Satisfaction with Long-Term Aesthetic and 10 Years Oncologic Outcome following Risk-Reducing Mastectomy and Implant-Based Breast Reconstruction with or without Nipple Preservation

O’Connell, Rachel; Tasoulis, Marios Konstantinos; Hristova, Evguenia; Teoh, Victoria; Agustí, Ana; Ward, Ann; Montgomery, Catherine; Mohammed, Kabir; Self, Janet; Rusby, Jennifer; Gui, Gerald

doi:10.3390/cancers14153607

Cited by 5 publications

(3 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This could be due to the tumor in ltrating the nipple or a surgeon-affected impact, although NSM has been proven to be oncologically safe [16,17]. In addition, we could not prove that NSM was associated with fewer complications [21,22]; however, this could be due to higher complication rates in patients with diseased breasts [13]. Similar to previous studies, we did not observe any difference in complication rates between sub-and pre-pectoral implant-based reconstruction [22][23][24][25].…”

Section: Discussionmentioning

confidence: 90%

Prophylactic mastectomies in patients with breast cancer and known germline pathogenetic variants: an Austrian registry

Leser,

Deutschmann,

Dorffner

et al. 2024

Preprint

View full text Add to dashboard Cite

Objectives Risk-reducing surgeries are common in patients with breast cancer gene (BRCA) mutations. Certain patients develop breast cancer before they opt for these surgeries. We aimed to examine the frequency of risk-reducing mastectomies and salpingo-oophorectomy among Austrian patients with breast cancer and BRCA mutations. Methods In 2014, we established an Austrian registry with patients with known germline pathogenetic variants. From onset until 2018, 111 patients were recruited from four breast cancer centers. Data on the type of mastectomy, reconstructions, and complications were collected. Results Of all patients, 13.5% had bilateral breast cancer. Among patients with unilateral breast cancer, the majority (86.8%) opted for prophylactic mastectomy on the contralateral side. Those who underwent modified radical mastectomy were more likely to choose prophylactic surgery (p = 0.001). A total of 19.4% of patients experienced cancer relapse postoperatively. Immediate reconstructions were recorded in 71.3% of the patients. In addition, patients undergoing immediate reconstruction were more likely to undergo a prophylactic operation on the contralateral side than those with delayed reconstruction (p = 0.001). A mesh was used in 47.8% of all reconstructions. The subpectoral implant was present in 75.6% of patients and the pre-pectoral in 13.3%. A mesh was inserted in all patients with pre-pectoral implants. Conclusion The results indicate that the willingness for risk-reducing surgeries is high and the option for immediate reconstruction is preferably selected by the patients with breast cancer.

show abstract

Section: Discussionmentioning

confidence: 90%

Prophylactic mastectomies in patients with breast cancer and known germline pathogenetic variants: an Austrian registry

Leser,

Deutschmann,

Dorffner

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Postoperative complication occurrence, based on recent studies, is reported to be around 43%, and thus not very far from the postoperative complication rate of breast reconstruction after oncological surgery independent of prophylactic indications, and additional surgery for medical or aesthetic purposes was required in about 72% of cases [ 14 , 15 , 16 ]. However, the current literature shows very promising results related to the long-term aesthetic outcomes of BRRM [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

Risk-Reducing Breast and Gynecological Surgery for BRCA Mutation Carriers: A Narrative Review

Bertozzi

Londero

Xholli

et al. 2023

JCM

View full text Add to dashboard Cite

This narrative review aims to clarify the role of breast and gynecological risk-reduction surgery in BRCA mutation carriers. We examine the indications, contraindications, complications, technical aspects, timing, economic impact, ethical issues, and prognostic benefits of the most common prophylactic surgical options from the perspectives of a breast surgeon and a gynecologist. A comprehensive literature review was conducted using the PubMed/Medline, Scopus, and EMBASE databases. The databases were explored from their inceptions to August 2022. Three independent reviewers screened the items and selected those most relevant to this review’s scope. BRCA1/2 mutation carriers are significantly more likely to develop breast, ovarian, and serous endometrial cancer. Because of the Angelina effect, there has been a significant increase in bilateral risk-reducing mastectomy (BRRM) since 2013. BRRM and risk-reducing salpingo-oophorectomy (RRSO) significantly reduce the risk of developing breast and ovarian cancer. RRSO has significant side effects, including an impact on fertility and early menopause (i.e., vasomotor symptoms, cardiovascular disease, osteoporosis, cognitive impairment, and sexual dysfunction). Hormonal therapy can help with these symptoms. Because of the lower risk of developing breast cancer in the residual mammary gland tissue after BRRM, estrogen-only treatments have an advantage over an estrogen/progesterone combined treatment. Risk-reducing hysterectomy allows for estrogen-only treatments and lowers the risk of endometrial cancer. Although prophylactic surgery reduces the cancer risk, it has disadvantages associated with early menopause. A multidisciplinary team must carefully inform the woman who chooses this path of the broad spectrum of implications, from cancer risk reduction to hormonal therapies.

show abstract

“…The increased use of preventive bilateral mastectomy has expanded the selection of the I-BBR one-stage technique as the preferred reconstructive method ( 60 , 61 ). One reason is that skin sparing mastectomy and nipple sparing mastectomy (SSM/NSM) incisions in the inframammary fold or lateral breast crease favor implant colocation over autologous options, in which access to the recipient’s vessels would be limited ( 62 ).…”

Section: Basic Concepts In Breast Reconstructionmentioning

confidence: 99%

Technical consideration for breast reconstruction in patients requiring neoadjuvant or adjuvant radiotherapy: a narrative review

Maita,

Torres-Guzman,

Avila

et al. 2023

Ann Transl Med

View full text Add to dashboard Cite

Background and Objective Surgical considerations for breast reconstruction (BR) in patients requiring neoadjuvant radiotherapy (NART) or adjuvant radiotherapy (ART) cannot be understated. The management of irradiated tissue leads surgeons to face several challenges. Therefore, it is essential to comprehensively understand the proper patient selection and preoperative planning to ensure the best outcomes and minimize the risk of complications. This narrative review aims to provide an update and summary of the most important technical considerations every breast surgeon must contemplate reconstructing the irradiated breast. Methods The search strategy was performed on January 10th, 2023. The PubMed, Embase, Cochrane Library, and Web of Science databases were queried to capture all publications regarding surgical considerations in BR of patients undergoing NART and ART. Key Content and Findings This review shows that the effects of radiotherapy (RT) on BR are still being studied. RT represents an essential factor for overall patient survival, and its use is increasing. However, the range of RT treatments across different cancer centers complicates the creation of a single treatment protocol. BR improves women’s quality of life, so finding the proper integration of BR and RT is essential. When deciding on the reconstructive method, there are several factors to consider, such as the patient’s body characteristics, tumor stage, RT protocol, and chemotherapy. To achieve the best surgical results and the most satisfied patient, using less aggressive and safer RT methods in the treatment sequence is recommended. Conclusions The timing of the radiation will influence the selection of the best reconstructive methods to be employed in the breast cancer patient. However, there is clear evidence of preference for immediate autologous-based BR in cases due to the low rate of complications in the long term. But patient individualization is the key. Therefore, the benefits and risks of immediate versus delayed and autologous versus implant-based reconstruction must be weighed in every single case.

show abstract

Satisfaction with Long-Term Aesthetic and 10 Years Oncologic Outcome following Risk-Reducing Mastectomy and Implant-Based Breast Reconstruction with or without Nipple Preservation

Cited by 5 publications

References 52 publications

Prophylactic mastectomies in patients with breast cancer and known germline pathogenetic variants: an Austrian registry

Prophylactic mastectomies in patients with breast cancer and known germline pathogenetic variants: an Austrian registry

Risk-Reducing Breast and Gynecological Surgery for BRCA Mutation Carriers: A Narrative Review

Technical consideration for breast reconstruction in patients requiring neoadjuvant or adjuvant radiotherapy: a narrative review

Contact Info

Product

Resources

About