Current Trends in Breast Reconstruction

Gürünlüoğlu, Raffi; Gurunluoglu, Aslin; Williams, Susan A.; Tebockhorst, Seth

doi:10.1097/sap.0b013e31822ed5ce

Cited by 153 publications

(47 citation statements)

References 53 publications

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“…More and more postmastectomy patients have immediate breast reconstructions mainly for cosmetic reasons 1, 2, 3, 4, 5, 6, 7. A temporary tissue expander, which usually includes a high‐density magnetic injection port, offers many advantages including relative simplicity, low morbidity, and good aesthetic results, over other types of breast reconstructions 3, 6.…”

Section: Introductionmentioning

confidence: 99%

Modeling of the metallic port in breast tissue expanders for photon radiotherapy

Yoon

Xie

Heins

et al. 2018

J Applied Clin Med Phys

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The purpose of this study was to model the metallic port in breast tissue expanders and to improve the accuracy of dose calculations in a commercial photon treatment planning system (TPS). The density of the model was determined by comparing TPS calculations and ion chamber (IC) measurements. The model was further validated and compared with two widely used clinical models by using a simplified anthropomorphic phantom and thermoluminescent dosimeters (TLD) measurements. Dose perturbations and target coverage for a single postmastectomy radiotherapy (PMRT) patient were also evaluated. The dimensions of the metallic port model were determined to be 1.75 cm in diameter and 5 mm in thickness. The density of the port was adjusted to be 7.5 g/cm3 which minimized the differences between IC measurements and TPS calculations. Using the simplified anthropomorphic phantom, we found the TPS calculated point doses based on the new model were in agreement with TLD measurements within 5.0% and were more accurate than doses calculated based on the clinical models. Based on the photon treatment plans for a real patient, we found that the metallic port has a negligible dosimetric impact on chest wall, while the port introduced significant dose shadow in skin area. The current clinical port models either overestimate or underestimate the attenuation from the metallic port, and the dose perturbation depends on the plan and the model in a complex way. TPS calculations based on our model of the metallic port showed good agreement with measurements for all cases. This new model could improve the accuracy of dose calculations for PMRT patients who have temporary tissue expanders implanted during radiotherapy and could potentially reduce the risk of complications after the treatment.

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Section: Introductionmentioning

confidence: 99%

Modeling of the metallic port in breast tissue expanders for photon radiotherapy

Yoon

Xie

Heins

et al. 2018

J Applied Clin Med Phys

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“…There was also a discernible increase in the percentage of plastic surgeons performing 1–20 cases/year in the 2012 survey compared with the 2010 survey 8 (Table 2). …”

Section: Discussionmentioning

confidence: 95%

“…8 A comparative analysis was conducted between 2 national surveys to capture similarities and notable changes regarding BR practice from 2010 to 2012.…”

mentioning

confidence: 99%

A Comparative Analysis of 2 National Breast Reconstruction Surveys

Gürünlüoğlu

Bronsert²

2014

Plastic and Reconstructive Surgery Global Open

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Background:Pertinent findings of two national breast reconstruction (BR) surveys from two different institutions at two separate times (2012 vs 2010) were analyzed for comparison.Methods:An appraisal of sampling methodology, sample demographics, years of practice, practice affiliation, BR type, and annual volume between the two studies was conducted using statistical analysis.Results:Proper sampling technique and adequate sample size were used in both surveys to represent the typical population of general US plastic surgeons practicing BR. There were no differences in mean age or years of practice between the sample population in both studies. The percentage of plastic surgeons with academic affiliation was higher in the 2012 survey compared to the 2010 survey (28% vs 18%, P<0.05). Implant-based BR was the predominant method among surveyed plastic surgeons in both surveys. There was a substantial decrease in the proportion of plastic surgeons performing >20 cases per year in the 2012 survey compared to the 2010 survey (P<0.05). A high volume of BR, defined as >60 cases per year in the 2010 survey and >20 cases per year in the 2012 survey, correlated significantly with academic practice and multidisciplinary cancer centers, respectively (P<0.05). There was a significant decline in the percentage of plastic surgeons performing microsurgical BR from 2010 to 2012 (35% vs 25%, P<0.05).Conclusions:Comparative data suggest that there are fewer high volume BR cases being performed by US plastic surgeons and that there has been a reduction among plastic surgeons in the use of microsurgical BR from 2010 to 2012. We believe that these findings may indicate early signs of the changes in BR trends in the US.

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“…But the majority of mutation carriers [22,23] and also patients with sporadic breast cancer decide for implant-based immediate reconstruction [24]. This is accompanied by a recent fast development of new materials and techniques to improve long-lasting esthetic results in implant-based and mesh-or acellular dermal matrix (ADM)-supported breast reconstruction.…”

Section: Best Choice For Bilateral Breast Reconstructionmentioning

confidence: 99%

Role of Breast Surgery in BRCA Mutation Carriers

Nestle-Krämling

Kühn

2012

Breast Care

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BRCA mutation carriers have a life-long breast cancer risk between 55 and 85% and a high risk of developing breast cancer at a very young age, depending on the type of mutation. The risk of developing contralateral breast cancer after a first breast cancer is elevated up to 65%, especially in case of BRCA1 mutation and young age at the first breast cancer. Since bilateral prophylactic mastectomy is associated with a risk reduction of 90–95% of developing primary or contralateral breast cancer, this option is a key point within the counseling process for patient information and shared decision-making of mutation carriers. Although the local control after breast-conserving therapy in mutation carriers seems to be comparable to that of sporadic breast cancer patients, individual patient information and counseling should include all alternative procedures of oncologically adequate mastectomy techniques and immediate reconstruction. Excellent cosmetic results, high levels of life quality, and good patient acceptance can be achieved with the recent developments in reconstructive surgery of the breast.

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Current Trends in Breast Reconstruction

Cited by 153 publications

References 53 publications

Modeling of the metallic port in breast tissue expanders for photon radiotherapy

Modeling of the metallic port in breast tissue expanders for photon radiotherapy

A Comparative Analysis of 2 National Breast Reconstruction Surveys

Role of Breast Surgery in BRCA Mutation Carriers

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