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Current Breast Cancer Reports
Erschienen in: Current Breast Cancer Reports 3/2012

01.09.2012 | Risk, Prevention, and Screening (MC Liu, Section Editor)

Options for Surgical Prophylaxis and Reconstruction

verfasst von: Benjamin J. Brown, Ali Al-Attar, Scott L. Spear

Erschienen in: Current Breast Cancer Reports | Ausgabe 3/2012

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Abstract

Mastectomy and breast reconstruction techniques have evolved over the past decade. In addition to therapeutic mastectomy for cancer, mastectomy for risk reduction (prophylactic mastectomy) is increasingly being performed. The willingness to undergo a potentially mutilating procedure for risk reduction is due to the combination of refined risk stratification along with technical improvements that offer reproducible, high-quality breast reconstruction. Multiple surgical options exist to offer the patient an acceptable balance between risk reduction and surgical intervention. This article provides an overview of current strategies and techniques for surgical risk reduction and reconstruction.
Literatur
1.
Zhou W-B, Liu X-A, Dai J-C, et al. Meta-analysis of sentinel lymph node biopsy at the time of prophylactic mastectomy of the breast. Can J Surg. 2011;54:300–6.PubMedCrossRef
2.
Orel S. Who should have breast magnetic resonance imaging evaluation? J Clin Oncol. 2008;26:703–11.PubMedCrossRef
3.
Chen CM, Disa JJ, Sacchini V, et al. Nipple-sparing mastectomy and immediate tissue expander/implant breast reconstruction. Plast Reconstr Surg. 2009;124:1772–80.PubMedCrossRef
4.
Sacchini V, Pinotti JA, Barros ACSD, et al. Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem? J Am Coll Surg. 2006;203:704–14.PubMedCrossRef
5.
Spear SL, Hannan CM, Willey SC, et al. Nipple-sparing mastectomy. Plast Reconstr Surg. 2009;123:1665–73.PubMedCrossRef
6.
• Spear SL, Willey SC, Feldman ED, et al. Nipple-sparing mastectomy for prophylactic and therapeutic indications. Plast Reconstr Surg. 2011;128:1005–14. This study evaluated 49 and 113 nipple-sparing mastectomies for therapeutic and prophylactic purposes, respectively. No patients in either group developed new a primary cancer at the nipple areolar complex over a mean follow-up of 43 months. Only 1.8 % of nipple areolar complexes were excised due to ischemia, 1 in the therapeutic group and 2 in the prophylactic group.PubMedCrossRef
7.
Babiera G, Simmons R. Nipple-areolar complex-sparing mastectomy: feasibility, patient selection, and technique. Ann Surg Oncol. 2010;17 Suppl 3:245–8.PubMedCrossRef
8.
Maxwell GP, Storm-Dickerson T, Whitworth P, et al. Advances in nipple-sparing mastectomy: oncological safety and incision selection. Aesthet Surg J. 2011;31:310–9.PubMedCrossRef
9.
• de Alcantara Filho P, Capko D, Barry JM, et al. Nipple-sparing mastectomy for breast cancer and risk-reducing surgery: the Memorial Sloan-Kettering Cancer Center experience. Ann Surg Oncol. 2011;18:3117–22. This study retrospectively reviewed 196 nipple-sparing mastectomies that were 271 performed for risk reduction. On final pathologic examination, 8 were found to have occult DCIS, and 3 272 were found to have invasive cancer; however, none had carcinoma at the NAC margin, and therefore 273 the NAC was preserved. At a median follow up of 10.38 months, no breasts developed breast cancer. 274 The complication rates for the 341 nipple-sparing mastectomies for therapeutic or risk reduction were 275 as follows: 0.2% suffered partial loss of NAC, 19.5% suffered some degree of skin desquamation, 3.3% 276 required operative debridement, 1% required removal of a tissue expander, 2% were treated for 277 infection. PubMedCrossRef
10.
Didier F, Radice D, Gandini S, et al. Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality? Breast Cancer Res Treat. 2009;118:623–33.PubMedCrossRef
11.
Djohan R, Gage E, Gatherwright J, et al. Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study. Plast Reconstr Surg. 2010;125:818–29.PubMedCrossRef
12.
Salgarello M, Visconti G, Barone-Adesi L. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg. 2010;126:1460–71.PubMedCrossRef
13.
Yueh JH, Houlihan MJ, Slavin SA, et al. Nipple-sparing mastectomy: evaluation of patient satisfaction, aesthetic results, and sensation. Ann Plast Surg. 2009;62:586–90.PubMedCrossRef
14.
Frost MH, Slezak JM, Tran NV, et al. Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance. J Clin Oncol. 2005;23:7849–56.PubMedCrossRef
15.
Frost MH, Hoskin TL, Hartmann LC, et al. Contralateral prophylactic mastectomy: long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits. Ann Surg Oncol. 2011;18:3110–16.PubMedCrossRef
16.
Alderman AK, Kuhn LE, Lowery JC, et al. Does patient satisfaction with breast reconstruction change over time? Two-year results of the Michigan Breast Reconstruction Outcomes Study. J Am Coll Surg. 2007;204:7–12.PubMedCrossRef
17.
Guyomard V, Leinster S, Wilkinson M. Systematic review of studies of patients' satisfaction with breast reconstruction after mastectomy. Breast. 2007;16:547–67.PubMedCrossRef
18.
Gurunluoglu R, Gurunluoglu A, Williams SA, et al. Current trends in breast reconstruction: survey of American Society of Plastic Surgeons 2010. Ann Plast Surg. 2011.
19.
Vardanian AJ, Clayton JL, Roostaeian J, et al. Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg. 2011;128:403e–10e.PubMedCrossRef
20.
Sbitany H, Serletti JM. Acellular dermis-assisted prosthetic breast reconstruction: a systematic and critical review of efficacy and associated morbidity. Plast Reconstr Surg. 2011;128:1162–69.PubMedCrossRef
21.
Roostaeian J, Crisera C. Current options in breast reconstruction with or without radiotherapy. Curr Opin Obstet Gynecol. 2011;23:44–50.PubMedCrossRef
22.
Salzberg CA, Ashikari AY, Koch RM, et al. An 8-year experience of direct-to-implant immediate breast reconstruction using human acellular dermal matrix (AlloDerm). Plast Reconstr Surg. 2011;127:514–24.PubMedCrossRef
23.
de la Peña-Salcedo JA, Soto-Miranda MA, Lopez-Salguero JF. Prophylactic mastectomy: is it worth it? Aesthetic Plast Surg. 2011.
24.
• Spear SL, Schwarz KA, Venturi ML, et al. Prophylactic mastectomy and reconstruction: clinical outcomes and patient satisfaction. Plast Reconstr Surg. 2008;122:1–9. This study evaluated 74 patients who had 101 breast reconstructions after prophylactic mastectomy, with a mean follow up of 31 months. They found breast reconstruction following prophylactic mastectomy to be as safe as reconstruction following therapeutic mastectomy, with results trending toward lower complication rates and higher satisfaction after prophylactic mastectomy, as compared with therapeutic mastectomy.PubMedCrossRef
25.
Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982;69:216–25.PubMedCrossRef
26.
Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994;32:32–8.PubMedCrossRef
27.
Nahabedian MY, Dooley W, Singh N, et al. Contour abnormalities of the abdomen after breast reconstruction with abdominal flaps: the role of muscle preservation. Plast Reconstr Surg. 2002;109:91–101.PubMedCrossRef
28.
Nahabedian MY, Momen B, Galdino G, et al. Breast reconstruction with the free TRAM or DIEP flap: patient selection, choice of flap, and outcome. Plast Reconstr Surg. 2002;110:466–75. discussion 476-7.PubMedCrossRef
29.
Arnez ZM, Smith RW, Eder E, et al. Breast reconstruction by the free lower transverse rectus abdominis musculocutaneous flap. Br J Plast Surg. 1988;41:500–5.PubMedCrossRef
30.
Nahabedian MY, Tsangaris T, Momen B. Breast reconstruction with the DIEP flap or the muscle-sparing (MS-2) free TRAM flap: is there a difference? Plast Reconstr Surg. 2005;115:436–44. discussion 445–6.PubMedCrossRef
31.
LoTempio MM, Allen RJ. Breast reconstruction with SGAP and IGAP flaps. Plast Reconstr Surg. 2010;126:393–401.PubMedCrossRef
32.
Serletti JM, Fosnot J, Nelson JA, et al. Breast reconstruction after breast cancer. Plast Reconstr Surg. 2011;127:124e–35e.PubMedCrossRef
Metadaten
Titel
Options for Surgical Prophylaxis and Reconstruction
verfasst von
Benjamin J. Brown
Ali Al-Attar
Scott L. Spear
Publikationsdatum
01.09.2012
Verlag
Current Science Inc.
Erschienen in
Current Breast Cancer Reports / Ausgabe 3/2012
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-012-0079-3

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