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Pesquisa : E04.466.823 [Categoria DeCS]
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[PMID]:28744750
[Au] Autor:Grobmyer SR; Djohan R
[Ad] Endereço:Cleveland Clinic, Cleveland, OH, USA. grobmys@ccf.org.
[Ti] Título:Comments on "Primary tumor location predicts the site of local relapse after nipple-areola complex (NAC) sparing mastectomy" by Cont et al. Breast Cancer Res Treat, 2017.
[So] Source:Breast Cancer Res Treat;166(1):323-324, 2017 11.
[Is] ISSN:1573-7217
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias da Mama
Mamilos
[Mh] Termos MeSH secundário: Seres Humanos
Mamoplastia
Mastectomia
Mastectomia Subcutânea
Recidiva Local de Neoplasia
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s10549-017-4409-z


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[PMID]:29064921
[Au] Autor:Colwell AS; Christensen JM
[Ad] Endereço:Boston, Mass. From the Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School.
[Ti] Título:Nipple-Sparing Mastectomy and Direct-to-Implant Breast Reconstruction.
[So] Source:Plast Reconstr Surg;140(5S Advances in Breast Reconstruction):44S-50S, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Breast reconstruction following mastectomy has evolved to preserve the native skin and nipple of the breast and create a natural-appearing reconstruction in 1 or 2 surgeries. Nipple-sparing procedures appear to be oncologically safe with low risks of cancer recurrence. In our series of 2,182 nipple-sparing mastectomies, there was no development or recurrence of cancer in the nipple. Direct-to-implant single-stage surgery offers the patient a complete reconstruction at the time of mastectomy. Patient selection centers on preoperative breast anatomy combined with postoperative goals for size and uplift of the breast. The best candidates for nipple-sparing mastectomy and direct-to-implant breast reconstruction include those with grade I-II breast ptosis and those desiring to stay approximately the same breast size. The choice of incision and width of the implant play key roles in nipple centralization. Partial muscle coverage with acellular dermal matrix remains the most common technique to support the implant and offers the advantage of more soft-tissue coverage in the upper pole. With experience, complications and revisions are similar in this approach compared with more traditional 2-stage tissue expander-implant reconstruction. Thus, nipple-sparing mastectomy and direct-to-implant breast reconstruction is emerging as a preferred method of breast reconstruction when the breast skin envelope is sufficiently perfused.
[Mh] Termos MeSH primário: Neoplasias da Mama/cirurgia
Mamoplastia/métodos
Mastectomia Subcutânea/métodos
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Manejo da Dor/métodos
Seleção de Pacientes
Cuidados Pós-Operatórios/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003949


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[PMID]:28841601
[Au] Autor:Gunnarsson GL; Bille C; Reitsma LC; Wamberg P; Thomsen JB
[Ad] Endereço:Skien, Norway; and Odense/Vejle, Denmark From the Department of Plastic Surgery, Telemark Hospital; the Department of Plastic Surgery, Odense University Hospital; and the Section for Breast Surgery, Department of Surgery, Vejle Lillebaelt Hospital.
[Ti] Título:Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?
[So] Source:Plast Reconstr Surg;140(3):449-454, 2017 Sep.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. METHODS: Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. RESULTS: Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. CONCLUSIONS: The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
[Mh] Termos MeSH primário: Doenças Mamárias/cirurgia
Neoplasias da Mama/prevenção & controle
Mastectomia Subcutânea/métodos
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Adulto
Mama/anormalidades
Mama/cirurgia
Feminino
Seres Humanos
Hipertrofia/cirurgia
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003621


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[PMID]:28841598
[Au] Autor:Gabriel A; Maxwell GP
[Ad] Endereço:Loma Linda, Calif.; and Vancouver, Wash. From the Department of Plastic Surgery, Loma Linda University Medical Center; and PeaceHealth Plastic Surgery.
[Ti] Título:Discussion: Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy.
[So] Source:Plast Reconstr Surg;140(3):444-446, 2017 09.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Mastectomia Subcutânea
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Neoplasias da Mama/cirurgia
Seres Humanos
Mamoplastia
Mastectomia
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003684


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[PMID]:28728962
[Au] Autor:Smith BL; Tang R; Rai U; Plichta JK; Colwell AS; Gadd MA; Specht MC; Austen WG; Coopey SB
[Ad] Endereço:Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA. Electronic address: blsmith1@mgh.harvard.edu.
[Ti] Título:Oncologic Safety of Nipple-Sparing Mastectomy in Women with Breast Cancer.
[So] Source:J Am Coll Surg;225(3):361-365, 2017 Sep.
[Is] ISSN:1879-1190
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nipple-sparing mastectomy (NSM) has gained popularity for breast cancer treatment and prevention. There are limited data about long-term oncologic safety of this procedure. STUDY DESIGN: We reviewed oncologic outcomes of consecutive therapeutic NSM at a single institution. Nipple-sparing mastectomy was offered to patients with no radiologic or clinical evidence of nipple involvement. RESULTS: There were 2,182 NSM performed from 2007 to 2016. Long-term outcomes were assessed in the 311 NSM performed in 2007 to 2012 for Stages 0 to 3 breast cancer; 240 (77%) NSM were for invasive cancer and 71 (23%) were for ductal carcinoma in situ. At 51 months median follow-up, 17 patients developed a recurrence of their cancer. Estimated disease-free survival was 95.7% at 3 years and 92.3% at 5 years. There were 11 (3.7%) locoregional recurrences and 8 (2.7%) distant recurrences; 2 patients had simultaneous locoregional and distant recurrences. There were 2 breast cancer-related deaths in patients with isolated distant recurrences. No patient in the entire 2,182 NSM cohort has had a recurrence in the retained nipple-areola complex. CONCLUSIONS: Rates of locoregional and distant recurrence are acceptably low after nipple-sparing mastectomy in patients with breast cancer. No patient in our series has had a recurrence involving the retained nipple areola complex.
[Mh] Termos MeSH primário: Neoplasias da Mama/cirurgia
Carcinoma Ductal de Mama/cirurgia
Carcinoma Intraductal não Infiltrante/cirurgia
Mastectomia Subcutânea
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/mortalidade
Carcinoma Ductal de Mama/mortalidade
Carcinoma Intraductal não Infiltrante/mortalidade
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia/epidemiologia
Estudos Retrospectivos
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE


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[PMID]:28654583
[Au] Autor:Dent BL; Miller JA; Eden DJ; Swistel A; Talmor M
[Ad] Endereço:New York, N.Y. From the Divisions of Plastic Surgery and Breast Surgery, Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine.
[Ti] Título:Tumor-to-Nipple Distance as a Predictor of Nipple Involvement: Expanding the Inclusion Criteria for Nipple-Sparing Mastectomy.
[So] Source:Plast Reconstr Surg;140(1):1e-8e, 2017 Jul.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A tumor-to-nipple distance of greater than 2 cm has traditionally been considered a criterion for nipple-sparing mastectomy. This study evaluates whether magnetic resonance imaging and sonographic measurements of tumor-to-nipple distance accurately reflect the risk of nipple involvement by disease. METHODS: All nipple-sparing mastectomy cases with implant-based reconstruction performed by the senior author between July 2006 and December 2014 were retrospectively reviewed. Therapeutic cases with preoperative magnetic resonance imaging or sonography were included. RESULTS: One hundred ninety-five cases were included. Preoperative imaging consisted of sonography (n = 169), magnetic resonance imaging (n = 152), or both (n = 126). With sonography, nipple involvement did not differ between nipple-sparing mastectomy candidates and noncandidates using a tumor-to-nipple distance cutoff of 2 cm (10.7 percent versus 10.6 percent; p = 0.988) or 1 cm (9.3 percent versus 15.0 percent; p = 0.307). With magnetic resonance imaging, nipple involvement did not differ between candidates and noncandidates using a cutoff of 2 cm (11.6 percent versus 12.5 percent; p = 0.881) or 1 cm (11.4 percent versus 13.8 percent; p = 0.718). When sonography and magnetic resonance imaging findings were both available and concordant, nipple involvement still did not differ between candidates and noncandidates using a cutoff of 2 cm (8.8 percent versus 11.8 percent; p = 0.711) or 1 cm (7.6 percent versus 14.3 percent; p = 0.535). CONCLUSION: A tumor-to-nipple distance as small as 1 cm, as measured by sonography or magnetic resonance imaging, should not be considered a contraindication to nipple-sparing mastectomy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
[Mh] Termos MeSH primário: Neoplasias da Mama/patologia
Neoplasias da Mama/cirurgia
Mastectomia Subcutânea
Mamilos/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/diagnóstico por imagem
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Meia-Idade
Invasividade Neoplásica
Mamilos/diagnóstico por imagem
Tratamentos com Preservação do Órgão
Prognóstico
Estudos Retrospectivos
Ultrassonografia Mamária
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003414


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[PMID]:28582336
[Au] Autor:Altundag K
[Ad] Endereço:MKA Breast Cancer Clinic, Tepe Prime, Cankaya, 06800 Ankara, Turkey, altundag66@yahoo.com.
[Ti] Título:Breast Cancer Molecular Subtypes and Chemotherapy Schedules Used in Neoadjuvant or Adjuvant Setting May Show Different Effects in Nipple-Sparing Mastectomy.
[So] Source:Plast Reconstr Surg;140(3):495e, 2017 09.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Terapia Neoadjuvante
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Neoplasias da Mama
Quimioterapia Adjuvante
Seres Humanos
Mamoplastia
Mastectomia
Mastectomia Subcutânea
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003609


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[PMID]:28582332
[Au] Autor:Frey JD; Choi M; Karp NS
[Ad] Endereço:Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, N.Y.
[Ti] Título:Reply: The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after Nipple-Sparing Mastectomy.
[So] Source:Plast Reconstr Surg;140(3):495e-496e, 2017 09.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Terapia Neoadjuvante
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Neoplasias da Mama
Quimioterapia Adjuvante
Seres Humanos
Mamoplastia
Mastectomia
Mastectomia Subcutânea
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003610


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[PMID]:28574950
[Au] Autor:Sbitany H; Piper M; Lentz R
[Ad] Endereço:San Francisco, Calif. From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco.
[Ti] Título:Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy.
[So] Source:Plast Reconstr Surg;140(3):432-443, 2017 Sep.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage. METHODS: A single surgeon's experience with immediate prosthetic reconstruction following nipple-sparing mastectomy from 2012 to 2016 was reviewed. Patient demographics, adjuvant treatment, length and characteristics of the expansion, and incidence of complications during the tissue expander stage were compared between the partial submuscular/partial acellular dermal matrix (dual-plane) cohort and the prepectoral cohort. RESULTS: Fifty-one patients (84 breasts) underwent immediate prepectoral tissue expander placement, compared with 115 patients (186 breasts) undergoing immediate partial submuscular expander placement. The groups had similar comorbidities and postoperative radiation exposure. There was no significant difference in overall complication rate between the two groups (17.9 percent versus 18.8 percent; p = 0.49). CONCLUSIONS: Prepectoral breast reconstruction provides a safe and effective alternative to partial submuscular reconstruction, that yields comparable aesthetic results with less operative morbidity. In the authors' experience, the incidence of acute and chronic postoperative pain and animation deformity is significantly lower following prepectoral breast reconstruction. This technique is now considered for all patients who are safe oncologic candidates and are undergoing nipple-sparing mastectomy and prosthetic reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
[Mh] Termos MeSH primário: Mamoplastia/métodos
Mastectomia Subcutânea
Mamilos
Tratamentos com Preservação do Órgão
Expansão de Tecido/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/cirurgia
Feminino
Seres Humanos
Meia-Idade
Complicações Pós-Operatórias
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003627


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[PMID]:28538559
[Au] Autor:Knox ADC; Ho AL; Leung L; Hynes S; Tashakkor AY; Park YS; Macadam SA; Bowman CC
[Ad] Endereço:Vancouver, British Columbia, Canada; and Chicago, Ill. From the Division of Plastic Surgery and the Department of Internal Medicine, Faculty of Medicine, University of British Columbia; Vancouver General Hospital; and the Department of Medical Education, University of Illinois at Chicago.
[Ti] Título:A Review of 101 Consecutive Subcutaneous Mastectomies and Male Chest Contouring Using the Concentric Circular and Free Nipple Graft Techniques in Female-to-Male Transgender Patients.
[So] Source:Plast Reconstr Surg;139(6):1260e-1272e, 2017 Jun.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many techniques exist for subcutaneous mastectomy in female-to-male transgender patients. The authors review outcomes for two techniques and present an algorithm to aid surgeons in technique selection. METHODS: One hundred one consecutive female-to-male transgender patients undergoing subcutaneous mastectomy using the concentric circular or free nipple graft technique were retrospectively reviewed. An algorithm for procedure selection was created using classification and regression tree analysis. Aesthetic results (nipple-areola complex, scar, and chest contour) were also independently reviewed. RESULTS: Two hundred two subcutaneous mastectomies were performed (concentric circular, 92 breasts; free nipple graft, 110 breasts). The overall complication rate was 21.3 percent, with 6.4 percent requiring operative intervention (free nipple graft, 1 percent; concentric circular, 13 percent; p < 0.001). The overall revision rate was 23.8 percent (free nipple graft, 12.7 percent; concentric circular, 37.0 percent; p < 0.001). In the concentric circular group, there were 3.3 times the odds of total complications (p = 0.03) and 4.0 times the odds of revision surgery (p < 0.001). Mean aesthetic scores for the concentric circular technique were superior to free nipple graft for scar (3.39 versus 2.62; p < 0.001) and contour (3.82 versus 3.34; p < 0.001). CONCLUSIONS: In patients who meet selection criteria, the concentric circular technique is preferred because of fewer scars, improved aesthetic contour, and potential for retained nipple sensation. These patients must be counseled regarding the higher rate of complications and revisions. It was determined that smokers and those with a nipple-to-inframammary fold distance greater than 7 cm or nipple-to-inframammary fold distance less than 7 cm and a body mass index greater than 27 kg/m should undergo the free nipple graft technique because of the increased risk of complications with the concentric circular technique. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
[Mh] Termos MeSH primário: Mastectomia Subcutânea/métodos
Satisfação do Paciente/estatística & dados numéricos
Transplante de Pele/métodos
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Bases de Dados Factuais
Estética
Feminino
Seguimentos
Seres Humanos
Masculino
Mastectomia Subcutânea/efeitos adversos
Meia-Idade
Mamilos/cirurgia
Complicações Pós-Operatórias/cirurgia
Reoperação/métodos
Estudos Retrospectivos
Medição de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003388



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