Pub Date : 2024-06-30Epub Date: 2023-11-10DOI: 10.21037/abs-23-33
Nikita Roy, Margaret H Downes, Taylor Ibelli, Uchechukwu O Amakiri, Troy Li, Sameer Saleem Tebha, Tara M Balija, Julie B Schnur, Guy H Montgomery, Peter W Henderson
Background: While it is often presumed that undergoing breast reconstruction (BR) after mastectomy has positive psychosocial effects, a comprehensive review of current knowledge on the topic is to date absent. The aim of this systematic review is to summarize the available literature on the effects of BR on postoperative psychological distress.
Methods: A systematic review of the literature was performed using PubMed, Google Scholar, EMBASE, PSYCinfo, and Web of Science. Inclusion criteria included clinical studies of patients who underwent BR post-mastectomy with psychological distress assessments as primary outcomes. Articles were independently reviewed and assessed for bias and evidence quality. Analyses were performed among patients receiving mastectomy alone (MA) versus mastectomy with breast reconstruction (MBR), immediate versus delayed mastectomy, and implant-based versus autologous reconstruction.
Results: Ninety-nine studies published from 1980-2021 met inclusion criteria and were reviewed. Twenty-six (26.3%) studies compared patients who underwent MBR to those who underwent MA. Of these, 18 (69.2%) found that MBR had superior effects on psychologic outcomes, 6 (23.1%) found no differences, and 2 (7.7%) found negative psychologic effects relative to MA. Fourteen (14.1%) studies compared immediate versus delayed BR, of which 4 (28.6%) found that immediate BR had superior psychologic outcomes while 10 (71.4%) found no significant differences. Sixteen (16.2%) studies compared autologous versus implant-based reconstruction. Eight (50.0%) of these reported patients with autologous BR were more satisfied with breast appearance.
Conclusions: While findings are not uniform, the majority of studies found that BR following mastectomy improves psychologic outcomes, with a possible benefit of immediate over delayed BR. Future studies should determine if BR type has an effect on psychological distress.
{"title":"The psychological impacts of post-mastectomy breast reconstruction: a systematic review.","authors":"Nikita Roy, Margaret H Downes, Taylor Ibelli, Uchechukwu O Amakiri, Troy Li, Sameer Saleem Tebha, Tara M Balija, Julie B Schnur, Guy H Montgomery, Peter W Henderson","doi":"10.21037/abs-23-33","DOIUrl":"10.21037/abs-23-33","url":null,"abstract":"<p><strong>Background: </strong>While it is often presumed that undergoing breast reconstruction (BR) after mastectomy has positive psychosocial effects, a comprehensive review of current knowledge on the topic is to date absent. The aim of this systematic review is to summarize the available literature on the effects of BR on postoperative psychological distress.</p><p><strong>Methods: </strong>A systematic review of the literature was performed using PubMed, Google Scholar, EMBASE, PSYCinfo, and Web of Science. Inclusion criteria included clinical studies of patients who underwent BR post-mastectomy with psychological distress assessments as primary outcomes. Articles were independently reviewed and assessed for bias and evidence quality. Analyses were performed among patients receiving mastectomy alone (MA) versus mastectomy with breast reconstruction (MBR), immediate versus delayed mastectomy, and implant-based versus autologous reconstruction.</p><p><strong>Results: </strong>Ninety-nine studies published from 1980-2021 met inclusion criteria and were reviewed. Twenty-six (26.3%) studies compared patients who underwent MBR to those who underwent MA. Of these, 18 (69.2%) found that MBR had superior effects on psychologic outcomes, 6 (23.1%) found no differences, and 2 (7.7%) found negative psychologic effects relative to MA. Fourteen (14.1%) studies compared immediate versus delayed BR, of which 4 (28.6%) found that immediate BR had superior psychologic outcomes while 10 (71.4%) found no significant differences. Sixteen (16.2%) studies compared autologous versus implant-based reconstruction. Eight (50.0%) of these reported patients with autologous BR were more satisfied with breast appearance.</p><p><strong>Conclusions: </strong>While findings are not uniform, the majority of studies found that BR following mastectomy improves psychologic outcomes, with a possible benefit of immediate over delayed BR. Future studies should determine if BR type has an effect on psychological distress.</p>","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"8 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Lymphedema is a progressive disease caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within soft tissues. The most common cause for secondary lymphedema in the developed world is treatment for breast cancer. In the past, almost a forgotten disease, frequently overlooked, nowadays we can provide patients with treatment and relief. We discuss the current approach to lymphedema treatment for the breast cancer patient from clinical diagnosis through different imaging modalities with their advantages and disadvantages. Possible conservative and operational treatments aimed to restore lymphatic function and reduce adipose hypertrophy are described. From reductive techniques such as resection or liposuction to physiologic techniques involving reconstructive microsurgery such as lymphatico-venous anastomosis (LVA), vascularized lymph node transfer (VLNT) and other lymphatic free flaps. A review of our constructed approach and guidelines for managing secondary lymphedema in the breast cancer patient from 2005 to present days is presented. It is based on our growing experience and evolving techniques. Management of lymphedema in the breast cancer patient is multi-disciplinary and involves both the general and plastic surgeons, oncologists, physical therapists, social workers and many more. A holistic approach to the patient is advocated. This is best performed by adjusting and tailoring the appropriate treatment for each patient.
{"title":"Current concepts of lymphedema treatment for the breast cancer patient: a clinical practice review","authors":"Tal Tobias, Assaf A. Zeltzer","doi":"10.21037/abs-21-154","DOIUrl":"https://doi.org/10.21037/abs-21-154","url":null,"abstract":"Abstract: Lymphedema is a progressive disease caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within soft tissues. The most common cause for secondary lymphedema in the developed world is treatment for breast cancer. In the past, almost a forgotten disease, frequently overlooked, nowadays we can provide patients with treatment and relief. We discuss the current approach to lymphedema treatment for the breast cancer patient from clinical diagnosis through different imaging modalities with their advantages and disadvantages. Possible conservative and operational treatments aimed to restore lymphatic function and reduce adipose hypertrophy are described. From reductive techniques such as resection or liposuction to physiologic techniques involving reconstructive microsurgery such as lymphatico-venous anastomosis (LVA), vascularized lymph node transfer (VLNT) and other lymphatic free flaps. A review of our constructed approach and guidelines for managing secondary lymphedema in the breast cancer patient from 2005 to present days is presented. It is based on our growing experience and evolving techniques. Management of lymphedema in the breast cancer patient is multi-disciplinary and involves both the general and plastic surgeons, oncologists, physical therapists, social workers and many more. A holistic approach to the patient is advocated. This is best performed by adjusting and tailoring the appropriate treatment for each patient.","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"756 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135907513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillaume Labilloy, B. Jasra, J. Widrich, Lauren Edgar, C. Smotherman, L. Neumayer, Brian G. Celso
{"title":"Machine learning determined risk factors associated with non-adherence to timely surgery for breast cancer patients","authors":"Guillaume Labilloy, B. Jasra, J. Widrich, Lauren Edgar, C. Smotherman, L. Neumayer, Brian G. Celso","doi":"10.21037/abs-22-31","DOIUrl":"https://doi.org/10.21037/abs-22-31","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46964023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Taher, Muhammad Nadeem, N. Velotti, M. Nava, S. Hamilton
{"title":"The impact of radiotherapy in pre-pectoral implant-based breast reconstruction: a narrative review","authors":"W. Taher, Muhammad Nadeem, N. Velotti, M. Nava, S. Hamilton","doi":"10.21037/abs-21-132","DOIUrl":"https://doi.org/10.21037/abs-21-132","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"182 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68292300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The pros and cons of breast screening in older women","authors":"A. Evans","doi":"10.21037/abs-21-114","DOIUrl":"https://doi.org/10.21037/abs-21-114","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45614447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1007/978-3-662-65952-6
Hisham Fansa
{"title":"Breast surgery","authors":"Hisham Fansa","doi":"10.1007/978-3-662-65952-6","DOIUrl":"https://doi.org/10.1007/978-3-662-65952-6","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88778752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Kondra, Eloise Stanton, Ara A Salibian, K. Patel
{"title":"Imaging in lymphedema management: a narrative review of preoperative assessment & surgical planning","authors":"K. Kondra, Eloise Stanton, Ara A Salibian, K. Patel","doi":"10.21037/abs-22-40","DOIUrl":"https://doi.org/10.21037/abs-22-40","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46542231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Idiopathic granulomatous mastitis","authors":"G. Xu, S. Limaye","doi":"10.21037/abs-22-57","DOIUrl":"https://doi.org/10.21037/abs-22-57","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41648455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Area deprivation, machine learning, and breast cancer surgery","authors":"Weichuan Dong, Shu Li","doi":"10.21037/abs-23-12","DOIUrl":"https://doi.org/10.21037/abs-23-12","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49129951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recent trends in nipple sparing mastectomy—a narrative review","authors":"C. Cheung, M. Co","doi":"10.21037/abs-21-45","DOIUrl":"https://doi.org/10.21037/abs-21-45","url":null,"abstract":"","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48273124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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