods: We systematically screened PubMed using the following key words: mastectomy, immediate vs. delayed reconstruction, psychosocial aspects and quality of life. To highlight different psychological outcomes, studies were categorized into those describing: anxiety, depression, body image and satisfaction with the surgical outcome. We also compared patients after mastectomy alone with those undergoing immediate or delayed reconstruction. Results: Methodologies and psychological outcomes varied among the identified studies, making it difficult to compare results. There are contradictory outcomes concerning the psychosocial aspects of breast cancer patients after mastectomy alone compared with those who underwent an immediate or delayed reconstruction following mastectomy. Some studies show that immediate reconstruction after mastectomy had a positive impact on patients' psychological well-being. In contrast, other studies indicated that in the long-term view the compared patient groups were very similar concerning psychosocial aspects. Conclusion: Analyzing different aspects of psychosocial well-being after breast cancer surgery, there might be an advantage in choosing immediate reconstruction, if oncological safety allows it.

scholarly journals Outcomes of skin sparing mastectomy with immediate breast reconstruction with Latissimus dorsi (LD) flap in surgical treatment of breast cancer

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S M Othman ◽  
A K Elfekky ◽  
M E Elshinawi ◽  
A G Othman
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Breast Conservation ◽  
Immediate Breast Reconstruction ◽  
Breast Conservation Surgery ◽  
Autologous Reconstruction ◽  
Immediate Reconstruction ◽  
Aesthetic Result

Abstract Introduction Breast cancer is a devastating disease affecting women of all ages worldwide with the age incidence in Egypt being one decade younger than the mean age incidence, the latissimus dorsi (LD) flap is an important volume-replacement option due to its stability and versatility as an autologous flap. LD flap could be used for total breast reconstruction after mastectomy in selective cases or to fill a large quadrantectomy defect. Aim The aim of this study is to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Patients On 25 patients breast cancer underwent skin-sparing mastectomy with immediate reconstruction using LD flap, Methods All patients were subjected to : (Complete history taken, General examination, Local examination and routine investigations) Surgical procedures 25 patients with breast cancer underwent skin-sparing mastectomy with immediate reconstruction with LD flap. Results Mean age of included patients was 41.12 years with mean BMI 29.17 kg/m2, regarding tumor classification DCIS represented 8% LCIS represented 20% IDC represented 32% ILC represented 40% of all patients, Positive lymph node 1-3 in 40% of patients and more than 3 in 20% of patients and 40% of patients had negative lymph node,96% of patients had no recurrence on the other hand only 4% shows locoregoinal recurrence, Regarding postoperative immediate complications 72% of patients showed no complications. Discussion In the current study we aimed to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Conclusion Skin sparing mastectomy with immediate breast reconstruction using latissimus dorsi muscular flap allows single-stage, totally autologous reconstruction with a satisfactory aesthetic result, low morbidity, and good quality of life. Recommendations Breast cancer patients are best managed by a multidisciplinary team, Breast conservation surgery does often leave a significant deformity which can best be corrected by an immediate LD flap reconstruction, this method is simple and effective, our concept should be further analyzed in larger comparative studies.

scholarly journals Thoracodorsal artery perforator flap in immediate breast reconstruction: a series of twenty cases

2019 ◽  
Vol 7 (1) ◽  
pp. 205
Author(s):  
Thyagaraj Reddy ◽  
Vashisht Dikshit ◽  
Balgangadhara Tilak ◽  
Ganesh M. S.
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Patients ◽  
Ablative Surgery ◽  
Thoracodorsal Artery Perforator Flap ◽  
Flap Elevation

Background: The management of breast cancer has shown a progressive change, from radical ablative surgery, to breast conserving techniques. Traditionally, the mini latissimus dorsi flap has been used for reconstruction; which is associated with donor site morbidity. Vascular research has now allowed the use of perforator-based flaps for reconstruction, which reduce donor site morbidity.Methods: Twenty thoracodorsal perforator flaps in twenty early breast cancer patients were studied between January 2018 and December 2018. Parameters studied were adequacy of volume, ease and time taken for flap elevation, and final aesthetic outcome.Results: Flap volume was adequate to fill defect. One of twenty cases had flap loss due to venous congestion secondary to pedicle kinking. Average time taken for flap elevation was 70.45 minutes. All patients were satisfied with cosmetic outcome.Conclusions: The TDAP flap is a safe and reliable flap which provides adequate volume for partial breast reconstruction. 

scholarly journals Complications after simultaneous prepectoral breast reconstruction using polyurethane-coated implants in patients with breast cancer

2021 ◽  
Vol 16 (4) ◽  
pp. 12-20
Author(s):  
M. Yu. Vlasova ◽  
A. D. Zikiryakhodzhaev ◽  
I. V. Reshetov ◽  
F. N. Usov ◽  
E. K. Saribekyan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Capsular Contracture ◽  
Functional Results ◽  
Infectious Complications ◽  
Breast Cancer Patients ◽  
Oncology Research ◽  
One Stage Reconstruction ◽  
Reconstructive Plastic Surgery

Background. The development and improvement of reconstructive breast surgery provides medical, psychological and social rehabilitation of cancer patients, allowing them to achieve the best cosmetic and functional results. The trend towards the return of prepectoral reconstruction is associated not only with the improvement of mastectomy techniques, but also with implant coating and the emergence of highly cohesive silicone gel filling of implants. The use of polyurethane-coated endoprostheses in prepectoral reconstruction provides more reliable fixation to the surrounding tissues and allows reconstruction of the mammary glands without additional covering of the endoprosthesis.Objective: to improve the results of surgical treatment when performing a one-stage reconstruction by pre-rectal placement of polyurethanecoated implants in breast cancer. Materials and methods. In the period from April 2017 to September 2020 at the Department of Oncology and Reconstructive Plastic Surgery of the Breast and Skin of P.A. Herzen Moscow Oncology Research Institute performed 340 prepectoral breast reconstructions (direct-toimplant) using polyurethane-coated implants in breast cancer patients. A group of patients was analyzed (n = 208).Results. We noted the following complications: prolonged seroma (more than 30 days) in 39 (18.6 %) patients, red breast syndrome in 31 (14.8 %) patients, capsular contracture III–IV degree by J.L. Baker in 43 (20.57 %) patients, protrusion/extrusion of the endoprosthesis in 23 (11 %) patients, suture divergence in 8 (3.8 %) patients, necrosis in 8 (3.8 %) patients, infectious complications in 14 (6.7 %) patients, ripping in 10 (4.8 %) patients. Also, 2 (0.95 %) patients had a violation of the integrity of the endoprosthesis, and 2 (0.95 %) patients had rotation of the endoprosthesis. Conclusions. Prepectoral breast reconstruction can be used as an alternative to subpectoral reconstruction in primary operable forms of breast cancer with sufficient thickness of integumentary tissues.

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

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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