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[PMID]: 29505504 [Au] Autor: Bae HS; Lee MY; Park JU [Ad] Endereço: Department of Plastic and Reconstructive Surgery, Seoul National University Boramae Medical Center. [Ti] Título: Intraoperative burn from a grounding pad of electrosurgical device during breast surgery: A CARE-compliant case report. [So] Source: Medicine (Baltimore);97(1):e8370, 2018 Jan. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONAL: Burns at the site of the return electrode (i.e., grounding pad) are possible effects of electrosurgery. Despite this knowledge, however, ignorance or negligence with regards to proper handling of the grounding pads still often occurs. Burn injuries can be easily prevented by taking the necessary precautions; thus, during plastic surgery, careful attention should to be paid. PATIENT CONCERNS: A 38-year-old female patient was admitted to our ward to be performed augmentation mammoplasty. Before the start of the procedure, the grounding pad was placed on the surgical table and the left calf of the patient was placed on the grounding pad. Before using the endoscope, we found a burn on patient's left calf, where the grounding pad had been placed. DIAGNOSIS: It was a 3-cm-by-3-cm-sized full thickness burn. The surrounding areas had no painful sensation with noninfectious sign. INTERVENTION: Debridement and direct closure was performed with elliptical incision of eschar. OUTCOMES: The patient did not require additional surgical procedure anymore and satisfied with the scar. LESSONS: Through this case, we present the appropriate management of electrical burns from a grounding pad, and emphasize the understanding of the mechanism of burn because of electrosurgery, and how to use the grounding pad optimally to minimize the patient's risk. [Mh] Termos MeSH primário: Queimaduras/etiologia Eletrocirurgia/instrumentação Complicações Intraoperatórias/etiologia [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Mamoplastia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180306 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008370

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[PMID]: 28954300 [Au] Autor: Jagsi R; Momoh AO; Qi J; Hamill JB; Billig J; Kim HM; Pusic AL; Wilkins EG [Ad] Endereço: Department of Radiation Oncology, Section of Plastic Surgery, Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI; Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. [Ti] Título: Impact of Radiotherapy on Complications and Patient-Reported Outcomes After Breast Reconstruction. [So] Source: J Natl Cancer Inst;110(2), 2018 Feb 01. [Is] ISSN: 1460-2105 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Background: Patients considering postmastectomy radiation and reconstruction require information regarding expected outcomes to make preference-concordant decisions. Methods: A prospective multicenter cohort study of women diagnosed with breast cancer at 11 centers between 2012 and 2015 compared complications and patient-reported outcomes of 622 irradiated and 1625 unirradiated patients who received reconstruction. Patient characteristics and outcomes between irradiated and unirradiated patients were analyzed using ttests for continuous variables and chi-square tests for categorical variables. Multivariable mixed-effects regression modelsassessed the impact of reconstruction type and radiotherapy on outcomes after adjusting for relevant covariates. All statistical tests were two-sided. Results: Autologous reconstruction was more commonly received by irradiated patients (37.9% vs 25.0%, P < .001). Immediate reconstruction was less common in irradiated patients (83.0% vs 95.7%, P < .001). At least one breast complication had occurred by two years in 38.9% of irradiated patients with implant reconstruction, 25.6% of irradiated patients with autologous reconstruction, 21.8% of unirradiated patients with implant reconstruction, and 28.3% of unirradiated patients with autologous reconstruction. Multivariable analysis showed bilateral treatment and higher body mass index to be predictive of developing a complication, with a statistically significant interaction between radiotherapy receipt and reconstruction type. Among irradiated patients, autologous reconstruction was associated with a lower risk of complications than implant-based reconstruction at two years (odds ratio [OR] = 0.47, 95% confidence interval [CI] = 0.27 to 0.82, P = .007); no between-procedure difference was found in unirradiated patients. The interaction was also statistically significant for satisfaction with breasts at two years (P = .002), with larger adjusted difference in satisfaction between autologous vs implant approaches (63.5, 95% CI = 55.9 to 71.1, vs 47.7, 95% CI = 40.2 to 55.2, respectively) in irradiated patients than between autologous vs implant approaches (67.6, 95% CI = 60.3 to 74.9, vs 60.5, 95% CI = 53.6 to 67.4) in unirradiated patients. Conclusions: Autologous reconstruction appears to yield superior patient-reported satisfaction and lower risk of complications than implant-based approaches among patients receiving postmastectomy radiotherapy. [Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia Neoplasias da Mama/cirurgia Mamoplastia/efeitos adversos [Mh] Termos MeSH secundário: Adulto Estudos de Coortes Feminino Seres Humanos Mamoplastia/métodos Meia-Idade Satisfação do Paciente Complicações Pós-Operatórias/etiologia Estudos Prospectivos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170928 [St] Status: MEDLINE [do] DOI: 10.1093/jnci/djx148

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[PMID]: 29450505 [Au] Autor: Henneman JR [Ad] Endereço: Petrie Institute of Western American Art, Denver Art Museum, Denver, Colorado. [Ti] Título: In Shadow and Light-Images of Transformation Through Breast Cancer. [So] Source: JAMA;319(6):532-534, 2018 Feb 13. [Is] ISSN: 1538-3598 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Neoplasias da Mama Medicina nas Artes Fotografia [Mh] Termos MeSH secundário: Neoplasias da Mama/cirurgia Feminino Seres Humanos Mamoplastia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180217 [St] Status: MEDLINE [do] DOI: 10.1001/jama.2017.21752

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[PMID]: 29384865 [Au] Autor: Qin Q; Tan Q; Lian B; Mo Q; Huang Z; Wei C [Ad] Endereço: Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China. [Ti] Título: Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study. [So] Source: Medicine (Baltimore);97(5):e9766, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Breast reconstruction after mastectomy plays an active role in improving the quality-of-life (QoL) and alleviating the psychological trauma of breast cancer patients, and has become an indispensable part of the comprehensive treatment in breast cancer. However, compared with mastectomy alone, breast reconstruction also increase operative complications. The surgical, oncological outcomes, and cosmetic effect of breast reconstruction remains to be evaluated. Data for patients with breast cancer who underwent breast reconstruction after mastectomy from February 2009 to November 2015 in our hospital were retrospectively analyzed, with a median follow-up time of 44 months. The operating time, blood loss, drainage fluid, postoperative complications, postoperative cosmesis, oncological outcomes, and QoL were evaluated and compared between different reconstruction types. A total of 151 women were included. The flap-based group had higher complication rates of marginal necrosis of incision, while the incidence of capsular contracture was higher in immediate implant group. There was no difference in blood loss, drainage fluid, and other postoperative complications. Several independent factors were associated with increased postoperative complications included diabetic, obese, and reconstruction with flap. There was no significant difference in the disease-free survival rate and overall survival rate between different surgical groups. In terms of cosmetic effect, patients in the tissue expander group were more likely to get a satisfactory postoperative breast appearance. QoL outcomes shown that the tissue expander group has better body image and sexual enjoyment, while there was no significant difference for other QoL domains. In conclusion, different methods of breast reconstruction are safe and feasible for patients with breast cancer, tissue expander implantation following delayed implant breast reconstruction is a more effective treatment on cosmetic and QoL outcomes. [Mh] Termos MeSH primário: Neoplasias da Mama/cirurgia Mamoplastia Mastectomia [Mh] Termos MeSH secundário: Adulto Implantes de Mama Feminino Seres Humanos Meia-Idade Satisfação do Paciente Qualidade de Vida Estudos Retrospectivos Retalhos Cirúrgicos Dispositivos para Expansão de Tecidos Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180221 [Lr] Data última revisão: 180221 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009766

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[PMID]: 29280856 [Au] Autor: Scheflan M; Grinberg-Rashi H; Hod K [Ad] Endereço: Tel Aviv, Israel From private practice; MedTech Industries; and the Research Division, Epidemiological Service, Assuta Medical Center. [Ti] Título: Bovine Acellular Dermal Matrix in Immediate Breast Reconstruction: A Retrospective, Observational Study with SurgiMend. [So] Source: Plast Reconstr Surg;141(1):1e-10e, 2018 01. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Acellular dermal matrices can be combined with implant-based breast reconstruction to help optimize outcomes. SurgiMend PRS is a fetal bovine dermis-derived acellular dermal matrix composed of type I collagen and approximately 30 percent type III collagen, sharing many of the properties of human cadaveric acellular dermal matrix. METHODS: This was a retrospective, single-center analysis of 111 adult patients (147 breasts) undergoing one-stage (83.7 percent) or two-stage (16.3 percent) immediate breast reconstruction after mastectomy. The aims were to characterize the safety profile of SurgiMend and investigate associations between risk factors and complications. RESULTS: The mean age of the patients was 47.9 years and the mean body mass index was 24.7 kg/m. After a median follow-up of 24.3 months, the overall rates of minor and major complications were 25.2 percent (n = 37 of 147) and 12.9 percent (n = 19 of 147), respectively. The most common major complications were seroma [n = 12 (8.2 percent)] and necrosis [n = 9 (6.1 percent)]. All occurred within 3 months after surgery. The rate of capsular contracture was 2.7 percent (n = 4). A total of 2.7 percent of implanted breasts (n = 4) required explantation. In a univariate analysis, smokers had a greater risk of major complications (p = 0.013), and postoperative radiation therapy and obesity were associated with an increased risk of capsular contracture (p = 0.006) and explantation (p = 0.006), respectively. In a multivariate analysis, several factors were associated with complications or explantation, including obesity (p < 0.05), preoperative chemotherapy (p < 0.001), and mastectomy weight (p < 0.05). These associations align with other studies of implant-based reconstruction and do not appear to be specific to this acellular dermal matrix. CONCLUSION: The results are consistent with previous analyses of SurgiMend, and support its value in implant-based breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. [Mh] Termos MeSH primário: Derme Acelular Colágeno Mamoplastia/métodos [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Animais Bovinos Feminino Seguimentos Seres Humanos Modelos Logísticos Mastectomia Meia-Idade Avaliação de Resultados (Cuidados de Saúde) Complicações Pós-Operatórias/epidemiologia Complicações Pós-Operatórias/etiologia Estudos Retrospectivos Fatores de Risco Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Surgimend); 9007-34-5 (Collagen) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180112 [Lr] Data última revisão: 180112 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003982

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[PMID]: 29245322 [Au] Autor: Kim DY; Seol YM; Kim H; Kim A; Choi YJ [Ad] Endereço: aDepartment of Hematology-OncologybDepartment of Pathology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea. [Ti] Título: Primary rhabdomyosarcoma of the breast in a 17-year-old girl: Case report. [So] Source: Medicine (Baltimore);96(49):e9076, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Primary rhabdomyosarcoma of the breast is very rare disease with poor prognosis and no definitive treatment has yet been established. PATIENT CONCERNS: A 17-year-old girl presented with right breast mass without distant metastasis in image study. DIAGNOSIS: The result of core needle biopsy was intraductal carcinoma; however, histopathologic finding after mastectomy was primary rhabdomyosarcoma of breast. INTERVENTIONS: Adjuvant chemotherapy was recommended because resection margin was involved by tumor cells, but she did not visit the clinic anymore. Five months later, tumor recurred with local invasion and chemotherapy of vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide and etoposide (VAC/IE) was done. OUTCOMES: In the course of chemotherapy and sequential follow-up, there was no tumor growth until now. LESSONS: Primary breast rhabdomyosarcoma is an uncommon disease, as a result diagnosis is often delayed. For the same reason, there is little information about treatment. This report may be helpful for managing the disease. [Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem Neoplasias da Mama/patologia Rabdomiossarcoma/diagnóstico por imagem Rabdomiossarcoma/patologia [Mh] Termos MeSH secundário: Adolescente Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico Biópsia por Agulha Neoplasias da Mama/terapia Terapia Combinada Feminino Seres Humanos Mamoplastia Mastectomia Recidiva Local de Neoplasia/tratamento farmacológico Rabdomiossarcoma/terapia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180108 [Lr] Data última revisão: 180108 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171217 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009076

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[PMID]: 29210972 [Au] Autor: Steffen LE; Johnson A; Levine BJ; Mayer DK; Avis NE [Ad] Endereço: Laurie E. Steffen, PhD, is a post-doctoral fellow at Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Aimee Johnson, PhD, is Johnson is an Assistant Professor at Department of Health Sciences, James Madison University, Harrisonburg, VA. Beverly J. Levine, PhD, is a Biostatistician at Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Deborah K. Mayer, PhD, RN, AOCN, FAAN, is a Professor and Director of Cancer Survivorship at UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC. Nancy E. Avis, PhD, is a Professor at Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. [Ti] Título: Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors. [So] Source: Plast Surg Nurs;37(4):146-153, 2017 Oct/Dec. [Is] ISSN: 1550-1841 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The purpose of this study was to evaluate the prevalence of met and unmet expectations after breast reconstruction among breast cancer survivors following mastectomy. A secondary objective was to examine reasons women report their experiences of reconstructive surgery were better or worse than expected. As part of a larger study of breast cancer survivors, participants completed self-administered questionnaires within 8 months of diagnosis and at 6, 12, and 18 months later. At the 18-month follow-up, women who had breast reconstruction were asked whether their reconstruction was better, the same, or worse than expected. The sample consisted of 130 survivors (mean age = 48.5 years) who had breast reconstruction following mastectomy and completed the 18-month follow-up, 42% of whom reported their reconstruction was worse than expected and only 25% reported it was better. Most frequently reported reasons for reconstruction being worse than expected were related to appearance of the reconstructed breast and pain. A high percentage of patients with breast cancer undergoing breast reconstruction following mastectomy reported the results as worse than expected, with the primary reasons for dissatisfaction related to the feel and appearance of the reconstructed breast. Patients with breast cancer considering breast reconstruction need better preoperative education or understanding about what to expect from reconstruction. [Mh] Termos MeSH primário: Neoplasias da Mama/psicologia Neoplasias da Mama/cirurgia Sobreviventes de Câncer Mamoplastia/psicologia Satisfação do Paciente [Mh] Termos MeSH secundário: Adulto Beleza Feminino Seguimentos Seres Humanos Estudos Longitudinais Mamoplastia/efeitos adversos Mastectomia Meia-Idade Dor Aparência Física Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171218 [Lr] Data última revisão: 171218 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 171207 [St] Status: MEDLINE [do] DOI: 10.1097/PSN.0000000000000205

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[PMID]: 29176426 [Au] Autor: Serrurier LCJ; Rayne S; Venter M; Benn CA [Ad] Endereço: University of the Witwatersrand and, Milpark Breast Care Centre of Excellence, Johannesburg, South Africa. [Ti] Título: Reply: Direct-to-Implant Breast Reconstruction without the Use of an Acellular Dermal Matrix Is Cost Effective and Oncologically Safe. [So] Source: Plast Reconstr Surg;140(6):821e-822e, 2017 12. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Derme Acelular Mamoplastia [Mh] Termos MeSH secundário: Implante Mamário Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; COMMENT [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171218 [Lr] Data última revisão: 171218 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003896

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[PMID]: 29176425 [Au] Autor: Kamali P; Lee M; Lee BT [Ad] Endereço: Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. [Ti] Título: Reply: Medial Row Perforators Are Associated with Higher Rates of Fat Necrosis in Bilateral DIEP Flap Breast Reconstruction. [So] Source: Plast Reconstr Surg;140(6):819e-820e, 2017 12. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Necrose Gordurosa/cirurgia Mamoplastia [Mh] Termos MeSH secundário: Artérias Epigástricas/cirurgia Seres Humanos Retalhos Cirúrgicos/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE; COMMENT [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171218 [Lr] Data última revisão: 171218 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003835

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[PMID]: 29208440 [Au] Autor: Ho AY; Hu ZI; Mehrara BJ; Wilkins EG [Ad] Endereço: Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: alice.ho@cshs.org. [Ti] Título: Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. [So] Source: Lancet Oncol;18(12):e742-e753, 2017 Dec. [Is] ISSN: 1474-5488 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: As the use of breast reconstruction and postmastectomy radiotherapy (PMRT) has increased over the past decade, the typical approach to integrating radiotherapy with breast reconstruction has provoked intense controversy in the management of breast cancer. PMRT can lead to an increased frequency of complications in the reconstructed breast. Conversely, the reconstructed breast can increase the complexity of radiotherapy delivery. How to minimise the frequency of complications without compromising oncological or cosmetic outcomes of the reconstructed breast is an important shared multidisciplinary goal for oncologists and their patients. Several questions remain, however, regarding the type of reconstruction that should be used with PMRT, when reconstruction should be done relative to PMRT and whether radiotherapy treatment should be directed towards the tissue expander or the implant for women who opt for a two-stage expander-implant reconstruction. Following advances in the planning of radiotherapy treatment, new questions about the application of these technologies in the setting of breast reconstruction have arisen. In this Review, we address these questions by reviewing contemporary evidence on the optimal integration of radiotherapy and breast reconstruction in the management of breast cancer. [Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia Neoplasias da Mama/cirurgia Mamoplastia/métodos Radioterapia Adjuvante/efeitos adversos [Mh] Termos MeSH secundário: Adulto Implante Mamário/efeitos adversos Implante Mamário/métodos Implantes de Mama Feminino Sobrevivência de Enxerto Seres Humanos Mamoplastia/efeitos adversos Mastectomia/métodos Meia-Idade Complicações Pós-Operatórias/epidemiologia Complicações Pós-Operatórias/fisiopatologia Prognóstico Dose de Radiação Medição de Risco Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171215 [Lr] Data última revisão: 171215 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171207 [St] Status: MEDLINE

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