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PubMedDate not supplied

[Immediate use of an expander during mastectomy. Analysis of 120 cases].

This study analyses a series of 116 patients, in whom mastectomy was followed by immediate insertion of temporary tissue expander. The technique is safe, simple and quick. It carries an acceptably low complication rate. Moreover, it does not interfere with any other local or general adjuvant therapy, if needed. The advantages are rapid post operative healing and psychological recovery, creation of a favorable site for a better quality breast reconstruction. Later on, any procedure for the breast reconstruction can be used. We concluded, that this procedure may be recommended more often; 62% of cases of mastectomies in this series.

Adult↗
PubMed1994

[Patients acceptance of immediate breast reconstruction after subcutaneous mastectomy in breast disease].

Most profound emotional impact for the women with breast carcinoma is experienced as loss of femininity as a result of surgical mutilation. From this point of view, the recommendation for reconstructive surgery provide the amelioration to patient's anxiety. Two hundred women with breast carcinoma including huge nonepithelial malignant and/or benign tumors who adopted the breast reconstruction were treated during a 13-year period in 1982-1994 at NCCH. The breast reconstruction was mainly created by latissmus dorsi musculocutaneous (LDMC) flap in one sitting (modified mastectomy plus simultaneous reconstruction). Thirty patients treated with subcutaneous mastectomy (conserving the nipple-areolar complex) among them, were followed by deepithelialized LDMC flap without implant as the procedure of choice in early carcinoma located in lateral half at a distance of at least 4-5 cm from the areola and in huge benign tumors. Although one patient was dissatisfied with ischemia of LDMC flap, this approach was safe, simple, and possible to produce the patient's satisfaction. There was a positive effect on life style and on sexual, social or work relationships.

Adolescent↗
PubMed1995

Sexuality of women after mastectomy.

Changes in sexual functioning, attitudes and sexual behaviour in local women after mastectomy and conservative breast surgery for breast cancer were assessed in this study. Given the social bearing, only married women agreed to be entered into the study. The complexities of variables other than breast loss, contributing to sexual difficulties were recognized and assessed. Through questionnaires designed for local women, a significant proportion of mastectomy women were found to have disturbances in at least one area in their sexual functioning after surgery. A significant number experienced changes in their sexual habits as well.

Adult↗
PubMedDate not supplied

[Immediate reconstruction after radical mastectomy using Becker's prosthesis: long-term results].

The authors present their experience about 36 immediate breast reconstruction after radical mastectomy by Becker's prostheses, concerning early and delayed postoperative complications, cosmetic results and patients satisfaction. The indication to reconstruction has been proposed considering stage disease, breast features (volume, skin flaps, symmetry with the other breast). The postoperative mortality was none; overall incidence of early complications was 11% and in two cases has obliged to implant removal. Mean follow-up has been 31 months: a severe contracture (Baker IV) has been observed in 2 patients which obliged to implants removal 90% of the patients (20 cases) had no contracture (Baker I) whereas 2 patients presented a Baker II contracture. The majority of the patients declared their complete satisfaction. Finally the authors suggest an immediate breast reconstruction after radical mastectomy because this procedure has a low incidence of complications and contracture and it can be surely done by a general surgeon.

Breast↗
PubMed2002

Modified radical mastectomy with knife technique.

Infusion of the breast with a tumescent solution of dilute epinephrine hydrochloride in lactated Ringer solution in patients undergoing modified radical mastectomy allows the procedure to be performed rapidly with scalpel dissection and minimal blood loss. The classic technique of modified radical mastectomy with addition of the tumescent solution is described herein.

Blood Loss, Surgical↗
PubMed1978

Mastectomy as an adjunct to combination chemotherapy.

Three patients with metastatic breast carcinoma who had untreated locally advanced primary tumors were treated initially with combination chemotherapy followed by hygienic mastectomy. There was marked regression of the primary tumor in each case after chemotherapy, allowing for a technically simpler mastectomy without skin grafts. There were no serious postoperative complications, or delay in the resumption of systemic chemotherapy in any of them. The postoperative chemotherapy produced complete disappearance of the distant metastases and the patients remain clinically free of disease without local recurrence for 21, 10, and 7 months, respectively. One of these patients had inflammatory carcinoma and did well with this combined approach. These findings suggest a rationale for such an approach in patients with inflammatory carcinoma and may be applicable to patients with stage III breast cancer in whom the primary tumors are locally advanced and technically difficult to resect.

Adenocarcinoma↗
PubMed1982

Modified radical mastectomy with immediate breast reconstruction.

Surgery for breast cancer continues to evolve. Less radical procedures and increasing concern about appearance and rehabilitation are now the trend. Such considerations prompted a detailed anatomic study and review of the location and course of the medial and lateral pectoral nerves, the development of a technique for immediate reconstruction of the breast during modified radical mastectomy that protects the innervation of the pectoral muscles and incorporates them in the construction of a submuscular pocket to receive a silicone breast prosthesis, and the administration of low doses of heparin sodium to prevent necrosis of ischemic breast flaps. Fifty immediate reconstructions of the breast after modified radical mastectomy were performed in 48 women with carcinoma of the breast. We believe this procedure greatly enhances rehabilitation and quality of life without diminishing the ability to diagnose or treat recurrent disease.

Adult↗
PubMed1982

Radical mastectomy: thick vs thin skin flaps.

Radical mastectomy with wide skin excision, ultrathin skin flaps, and autogenous skin grafts was a selected treatment of 45 women with curable breast cancer. A similar group of 45 women were treated by radical mastectomy with less wide skin excision, primary wound closure, and without ultrathin skin flaps. The two patient series were comparable in clinical disease staging, age, axillary node metastases, and frequency of adjunctive chest-wall irradiation. Retrospective chart reviews of the two patient series and statistical analyses indicated that five-and ten-year survival and local recurrences were comparable, but wound complications, hospital stays, and subsequent lymphedema were significantly greater in the series with thinner skin flaps. We recommend that routine use of ultrathin flaps be abandoned for treatment of breast cancer.

Breast Neoplasms↗
PubMed1987

Does radical mastectomy still have a place in the treatment of primary operable breast cancer?

This study (Alabama Breast Cancer Project) reports the ten-year surgical results of a prospective randomized trial comparing Halsted radical mastectomy (RM) with modified radical mastectomy (MRM) for breast cancer. We entered 311 patients in the study between 1975 and 1978. Patients with histologically positive axillary lymph nodes were randomized after operation to receive melphalan or intermittent intravenous cyclophosphamide, methotrexate, and fluorouracil for one year. After a median follow-up of ten years, there was no significant difference in the survival of the two groups (RM, 71%; MRM, 64%). Local recurrence after RM was significantly lower than after MRM. A subset of patients with more advanced cancers (T3 and T2 with clinically positive axillary nodes) experienced significantly better survival at ten years following RM compared with MRM (59% vs 38%, respectively). These results indicate that overall survival is similar for patients treated by either RM or MRM. However, there is subset of patients with more advanced cancers whose ultimate survival can be favorably influenced by RM.

Breast Neoplasms↗
PubMed1989

Oncological aspects of immediate breast reconstruction following mastectomy for malignancy.

One hundred eighteen women treated with mastectomy and immediate breast reconstruction for carcinoma were evaluated for recurrence of disease and survival. Fourteen women (12%) suffered relapse of their cancer and 10 patients (9%) died of their disease during a median follow-up of 2.3 years. All seven local recurrences (6%) were detected at an early stage and treated without removal of the prosthesis. Recurrence of disease occurred more frequently in patients with involved axillary lymph nodes and larger tumors. Patient survival was adversely affected by nodal metastasis and the absence of tumor estrogen receptors. Adverse outcome in this series correlated to known prognostic factors for breast cancer. Disease-free and overall survivals were comparable with our previous experience with mastectomy alone for breast carcinoma. In the absence of any apparent negative impact on patient outcome, and because of the well-documented positive psychosocial benefit of immediate reconstruction, this procedure should be routinely offered to women with operable breast cancer.

Adult↗
PubMed1991

Local-regional breast cancer recurrence following mastectomy.

Local-regional recurrence patterns were investigated in 1392 patients with breast cancer. Primary treatment for all patients included a mastectomy. Nine hundred seventeen patients had negative nodes and did not receive systemic therapy. Four hundred seventy-five patients had node metastases and were randomized to receive different combinations of chemoendocrine therapy. Follow-up ranged between 5 and 16 years. Two hundred thirty (25.8%) node-negative patients have had recurrences, with the initial recurrence being local-regional in 9.2%. Two hundred forty-two (50.9%) node-positive patients have had recurrences, with the initial recurrence being local-regional in 17.1%. Larger tumors and more extensive node involvement were associated with more first local-regional recurrences. The relative percent of first local-regional recurrence among patients in whom cancer recurred was similar for node-negative and node-positive patients (35.4% and 33.5%, respectively). In 63.6% of patients in whom cancer recurred, first local-regional recurrence were distant. Larger tumors, more extensive node involvement, and a shorter disease-free interval after mastectomy were associated with more rapid appearance of distant recurrence among these patients.

Breast Neoplasms↗
PubMed1992

Cutaneous angiosarcoma of the breast after segmental mastectomy and radiation therapy.

Angiosarcoma of the breast is an uncommon entity, and the development of cutaneous angiosarcoma of the breast after segmental mastectomy and irradiation therapy is even less common. We report a case of cutaneous angiosarcoma that developed 4 1/2 years after segmental mastectomy (lumpectomy) with axillary dissection and irradiation therapy for infiltrating ductal carcinoma of the breast.

Aged↗
PubMed1975

Multicentric breast cancer. The incidence of new cancers in the homolateral breast after partial mastectomy.

Multicentric microfoci of cancer are often present in patients with cancer of the breast and affect the contralateral breast as well as the originally affected one. despite the high incidence of these microfoci of cancer, the appearance of new clinical cancers is rare. In a period of 610 patient-years of exposure after partial mastectomy for cancer, six new cancers appeared in the contralateral breast and four in the affected one. These findings suggest that after partial mastectomy the danger of the appearance of a new cancer in the affected breast is less than might have been anticipated.

Breast Neoplasms↗
PubMed1978

Lymphangioma circumscriptum following radical mastectomy and radiation therapy.

Lymphangioma circumscriptum, a rare long-term complication of chronic lymphedema, has been described only twice following radical mastectomy. The case discussed in this report developed 25 years after radical mastectomy and radiation therapy. Both this condition and lymphangiosarcoma, its malignant counterpart, may arise in lymphedematous extremities regardless of the etiology of the lymphatic obstruction.

Aged↗
PubMed1980

Pseudolymphoma of the breast. I. In a study of 8,654 consecutive tylectomies and mastectomies.

Pseudolymphoma is a benign pathological process that morphologically resembles malignant lymphoma. Its occurrence in the mammary tissue has been described but has not been well investigated. We conducted a prospective and retrospective study of 8,654 consecutive mastectomies and tylectomies of the breast and found only 9 cases (0.1%) of primary lymphoreticular lesions. Of these 9, 5 were pseudolymphomas; 3, histiocytic lymphomas; and 1, Hodgkin's disease. Clinically, pseudolymphoma of the breast was described as an enlarging mass giving a dull, aching sensation. A history of physical trauma to the affected area could be traced in 3 patients with certainty. The mean patient age of the entire series was 36 years. Grossly, the tumor was a solid, firm nodule without any evidence of fibrocystic disease. Microscopically, it showed a lymphoid infiltrate with a nodular pattern. Three of the 5 cases revealed distinct germinal centers. Atypical lymphoid cells were not observed in any of these cases. After local excision, no patients had recurrence over a period of two to eight years. In view of a history of trauma, accompany fat necrosis in some cases, IgG gammopathy, it is postulated that pseudolymphoma of the breast, probably akin to pseudolymphoma of the lung, may represent an overwhelming local response to an injury. This lesion, reactive in nature, should be differentiated from a malignant lymphoma so that patients are not subjected to unnecessary mastectomy, radiation, or chemotherapy.

Adult↗
PubMed1980

Alternatives in reconstructive surgery after mastectomy.

The modern era of breast reconstruction began about ten years ago. Today, reconstruction is possible for any woman who has had a mastectomy. The decision should be made only after discussion with both the woman's ablative surgeon and her plastic surgeon. Today there are a number of alternative methods to breast reconstruction. These include the following possibilities: immediate reconstruction, simple correction of a disturbing scar, reduction of a large remaining breast to simplify proper fitting of an external prosthesis, simple creation of a mound on the mastectomy side, insertion of a special prosthesis to fill in the subclavicular area, and reconstruction of the areolar nipple complex. Where more radical surgery has been done, the use of a myocutaneous flap, and in some special situations, reconstruction by means of microvascular anastomosis may be carried out. Some of these methods can be used in combination to fit the needs of the individual woman. It is the plastic surgeon's desire to help in the team approach in the treatment of breast cancer and by making suggestions to the ablative surgeon to make final reconstruction easier. Additional benefit might be the patients willingness to present herself earlier if she knows that in the long run reconstruction can be carried out.

Breast↗
PubMed1981

Findings from NSABP Protocol No. B-04: comparison of radical mastectomy with alternative treatments. II. The clinical and biologic significance of medial-central breast cancers.

Findings from 1665 women with primary breast cancer, treated at 34 NSABP institutions in Canada and the United States, have failed to demonstrate that patients with medial-central tumors had a greater probability of developing distant metastases or dying than did those with lateral tumors despite the greater incidence of internal mammary (IM) node involvement when tumors are medial-central in location. A comparison of patients with similar clinical nodal status and tumor location who were treated either by radical mastectomy (RM) or by total mastectomy plus radiation therapy (TM + RT) failed to indicate that radiation of IM nodes reduced the probability of distant treatment failure (TF) or mortality. When findings from patients having equivalent clinical nodal status and tumor location treated by TM alone or TM + RT were compared, it was found that the addition of RT failed to alter the probability of the occurrence of a distant TF or of death. This was despite the fact that in the nonradiated group two putative sources of further tumor spread, i.e., positive axillary and IM nodes, were left unremoved and untreated. The findings provide further insight into the biologic significance of the positive lymph node and confirm our prior contention that positive regional lymph nodes are indicators of a host-tumor relationship which permits the development of metastases and that they are not important investigators of distant disease.

Axilla↗
PubMed1982

Bimodal age-frequency distribution of epitheliosis in cancer mastectomies: relevance to preneoplasia.

A census of epitheliosis in 500 consecutive cancer mastectomies has been carried out. The probability of concurrence of this phenomenon with cancer has a bimodal age-frequency distribution. It is high in cancer mastectomies from women in their early 40s, low in the late 50s and high again in the elderly. Epitheliosis during the reproductive life span is regarded as a reversible ovary-dependent abnormality. It is greatly increased in the premenopausal cancerous breast and it is thought that it carries increased risk for cancer initiation. In contrast the probability of epitheliosis in the breast in the elderly cancer patient is only slightly greater than in "noncancerous" post mortem breasts of similar age. Much of this "epitheliosis" may represent, in fact, indolent autonomous cancer though a small proportion could be epitheliosis supported by extraovarian estrogen.

Adult↗