scholarly journals Comparison of breast volume change between oncoplastic breast-conserving surgery with radiation therapy and a simultaneous contralateral balancing procedure through the inverted-T scar technique

2020 ◽  
Vol 47 (6) ◽  
pp. 583-589
Author(s):  
Min Wook Kim ◽  
Won Seok Oh ◽  
Jae Woo Lee ◽  
Hyun Yul Kim ◽  
Youn Joo Jung ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Volume Change ◽  
Volume Ratio ◽  
Breast Conserving Surgery ◽  
Reduction Mammoplasty ◽  
Computed Tomography Images ◽  
Post Radiation ◽  
Average Body Mass ◽  
Ptotic Breasts ◽  
Average Body

Background Reduction mammoplasty or mastopexy is performed as an additional balancing procedure in patients with large or ptotic breasts who undergo breast-conserving surgery (BCS). Radiation therapy on breasts that have undergone surgery may result in changes in the volume. This study presents a comparative analysis of patients who received post-BCS balancing procedures to determine whether volume changes were larger in breasts that received radiation therapy than on the contralateral side.Methods Thirty-six participants were selected among patients who received BCS using the inverted-T scar technique between September 2012 and July 2017, were followed up for 2 or more years, and had pre-radiation therapy computed tomography images and post-radiation therapy images taken between 12 and 18 months after completion. The average age of the participants was 53.5 years, their average body mass index was 26.62 kg/m<sup>2</sup>.Results The pre- and post-radiation therapy volumes of the breasts receiving BCS were 666.08±147.48 mL and 649.33±130.35 mL, respectively. In the contralateral breasts, the volume before radiation therapy was 637.69±145.72 mL, which decreased to 628.14±166.41 mL after therapy. The volume ratio of the affected to the contralateral breasts was 1.05±0.10 before radiation therapy and 1.06±0.12 after radiation therapy.Conclusions The ratio of the volume between the two breasts immediately after surgery and at roughly 18 months postoperatively was not significantly different (P=0.98). For these reasons, we recommend a simultaneous single-stage balancing procedure as a reasonable option for patients who require radiation therapy after BCS without concerns regarding volume change.

scholarly journals Can Reduction Mammoplasty Patients Be Promised a Particular Size Postoperatively?

2005 ◽  
Vol 13 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Arianna Dal Cin ◽  
Elizabeth Rose Jeans
Keyword(s):  
Telephone Survey ◽  
Reduction Mammoplasty ◽  
Size Change ◽  
Future Studies ◽  
Band Size ◽  
Average Body Mass ◽  
The Difference ◽  
Reported Data ◽  
Letter Size ◽  
Average Body

This retrospective study used self-reported bra sizes, heights and weights pre- and postoperatively in patients who underwent reduction mammoplasty by one surgeon between 2001 and 2003. Preoperative data were collected on 91 patients. Postoperative data were collected from 69 respondents by telephone survey. Bra sizes were standardized according to cup size. In bra-making, the cup is the same size for decreasing cup letter size as the band size increases. The most common standardized cup size was seven, representing bra sizes 34 F, 36 E, 38 D, 40 C, etc. The range of preoperative cup sizes was five (34 D) to 17 (42 L). The mass of tissue removed from each breast was averaged for each patient and ranged from 147 g to 2453 g (mean 522 g). The average body mass index was 29.6 kg/m preoperatively and 29.3 kg/m2 postoperatively, with six patients reporting weight gain, 13 reporting weight loss and 50 reporting no change at all. Postoperative standardized cup sizes ranged from five (34 D) to 14 (44 H). The difference between pre- and postoperative cup size ranged from zero to eight as follows: for no cup size change (n=17), mean tissue removed per breast was 577.1 g; decrease by one cup size (n=23), 489.2 g; decrease by two cup sizes (n=25), 425.8 g. These data indicate that when self-reported data from patients are used, a plastic surgeon may find that as many as 25% report no change in bra size after reduction mammoplasty, even when more than 500 g of tissue is removed from each breast, which may adversely affect patients’ satisfaction with the surgical results. Future studies will determine the cause of the apparent discrepancy between operative and self-reported results.

scholarly journals Lichenoid Dermatitis After Hypofractionated Radiation Therapy for Breast Cance

2019 ◽  
Author(s):  
Yukihiro Hama ◽  
Etsuko Tate
Keyword(s):  
Radiation Therapy ◽  
Lichen Planus ◽  
Rare Complication ◽  
Breast Conserving Surgery ◽  
Clinical Findings ◽  
Tumor Bed ◽  
Post Radiation ◽  
Hypofractionated Radiation Therapy ◽  
Hypofractionated Radiation ◽  
Delayed Hypersensitivity Reaction

Lichenoid dermatitis is a rare complication after radiation therapy and is often considered as a delayed hypersensitivity reaction. It is different from lichen planus and is characterized by fine white scale (Wickham’s striae). Here, we report a case of lichenoid dermatitis developed after hypofractionated whole-breast radiation therapy followed by breast-conserving surgery. A 60-year-old female patient underwent hypofractionated whole-breast radiation therapy followed by a boost to the tumor bed. Post-radiation course was uneventful, but violaceous, polyangular, and pruritic papules accompanied by the eruption were noted at the boost site. Clinical findings were consistent with lichenoid dermatitis, so steroid ointment and oral antihistamines were administered. Her lichenoid dermatitis was completely relieved in 2 weeks, and there was no sign of relapse during the 5 years follow-up. There are some reports of lichen planus induced after radiotherapy; however, this is the first report that shows lichenoid dermatitis as a possible complication after hypofractionated radiation therapy for breast cancer.

The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients

2021 ◽  
Author(s):  
Taehee Jo ◽  
Dong Nyeok Jeon ◽  
Hyun Ho Han
Keyword(s):  
Donor Site ◽  
Wound Dehiscence ◽  
Diep Flap ◽  
Separate Analysis ◽  
Flap Reconstruction ◽  
Average Body Mass Index ◽  
Deep Inferior Epigastric Perforator ◽  
Average Body Mass ◽  
Artery Perforator ◽  
Average Body

Abstract Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated. Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis. Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights. Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.

scholarly journals Determining the Impact of Thickened Liquids on Swallowing in Patients Undergoing Irradiation for Oropharynx Cancer

2021 ◽  
pp. 019459982110104
Author(s):  
Carly E. A. Barbon ◽  
Douglas B. Chepeha ◽  
Andrew J. Hope ◽  
Melanie Peladeau-Pigeon ◽  
Ashley A. Waito ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Clinical Benefit ◽  
Oropharyngeal Cancer ◽  
Thickened Liquids ◽  
Current Standard ◽  
Oropharynx Cancer ◽  
Post Radiation ◽  
Thin Liquids ◽  
The Impact

The current standard for the treatment of oropharynx cancers is radiation therapy. However, patients are frequently left with dysphagia characterized by penetration-aspiration (impaired safety) and residue (impaired efficiency). Although thickened liquids are commonly used to manage dysphagia, we lack evidence to guide the modification of liquids for clinical benefit in the head and neck cancer population. The objective of this study was to assess the impact of slightly and mildly thick liquids on penetration-aspiration and residue in 12 patients with oropharyngeal cancer who displayed penetration-aspiration on thin liquid within 3 to 6 months after completion of radiotherapy. Significantly fewer instances of penetration-aspiration were seen with slightly and mildly thick liquids as compared with thin ( P < .05). No differences were found across stimuli in the frequency of residue. Patients with oropharyngeal cancers who present with post–radiation therapy dysphagia involving penetration-aspiration on thin liquids may benefit from slightly and mildly thick liquids without risk of worse residue.

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