scholarly journals Novel Pre-Mastectomy Permanent Implant Reconstruction

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Short Form ◽  
Tissue Expander ◽  
Silicone Implants ◽  
Life Questionnaire ◽  
Dermal Substitute ◽  
Breast Cancer Patients ◽  
Permanent Implant ◽  
Implant Reconstruction

Background: Breast reconstruction has been shown to have significant psychosocial benefits for breast cancer patients. Multiple techniques have been used to improve patient satisfaction, aesthetic outcomes, and decrease complications. However, while these techniques are advantageous, they have some significant disadvantages. We are presenting a novel two-stage, pre-mastectomy permanent implant reconstruction (PPIR) technique in an attempt to overcome some of these disadvantages. Methods: Five patients met the essential criteria: they underwent PPIR by insertion of silicone implants three weeks before a proposed mastectomy. The Short Form-36 quality of life questionnaire and the Michigan Breast Reconstruction Outcomes Survey were used before and after the surgery to assess outcome and patient satisfaction. Paired sample t-tests were used to compare changes in the survey scores for various psychosocial subscales and to determine whether score changes after reconstruction were significant. Result: Five patients underwent seven breast reconstructions using PPIR. None of the patients experienced surgical complications (e.g. mastectomy flap complication, wound dehiscence, surgical site infection, or implant-related complications). The PPIR technique resulted in improved psychosocial outcomes and body image with high patient satisfaction. Conclusion: Pre-mastectomy permanent implant reconstruction is a promising potential technique with good aesthetic outcome and patient satisfaction that carries no tissue expander complications and eliminates multiple clinic visits and the usage of a dermal substitute.

scholarly journals The impact of adjuvant radiotherapy on the outcome of immediate breast reconstruction after mastectomy in breast cancer patients

2019 ◽  
Vol 10 (4) ◽  
pp. 81-88
Author(s):  
Nikolay Sergeevich Romanenkov ◽  
Konstantin N. Movchan
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Adjuvant Radiotherapy ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Silicone Implants ◽  
Breast Cancer Patients ◽  
Tissue Expanders ◽  
The Impact

Background. Data allowing to estimate the impact of postoperative radiotherapy on the possibility of prosthetic breast reconstruction with silicone implants or tissue expanders are mainly presented in single-level retrospective cohort studies. Material and methods. We searched for scientific papers in English published from January 1, 2000 to September 30, 2018 in the PubMed/MEDLINE database. The study parameters included demographic data, the method of breast reconstruction, information about adjuvant radiotherapy parameters, the incidence of postoperative complications. Results and discussion. Having studied the data about immediate prosthetic breast reconstruction with silicone implant or a tissue expander performed after mastectomy in 3,654 breast cancer patients. The complications after surgery were reported in 40% of all clinical observations. In 15% of cases, the specialists stopped the attempts to perform breast reconstruction. In general, the aesthetic results of immediate prosthetic breast reconstruction performed before postop radiotherapy are far from being perfect. Nevetheless, most patients are satisfied with them after the surgery. Conclusion. Adjuvant radiotherapy has a negative impact on the results of immediate prosthetic breast reconstruction after mastectomy. Despite this, the need for radiotherapy should not be regarded as an absolute contraindication for the immediate breast reconstruction with silicone implants and tissue expanders.

Assessing the Influence of Failed Implant Reconstruction on Patient Satisfaction and Decision Regret after Salvage Free-Flap Breast Reconstruction

2021 ◽  
Author(s):  
Ronnie L. Shammas ◽  
Amanda R. Sergesketter ◽  
Mahsa Taskindoust ◽  
Sonali Biswas ◽  
Scott T. Hollenbeck ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Free Flap ◽  
Well Being ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Decision Regret ◽  
History Of ◽  
Implant Reconstruction

Abstract Background Free-flap breast reconstruction after failed implant reconstruction is associated with improved patient outcomes. How the level of satisfaction achieved compares between patients with and without previously failed implant reconstruction remains unknown. The aim of this study was to assess the influence of prior failed implant-based reconstruction on long-term patient-reported outcomes after free-flap breast reconstruction. Methods All patients undergoing free-flap breast reconstruction between 2015 and 2019 were identified. Patient satisfaction using the BREAST-Q and decisional regret using the Decision Regret Scale were compared between patients with and without a history of implant breast reconstruction. Results Overall, 207 patients were contacted and 131 completed the BREAST-Q and Decision Regret Scale. A total of 23 patients had a history of failed implant-based reconstruction requiring free-flap-flap salvage, most commonly due to infection (39.1%), chronic pain (34.8%), capsular contracture (26%), and implant malposition (26.1%). Following definitive free-flap reconstruction, patients with prior failed implant reconstruction had significantly lower BREAST-Q scores for satisfaction with breast (61.2 ± 16.7 vs. 70.4 ± 18.7; p = 0.04) and sexual well-being (38.5 ± 18.2 vs. 52.8 ± 24.7; p = 0.01) and reported higher decision regret (19.1 ± 18.6 vs. 9.6 ± 15.6, respectively). There were no significant differences for psychosocial well-being (p = 0.67), physical well-being (chest; p = 0.27), and physical well-being (abdomen; p = 0.91). Conclusion A history of failed implant-based reconstruction is associated with reduced satisfaction and increased decision regret with the final reconstructive outcome. This data underscores the importance of appropriate patient selection at the initial consultation, and informed preoperative counseling regarding long-term outcomes in patients presenting for free-flap reconstruction after a failed implant-based reconstruction.

Outcomes of Breast Reconstruction After Mastectomy Using Tissue Expander and Implant Reconstruction

2016 ◽  
Vol 76 ◽  
pp. S316-S319 ◽  
Author(s):  
Katherine M. Huber ◽  
Kristen L. Zemina ◽  
Bugra Tugertimur ◽  
Sequoya R. Killebrew ◽  
Augustine Reid Wilson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tissue Expander ◽  
Implant Reconstruction

The impact of breast reconstruction on the decision to undergo contralateral prophylactic mastectomy.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 96-96
Author(s):  
L. J. McGhan ◽  
B. A. Pockaj ◽  
R. J. Gray ◽  
S. P. Bagaria ◽  
S. A. McLaughlin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Breast Reconstruction ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Tumor Grade ◽  
Breast Cancer Patients ◽  
Unilateral Breast Cancer ◽  
The Impact ◽  
Implant Reconstruction

96 Background: In the last decade there has been an increase in the incidence of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer. Although many factors have been proposed to explain this trend, the impact of breast reconstruction on the decision to undergo CPM has not been extensively studied. Methods: A retrospective review of breast cancer patients from Surveillance, Epidemiology and End Results (SEER) registry data (2004-2008) was conducted. Characteristics of patients undergoing CPM were evaluated. Results: 71,176 patients with a diagnosis of stage I-III infiltrating ductal or lobular breast cancer underwent mastectomy for their primary lesion. Among these, 10,558 patients (15%) underwent a CPM. A significantly higher proportion of women undergoing CPM had reconstruction performed (44%) than those patients not undergoing CPM (13%), p<0.001. On multivariate analysis (Table), significant variables predicting CPM included age <50 years (OR 10.12), breast reconstruction (OR 3.58), and lobular histology (OR 1.41), all p<0.001. Of the 12,466 patients (18%) who underwent reconstruction, 4,636 (37%) had implant reconstruction, 4,498 (36%) had tissue reconstruction, and 1,122 (9%) had combined tissue/implant reconstruction (no data for 18%). On multivariate analysis, predictors of reconstruction included age <50 years (OR 20.5; CI 18.5-22.7), year of surgery (2008 vs. 2004; OR 1.60; CI 1.49-1.71), low tumor grade (OR 1.19; CI 1.13-1.25) and ER+ status (OR 1.16; 95% CI 1.10-1.23). The use of radiation therapy was associated with a lower likelihood of pursuing reconstruction (OR 0.61; CI 0.58-0.65). Conclusions: Apart from age, the factor most strongly associated with CPM is the decision to have reconstructive surgery performed. This suggests that CPM may not be purely associated with risk-reduction but also with treatment factors such as cosmesis. [Table: see text]

Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study

The Breast ◽  
2005 ◽  
Vol 14 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Elisabeth Edström Elder ◽  
Yvonne Brandberg ◽  
Tina Björklund ◽  
Richard Rylander ◽  
Jakob Lagergren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Prospective Study ◽  
Cancer Patients ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Patients ◽  
A Prospective Study

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

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
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.

scholarly journals A novel technique for an immediate nipple reconstruction with a rectangle flap in implant-based breast reconstruction

2021 ◽  
Author(s):  
Piotr Pluta ◽  
Janusz Piekarski ◽  
Marek Zadrożny
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Breast Surgery ◽  
Tissue Expander ◽  
Reconstruction Technique ◽  
Nipple Reconstruction ◽  
Breast Cancer Patients ◽  
Alternative Approach ◽  
The Given

IntroductionA nipple reconstruction complements breast mound restoring in postmastectomy breast cancer patients. It positively affects patients' welfare, both in psycho-social and sexual aspects. An immediate nipple reconstruction is an alternative approach to delayed surgery. We describe an original technique for an immediate nipple reconstruction by the use of a modified rectangular flap.Material and methodsOne hundred seventeen nipple reconstructions in 112 breast cancer patients were performed. This technique was used during skin-sparing mastectomy, including 104 implants (88.9%) and 13 tissue-expander (11.1%) breast reconstructions. Synthetic meshes covered with titanium supported lower breast poles in 72 implantations (61.5%); in remaining cases, (38.5%) muscles covered the entire implant. Preoperative chemotherapy was applied in 18.75% of the patients; adjuvant chemo- and hormonal therapy obtained 29.5% and 74.1% of the patients, respectively. Twenty-four patients (21.4%) were irradiated postoperatively.ResultsIn 5 out of 117 surgeries (4.3%), necrosis of the rectangular flap was observed. Twelve months since surgery, two-loss of projection of reconstructed nipple was reported (1.7%). In the twelfth month of observation, of the subgroup of 102 patients with permanent nipple presentation, 93.1% gave a positive opinion regarding the procedure.ConclusionsThe given immediate nipple reconstruction technique performed during a skin-sparing mastectomy and implant/expander-based breast reconstruction was an effective and safe adjunct curative breast surgery.

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