Annals of breast surgery : an open access journal to bridge breast surgeons across the world最新文献_第5页

Osteosarcoma of the breast: a case report of a rare breast malignancy in a patient with prior partial mastectomy 乳房骨肉瘤:一个罕见的乳房恶性肿瘤的病例报告，患者先前乳房部分切除术

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-20-104

Genevieve Hattingh, Diego A Hanssen, J. Medina, Mansi Sanghvi, Ajay Shah

{"title":"Osteosarcoma of the breast: a case report of a rare breast malignancy in a patient with prior partial mastectomy","authors":"Genevieve Hattingh, Diego A Hanssen, J. Medina, Mansi Sanghvi, Ajay Shah","doi":"10.21037/abs-20-104","DOIUrl":"https://doi.org/10.21037/abs-20-104","url":null,"abstract":": Primary osteosarcoma of the breast (OSB) is a rare malignancy of the breast with poor prognosis. There are some reported cases of this infrequent malignant neoplasia, showing that in some instances it can be related to prior trauma or local irradiation in the area. Most malignant mesenchymal neoplasia can be found on the extremities, retroperitoneum, the trunk area and less common, breast, heart, thyroid and the lung. We present a 68-year-old female without any significant medical problems but with prior history of right breast cancer treated with partial mastectomy, adjuvant chemotherapy and local radiation in 2004, presenting to our breast clinic in 2020 with a palpable lesion and biopsy proven poorly differentiated malignant neoplasm, favoring poorly differentiated mammary carcinoma with osteoblastic giant cells. This patient went for a right total mastectomy with final pathology showing high grade osteoblastic osteosarcoma, requiring subsequent re-excision for positive margins. Here we discuss the recommended management and treatment for such a rare diagnosis, as currently no official treatment guidelines exist. We recommend wide local excision without lymph node biopsy and adjuvant chemotherapy. Radiation may be an option but should be decided upon on a case by case basis given the lack of data on its efficacy.","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":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43565016","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}

引用次数: 0

Perspectivising tumescent mastectomy: innovation in preserving mastectomy skin flap perfusion—a narrative review 乳房肿胀切除术的透视:保留乳房切除术皮瓣灌注的创新-一篇叙述性综述

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/ABS-21-4

C. Bille

{"title":"Perspectivising tumescent mastectomy: innovation in preserving mastectomy skin flap perfusion—a narrative review","authors":"C. Bille","doi":"10.21037/ABS-21-4","DOIUrl":"https://doi.org/10.21037/ABS-21-4","url":null,"abstract":": Mastectomy is used in breast cancer treatment and as risk-reducing in women with genetic high risk of breast cancer. Immediate breast reconstruction including direct to implant but also autologous breast reconstruction is increasingly offered to women planned to have mastectomy. Either simple mastectomy or skin sparring mastectomy followed by immediate breast reconstruction, two specific issues are crucial. (I) Oncologic safety. That is, removal of any diagnosed pathologic finding, but also all breast tissue including the often breast tissue containing Coopers ligaments and thereby minimizing residual breast tissue. (II) Low complication rate. During mastectomy, the skin flaps are dissected from the breast gland. The interruption of blood supply to the skin flaps from below results in diminished perfusion of the skin flaps. This comprises a risk of necrosis and infection and ultimately prolonged time to adjuvant therapy, prolonged recovery, and possible loss of reconstruction. Tumescent technique with epinephrine solution meets both challenges, especially when used under visual guidance. It accentuates breast tissue and makes it easier to dissect the breast tissue and Coopers ligaments free from the subcutaneous fatty tissue. Furthermore, it is atraumatic and preserves the insulating fatty tissue and the blood supply running through this. Maintaining skin flap perfusion diminishes the risk of necrosis and infection. On top of that, tumescent mastectomy leaves more fatty tissue resulting in a more pleasant aesthetic result regardless of either simple or skin sparring mastectomy and regardless of either direct to implant or autologous reconstruction. The powerful ICG-angiography, often used to assess areas with low perfusion and previously shown to be superior to clinical assessment, can, however, not be relied on when tumescent mastectomy technique has been used.","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":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45560182","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}

引用次数: 0

Gestational gigantomastia complicated by breast infarctive necrosis in the setting of COVID-19 infection: a case report 新冠肺炎感染时妊娠期巨乳症合并乳腺梗死坏死1例报告

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-21-140

N. Ecanow, A. Chichura, K. Kopkash, C. Pesce, M. Sullivan, K. Yao

引用次数: 0

Identification of factors that predict premature tissue expander loss in immediate breast reconstruction 确定预测乳房重建中过早组织扩张器丢失的因素

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-21-77

Bridgette Bolshem, A. Fahey, A. Melillo, Katherine A. Rodby, G. Rapaport, J. Gaughan, M. Matthews

引用次数: 0

Work-up and management of breast pain 乳房疼痛的检查和处理

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-20-102

Pamela Li, A. Simpson, Jill M. Dietz

{"title":"Work-up and management of breast pain","authors":"Pamela Li, A. Simpson, Jill M. Dietz","doi":"10.21037/abs-20-102","DOIUrl":"https://doi.org/10.21037/abs-20-102","url":null,"abstract":"Breast pain, or mastalgia, is a common symptom and a frequent reason for breast center referrals. It can be categorized as cyclical or non-cyclical pain. Cyclical breast pain is more common and varies with the menstrual cycle. Non-cyclical breast pain includes true breast pain and extramammary causes. Categorizing breast pain helps to guide the work-up and management. A thorough history and physical exam should be performed in all patients presenting with breast pain. Though breast pain alone is rarely a sign of breast cancer, breast imaging may be still be appropriate. If there are no concerning findings on the physical exam, the imaging work-up is determined by patient age and the type of breast pain. Management of breast pain without suspicious findings on physical exam or breast imaging is driven by the severity of the pain. Reassurance of the negative findings and that the patient does not have breast cancer is often all that is required. Breast pain frequently resolves spontaneously and no further treatments are necessary. If pain is persistent or impacting quality of life, initial management is centered on conservative therapies such as physical support. Medications can be considered for severe and persistent pain, but the side effects of these therapies need to be considered.","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":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47832675","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}

引用次数: 0

Immediate or delayed breast reconstruction: the aspects of timing, a narrative review 立即或延迟乳房重建:时间方面，叙述回顾

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-21-44

L. Hölmich, Farah Sayegh, C. Salzberg

引用次数: 0

“Scarless” excision of a nipple adenoma case report—a good aesthetic outcome after a circular nipple excision with purse-string closure technique 乳头腺瘤“无疤痕”切除术一例报告——荷包扣技术环形乳头切除术后的良好美学效果

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-21-66

J. X. Hing, E. Kua, Wai Peng Lee

{"title":"“Scarless” excision of a nipple adenoma case report—a good aesthetic outcome after a circular nipple excision with purse-string closure technique","authors":"J. X. Hing, E. Kua, Wai Peng Lee","doi":"10.21037/abs-21-66","DOIUrl":"https://doi.org/10.21037/abs-21-66","url":null,"abstract":": Complete surgical excision of nipple adenoma with clear margins offers the lowest risk of recurrence of this locally infiltrative yet benign entity. A thorough triple assessment including histological assessment is crucial to exclude any malignant pathology, and confirm the diagnosis. There are many excisional and ablative techniques published that can give clear resection margins, but there remains a paucity of data on acceptable aesthetic outcomes. It is important to balance between adequate surgical margins to prevent recurrence and a good aesthetic outcome, particularly in a young patient. We wish to highlight a good aesthetic outcome following a simple circular excision with purse-string closure of the nipple defect. We present a 28-year-old lady with a progressively ulcerative lesion that involved the entire nipple. Ultrasound did not show any other underlying lesions or intraductal extension. Punch biopsy confirms the diagnosis of a benign nipple adenoma. She was counselled for complete nipple excision and the defect was primarily closed with purse-string technique. This may not be a novel technique as it has been described for closure of other defects. However, the benefit of a purse-string closure of a circular nipple excision defect to reduce scarring may be underreported in the literature. This technique helps to conceal the scar within the areola, retain its natural corrugated appearance, and prevent distortion to the overall shape of the areolar complex. The final outcome of a complete nipple excision resembles that of a ‘scarless’ excision and remains aesthetically pleasing. We hope to allay fears of clinician and patients faced with similar condition by offering a safe, easily reproducible, single staged technique that offers high patient satisfaction in selected patients. Using this technique may even preclude the need for further nipple 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":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47959846","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}

引用次数: 0

Superparamagnetic iron oxide sentinel lymph node biopsy in early breast cancer: an analysis of artefacts on post-operative breast imaging 癌症早期乳腺癌超顺磁性铁氧化物前哨淋巴结活检术后乳腺成像伪影分析

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/abs-21-110

V. Man, M. Cheung, Christine Lo, Tina Lam, A. Kwong

引用次数: 1

An update on breast animation deformity grading systems—a systematic review 乳房动画畸形分级系统的更新-系统回顾

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/ABS-21-46

Farima Dalaei, D. L. Dyrberg, C. Bille, C. Salzberg, J. A. Sørensen, J. Thomsen

引用次数: 2

Novel innovations and advancements in breast reconstruction 乳房再造的创新与进步

Annals of breast surgery : an open access journal to bridge breast surgeons across the world Pub Date : 2021-01-01 DOI: 10.21037/ABS-21-17

E. Chang

{"title":"Novel innovations and advancements in breast reconstruction","authors":"E. Chang","doi":"10.21037/ABS-21-17","DOIUrl":"https://doi.org/10.21037/ABS-21-17","url":null,"abstract":"The field of breast reconstruction has witnessed tremendous advancements over the years both in terms of breast conservation as well as reconstruction following a mastectomy. The field of oncoplastic surgery has quickly become the standard of care where techniques engrained in the field of cosmetic, aesthetic plastic surgery are now employed to provide the most optimal means of reconstruction for patients undergoing a partial mastectomy. However, other techniques including local pedicle flaps as well as fat grafting or lipofilling have also become useful adjuncts to improve the overall cosmetic results for these patients. For patients undergoing reconstruction following a mastectomy, new technologies are constantly emerging to optimize reconstruction using a prosthesis-based approach, not simply in terms of the devices themselves, but also in terms of surgical techniques and in particular acellular dermal matrices (ADM). The frequent use of ADM has ushered in an era where the prosthesis has returned to a subcutaneous or prepectoral location which was previously plagued with high complications including capsular contracture. Early studies examining this approach have demonstrated high satisfaction and promising results. However, just as there have been beneficial developments in breast reconstruction, so have controversies arisen, the most prevalent of which is the description of breast implant associatedanaplastic large cell lymphoma associated with textured devices. Tremendous advancements have also occurred in the arena of autologous reconstruction where free tissue transfer has quickly become the gold standard means of reconstruction. However, whereas previously the abdominal donor site was the only means of autologous reconstruction, novel donor sites including the thigh and lumbar region are quickly gaining in popularity with the increased comfort with perforator flaps and microvascular surgery. With the growing experience with microsurgery, free tissue transfer no longer focuses solely on achieving a viable flap, but on optimizing patient satisfaction and outcomes. The creation of a sensate flap through neurotization is also quickly becoming commonplace, but long-term outcomes remain to be determined. Finally, the field of lymphedema super microsurgery is now a critical component for reconstruction in patients undergoing treatment for breast cancer. Given the need for multimodality therapy including chemotherapy and radiation, coupled with the need for an axillary dissection in patients with more advanced disease, the risks of lymphedema are only expected to increase. The two physiologic techniques, the lymphovenous bypass (LVB) and vascularized lymph node transfer (VLNT) have proven to be remarkably effective and have dramatically altered the treatment for breast cancer related lymphedema (BCRL) and proven to be an effective means at improving the quality of life of patients suffering from BCRL. The current compendium of articles in the se","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":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68292461","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}

引用次数: 0