nach oben

26.04.2016 | Local-Regional Evaluation and Therapy (EP Mamounas, Section Editor) | Ausgabe 2/2016

The Optimal Approach to Post-Mastectomy and Post-Lumpectomy Breast Reconstruction

Zeitschrift:: Current Breast Cancer Reports > Ausgabe 2/2016

Autoren:: Merisa L. Piper, Hani Sbitany

» Jetzt Zugang zum Volltext erhalten

Wichtige Hinweise

This article is part of the Topical Collection on Local-Regional Evaluation and Therapy

Abstract

The surgical management of breast cancer has changed dramatically over the past 30 years, attributed to improved chemotherapy regimens and a better understanding of tumor biology. There is now a greater emphasis on decreasing surgical morbidity and preserving the breast form. The evolution of oncoplastic surgery has enabled more patients to be candidates for breast-conserving therapy, and the preservation of the entire skin and nipple areolar complex with mastectomy has markedly improved esthetic and patient-reported outcomes. This review provides an overview of the reconstructive options for partial and complete mastectomy, as well as discusses several key factors which markedly influence outcomes.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Jetzt einloggen Kostenlos registrieren

★ PREMIUM-INHALT

e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Jetzt gratis testen * Jetzt kaufen

Sie können e.Med Interdisziplinär 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

e.Med Onkologie

Kombi-Abonnement

Mit e.Med Onkologie erhalten Sie Zugang zu CME-Fortbildungen des Fachgebietes Onkologie, den Premium-Inhalten der onkologischen Fachzeitschriften, inklusive einer gedruckten onkologischen Zeitschrift Ihrer Wahl.

Jetzt testen ¹

e.Med Gynäkologie & Urologie

Kombi-Abonnement

Mit e.Med Gynäkologie & Urologie erhalten Sie Zugang zu CME-Fortbildungen der beiden Fachgebiete, den Premium-Inhalten der Fachzeitschriften, inklusive einer gedruckten gynäkologischen oder urologischen Zeitschrift Ihrer Wahl.

Jetzt testen ²

Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366(9503):2087–106. CrossRefPubMed

Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34. CrossRefPubMedPubMedCentral

Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41. CrossRefPubMed

Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med. 2002;347(8):567–75. CrossRefPubMed

Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 1998;16(8):2672–85.

6.••

Hart AM, Pinell-White X, Egro FM, Losken A. The psychosexual impact of partial and total breast reconstruction: a prospective 1-year longitudinal study. Ann Plast Surg. 2014, Prospective study exploring patient satisfaction and sexuality between two patient groups: mastectomy with immediate reconstruction, and lumpectomy with reduction mammoplasty. Found the two groups had similar overall satisfaction with sex life and body image, but the breast conserving therapy with reduction mammoplasty group had larger gains in body image perception.

7.••

Losken A, Dugal CS, Styblo TM, Carlson GW. A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Ann Plast Surg. 2014;72(2):145–9. Metaanalysis comparing BCT alone, BCT with oncoplastic flap techniques, and BCT with oncoplastic reduction techniques. Found oncoplastic techniques with BCT decreased the positive margin rate and improved patient satisfaction.

8.••

Losken A, Pinell-White X, Hart AM, Freitas AM, Carlson GW, Styblo TM. The oncoplastic reduction approach to breast conservation therapy: benefits for margin control. Aesthet Surg J / Am Soc Aesthet Plast Surg. 2014;34(8):1185. Compared patients who underwent lumpectomy, and lumpectomy with oncoplastic reduction, by a single surgeon. Found oncoplastic reduction techniques resulted in fewer re-excisions and fewer positive margins.

Chan SW, Cheung PS, Lam SH. Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery. World J Surg. 2010;34(7):1447–52. CrossRefPubMed

10.••

Peled AW, Sbitany H, Foster RD, Esserman LJ. Oncoplastic mammoplasty as a strategy for reducing reconstructive complications associated with postmastectomy radiation therapy. Breast J. 2014;20(3):302–7. This paper sought to evaluate whether neo-adjuvant chemotherapy and oncoplastic mammoplasty had improved outcomes as compared to mastectomy and immediate reconstruction in patients who require XRT. Found that patients who underwent BCT and oncoplastic mammoplasty had fewer post-operative complications than patients who underwent mastectomy with immediate reconstruction in the setting of radiation therapy.

11.

Veiga DF, Veiga-Filho J, Ribeiro LM, Archangelo-Junior I, Mendes DA, Andrade VO, et al. Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: a prospective controlled study. Breast (Edinb Scotl). 2011;20(5):407–12. CrossRef

12.

Garwood ER, Moore D, Ewing C, Hwang ES, Alvarado M, Foster RD, et al. Total skin-sparing mastectomy: complications and local recurrence rates in 2 cohorts of patients. Ann Surg. 2009;249(1):26–32. CrossRefPubMed

13.

Chen CM, Disa JJ, Sacchini V, Pusic AL, Mehrara BJ, Garcia-Etienne CA, et al. Nipple-sparing mastectomy and immediate tissue expander/implant breast reconstruction. Plast Reconstr Surg. 2009;124(6):1772–80. CrossRefPubMed

14.

Spear SL, Hannan CM, Willey SC, Cocilovo C. Nipple-sparing mastectomy. Plast Reconstr Surg. 2009;123(6):1665–73. CrossRefPubMed

15.

Spear SL, Willey SC, Feldman ED, Cocilovo C, Sidawy M, Al-Attar A, et al. Nipple-sparing mastectomy for prophylactic and therapeutic indications. Plast Reconstr Surg. 2011;128(5):1005–14. CrossRefPubMed

16.

Peled AW, Duralde E, Foster RD, Fiscalini AS, Esserman LJ, Hwang ES, et al. Patient-reported outcomes and satisfaction after total skin-sparing mastectomy and immediate expander-implant reconstruction. Ann Plast Surg. 2014;72 Suppl 1:S48–52. PubMed

17.••

Cemal Y, Albornoz CR, Disa JJ, McCarthy CM, Mehrara BJ, Pusic AL, et al. A paradigm shift in U.S. breast reconstruction: part 2. The influence of changing mastectomy patterns on reconstructive rate and method. Plast Reconstr Surg. 2013;131(3):320e–6. Used the NIS database to look at mastectomy and reconstruction trends from 1998–2008. Found contralateral and bilateral prophylactic mastectomy rates have increased, and implant use has increased for all mastectomy types.

18.••

Wang F, Peled AW, Garwood E, Fiscalini AS, Sbitany H, Foster RD, et al. Total skin-sparing mastectomy and immediate breast reconstruction: an evolution of technique and assessment of outcomes. Ann Surg Oncol. 2014;21(10):3223–30. Evaluation of all cases of total skin-sparing mastectomy with immediate reconstruction at a single institution demonstrated improved post-operative complication rates with greater experience, and no compromise in oncologic safety compared with skin-sparing mastectomy.

19.

Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Lancet. 2000;355(9217), 1757–1770.

20.

Clough KB, Ihrai T, Oden S, Kaufman G, Massey E, Nos C. Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant atlas. Br J Surg. 2012;99(10):1389–95. CrossRefPubMed

21.

Losken A, Styblo TM, Carlson GW, Jones GE, Amerson BJ. Management algorithm and outcome evaluation of partial mastectomy defects treated using reduction or mastopexy techniques. Ann Plast Surg. 2007;59(3):235–42. CrossRefPubMed

22.

Losken A, Hamdi M. Partial breast reconstruction: current perspectives. Plast Reconstr Surg. 2009;124(3):722–36. CrossRefPubMed

23.

Anderson BO, Masetti R, Silverstein MJ. Oncoplastic approaches to partial mastectomy: an overview of volume-displacement techniques. Lancet Oncol. 2005;6(3):145–57. CrossRefPubMed

24.

Clough KB, Kroll SS, Audretsch W. An approach to the repair of partial mastectomy defects. Plast Reconstr Surg. 1999;104(2):409–20. CrossRefPubMed

25.

Papp C, Wechselberger G, Schoeller T. Autologous breast reconstruction after breast-conserving cancer surgery. Plast Reconstr Surg. 1998;102(6):1932–6. discussion 1937–8. CrossRefPubMed

26.

Slavin SA, Love SM, Sadowsky NL. Reconstruction of the radiated partial mastectomy defect with autogenous tissues. Plast Reconstr Surg. 1992;90(5):854–65. discussion 866–9. CrossRefPubMed

27.

Benelli L. A new periareolar mammaplasty: the “round block” technique. Aesthet Plast Surg. 1990;14(2):93–100. CrossRef

28.

Amanti C, Regolo L, Moscaroli A, Lo Russo M, Catracchia V. Total periareolar approach in breast-conserving surgery. [Approccio periareolare totale nella chirugia conservativa della mammella.]. Tumori. 2003;89(4 Suppl):169–72. PubMed

29.

Macmillan RD, James R, Gale KL, McCulley SJ. Therapeutic mammaplasty. J Surg Oncol. 2014;110(1):90–5. CrossRefPubMed

30.

Newman LA, Kuerer HM, McNeese MD, Hunt KK, Gurtner GC, Vlastos GS, et al. Reduction mammoplasty improves breast conservation therapy in patients with macromastia. Am J Surg. 2001;181(3):215–20. CrossRefPubMed

31.

Spear SL, Pelletiere CV, Wolfe AJ, Tsangaris TN, Pennanen MF. Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of breast cancer. Plast Reconstr Surg. 2003;111(3):1102–9. CrossRefPubMed

32.

Berry MG, Fitoussi AD, Curnier A, Couturaud B, Salmon RJ. Oncoplastic breast surgery: a review and systematic approach. J Plastic Reconstr Aesthet Surg. 2010;63(8):1233–43. CrossRef

33.

Hall-Findlay EJ. A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg. 1999;104(3):748–59. discussion 760–3. CrossRefPubMed

34.

Hall-Findlay EJ. Vertical breast reduction. Semin Plast Surg. 2004;18(3):211–24. CrossRefPubMedPubMedCentral

35.

Lassus C. Breast reduction: evolution of a technique—a single vertical scar. Aesthet Plast Surg. 1987;11(2):107–12. CrossRef

36.

Lejour M. Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg. 1994;94(1):100–14. CrossRefPubMed

37.

Losken A, Elwood ET, Styblo TM, Bostwick 3rd J. The role of reduction mammaplasty in reconstructing partial mastectomy defects. Plast Reconstr Surg. 2002;109(3):968–75. Discussion 976–7. CrossRefPubMed

38.

Barnea Y, Inbal A, Barsuk D, Menes T, Zaretski A, Leshem D, et al. Oncoplastic reduction using the vertical scar superior-medial pedicle pattern technique for immediate partial breast reconstruction. Can J Surg J Can Chir. 2014;57(4):E134–40. CrossRef

39.

Kroll SS, Singletary SE. Repair of partial mastectomy defects. Clin Plast Surg. 1998;25(2):303–10. PubMed

40.

Losken A, Pinell XA, Eskenazi B. The benefits of partial versus total breast reconstruction for women with macromastia. Plast Reconstr Surg. 2010;125(4):1051–6. PubMed

41.

Chang E, Johnson N, Webber B, Booth J, Rahhal D, Gannett D, et al. Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia. Am J Surg. 2004;187(5):647–50. discussion 650–1. CrossRefPubMed

42.••

Piper M, Peled AW, Sbitany H, Foster RD, Esserman LJ, Price ER. Comparison of mammographic findings following oncoplastic mammoplasty and lumpectomy without reconstruction. Ann Surg Oncol. 2016;23(1):65–71. Comparison of patients who underwent BCT with oncoplastic reduction mammoplasty to BCT alone found no significant difference in abnormal mammographic findings or biopsy rates despite the substantial tissue rearrangement that is performed.

43.

Chang EI, Peled AW, Foster RD, Lin C, Zeidler KR, Ewing CA, et al. Evaluating the feasibility of extended partial mastectomy and immediate reduction mammoplasty reconstruction as an alternative to mastectomy. Ann Surg. 2012;255(6):1151–7. CrossRefPubMed

44.••

Wang F, Peled AW, Chin R, Fowble B, Alvarado M, Ewing C, et al. The impact of radiation therapy, lymph node dissection, and hormonal therapy on outcomes of tissue expander-implant exchange in prosthetic breast reconstruction. Plast Reconstr Surg. 2016;137(1):1–9. An evaluation of all patients at a single institution who underwent total skin-sparing mastectomy with tissue expander-implant reconstruction found that axillary lymph node dissection increases the risk of implant loss compared with sentinel lymph node biopsy, regardless of radiation exposure.

45.

Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006;118(3 Suppl):108S–20. CrossRefPubMed

46.

Illouz YG. Body contouring by lipolysis: a 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983;72(5):591–7. CrossRefPubMed

47.

Rigotti G, Marchi A, Galiè M, Baroni G, Benati D, Krampera M, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg. 2007;119(5):1409–22. CrossRefPubMed

48.

Wang Y, Lehuédé C, Laurent V, Dirat B, Dauvillier S, Bochet L, et al. Adipose tissue and breast epithelial cells: a dangerous dynamic duo in breast cancer. Cancer Lett. 2012;324(2):142–51. CrossRefPubMed

49.

Wang C, Zhou Z, Yan Y, Zhao D, Chen F, Qiao Q. Clinical analyses of clustered microcalcifications after autologous fat injection for breast augmentation. Plast Reconstr Surg. 2011;127(4):1669–73. CrossRefPubMed

50.

Bertolini F. Contribution of endothelial precursors of adipose tissue to breast cancer: progression-link with fat graft for reconstructive surgery. Ann Endocrinol. 2013;74(2):106–7. CrossRef

51.

Pearl RA, Leedham SJ, Pacifico MD. The safety of autologous fat transfer in breast cancer: lessons from stem cell biology. J Plast Reconstr Aesthet Surg. 2012;65(3):283–8. CrossRefPubMed

52.

Coleman SR, Saboeiro AP. Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg. 2007;119(3):775–85. Discussion 786–7. CrossRefPubMed

53.

Rigotti G, Marchi A, Stringhini P, Baroni G, Galie M, Molino AM, et al. Determining the oncological risk of autologous lipoaspirate grafting for post-mastectomy breast reconstruction. Aesthet Plast Surg. 2010;34(4):475–80. CrossRef

54.

Delay E, Garson S, Tousson G, Sinna R. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J / Am Soc Aesthet Plast Surg. 2009;29(5):360–76. CrossRef

55.••

Kling RE, Mehrara BJ, Pusic AL, Young VL, Hume KM, Crotty CA, et al. Trends in autologous fat grafting to the breast: a national survey of the American Society of Plastic Surgeons. Plast Reconstr Surg. 2013;132(1):35–46. Survey of plastic surgeons who are members of ASPS found that 62 % used fat grafting for breast reconstruction, and 28 % used it for aesthetic breast surgery, demonstrating the increasing prevalence of this technique.

56.

Wijayanayagam A, Kumar AS, Foster RD, Esserman LJ. Optimizing the total skin-sparing mastectomy. Arch Surg (Chicago, Ill: 1960). 2008;143(1):38–45. Discussion 45. CrossRef

57.••

Alperovich M, Tanna N, Samra F, Blechman KM, Shapiro RL, Guth AA, et al. Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastopexy: how safe is it? Plast Reconstr Surg. 2013;131(5):962–7. Study of 13 breasts in 8 patients who underwent nipple-sparing mastectomy following reduction mammoplasty or mastopexy. There was no nipple loss and no subareolar positive biopsies, thus the authors concluded nipple-sparing mastectomy can be offered to patients who had a prior history of mammoplasty or mastopexy.

58.

Spear SL, Rottman SJ, Seiboth LA, Hannan CM. Breast reconstruction using a staged nipple-sparing mastectomy following mastopexy or reduction. Plast Reconstr Surg. 2012;129(3):572–81. CrossRefPubMed

59.••

Piper M, Peled AW, Foster RD, Moore DH, Esserman LJ. Total skin-sparing mastectomy: a systematic review of oncologic outcomes and postoperative complications. Ann Plast Surg. 2013, Systematic review assessing outcomes following total skin-sparing mastectomy identified 27 studies with a total of 3331 patients. Partial nipple necrosis found in 9.1 %, total NAC loss in 2 %, and overall local-regional cancer recurrence rate was 2.8 %. Concluded current data support TSSM without compromising therapeutic efficacy.

60.••

Fowble B, Park C, Wang F, Peled A, Alvarado M, Ewing C. et al. Rates of reconstruction failure in patients undergoing immediate reconstruction with tissue expanders and/or implants and postmastectomy radiation therapy. Int J Radiat Oncol Biol Phys. 2015, This study evaluates tissue expander-implant failure in the setting of post-mastectomy radiation therapy. Found TE/I failure rate was 18 %, and the strongest predictor of reconstructive failure was lack of total TE/I coverage with ADM or muscle at the time of radiation.

61.

Peled AW, Foster RD, Garwood ER, Moore DH, Ewing CA, Alvarado M, et al. The effects of acellular dermal matrix in expander-implant breast reconstruction after total skin-sparing mastectomy: results of a prospective practice improvement study. Plast Reconstr Surg. 2012;129(6):901e–8. CrossRefPubMed

62.

Salzberg CA, Ashikari AY, Koch RM, Chabner-Thompson E. An 8-year experience of direct-to-implant immediate breast reconstruction using human acellular dermal matrix (AlloDerm). Plast Reconstr Surg. 2011;127(2):514–24. CrossRefPubMed

63.

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(6):1162–9. CrossRefPubMed

64.

Nahabedian MY. AlloDerm performance in the setting of prosthetic breast surgery, infection, and irradiation. Plast Reconstr Surg. 2009;124(6):1743–53. CrossRefPubMed

65.

Ward J, Cohen IK, Knaysi GA, Brown PW. Immediate breast reconstruction with tissue expansion. Plast Reconstr Surg. 1987;80(4):559–66. CrossRefPubMed

66.••

Spear SL, Murphy DK, Allergan Silicone Breast Implant U.S. Core Clinical Study Group. Natrelle round silicone breast implants: core study results at 10 years. Plast Reconstr Surg. 2014;133(6):1354–61. A 10-year study evaluating Allergan’s Natrelle smooth and textured round silicone implants found high patient satisfaction and appropriate safety.

67.••

Colwell AS, Tessler O, Lin AM, Liao E, Winograd J, Cetrulo CL, et al. Breast reconstruction following nipple-sparing mastectomy: predictors of complications, reconstruction outcomes, and 5-year trends. Plast Reconstr Surg. 2014;133(3):496–506. This single institution retrospective review evaluated 285 patients (500 mastectomies) who underwent nipple-sparing mastectomies over a 5-year period. They found body mass index, smoking, incision type, and preoperative radiation were predictors of complications.

68.

Cordeiro PG, Pusic AL, Disa JJ, McCormick B, VanZee K. Irradiation after immediate tissue expander/implant breast reconstruction: outcomes, complications, aesthetic results, and satisfaction among 156 patients. Plast Reconstr Surg. 2004;113(3):877–81. CrossRefPubMed

69.

Brody GS. Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 cases. Plast Reconstr Surg. 2015;136(4):553e–4. CrossRefPubMed

70.

Kroll SS, Baldwin B. A comparison of outcomes using three different methods of breast reconstruction. Plast Reconstr Surg. 1992;90(3):455–62. CrossRefPubMed

71.

Kronowitz SJ. Redesigned gluteal artery perforator flap for breast reconstruction. Plast Reconstr Surg. 2008;121(3):728–34. CrossRefPubMed

72.••

Fischer JP, Nelson JA, Cleveland E, Sieber B, Rohrbach JI, Serletti JM, et al. Breast reconstruction modality outcome study: a comparison of expander/implants and free flaps in select patients. Plast Reconstr Surg. 2013;131(5):928–34. This study compared outcomes and cost between abdominally based autologous free flap and tissue expander-implant based breast reconstruction. They found that free flap reconstruction had faster time to complete reconstruction, lower rates of complications and failures, and fewer clinic visits.

73.

Yueh JH, Slavin SA, Adesiyun T, Nyame TT, Gautam S, Morris DJ, et al. Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg. 2010;125(6):1585–95. CrossRefPubMed

74.••

Sbitany H, Wang F, Peled AW, Lentz R, Alvarado M, Ewing CA, et al. Immediate implant-based breast reconstruction following total skin-sparing mastectomy: defining the risk of preoperative and postoperative radiation therapy for surgical outcomes. Plast Reconstr Surg. 2014;134(3):396–404. Evaluated effects of radiation of tissue expander-implant based breast reconstruction following total skin-sparing mastectomy. Found that both pre-operative and post-operative radiation had higher infection rates and more expander-implant loss, but no difference in NAC necrosis rates, than patients who did not undergo radiation.

75.••

Piper ML, Lentz R, Evangelista M, Hansen S, Sbitany H. The “dual-plane” DIEP free flap: defining the effect of perfusion enhancement of clinical outcomes. American Society of Reconstructive Microsurgery Annual Meeting. Scottsdale, AZ, 2016. In select patients undergoing DIEP flap breast reconstruction, rerouting the SIEA/SIEV system directly into the superior continuation of the deep vascular system pedicle leads to lower rates of fat necrosis that single-perforator “traditional” DIEP free flaps.

76.••

Piper ML, Evangelista M, Amara D, Daar D, Foster RD, Fowble B, Sbitany H. A custom bolus approach to post-mastectomy radiation delivery following autologous breast reconstruction: an 8-year experience. American Society of Reconstructive Microsurgery Annual Meeting. Scottsdale, AZ. 2016. In women undergoing immediate autologous tissue breast reconstruction who require post-mastectomy radiation therapy, custom bolus may be a favorable option. This technique allows more uniform dosing of the skin, limits radiation to the pedicle, and provides adequate radiation dose to prevent recurrence. Preliminary data indicates this technique may lead to fewer radiation-induced skin changes, less fibrosis, less volume loss, and fewer contour deformities.

Titel: The Optimal Approach to Post-Mastectomy and Post-Lumpectomy Breast Reconstruction
Autoren:: Merisa L. Piper
Hani Sbitany
Publikationsdatum: 26.04.2016
DOI: https://doi.org/10.1007/s12609-016-0210-y
Verlag: Springer US
Zeitschrift: Current Breast Cancer Reports
Ausgabe 2/2016
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596

Sie können e.Med Onkologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.
Sie können e.Med Gynäkologie & Urologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Onkologie

25.02.2021 | Prostatakarzinom | Nachrichten

Newsletter bestellen

Bildnachweise

Mail Icon II

Springer Medizin

The Optimal Approach to Post-Mastectomy and Post-Lumpectomy Breast Reconstruction

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Onkologie

e.Med Gynäkologie & Urologie

Neu im Fachgebiet Onkologie

Active Surveillance bei Prostata-Ca.: Ist mehr Vorsicht angebracht?

Krebsmortalität sinkt europaweit – mit Ausnahmen

Antikörper-Wirkstoff-Konjugat senkt Urothelkarzinom-Mortalität um 30%

r/r MM: Anti-CD38-Antikörper zur subkutanen Applikation

Newsletter

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Onkologie

e.Med Gynäkologie & Urologie

Weitere Artikel der Ausgabe 2/2016

Oncoplastic Breast Surgery: What, When and for Whom?

Margins in Breast-Conserving Surgery for Early Breast Cancer: How Much is Good Enough?

New Developments in Assessing Risk of Local Recurrence in Patients with Ductal Carcinoma In Situ after Lumpectomy and Breast Radiation

Role of Breast MRI in Patients with Newly Diagnosed Breast Cancer

Emerging Biomarkers of the Future: Changing Clinical Practice for 2020

Nipple-Sparing Mastectomy in Patients with Germline BRCA Mutations: Is it Safe?

Neu im Fachgebiet Onkologie

Active Surveillance bei Prostata-Ca.: Ist mehr Vorsicht angebracht?

Krebsmortalität sinkt europaweit – mit Ausnahmen

Antikörper-Wirkstoff-Konjugat senkt Urothelkarzinom-Mortalität um 30%

r/r MM: Anti-CD38-Antikörper zur subkutanen Applikation

Newsletter