Вопросы реконструктивной и пластической хирургии № 2 (61) июнь'2017 of injury, blood loss, and surgery time, as well as assumes no defects of donor zones. The paper presents the review of publications and results obtained by the authors. Material and methods. Since 2013 till 2016, specialists of the P. Herzen Moscow Oncology Research Institute made 104 one-time breast cancer reconstructions with the use of mesh implants in 80 cases, acellular dermal matrix in 24 cases after radical skin-sparing or subcutaneous mastectomy. Average age of patients was 47.2 years. Stage 0 breast cancer was diagnosed in 2% of cases, I-30%, IIA-33%, IIB-16%, IIIA-15%, IIIB-2%, IIIC-2%. Titanium mesh implants were used in 12 patients, and polyester 3D mesh implants were applied in 68 cases. The size of silicone implants varied from 120 to 585 cm 3 depended on anatomic features of chest wall and breast constitution. Results. Cosmetic results were considered as excellent in 67.3% of cases, good in 19.2% of cases, satisfactory in 7.7% of cases, and poor in 5.8% of cases. The frequency of removal of silicone implant was 5.8% when titanium mesh implant was used and 0% for the polyester 3D mesh implant. Seroma was diagnosed in 1.9% of cases with the use of acellular dermal matrix and in 2.9% with the use of titanium mesh implant. Nipple-areola necrosis was observed in 1.9% of cases with the use of titanium mesh implant. Infection of implant site was observed in 2.9% of cases. Capsular contracture developed in 5.8% of cases after application of radiotherapy to the reconstructed breast. Conclusions. Biological and synthetic materials form a significant alternative to existing ways of breast reconstruction and, in many cases, adequate replacement of autologous muscular flaps at the proper selection of patients.
Background: Patients who undergo breast cancer treatment require psychosocial and aesthetic rehabilitation. Advantages of breast reconstruction in-patient rehabilitation are well known. Oncoplastic organ-preserving surgery offers aesthetically better results, yet is often considered less safe than more radical procedures. We compared the aesthetic and psychological outcomes in patients undergoing breast reconstruction and oncoplastic breast cancer treatment. Methods: In total, 1130 patients who received either breast reconstruction or oncoplastic breast cancer surgery were included in the study. Patients were classified into two groups. Group 1 included 510 patients who received breast reconstruction surgery. Group 2 included 620 patients who received oncoplastic surgery. The following aspects were compared between the two groups: demographics, tumor progression, and immunohistochemical aspects, complications, hospitalization stay, and psychological and aesthetic outcomes. Results: Patients in the oncoplastic group showed statistically significant higher psychosocial and aesthetic outcomes, as well as lower incidence of complications, revision rate, disease progression, and recurrence. The majority of oncoplastic patients were treated in early stages of breast cancer. Conclusion: Offering superior treatment results, oncoplastic organ-preserving surgery should be favored in patients with earlier stages of cancer progression.
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