scholarly journals Retrospective review of 108 breast reconstructions using the round block technique after breast-conserving surgery: Indications, complications, and outcomes

2020 ◽  
Vol 47 (6) ◽  
pp. 574-582
Author(s):  
Seok Kyung In ◽  
Yoon Soo Kim ◽  
Ho Sung Kim ◽  
Jin Hyung Park ◽  
Hong Il Kim ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Breast Conserving Surgery ◽  
Tumor Location ◽  
Breast Volume ◽  
Cosmetic Results ◽  
Major Complications ◽  
Resected Tumor ◽  
Good Cosmetic

Background Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio.Methods All breast reconstructions using the round block technique after BCS were included in this analysis. Patients’ data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated.Results In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation.Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

scholarly journals Correlation of Specimen/Breast Volume Ratio to Cosmetic Outcome After Breast Conserving Surgery

2019 ◽  
Vol 10 (4) ◽  
pp. 668-672
Author(s):  
Tarek Hashem ◽  
Ahmed Morsi ◽  
Ahmed Farahat ◽  
Tarek Zaghloul ◽  
Amira Hamed
Keyword(s):  
Volume Ratio ◽  
Breast Conserving Surgery ◽  
Cosmetic Outcome ◽  
Breast Volume

Postscript: management of early breast cancer (6 July, page 53)

1992 ◽  
Vol 30 (19) ◽  
pp. 76.1-76
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Early Breast Cancer ◽  
Surgical Oncology ◽  
British Association ◽  
Cosmetic Results ◽  
Good Cosmetic

In our article we did not mention breast reconstruction, the timing of which (delayed or at mastectomy) is controversial, but good cosmetic results can be obtained from either. The British Association of Surgical Oncology now recommends that all specialist breast units should be able to offer advice on reconstruction to women who need a mastectomy. This should include a careful explanation of outcome and risks from treatment.

scholarly journals Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Jaime Letzkus ◽  
Maria José Del Río ◽  
Carlos Rencoret ◽  
Alejandro Belmar ◽  
Galina Ivanova ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Breast Tumors ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Advancement Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Areola Complex ◽  
Good Cosmetic ◽  
Breast Weight

Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumors located at the superior edge of the upper quadrant or at the upper inner quadrant represent a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a modified Burow's triangle advancement flap for breast-conserving surgery in patients with breast tumors at these locations. This retrospective observational study analyzed 8 out of 213 patients submitted to major oncoplastic breast procedures, who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow's triangle advancement flap. All patients were treated in public and private health systems in Santiago, Chile. The median age at diagnosis was 47 years. The average initial tumor size was 5.9 cm, and the mean excised breast weight was 117 g. Patients required neither symmetrization nor displacement of the nipple-areola complex. Only one patient had a minor complication (wound dehiscence). During follow-up, no local recurrences were reported. We conclude that the modified Burow's triangle advancement flap is a safe and effective technique to manage tumors at this complex location. It provides adequate oncological margins, good cosmetic results, and contralateral symmetry, with complication rates similar to those of standard conservative surgery.

scholarly journals A predictive factor for axillary lymph node metastasis in invasive ductal breast cancer: the value of tumor and breast volume ratio

2018 ◽  
Vol 6 (1) ◽  
pp. 152
Author(s):  
Mehmet Kubat ◽  
Soykan Dinç
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Axillary Lymph Node ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Breast Volume ◽  
Node Metastasis

Background: The objective of this study was to witness the effect of tumor volume/breast volume ratio on the presence of axillary lymph node metastasis and to examine the strategy in surgical treatment approach for patients.Methods: This study was carried out prospectively by examining the patients undergoing modified radical mastectomy surgery due to breast cancer (n=99).  Breast volumes were measured through liquid overflow method in graduated bowl tumor volume was measured according to ellipsoid volume formula with diameters determined by pathological specimen, ultrasonography or MRI.Results: Axillary lymph node metastasis (ALNM) was positive in 64.6% of them (n=64). Average breast volume was found to be 693.89cm³ in the measurement of mastectomy materials. Average tumor volume was found to be 9.58cm³. In line with these results, average tumor volume/breast volume (vTm/vMm) ratio was: 0.0176. Author found axillary lymph node metastasis possibility significantly higher in patients with vTm/vMm ratio>0.016 (Odds ratio 9.437, p-value 0.007).Conclusions: The presence of ALNM is the most important factor in indicating the prognosis of patients with invasive breast cancer and planning the treatment. Thus, knowing whether there exists an ALNM or not during preoperative period draws the attention of both the doctors performing treatment and patients. In this study efficiencies of largest tumor diameter, tumor volume and tumor volume (vTm)/Breast volume (vMm) ratio in indicating ALNM presence in cases with T2 invasive ductal breast cancer were evaluated. It was found that vTm/vMm ratio was a recent and effective prognostic criterion in determining ALNM.

scholarly journals MRI-Derived Tumour-to-Breast Volume Is Associated with the Extent of Breast Surgery

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 204
Author(s):  
Andrea Cozzi ◽  
Simone Schiaffino ◽  
Gianmarco Della Pepa ◽  
Serena Carriero ◽  
Veronica Magni ◽  
...  
Keyword(s):  
Large Scale ◽  
Breast Surgery ◽  
Volume Ratio ◽  
Tumour Volume ◽  
Breast Conserving Surgery ◽  
Interquartile Range ◽  
Breast Volume ◽  
Surgical Decision ◽  
Magnetic Resonance Imaging Mri ◽  
Surgical Decision Making

The tumour-to-breast volume ratio (TBVR) is a metric that may help surgical decision making. In this retrospective Ethics-Committee–approved study, we assessed the correlation between magnetic resonance imaging (MRI)-derived TBVR and the performed surgery. The TBVR was obtained using a fully manual method for the segmentation of the tumour volume (TV) and a growing region semiautomatic method for the segmentation of the whole breast volume (WBV). Two specifically-trained residents (R1 and R2) independently segmented T1-weighted datasets of 51 cancer cases in 51 patients (median age 57 years). The intraobserver and interobserver TBVR reproducibility were calculated. Mann-Whitney U, Spearman correlations, and Bland-Altman statistics were used. Breast-conserving surgery (BCS) was performed in 31/51 cases (61%); mastectomy was performed in 20/51 cases (39%). The median TBVR was 2.08‰ (interquartile range 0.70–9.13‰) for Reader 1, and 2.28‰ (interquartile range 0.71–9.61‰) for Reader 2, with an 84% inter-reader reproducibility. The median segmentation times were 54 s for the WBV and 141 s for the TV. Significantly-lower TBVR values were observed in the breast-conserving surgery group (median 1.14‰, interquartile range 0.49–2.55‰) than in the mastectomy group (median 10.52‰, interquartile range 2.42–14.73‰) for both readers (p < 0.001). Large scale prospective studies are needed in order to validate MRI-derived TBVR as a predictor of the type of breast surgery.

scholarly journals The Comparison of Breast Reconstruction Using Two Types of Acellular Dermal Matrix after Breast-Conserving Surgery

2021 ◽  
Vol 10 (15) ◽  
pp. 3430
Author(s):  
Jeongshin An ◽  
Hyungju Kwon ◽  
Woosung Lim ◽  
Byung-In Moon ◽  
Nam Sun Paik
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Acellular Dermal Matrix ◽  
Breast Conserving Surgery ◽  
The Body ◽  
Surgical Time ◽  
Dermal Matrix ◽  
Specimen Weight ◽  
Breast Shape ◽  
Acellular Dermal

Breast reconstruction during breast-conserving surgery (BCS) can improve the breast shape. This study introduces breast reconstruction in BCS with two types of acellular dermal matrix (ADM). The study included 134 patients who underwent BCS due to breast cancer from February 2018 to May 2021. This study was conducted by one surgeon, and is the result of a three-year study. The patient group who underwent BCS using ADM was mainly targeted at patients with minor to severe defects after the operation. The average age of the patients was 51.8 years, and the body mass index (BMI) was 23.8 kg/m. The specimen weight was 30–120 g. The average surgical time, including reconstruction, was 100.4 min, combined with reconstruction. There were minor complications in six patients. The advantage of using ADM is that it can quickly correct the shape of the breast after conventional BCS surgery. Pellet-type ADM, rather than sheet-type, can create a breast shape similar to that before surgery. Breast reconstruction using ADM can be an easy and convenient method for making a better shape from BCS.

scholarly journals The importance of pial blood supply to the development of peritumoral brain edema in meningiomas

1997 ◽  
Vol 2 (4) ◽  
pp. E6 ◽  
Author(s):  
Michael Bitzer ◽  
Lars Wöckel ◽  
Andreas R. Luft ◽  
Ajay K. Wakhloo ◽  
Dirk Petersen ◽  
...  
Keyword(s):  
Brain Edema ◽  
Blood Supply ◽  
Tumor Size ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Total Tumor Volume ◽  
Pial Vessels ◽  
Peritumoral Brain Edema ◽  
Tumor Region ◽  
The Mean

The authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tumor size were calculated using computerized tomography. The edema-tumor volume ratio was defined as Edema Index (EI). There were 49 meningiomas with PTBE; of those tumors, 46 were supplied by pial vessels, and three were supplied exclusively by dural vessels. Tumors without PTBE showed no pial blush. The mean EI in meningiomas with pial blush was significantly larger (EI = 3.0) than in meningiomas without pial supply (EI = 1.1; p < 0.0001). Meningiomas in which 10% of the whole tumor volume was supplied by pial vessels had only a small mean EI of 2.2, whereas tumors with pial blood supply greater than or equal to 20% had a mean EI of 3.3 (p < 0.026). In 69.9% of cases with pial blood supply, major portions of the edema were located adjacent to the tumor region supplied by pial vessels. Edema index differences among tumors of different subgroups, as defined by size or histology, were significantly related to the pial supply in each subset. Thus, pial blood supply may be causative for the development of PTBE in meningiomas.

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