Breast Journal最新文献

{"title":"Targeted Treatment of Metastatic Triple-Negative Breast Cancer: A Systematic Review","authors":"Anna Martha Hammershøi Madsen,&nbsp;Rikke Helene Løvendahl Eefsen,&nbsp;Dorte Nielsen,&nbsp;Iben Kümler","doi":"10.1155/2024/9083055","DOIUrl":"https://doi.org/10.1155/2024/9083055","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Triple-negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has so far been the only approved treatment option, and patients with metastatic cancer have a dismal prognosis with a median overall survival (OS) of approximately 14 months. Identification of druggable targets for metastatic TNBC is therefore of special interest. <i>Methods</i>. A systematic search was performed, to review the existing evidence on targeted therapies in metastatic TNBC. <i>Results</i>. A total of 37 phase 2/3 studies were identified, evaluating 29 different targeted agents. In this review, results on progression free survival (PFS) and OS are presented. <i>Conclusion</i>. In most of the studies included, no improvement was observed for neither PFS nor OS; however, a few studies did show improvement with targeted agents and have led to new treatment options in subgroups of patients. The antibody drug conjugate, sacituzumab govitecan, demonstrated superior PFS and OS in comparison to chemotherapy. Immunotherapy with checkpoint inhibitors such as atezolizumab and pembrolizumab is now recommended as a first-line treatment option for patients with expression a PD-L1 positive tumor. Finally, the poly adenosine diphosphate-ribose polymerase (PARP) inhibitors talazoparib and olaparib are recommended, as first-line treatment options in patients with metastatic breast cancer and a germline BRCA mutation, but an immune checkpoint inhibitor should be considered for the subset of these patients who are PD-L1 positive.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9083055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141597120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upregulated SAE1 Drives Tumorigenesis and Is Associated with Poor Clinical Outcomes in Breast Cancer","authors":"Hong Liu,&nbsp;Jing Wang,&nbsp;Yunhai Li,&nbsp;Feng Luo,&nbsp;Lei Xing","doi":"10.1155/2024/2981722","DOIUrl":"https://doi.org/10.1155/2024/2981722","url":null,"abstract":"&lt;div&gt;\u0000 &lt;p&gt;&lt;i&gt;Background&lt;/i&gt;. The purpose of this study was to analyze SUMO activating enzyme subunit 1 (SAE1) expression in breast cancer (BC). Through bioinformatics analysis and in vitro experiments, the biological function and possibly associated signal pathways of SAE1 in BC were further analyzed. &lt;i&gt;Methods&lt;/i&gt;. Bioinformatics analysis was applied to analyze SAE1 expression in BC and normal breast tissues, its relationship with clinicopathologic characteristics and prognosis in BC patients, and data from the Cancer Genome Atlas database and Gene Expression Omnibus dataset. We performed immunohistochemistry to analyze SAE1 expression in BC tissues and para-cancer tissues in 79 breast cancer patients. BC cell proliferation was detected with the Cell Counting Kit-8 and by the colony formation assay. Cell cycle progression was analyzed by flow cytometry, and the expression of cell cycle-related proteins (E2F1, cyclin D3, and cyclin-dependent kinase 2) was determined by western blots in SAE1 small interfering RNA (siRNA) transfected cells. The GSE1456 dataset was used to analyze possible signal pathways associated with SAE1 by gene set enrichment analysis (GSEA), and the expression of PI3K/AKT/mTOR pathway-related proteins (such as p-PI3K, p-AKT, and mTOR) in SAE1-siRNA cells was detected by western blots. &lt;i&gt;Results&lt;/i&gt;. The bioinformatics and immunohistochemical results showed that SAE1 mRNA and protein expression in BC tissues were significantly higher than those in normal tissues. The SAE1 overexpression was significantly associated with the tumor size, tumor-node-metastasis stage, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and whether or not it was a triple-negative BC. Patients with SAE1 overexpression had a worse overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival compared with lower expression patients. Multivariate Cox regression analysis showed that SAE1 may be an independent prognostic factor for OS of BC patients. The proliferation and cell cycle process of BC cells were inhibited by SAE1-siRNA in vitro. The result of GSEA showed that SAE1 was significantly associated with 12 gene sets, including unfolded protein reaction, DNA repair, oxidative phosphorylation, and cell cycle, among others. Additionally, two signal pathways, mTORC1 and PI3K/Akt/mTOR, were significantly correlated with SAE1 overexpression. Western blots confirmed that the expression of PI3K/Akt/mTOR pathway-related proteins (p-PI3K, p-AKT, and mTOR) in BC cells was decreased after knocking down SAE1. &lt;i&gt;Conclusion&lt;/i&gt;. SAE1 was highly expressed in BC. Its overexpression was associated with poor BC prognosis. Additionally, it was an independent prognostic factor for BC patients. We demonstrated that in vitro SAE1 knockdown effectively inhibited BC proliferation and its cell cycle process. Furthermore, the biological function of SAE1 may be associated with the PI3K/Akt/mTOR pathwa","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2981722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of Unwarranted Variation and Disparity in Breast Cancer Management in Regional and Rural Area","authors":"Kimberley J. Davis,&nbsp;Chantal Campbell,&nbsp;Rebekah Costelloe,&nbsp;Ting Song,&nbsp;Glaucia Fylyk,&nbsp;Ping Yu,&nbsp;Steven J. Craig","doi":"10.1155/2024/9354395","DOIUrl":"https://doi.org/10.1155/2024/9354395","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Breast cancer management is complex, requiring personalised care from multidisciplinary teams. Research shows that there is unwarranted clinical variation in mastectomy rates between rural and metropolitan patients; that is, variation in treatment which cannot be explained by disease progression or medical necessity. This study aims to determine the clinical and nonclinical factors contributing to any unwarranted variation in breast cancer management in rural patients and to evaluate how these factors and variations relate to patient outcomes. <i>Methods</i>. Comprehensive data from patients who had primary breast cancer surgery from 2010 to 2014 in either a rural or metropolitan location in a single local health district was analysed (<i>n</i> = 686). Records were subset into two rurality groupings based on the postcode in which the patient resided, and the Modified Monash Model (MMM), an Australian system for classifying rurality. Statistical analysis was used to compare rural and metropolitan cohorts on treatments, patient characteristics, timeliness, and outcomes (recurrence and survival). <i>Results</i>. Rural patients had higher mastectomy rates than metropolitan patients (57% vs. 34%, <i>p</i> &lt; 0.001), despite a lack of difference in clinical or demographic factors accounting for such variation. The length of time between treatment pathway stages was consistently longer amongst rural patients (<i>p</i> &lt; 0.01). Rural women also had worse survival outcomes, especially amongst HER2-positive patients who had significantly lower survival (5-year 74% vs 82%; 10-year 49% vs 71%, <i>p</i> &lt; 0.05) than metropolitan HER2-positive patients. <i>Conclusion</i>. This study reveals clinical disparities among rural breast cancer patients, that cannot be explained by demographic and clinical factors alone. Rural patients face lower rates of breast-conserving surgery and treatment delays, attributable to systemic barriers such as limited access to specialist care, high travel costs, and suboptimal care coordination. These findings have important implications for improving equity and collaboration in delivering person-centred breast cancer care.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9354395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141430254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Optimize Deimplementation of Sentinel Lymph Node Biopsy?","authors":"Ida Dragvoll,&nbsp;Anna M. Bofin,&nbsp;Håvard Søiland,&nbsp;Monica Jernberg Engstrøm","doi":"10.1155/2024/7623194","DOIUrl":"10.1155/2024/7623194","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The omission of sentinel lymph node biopsy in low-risk elderly breast cancer patients has been introduced in several guidelines. Despite evidence to support its safety, this recommendation has not been implemented by many clinicians. We have examined two aspects of this recommendation that may explain why sentinel lymph node biopsy continues to be performed in most of these patients. Firstly, we quantified the proportion of patients diagnosed with axillary metastases postoperatively. Secondly, we examined adherence to antihormonal therapy in the same group of patients. <i>Methods</i>. In this single-centre retrospective cohort study, the study population comprised 98 patients with breast cancer. Patients were aged ≥70 years and diagnosed with hormone receptor positive breast cancers less than 20 mm (T1). All patients underwent surgery and were subsequently prescribed five years of adjuvant antihormonal treatment. <i>Results</i>. Axillary lymph node metastases, as confirmed by the postoperative histology report, were seen in 36.3%. Nonadherence was seen in 33.7% of the patients. Primary nonadherence, that is, patients that never collect their first or subsequent prescriptions at the pharmacy, comprised 11.2% of the total study population. <i>Conclusion</i>. The high proportion of axillary metastases demonstrated suggests that clinical examination of the axilla alone is not sufficient in the preoperative assessment of the axilla. The less-than-optimal adherence rates show that adherence in these patients cannot be taken for granted. We suggest that these factors reflect some of the reluctance among clinicians to omit the sentinel lymph node procedure in these patients.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7623194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141149925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening of Breast among Women: A Cross-Sectional Study in Nepal","authors":"Sangam Shah,&nbsp;Krishna Dahal,&nbsp;Paras Pangeni,&nbsp;Sandhya Niroula,&nbsp;Kiran Paudel,&nbsp;Prativa Subedi,&nbsp;Sarita Dhakal,&nbsp;Prince Mandal,&nbsp;Laba Rawal,&nbsp;Nikita Bhatta,&nbsp;Anisha Shrestha,&nbsp;Ganesh Bhattarai,&nbsp;Pragya Bhandari","doi":"10.1155/2024/9969169","DOIUrl":"10.1155/2024/9969169","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Breast cancer ranks as the second most prevalent malignancy among women in Nepal. This cancer has a high likelihood of cure, if detected early. Therefore, it is imperative to emphasize awareness and screening for breast cancer in Nepal. It indeed underscores the importance of clinical breast examination. The study aims to find the disease burden, association of abnormal breast condition with sociodemographic variables, and the need for change in the breast cancer screening protocol. <i>Methods</i>. A cross-sectional study was conducted from July to September 2023 on 100 female participants who were older than 18 years. Data were collected through face-to-face interviews using a structured questionnaire. The chi-square test was used to compare nominal variables while the independent sample <i>t</i>-test and the paired sample <i>t</i>-test were used to compare nominal and continuous variables. <i>Results</i>. The findings of the study showed that 19% of all participants complained about abnormal breast, out of which 31.7% reported lumps, 26.31% reported discharge , another 26.31% reported pain, and the remaining 15.7% reported soreness. The upper outer quadrant and lower inner quadrant each individually accounted for 33.33% of the abnormal findings. The complaints of the participants in our study were significantly correlated with age at marriage, number of pregnancies, and use of contraception. <i>Conclusion</i>. Our study revealed considerable abnormal breast findings. This warrants the need for the change in breast cancer screening protocols which lead to early diagnosis and higher curability.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9969169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the Coexpression of MET and ESR Genes on Prognosticators and Clinical Outcomes of Breast Cancer: An Analysis for the METABRIC Dataset","authors":"Nehad M. Ayoub,&nbsp;Ghaith M. Al-Taani,&nbsp;Amer E. Alkhalifa,&nbsp;Dalia R. Ibrahim,&nbsp;Aymen Shatnawi","doi":"10.1155/2024/2582341","DOIUrl":"10.1155/2024/2582341","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Breast cancer is a heterogeneous disease. Exploring new prognostic and therapeutic targets in patients with breast cancer is essential. This study investigated the expression of MET, ESR1, and ESR2 genes and their association with clinicopathologic characteristics and clinical outcomes in patients with breast cancer. <i>Methods</i>. The METABRIC dataset for breast cancer was obtained from the cBioPortal public domain. Gene expression data for <i>MET</i>, <i>ESR1</i>, and <i>ESR2</i>, as well as the putative copy number alterations (CNAs) for <i>MET</i> were retrieved. <i>Results</i>. The <i>MET</i> mRNA expression levels correlated inversely with the expression levels of <i>ESR1</i> and positively with the expression levels of <i>ESR2</i> (<i>r</i> = −0.379, <i>p</i> &lt; 0.001 and <i>r</i> = 0.066, and <i>p</i> = 0.004, respectively). The <i>ESR1</i> mRNA expression was significantly different among <i>MET</i> CNAs groups (<i>p</i> &lt; 0.001). Patients with high <i>MET</i>/<i>ESR1</i> coexpression had favorable clinicopathologic tumor characteristics and prognosticators compared to low <i>MET/ESR1</i> coexpression in terms of greater age at diagnosis, reduced Nottingham Prognostic Index, lower tumor grade, hormone receptor positivity, HER2-negative status, and luminal subtype (<i>p</i> &lt; 0.001). In contrast, patients with high <i>MET</i>/<i>ESR2</i> coexpression had unfavorable tumor features and advanced prognosticators compared to patients with low <i>MET</i>/<i>ESR2</i> coexpression (<i>p</i> &lt; 0.001). No significant difference in overall survival was observed based on the <i>MET/ESR</i> coexpression status. However, when data were stratified based on the treatment type (chemotherapy and hormonal therapy), survival was significantly different based on the coexpression status of <i>MET/ESR</i>. <i>Conclusions</i>. Findings from our study add to the growing evidence on the potential crosstalk between MET and estrogen receptors in breast cancer. The expression of the MET/ESR genes could be a novel prognosticator and calls for future studies to evaluate the impact of combinational treatment approaches with MET inhibitors and endocrine drugs in breast cancer.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2582341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140937822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flat Aesthetic Mastectomy Closure with the Angel Wing Technique to Address Lateral Adiposity: Technique and Outcome Analysis","authors":"E. Klenotic,&nbsp;D. Ochoa,&nbsp;K. Stephenson,&nbsp;C. Croswell,&nbsp;S. Sullivan,&nbsp;A. C. Sherman,&nbsp;R. Henry-Tillman","doi":"10.1155/2024/7349633","DOIUrl":"10.1155/2024/7349633","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Oncologic mastectomy in the setting of obesity poses challenges in achieving a flat closure that includes the lateral adiposity. The angel wing (AW) technique was developed to address this issue. We aim to demonstrate the safety of AW by evaluating incidence of arm lymphedema (AL) and decreased range of motion (dROM) in patients postmastectomy with and without the AW closure. <i>Methods</i>. We performed a single-center retrospective cohort study at an academic referral center of patients who underwent mastectomy with and without the AW technique from May 2014 to October 2022. Those who received breast reconstruction (immediate or delayed), partial mastectomy, and male patients were excluded. The presence of postoperative AL and dROM was evaluated. Subgroup analysis was performed for patient factors including BMI, extent of axillary surgery, PMRT, and pathologic stage. <i>Results</i>. A total of 390 patients met inclusion criteria. Of those, 173 (44.4%) underwent AW and 217 (55.6%) had non-AW mastectomy. Expectedly, the average BMI was significantly higher in the AW cohort (<i>p</i> &lt; 0.0001). The overall rate of AL was 51/390 (13.1%), seen in 27 (15.6%) undergoing AW and 24 (11.1%) non-AW (<i>p</i> value = 0.18). While the rate of dROM within the cohort was 52/390 (13.1%), 27 (15.6%) underwent AW vs. 24 (11.1%) non-AW (<i>p</i> value = 0.22), resulting in no statistical significance between AW and non-AW mastectomy upon subsequent development of AL or dROM. <i>Conclusion</i>. Our study demonstrates the AW technique does not convey an increased risk of overall AL or dROM, even when considering known risk factors such as obesity, PMRT, and extent of axillary surgery. As we strive to provide our patients with improved surgical techniques for oncologic resection, we submit that this technique is a viable and safe option for achieving the goals of cosmesis with oncologic safety.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7349633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140300732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Quality of Risk Prediction Models to Assess the Individual Breast Cancer Risk in Women: An Overview of Reviews","authors":"Sarah Wolf,&nbsp;Ingrid Zechmeister-Koss,&nbsp;Irmgard Fruehwirth","doi":"10.1155/2024/1711696","DOIUrl":"10.1155/2024/1711696","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Breast cancer is the most common cancer among women globally, with an incidence of approximately two million cases in 2018. Organised age-based breast cancer screening programs were established worldwide to detect breast cancer earlier and to reduce mortality. Currently, there is substantial anticipation regarding risk-adjusted screening programs, considering various risk factors in addition to age. The present study investigated the discriminatory accuracy of breast cancer risk prediction models and whether they suit risk-based screening programs. <i>Methods</i>. Following the PICO scheme, we conducted an overview of reviews and systematically searched four databases. All methodological steps, including the literature selection, data extraction and synthesis, and the quality appraisal were conducted following the 4-eyes principle. For the quality assessment, the AMSTAR 2 tool was used. <i>Results</i>. We included eight systematic reviews out of 833 hits based on the prespecified inclusion criteria. The eight systematic reviews comprised ninety-nine primary studies that were also considered for the data analysis. Three systematic reviews were assessed as having a high risk of bias, while the others were rated with a moderate or low risk of bias. Most identified breast cancer risk prediction models showed a low prognostic quality. Adding breast density and genetic information as risk factors only moderately improved the models’ discriminatory accuracy. <i>Conclusion</i>. All breast cancer risk prediction models published to date show a limited ability to predict the individual breast cancer risk in women. Hence, it is too early to implement them in national breast cancer screening programs. Relevant randomised controlled trials about the benefit-harm ratio of risk-adjusted breast cancer screening programs compared to conventional age-based programs need to be awaited.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1711696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140201488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Capsulotomies and Partial Capsulectomy in Implant-Based Breast Reconstruction Revision Surgery","authors":"Pietro Susini,&nbsp;Gianluca Marcaccini,&nbsp;Francesco Ruben Giardino,&nbsp;Mirco Pozzi,&nbsp;Francesco Volanti,&nbsp;Giuseppe Nisi,&nbsp;Roberto Cuomo,&nbsp;Luca Grimaldi","doi":"10.1155/2024/9097040","DOIUrl":"10.1155/2024/9097040","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Breast cancer with about 2.3 million diagnoses and 685,000 deaths globally is the most frequent malignancy in the female population. Continuous research has led to oncological and reconstructive advances in the management of breast cancer, thus improving outcomes and decreasing patient morbidity. Nowadays, the submuscular expander and prosthesis (E/P) implant-based breast reconstruction (IBR) accounts for 73% of all reconstructions. Despite its widely accepted efficacy, the technique is not free from complications and up to 28% of cases require revision surgery for mechanical complications such as capsular contracture, implant displacement/rotation, and implant rupture. With this study, the authors report their experience in the management of E/P IBR revision surgery through the technique of Selective Capsulotomies (SCs) and Partial Capsulectomy (PC). <i>Methods</i>. A retrospective study was conducted on patients who had previously undergone E/P IBR and presented for revision reconstruction between January 2013 and May 2023 at the Department of Plastic Surgery of the University of Siena, Italy. Reasons for revision included capsular contracture, implant displacement/rotation, and implant rupture. Revision reconstructions involved SC and PC with implant replacement. Fat grafting was also considered. The complication rate was evaluated by analysis of patients’ medical records. Patients’ satisfaction with the treatment was assessed through a specific questionnaire. <i>Results</i>. 32 patients underwent revision surgeries. No early complication occurred. Recurrence rate was assessed at 19% with average follow-up of 59 months (range: 13–114 months). The average time between revision surgery and recurrence was 3 years (range: 1–6 years). 23 patients answered the questionnaire and were overall satisfied with the treatments (8.29/10). <i>Conclusions</i>. SC possibly associated to PC is a valuable option for E/P IBR revision surgery with minimal complications, reduced surgical trauma, short operating time, and relatively low recurrence risk. In addition, treated patients are overall satisfied with the results over time.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9097040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mammoplasty Using Modified Superomedial Pedicle Technique in Severely Macromastia and Ptotic Breasts","authors":"Engin Selamioğlu,&nbsp;Özgür Agdoğan","doi":"10.1155/2024/7635485","DOIUrl":"10.1155/2024/7635485","url":null,"abstract":"<div>\u0000 <p>Mammoplasty is a surgery commonly used for macromastia. Many mammoplasty techniques are described, all with their specific pros and cons. However, the concern to avoid serious complications sometimes takes precedence, and the ideal result cannot be. For macromastia and severely ptotic breasts, usually the free nipple-areolar complex (NAC) mammoplasty technique is implemented. The results, however, may only be completely satisfactory regarding cosmetics. Loss of NAC, poor appearance, flabbiness, flattening, and ptosis are among the disadvantages of this technique. This study aimed to present the results of mammoplasty employing the superomedial pedicle technique without interrupting a macromastia central base with a pedicle length of 8 to 18 cm. According to the literature, many plastic surgeons recommend the free NAC rather than the pedicle technique because of the high complication rates in mammoplasties planned for highly ptotic breasts and macromastia. On the other hand, many free NAC techniques and their modifications with pedicle mammoplasty are described. The general conviction is that a standard method, protocol, or technique good for all patients does not exist. Our results are more acceptable both cosmetically and physiologically. Therefore, the superomedial pedicle technique can be modified to achieve ideal results where free NAC mammoplasty is considered for severe macromastia and ptotic patients. This combined method contributes to the viability of NAC by increasing blood supply to breast tissue and providing an ideal breast appearance.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2024 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7635485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139751266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}