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Gland Surgery

journal
https://read.qxmd.com/read/30842935/-gland-surgery-is-indexed-by-science-citation-index-expanded-the-best-ending-of-2018
#1
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Gland Surgery
https://read.qxmd.com/read/30842934/an-overview-of-animation-deformity-in-prosthetic-breast-reconstruction
#2
REVIEW
Megan Fracol, Lauren N Feld, Wen-Kuan Chiu, John Y S Kim
Animation deformity is an unsightly complication after sub-pectoral breast reconstruction characterized by implant displacement with pectoralis muscle contraction. Recent increased awareness of this phenomenon has driven interest in pre-pectoral breast reconstruction but research is limited regarding the causes and implications of animation deformity. Specifically, no patient-specific risk factors have been identified as contributing to animation deformity. Placement in a sub-pectoral plane and division of the pectoralis are the only peri-operative factors associated with severity of animation deformity...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842933/bridging-autologous-reconstruction-with-pre-pectoral-tissue-expanders
#3
REVIEW
Kenneth R Lee, Nicholas Clavin
Pre-pectoral reconstruction is steadily becoming more mainstream with recent publications showing equivalent results with traditional sub-pectoral published literature. Multiple authors have demonstrated short-term acceptable rates of infection, expander failure, success in radiated patients, and overall patient satisfaction. Some data has even shown improved outcomes in prepectoral reconstruction when compared to published subpectoral literature. For the past 4 years, our practices have utilized a "piggy-back" method of immediate pre-pectoral expander reconstruction before performing delayed immediate microsurgical free tissue transfers...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842932/hybrid-breast-reconstruction-the-best-of-both-worlds
#4
Suhail Kanchwala, Arash Momeni
The two common reconstructive modalities following mastectomy include implant-based reconstruction and autologous reconstruction. While the majority of patients can be successfully treated with either one of these approaches, a subset of patients will benefit from a third reconstructive approach which combines implant-based and autologous reconstruction, i.e., hybrid reconstruction. Here, the authors discuss indications, surgical technique, results and additional reconstructive considerations of combining free abdominal tissue transfer with simultaneous implant placement...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842931/correction-of-animation-deformity-with-subpectoral-to-prepectoral-implant-exchange
#5
Rachel Lentz, Andre Alcon, Hani Sbitany
Background: Breast animation deformity is a known complication associated with submuscular prosthetic breast reconstruction. Patients often will present months to years after their initial reconstruction complaining of chronic pain and visible contraction deformity of their chest, with minimal voluntary activation of their pectoralis musculature. This is aesthetically displeasing and physically uncomfortable. Our preferred method for addressing existing animation deformity and alleviating patients' symptoms involves reoperation, with implant pocket conversion to the prepectoral plane, with acellular dermal matrix (ADM) coverage...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842930/prepectoral-breast-reconstruction-and-radiotherapy-a-closer-look
#6
Steven Sigalove
Background: Prosthetic breast reconstruction in the setting of post-mastectomy radiation therapy (PMRT) has historically been plagued by complications and poor outcomes. We study the effects of PMRT in the setting of prepectoral prosthetic breast reconstruction in an attempt to ascertain the value of this muscle sparing technique as it relates to complications and outcomes. Methods: A retrospective analysis was performed on patients who underwent immediate, prepectoral, direct-to-implant or two-staged expander/implant breast reconstruction following skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) and had postmastectomy radiotherapy...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842929/the-role-of-fat-grafting-in-prepectoral-breast-reconstruction
#7
Halley Darrach, Franca Kraenzlin, Nima Khavanin, Karan Chopra, Justin M Sacks
Prepectoral breast reconstruction has reemerged as a promising alternative to submuscular implants, as they place the patient at lower risk for pain, muscular impairment, and animation deformity. However, the thinner amount of overlying tissue in prepectoral reconstruction presents its own unique set of challenges. A "rippling" deformity is seen in some prepectoral patients, which is typically corrected with fat grafting. This report details our recommended technique for fat grafting in the prepectorally implanted patient...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842928/single-stage-direct-to-implant-pre-pectoral-breast-reconstruction
#8
Glyn Jones, Anuja K Antony
Background: Given the current trends in skin preservation during mastectomy, improved biofilm reduction algorithms, and advancements in tissue bioengineering and perfusion assessment, acellular dermal matrix (ADM)-reinforced single stage, direct to implant insertion in the pre-pectoral space has become a viable alternative to two-stage expander-based, sub-pectoral reconstruction. Methods: The authors performed a retrospective review of their pre-pectoral cases evaluating outcomes for all single stage, direct to implant procedures...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842927/two-stage-prepectoral-breast-reconstruction
#9
REVIEW
Maurice Y Nahabedian, Steven R Jacobson
The options for prosthetic breast reconstruction have expanded and include prepectoral versus subpectoral location of devices as well as performing these operations in one- or two-stage. Current practice patterns are evolving toward the placement of devices in the prepectoral plane in a single stage. The authors' patient selection criteria and surgical technique were reviewed and organized in a step-by-step format. On and off label techniques for acellular dermal matrix (ADM) assembly were reviewed. A review of surgical outcomes was completed...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842926/implant-selection-in-the-setting-of-prepectoral-breast-reconstruction
#10
REVIEW
Allen Gabriel, G Patrick Maxwell
Implants vary in width, height, projection, volume, fill consistency, shell surface, and shape. Given the wide variety of implants that are available, selecting an implant that best suits a patient can be challenging. This article reviews the principles governing implant selection. Based on the authors' clinical experience, an algorithm for implant selection is proposed.
February 2019: Gland Surgery
https://read.qxmd.com/read/30842925/the-breast-surgeons-approach-to-mastectomy-and-prepectoral-breast-reconstruction
#11
REVIEW
Toni Storm-Dickerson, Noemi M Sigalove
The purpose of this review article is to discuss and highlight the data, techniques and our experience performing mastectomies in the setting of prepectoral breast reconstruction. Using a systematic review of the approach to mastectomy in the oncologic setting encompassing patient selection, safety, anatomy and methods including a literature review of mastectomy trends, safety data and outcomes, anatomy and our experience, we are able to illustrate the safety and utility of this technique. The literature strongly supports the oncologic safety of these methods...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842924/optimizing-perioperative-strategies-to-maximize-success-with-prepectoral-breast-reconstruction
#12
REVIEW
Dhivya R Srinivasa, Michael Holland, Hani Sbitany
Implant based reconstruction is still the most commonly employed method of post mastectomy reconstruction in the United States and internationally. Mastectomy techniques are improving, and adjuncts such as tissue perfusion technology and biologic implants allow for re-evaluation of traditional reconstructive methods. Subpectoral implant placement is used in a large majority of patients undergoing implant based reconstruction. However, with the advent of acellular dermal matrix (ADM), a "sling" for the expander and implant can be placed with surgical precision to create the optimal breast pocket...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842923/strategies-and-considerations-in-selecting-between-subpectoral-and-prepectoral-breast-reconstruction
#13
REVIEW
Ara A Salibian, Jordan D Frey, Nolan S Karp
Implant-based breast reconstruction has evolved through advances in mastectomy and reconstruction techniques to offer excellent outcomes with both prepectoral and subpectoral implant placement. Proper patient selection and surgical technique are key for optimizing outcomes and minimizing complications regardless of implant location. Therefore, familiarity with the benefits and limitations of each technique is vital. Several patient characteristics, such as history of significant comorbidities, radiation or active smoking, portend higher risk of complications with prepectoral reconstruction, in which case subpectoral implant placement may be a safer option...
February 2019: Gland Surgery
https://read.qxmd.com/read/30842922/the-use-of-acellular-dermal-matrix-in-breast-reconstruction-evolution-of-techniques-over-2-decades
#14
REVIEW
Ilana G Margulies, C Andrew Salzberg
Acellular dermal matrices (ADMs) are biotechnologically derived tissues that have become a cornerstone of implant-based breast reconstruction over the last 2 decades. Their use in both dual-plane and prepectoral approaches have provided greater soft tissue coverage and implant support with good cosmetic outcomes and low rates of complication. This review describes the evolution of notable ADM-assisted surgical techniques that have advanced the field and broadened implant-based reconstructive options.
February 2019: Gland Surgery
https://read.qxmd.com/read/30842921/pre-pectoral-breast-reconstruction-a-less-invasive-option
#15
Hani Sbitany
No abstract text is available yet for this article.
February 2019: Gland Surgery
https://read.qxmd.com/read/30687632/the-sick-lobe-hypothesis-field-cancerisation-and-the-new-era-of-precision-breast-surgery
#16
REVIEW
Mona P Tan, Tibor Tot
Understanding the ductal anatomy of the breast provides insights into tumorigenesis, which in turn offers guidance on therapeutic decisions. In this regard, the sick lobe hypothesis, which states that cancer arises from genetically unstable cells through mutations acquired in utero, forms the basis of malignant transformation. These 'at risk' cells line the mammary ductal-lobular system of a single 'sick' lobe and when exposed to noxious events in the surrounding microenvironment, further genetic changes occur which completes conversion to malignancy, in certain defined patterns...
December 2018: Gland Surgery
https://read.qxmd.com/read/30687631/accelerated-partial-breast-radiotherapy-a-review-of-the-literature-and-future-directions
#17
REVIEW
Nathan R Bennion, Michael Baine, Andrew Granatowicz, Andrew O Wahl
Breast conservation therapy exemplifies the tailoring of medicine in the care of patients with cancer. Akin to improvements in surgical approaches, accelerated partial breast irradiation (APBI) tailors the treatment volume and duration to the needs of well selected patients. Here, we examine the evidence supporting APBI as well as the lessons in patient selection, dose and delivery techniques. Examination of historical techniques and their associated outcomes will support more correct patient selection and treatment delivery in an era where we await the reports of several large prospective trials...
December 2018: Gland Surgery
https://read.qxmd.com/read/30687630/evolution-of-radiotherapy-techniques-in-breast-conservation-treatment
#18
REVIEW
John Boyages, Lesley Baker
Radiation therapy (RT) is an important component of breast cancer treatment that reduces local recurrence and improves survival after breast conservation. Breast conservation rates have increased significantly since the late 1980s and techniques have improved with greater awareness of the impact of radiation on the heart. An overview of randomized controlled trials of breast conservation using standard whole breast irradiation, whole breast hypofractionation, accelerated partial breast irradiation (APBI) and intraoperative radiation are reviewed...
December 2018: Gland Surgery
https://read.qxmd.com/read/30687629/primary-medical-therapy-and-breast-conservation-treatment-the-medical-oncology-perspective
#19
REVIEW
Nan Soon Wong
Primary systemic therapy (PST) is a widely adopted strategy for increasing operability and breast conservation rates. Although first generation PST trials failed to demonstrate improvements in disease free and overall survival compared to adjuvant systemic therapy (AST), they did demonstrate a strong association between attainment of pathologic complete response (pCR) and improved survival outcomes, leading to the widespread adoption of pCR as the primary endpoint in subsequent PST trials. First generation trials also showed that preoperative PST can improve breast conservation rates and downstage the axilla...
December 2018: Gland Surgery
https://read.qxmd.com/read/30687628/preoperative-imaging-for-breast-conservation-surgery-do-we-need-more-than-conventional-imaging-for-local-disease-assessment
#20
REVIEW
Eugene Ong
Breast conservation surgery (BCS) is offered for early breast cancer. Conventional imaging with mammography and ultrasound would have been performed prior to surgery. This article considers other imaging modalities available [such as 3D tomosynthesis, magnetic resonance imaging (MRI), contrast-enhanced spectral mammography, positron emission mammography (PEM), breast-specific gamma imaging (BSGI) and cone beam computed tomography (CBCT)] and discusses the evidence for these in terms of diagnostic accuracy and clinical outcomes...
December 2018: Gland Surgery
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