{"title":"The neoadjuvant systemic treatment of early breast cancer: a narrative review","authors":"O. Globus, Inbal Greenhouse, T. Sella, E. Gal-Yam","doi":"10.21037/abs-21-109","DOIUrl":"https://doi.org/10.21037/abs-21-109","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":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42076972","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":"Can we avoid treatment in patients with low-risk ductal carcinoma in situ?","authors":"C. Fuentes-Sánchez, C. González-San Segundo","doi":"10.21037/abs-22-21","DOIUrl":"https://doi.org/10.21037/abs-22-21","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":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46259645","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":"Benign breast disease primer","authors":"K. Yao","doi":"10.21037/abs-21-86","DOIUrl":"https://doi.org/10.21037/abs-21-86","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":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45232131","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":"Current challenges in breast reconstruction","authors":"D. Nguyen","doi":"10.21037/abs-21-85","DOIUrl":"https://doi.org/10.21037/abs-21-85","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":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47122137","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}
Diana Carrau, Zoey Del Pinto, A. Carraher, M. Chetta
{"title":"Breast reinnervation—the next frontier in autologous breast reconstruction: a review of early results","authors":"Diana Carrau, Zoey Del Pinto, A. Carraher, M. Chetta","doi":"10.21037/abs-20-146","DOIUrl":"https://doi.org/10.21037/abs-20-146","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":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43118485","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":"A novel abdominal retractor for reconstructive breast surgery","authors":"Muhammad Umair Javed","doi":"10.21037/abs-21-69","DOIUrl":"https://doi.org/10.21037/abs-21-69","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":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68292619","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}
: Breast reconstruction after mastectomy is increasingly being performed for women diagnosed with breast cancer, as well as those with a genetic predisposition to developing breast cancer. Techniques include implant-based or autologous tissue reconstruction where the abdominal soft tissue is most commonly used. As more women seek to avoid the use of implants, minimize donor site morbidity, and desire a natural-appearing breast after reconstruction, an alternative to the standard approaches is needed. The omentum has historically been used as a pedicled flap for surgical defects or infection. It has been used for breast reconstruction, but primarily as a pedicled flap and for treatment of partial breast defects. To optimize the use of the omentum for breast reconstruction, a novel technique using an omental fat-augmented free flap (O-FAFF) has recently been reported. This approach allows 360 degrees of freedom in positioning the autologous tissue reconstruction while also increasing the volume of the autologous free flap using fat grafting. An acellular dermal matrix (ADM) mold is used to provide structure. The result is an augmented appearance that feels similar to biologic soft tissue. This review discusses the evolution of breast reconstruction using the omentum and the potential increasing role that the O-FAFF may have in breast reconstruction.
{"title":"Evolution in breast reconstruction using the omentum","authors":"I. Ma, Peter L. Deptula, D. Nguyen","doi":"10.21037/ABS-20-109","DOIUrl":"https://doi.org/10.21037/ABS-20-109","url":null,"abstract":": Breast reconstruction after mastectomy is increasingly being performed for women diagnosed with breast cancer, as well as those with a genetic predisposition to developing breast cancer. Techniques include implant-based or autologous tissue reconstruction where the abdominal soft tissue is most commonly used. As more women seek to avoid the use of implants, minimize donor site morbidity, and desire a natural-appearing breast after reconstruction, an alternative to the standard approaches is needed. The omentum has historically been used as a pedicled flap for surgical defects or infection. It has been used for breast reconstruction, but primarily as a pedicled flap and for treatment of partial breast defects. To optimize the use of the omentum for breast reconstruction, a novel technique using an omental fat-augmented free flap (O-FAFF) has recently been reported. This approach allows 360 degrees of freedom in positioning the autologous tissue reconstruction while also increasing the volume of the autologous free flap using fat grafting. An acellular dermal matrix (ADM) mold is used to provide structure. The result is an augmented appearance that feels similar to biologic soft tissue. This review discusses the evolution of breast reconstruction using the omentum and the potential increasing role that the O-FAFF may have in breast reconstruction.","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":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49328478","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}
A. Choubey, A. Parsikia, Christina Dubchuk, M. Castaldi, R. Latifi, Jorge Ortiz
Background: Breast carcinoma has the highest incidence of any cancer in adult females. The impact of a previous kidney transplant (KT) on breast cancer surgery outcomes has not been examined. We aim to evaluate the influence of a KT on the short-term outcomes of mastectomy or lumpectomy to inform future treatment decisions in this population. Methods: A retrospective cohort analysis was conducted using Nationwide Inpatient Sample (NIS) data between 2005 and 2014. Population included adult females with KT surgically treated for breast malignancy. Weighted multivariate regression models were employed to compare outcomes at transplant and nontransplant centers. Results: Three hundred and ninety-eight women met the inclusion criteria. KT recipients (KTR) had higher Elixhauser Comorbidity Index (ECI). We noted longer length of stay (P<0.001), higher expenditure (P=0.001), and complications (P<0.001). Specifically, rates of hematomas (P=0.041), acute renal failure (P<0.001), blood transfusion (P<0.001), fresh frozen plasma transfusion (P<0.001), cardiovascular (P<001), and other complications (P=0.012) were increased. There was no mortality in transplant recipients. Weighted multivariate analyses highlight that rates of complication (P=0.040), and length of stay (P<0.001) are lower at transplant centers (TCs). Conclusions: History of KT has a significant impact on the outcomes of mastectomy or lumpectomy. These patients suffer more post-operative adverse events. However, KTR experience superior outcomes at TCs.
{"title":"Renal transplant recipients suffer significantly more complications but not mortality after breast cancer surgery and benefit from treatment at transplant centers","authors":"A. Choubey, A. Parsikia, Christina Dubchuk, M. Castaldi, R. Latifi, Jorge Ortiz","doi":"10.21037/ABS-20-56","DOIUrl":"https://doi.org/10.21037/ABS-20-56","url":null,"abstract":"Background: Breast carcinoma has the highest incidence of any cancer in adult females. The impact of a previous kidney transplant (KT) on breast cancer surgery outcomes has not been examined. We aim to evaluate the influence of a KT on the short-term outcomes of mastectomy or lumpectomy to inform future treatment decisions in this population. Methods: A retrospective cohort analysis was conducted using Nationwide Inpatient Sample (NIS) data between 2005 and 2014. Population included adult females with KT surgically treated for breast malignancy. Weighted multivariate regression models were employed to compare outcomes at transplant and nontransplant centers. Results: Three hundred and ninety-eight women met the inclusion criteria. KT recipients (KTR) had higher Elixhauser Comorbidity Index (ECI). We noted longer length of stay (P<0.001), higher expenditure (P=0.001), and complications (P<0.001). Specifically, rates of hematomas (P=0.041), acute renal failure (P<0.001), blood transfusion (P<0.001), fresh frozen plasma transfusion (P<0.001), cardiovascular (P<001), and other complications (P=0.012) were increased. There was no mortality in transplant recipients. Weighted multivariate analyses highlight that rates of complication (P=0.040), and length of stay (P<0.001) are lower at transplant centers (TCs). Conclusions: History of KT has a significant impact on the outcomes of mastectomy or lumpectomy. These patients suffer more post-operative adverse events. However, KTR experience superior outcomes at TCs.","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":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42223717","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}
Background: Tamoxifen is a selective oestrogen receptor modulator that is used in the treatment of hormone receptor positive breast cancer. It has been shown to significantly reduce the risk of breast cancer recurrence and has been shown to improve breast cancer survival. It is however associated with an increased risk of thromboembolic events, with an increased risk in patients undergoing free flap breast reconstruction due to the prolonged period of immobility. As tamoxifen has implications for macrovascular thrombosis, this study aimed to assess if it has implications for microvascular thrombosis. Methods: A systematic review and meta-analysis was performed on all published data assessing the impact of tamoxifen on microvascular complications. Relative risk was calculated using the Mantel-Haenszel statistical methodology. Primary outcomes were arterial and venous complications and partial and total flap failure. Secondary outcomes were the incidence of deep vein thrombosis (DVT) and pulmonary embolism. Results: Five studies were identified for inclusion, comprising 2,528 patients. There was an increased rate of flap failure (2.8% vs. 1.55%) in those taking tamoxifen, however there was no statistically significant increase in risk (P=0.2). There was a slightly increased rate of post-operative pulmonary embolism in those taking tamoxifen (0.56% vs. 0.26%), but again this was not statistically significant (P=0.43). Conclusions: The use of tamoxifen in the perioperative period may have implications on the success of free flap breast reconstruction, as well as systemic implications for the patient. We recommend that tamoxifen be held for four weeks preoperatively until two weeks postoperatively to minimise the risk.
{"title":"Tamoxifen use in microvascular breast reconstruction & its effect on microvascular complications: a systematic review & meta-analysis","authors":"S. Beecher, J. Woods","doi":"10.21037/ABS-20-57","DOIUrl":"https://doi.org/10.21037/ABS-20-57","url":null,"abstract":"Background: Tamoxifen is a selective oestrogen receptor modulator that is used in the treatment of hormone receptor positive breast cancer. It has been shown to significantly reduce the risk of breast cancer recurrence and has been shown to improve breast cancer survival. It is however associated with an increased risk of thromboembolic events, with an increased risk in patients undergoing free flap breast reconstruction due to the prolonged period of immobility. As tamoxifen has implications for macrovascular thrombosis, this study aimed to assess if it has implications for microvascular thrombosis. Methods: A systematic review and meta-analysis was performed on all published data assessing the impact of tamoxifen on microvascular complications. Relative risk was calculated using the Mantel-Haenszel statistical methodology. Primary outcomes were arterial and venous complications and partial and total flap failure. Secondary outcomes were the incidence of deep vein thrombosis (DVT) and pulmonary embolism. Results: Five studies were identified for inclusion, comprising 2,528 patients. There was an increased rate of flap failure (2.8% vs. 1.55%) in those taking tamoxifen, however there was no statistically significant increase in risk (P=0.2). There was a slightly increased rate of post-operative pulmonary embolism in those taking tamoxifen (0.56% vs. 0.26%), but again this was not statistically significant (P=0.43). Conclusions: The use of tamoxifen in the perioperative period may have implications on the success of free flap breast reconstruction, as well as systemic implications for the patient. We recommend that tamoxifen be held for four weeks preoperatively until two weeks postoperatively to minimise the risk.","PeriodicalId":72212,"journal":{"name":"Annals of breast surgery : an open access journal to bridge breast surgeons across the world","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41305163","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. Abou-Jaoude, John M. Edwards, S. Yackzan, Stacy R Stanifer, M. Monroe, Stace Dollar, B. Self, H. Shearin, T. J. Young
Baptist Health Lexington, Lexington, KY, USA Contributions: (I) Conception and design: W Abou-Jaoude, JM Edwards 3rd, SD Dollar, S Stanifer, SG Yackzan, TJ Young, H Shearin; (II) Administrative support: W Abou-Jaoude, JM Edwards 3rd, SD Dollar, S Stanifer, SG Yackzan, M Monroe; (III) Provision of study materials or patients: W Abou-Jaoude, S Stanifer, SG Yackzan; (IV) Collection and assembly of data: W Abou-Jaoude, S Stanifer, SG Yackzan, B Self; (V) Data analysis and interpretation: W Abou-Jaoude, JM Edwards 3rd, S Stanifer, SG Yackzan, M Monroe; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: John M. Edwards III, MS, CRNA. 1740 Nicholasville Rd. Lexington, KY 40503, USA. Email: John.Edwards@bhsi.com.
{"title":"Reduction in opioid consumption, pain, and antiemetic use following use of an enhanced recovery after surgery protocol for breast cancer patients undergoing mastectomy","authors":"W. Abou-Jaoude, John M. Edwards, S. Yackzan, Stacy R Stanifer, M. Monroe, Stace Dollar, B. Self, H. Shearin, T. J. Young","doi":"10.21037/ABS-20-118","DOIUrl":"https://doi.org/10.21037/ABS-20-118","url":null,"abstract":"Baptist Health Lexington, Lexington, KY, USA Contributions: (I) Conception and design: W Abou-Jaoude, JM Edwards 3rd, SD Dollar, S Stanifer, SG Yackzan, TJ Young, H Shearin; (II) Administrative support: W Abou-Jaoude, JM Edwards 3rd, SD Dollar, S Stanifer, SG Yackzan, M Monroe; (III) Provision of study materials or patients: W Abou-Jaoude, S Stanifer, SG Yackzan; (IV) Collection and assembly of data: W Abou-Jaoude, S Stanifer, SG Yackzan, B Self; (V) Data analysis and interpretation: W Abou-Jaoude, JM Edwards 3rd, S Stanifer, SG Yackzan, M Monroe; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: John M. Edwards III, MS, CRNA. 1740 Nicholasville Rd. Lexington, KY 40503, USA. Email: John.Edwards@bhsi.com.","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":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42223418","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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