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 Risk Assessment and Anesthesia Classification in Breast Cancer Surgery

2018 ◽  
pp. 168-172
Author(s):  
Kasra Karvandian ◽  
Jayran Zebardast ◽  
Nazila Zolfaghari Borra
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Reconstruction ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Diep Flap ◽  
Breast Cancer Patients ◽  
Risk Patients ◽  
Group 2 ◽  
Group 1

Background: There are various factors affecting the effectiveness of the treatment of breast cancer patients. Although the disease pathology, along with surgery and other therapeutic modalities, plays the principal role in patient outcomes, anesthesia still plays an important role in the success of treatment. This study was designed to show the effects of anesthetic plans on risk classification and assessment in breast cancer surgeries. Methods: Two hundred sixty patients receiving different types of breast cancer surgery for therapeutic and reconstructive purposes were enrolled in this study. They were divided into three groups according to the anesthesia risk assessment. Group 1 consisted of low-risk patients (ASA I) who received small surgeries such as lumpectomy. Patients with intermediate risk of anesthesia (ASA II) or those who underwent breast cancer and axillary surgery with overnight admission (ASA I or II) were considered as group 2. Group 3 comprised the patients with higher risk for anesthesia (ASA class III) regardless of the surgery type or those in any ASA class who were about to undergo advanced and prolonged surgeries such as breast reconstruction with free or pedicle flaps. Results: Two hundred sixty-eight surgical interventions were done in 260 patients. There were 106, 107, and 47 patients in groups 1, 2, and 3, respectively. In group 1, five patients out of 106 were admitted in the hospital for 24 hours after surgery and the remaining 101 patients were discharged from the hospital in a few hours after the operation when they were fully conscious and could tolerate the diet completely. All 107 patients in group 2 were admitted in the hospital for a few days after the operation, though the vast majority of them (98 patients) discharged from the hospital the day after surgery. In the last group, 6 out of 47 patients showed the signs of surgical complications such as partial flap ischemia in the postoperative period, mostly after TRAM or DIEP flap breast reconstruction surgery. Conclusion: The findings of this study support the idea that breast surgeries can be done in an ambulatory situation with no considerable risk. In contrast, all medical and anesthetic considerations should be taken into account in more complex surgeries, especially when they are applied in high-risk patients.

Article Commentary: Pain after Mastectomy and Breast Reconstruction

2008 ◽  
Vol 74 (4) ◽  
pp. 285-296 ◽  
Author(s):  
Nalini Vadivelu ◽  
Maggie Schreck ◽  
Javier Lopez ◽  
Gopal Kodumudi ◽  
Deepak Narayan
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Minimally Invasive ◽  
Breast Reconstruction ◽  
Sentinel Node ◽  
Breast Cancer Surgery ◽  
Phantom Pain ◽  
Preventative Measures ◽  
Pain Syndromes ◽  
Post Operative Pain

Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.

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 Evaluation of women’s quality of life after breast reconstruction surgery

2020 ◽  
Vol 66 (2) ◽  
Author(s):  
Marta Stanisz ◽  
Ewelina Kolak ◽  
Dorota Branecka-Woźniak ◽  
Renata Robaszkiewicz-Boukaz ◽  
Przemysław Ciepiela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Great Influence ◽  
Well Being ◽  
World Health ◽  
World Health Organization Quality ◽  
Reconstruction Surgery ◽  
The Impact

Introduction: Breast cancer is the most common malignancy among women, and is usually treated surgically. Mastectomy has a great influence on the mental and physical condition of women. Breast reconstruction offers them a chance to improve their quality of life (QOL) and self-image.The main aim of the study was to gain knowledge about the impact of breast reconstruction on the QOL of women following mastectomy, and an analysis of the QOL after breast reconstruction, in the context of prosthesis effect assessment.Materials and methods: The study comprised 100 women following breast reconstructive surgery involved in 1 of the 7 “Amazon Clubs” (post-mastectomy women’s associations) in the West Pomeranian Voivodeship, northwest Poland. The study was based on the author’s questionnaire, and a shortened standardized version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Statistical calculations were performed with StatSoft Statistica v10 software, adopting a significance level of p < 0.05.Results: The women who decided to have breast reconstruction surgery, noticed improved well-being (67%) and experiencedan increase in self-confidence (61%). The vast majority ofthe patients surveyed (93%) were satisfied with the effectof the prosthesis. Statistically significant differences in QOL were observed in the following spheres: rest and sleep, work capacity, negative feelings, and financial resources (p < 0.05) in relation to the evaluation of the prosthesis effect.Conclusions: 1. Breast reconstruction has a positive influence on improvements in well-being, increasing self-esteem, and the assessment of a more attractive appearance in women of all ages. 2. Breast reconstruction surgery has a positive impact on QOL and health in the physical, psychological, and environmental domains, especially in the women who are satisfied with the effects of the surgery. 3. A negative assessment of the breast reconstruction effect has an adverse influence on QOL. Identifying the factors affecting dissatisfaction with the post-operative outcome is crucial for a complete understanding of the subject, and for implementing measures aimed at improving the QOL of these women.Keywords: quality of life; mastectomy; breast cancer; breast reconstruction; breast surgery.

Breast Cancer Surgery

2019 ◽  
pp. 144-156
Author(s):  
Peter A. van Dam ◽  
Cary Kaufman ◽  
Carlos Garcia-Etienne ◽  
Marie-Jeanne Vrancken Peeters ◽  
Robert Mansel
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Diseases ◽  
Breast Cancer Patients ◽  
Breast Conserving Treatment ◽  
Sentinel Node Concept

Abstract: The role of the surgeon managing breast diseases has been the subject of continuous evolution, moving from the cancer-extirpative surgeon to a deeply informed surgical leader, who interacts in a multidisciplinary setting also encompassing tasks for risk assessment, genetic counselling, and new diagnostic approaches. Surgical removal of the tumour remains the cornerstone in treating early stage breast cancer. During the last century, breast cancer surgery became less radical, breast-conserving treatment emerged, and the role of axillary lymphadenectomy changed from a therapeutic procedure into a staging procedure with prognostic implications. Later, the sentinel node concept reduced the need for complete axillary clearance in most cases. Nowadays, thanks to breast-conserving surgery, oncoplastic techniques, and reconstructive procedures, most breast cancer patients can overcome this disease without serious permanent physical mutilation. A multidisciplinary approach, benchmarking, and quality assurance have improved outcomes markedly.

Breast Cancer Screening in Older Women—Current Evidence and Future Perspectives

2015 ◽  
Vol 11 (01) ◽  
pp. 34
Author(s):  
Nienke A de Glas ◽  
Gerrit-Jan Liefers ◽  
◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Older Women ◽  
Breast Cancer Screening ◽  
Early Stage ◽  
Developed Countries ◽  
Population Based ◽  
Current Data ◽  
Current Evidence ◽  
Strong Increase

As populations of developed countries are aging, the number of older women with breast cancer will strongly increase. Randomized controlled trials in breast cancer screening rarely included patients over the age of 68. As a consequence, there is no solid evidence for beneficial effects of breast cancer screening in older women. In a recent observational study, we showed that the implementation of screening in women aged 70–75 in the Netherlands resulted in a strong increase of the incidence of early-stage breast cancer, while the incidence of advanced stage breast cancer barely decreased. Hence, current data do not support population-based screening in women over the age of 70.

Financial and employment toxicity related to breast reconstruction following mastectomy in a diverse population-based cohort.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 78-78
Author(s):  
Nicholas L. Berlin ◽  
Adeyiza O. Momoh ◽  
Paul Abrahamse ◽  
Steven J. Katz ◽  
Reshma Jagsi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Employment Status ◽  
Early Stage ◽  
Insurance Coverage ◽  
The United States ◽  
Population Based ◽  
Early Stage Breast Cancer ◽  
Financial Barriers ◽  
Spanish Speaking

78 Background: Despite mandated private insurance coverage for breast reconstruction following mastectomy, health care costs are increasingly passed onto women who seek these procedures through cost-sharing arrangements and high-deductible health plans. In this population-based study, we sought to characterize financial and employment toxicities related to pursuing breast reconstruction following mastectomy. Methods: Women (white, African American, and Latina-English and Spanish speaking) with early stage breast cancer (stages 0-II) diagnosed between July 2013 to September 2014 and who underwent mastectomy were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results (SEER) registries and surveyed. Primary outcome measures included patient-reported appraisal of financial toxicity and employment status following breast cancer treatment using previously developed measures. Multivariable models evaluated the association between breast reconstruction and self-reported financial and employment status. Results: Among 868 breast cancer patients who underwent mastectomy, 43.5% (n = 378) did not undergo breast reconstruction and 56.5% (n = 490) underwent reconstruction. 43.4% of the cohort reported being worse off financially since their diagnosis (49.4% with reconstruction vs. 35.0% without reconstruction, P< .001). Among women who were employed at time of breast cancer diagnosis (n = 535), 70.2% who underwent reconstruction reported being worse off regarding employment status compared to 51.1% who did not undergo reconstruction ( P< .001). Receipt of reconstruction was independently associated with a self-reported decline in financial status (Odds Ratio (OR) 2.1, 95% Confidence Interval (CI) 1.4-3.4, P= .001). Similarly, reports of being worse off regarding employment status were also higher in those who underwent reconstruction vs. not (OR 2.2, 95% CI 1.2-3.8, P= .006). Spanish-speaking Latina women more often reported being worse off regarding employment status (OR 4.3, 95% CI 2.1-9.0, P< .001) than white women. Conclusions: In this diverse cohort of women who underwent mastectomy for early stage breast cancer, women who elected to undergo reconstruction experienced more self-reported financial and employment toxicities. Patients should be counseled regarding the potential costs related to these procedures. Policy-makers should be aware of the financial barriers for women who undergo reconstruction despite mandatory insurance coverage in the United States.

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