Background and Aims: breast reconstruction with silicone prosthesis following nipplesparing mastectomy has become widely accepted as a reconstruction option in women requiring mastectomy for cancer. the purpose of this study was to evaluate the incidence and some factors influencing early local complications in patients undergoing nsm with immediate implant reconstruction.Material and Methods: prospective study was performed on a consecutive series of 214 breast reconstructions in 205 patients. all complications during the six weeks after surgery were recorded. 42 prostheses were implanted after neoadjuvant chemotherapy, 27 patients previously had radiotherapy due to breast conserving surgery and in all other cases surgery was the primary treatment for cancer.Results: the overall six-week complication rate was 16% (35) and included: major skin flap necrosis (4%, 9 procedures), minor skin necrosis (3%, 7), major infection (2%, 5), minor infection (3%, 7), prolonged seroma formation (3%, 6), haematoma (1%, 2) and epidermolysis (1%, 2). in 6% (12) reconstruction procedures explantation of prosthesis was done. neoadjuvant chemotherapy and radiotherapy were not associated with higher rate of complications.Conclusion: nipple-sparing mastectomy with immediate implant reconstruction has acceptable morbidity rate in the hand of experienced oncoplastic surgeon and therefore should be considered as treatment option to women requiring mastectomy.

Dermatofibrosarcoma protuberans (DFSP) of the breast is a rare malignant tumor, and its preoperative diagnosis is extremely difficult. Local recurrence of DFSP is frequent after incomplete resection because of either false diagnosis or inadequate standard surgical excision. We present a case of DFSP that showed disconcordant results using different imaging modalities, suggesting that the MRI finding of subcutaneously located highly vascular tumor with suspicious kinetics but together with negative Cho peak on (1H) MRS, might be suggestive of the diagnosis of DFSP.

Background: This study aimed to examine the incidence of surgical complications associated with nipple-sparing mastectomy (NSM) with primary implant reconstruction, analyze risk factors for early and late surgical complications of NSM, and determine the incidence of local recurrences and the safety of sparing the nipple-areola complex (NAC). Methods: This retrospective cohort study included 435 patients with 441 NSM procedures over a period of 9 years (2004-2012). All surgical complications and the oncological outcome were recorded during follow-up. Results: The most common early surgical complication was skin flap ischemia/necrosis (26 patients, 5.9%). Prosthesis explantation due to complications was carried out in 11 (2.5%) cases. Neoadjuvant chemotherapy, implant size >500 ml, diabetes mellitus, body mass index > 25 kg/m², and incisions other than lateral were risk factors for early complications (p < 0.001). The NAC excision rate was 5.4% (24 cases) due to confirmed presence of cancer cells in the subareolar tissue. Capsular contracture as a late complication occurred in 33 (7.48%) cases. Local relapse occurred in 32 (7.3%) patients. Distant metastases were diagnosed in 68 (15.6%) patients, and 53 (12.2%) patients died during the follow-up period. Conclusions: NSM with immediate implant reconstruction has an acceptable morbidity rate and is an oncologically and surgically appropriate treatment for most women requiring mastectomy.

Diffusion-weighted imaging (DWI) has not been well explored in differentiation of malignant from benign breast lesions. The aims of this study were to examine the role of apparent diffusion coefficient (ADC) values in differentiation of malignant from benign tumors and distinguishing histological subtypes of malignant lesions, and to determine correlations between ADC values and breast tumors structure. This cohort-study included 174 female patients who underwent contrast-enhanced breast MR examination on a 3T scanner and were divided into two groups: patient group (114 patients with proven tumors) and control group (60 healthy patients). One-hundred-thirty-nine lesions (67 malignant and 72 benign) were detected and pathohistologically analyzed. Differences between variables were tested using chi-square test; correlations were determined using Pearson's correlation test. For determination of cut off values for diagnostic potential, Receiver Operating Characteristic curves were constructed. Statistical significance was set at p < 0.05. Mean ADC values were significantly lower in malignant compared to benign lesions (0.68 × 10 −3 mm 2 /s vs. 1.12 × 10 −3 mm 2 /s, p < 0.001). The cut off value of ADC for benign lesions was 0.792 × 10 −3 mm 2 /s (sensitivity 98.6%, specificity 65.7%), and for malignant 0.993 × 10 −3 mm 2 /s (98.5, 80.6%). There were no significant correlations between malignant lesion subtypes and ADC values. DWI is a clinically useful tool for differentiation of malignant from benign lesions based on mean ADC values. The cut off value for benign lesions was higher than reported recently, due to high amount of fibrosis in included benign lesions. Finally, ADC values might have implications in determination of the biological nature of the malignant lesions.