Publications

5
publisher: Cancer Intelligence
by: C Calabrese ; L Orzalesi ; D Casella ; L Cataliotti
date:

Background: The success of fat grafting in breastreconstruction depends on fat retention. The use of stem-cells-enriched fat graft is an alternative method for graft stability. Case report: A case of nipple-areola sparingmastectomy double stage reconstruction with the use of stem cells enhanced fat graft is reported. Conclusions: Fat grafting is growing as a new and promising tool in reconstruction following nipple and areola sparing mastectomies as a way to restore a sufficient and reliable subcutaneous space in the mastectomy flap. This combined with an anatomical gel implant offers an integrated system of achieving a natural shaped breast.

publisher: Cancer Intelligence
by: C Calabrese ; L Orzalesi ; D Casella ; L Cataliotti
date:

Background: The success of fat grafting in breastreconstruction depends on fat retention. The use of stem-cells-enriched fat graft is an alternative method for graft stability. Case report: A case of nipple-areola sparingmastectomy double stage reconstruction with the use of stem cells enhanced fat graft is reported. Conclusions: Fat grafting is growing as a new and promising tool in reconstruction following nipple and areola sparing mastectomies as a way to restore a sufficient and reliable subcutaneous space in the mastectomy flap. This combined with an anatomical gel implant offers an integrated system of achieving a natural shaped breast.

publisher: Elsevier Ltd
by: K.P. Benediktsson ; L. Perbeck
date:

Abstract Aim Validation of the oncological safety of nipple-sparing subcutaneousmastectomy and immediate reconstruction with implants (NSM) and of the outcome in patients with locoregional recurrences (LRRs) after this procedure. Methods Two-hundred and sixteen patients, mean age of 52.8 (29–81) years with primary unilateral breast cancer, not suitable for partial mastectomy because of large (>3 cm) or multifocal carcinoma, underwent NSM, a single procedure lasting about 1 h 30 min, between December 1988 and September 1994. Lymph node metastases were found in 40.3% of the patients, and 47 patients received radiotherapy (RT) postoperatively. All patients were monitored for at least 11.6 years or as long as they lived. Median follow-up was 13 years. The end-points were locoregional recurrence (LRR) or distant metastases (DM) as first events, disease-free survival (DFS) and overall survival (OS). Results Specificity at frozen section from sub-areolar tissues was 98.5%. LRR occurred in 52 patients and DM in 44 patients. DFS was 51.3% and OS was 76.4%. The frequency of LRR was 8.5% among irradiated and 28.4% among non-irradiated patients ( p = 0.025). These results compare well with results after conventional mastectomy in other trials. All patients were monitored for at least 6 years after the occurrence of LRR, finding 5 years freedom from further LRR or DM of 60% and OS of 82%. Conclusions NSM is an oncologically safe procedure and could be offered to most patients with breast cancer unsuitable for sector resection only. RT effectively lowers the frequency of LRR. The occurrence of LRR after this operation does not significantly affect OS.

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publisher: Elsevier Ltd
by: Kerry Davies ; Lyra Allan ; Paul Roblin ; David Ross ; Jian Farhadi

Abstract Skin sparingmastectomy (SSM) followed by immediate breastreconstruction (IBR) is not only oncologically safe but provides also significant benefits both cosmetically and functionally. The superiority of this technique can only be fully established, however, by developing a framework for minimising complications. The present study seeks to elucidate the key factors affecting outcome. Methods Data for all skin sparing mastectomies with immediate autologous and implant based reconstructions, performed in a three year period (2006–2008) was retrospectively collated. Complications were classified into major and minor. Patients were excluded who had flap loss due to vascular complications. Results The total number analysed was 151. 17.2% had major complications, 23% had minor and 61% had no complications. The Wise and the “tennis” incision had significantly higher rates of wound dehiscence when compared with the periareolar incision (p = 0.025, p = 0.098). There was no significant difference between diathermy or blade dissection techniques, or the use of subcutaneous adrenaline infiltration. Increasing BMI was associated with increased skin flap necrosis and wound dehiscence, and an excised breast mass of greater than 750 g and a sternal notch to nipple length of greater than 26 cm are associated as well with increased flap-related complications (p = 0.0002, p = 0.0049). Conclusion Factors such as Wise pattern and tennis racquet incision, BMI and breast mass and sternal notch to nipple length adversely affect skin sparingmastectomy flap morbidity. These factors should be factored in to patient selection and operative planning especially for obese and large breasted women undergoing skin sparingmastectomy with immediate breast reconstruction.

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publisher: Elsevier Ltd
by: Guido H.C.G. Dolmans ; Maarten M. Hoogbergen ; Julien H.A. van Rappard
date:

Summary A rare case of giant fibroadenoma of the left breast is presented. We performed a nipplesparingsubcutaneousmastectomy of the left breast. Since the patient desired larger breasts, a contralateral augmentation mammaplasty was carried out in a single stage operation. A satisfactory result was achieved.

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