Necrotizing Soft Tissue Infection of the Breast: Case Report and Literature Review

Vieira, René Aloísio da Costa; Mathes, Angelo Gustavo Zucca; Michelli, Rodrigo Augusto Depieri; Ribeiro, Gustavo Henrique Fabri Pereira; Haikel, Raphael Luiz; Viana, Cristiano Ribeiro; Castro, Paulo de Tarso Oliveira; Uemura, Gilberto

doi:10.1089/sur.2011.029

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…A total of 13 articles were excluded based on inclusion criteria. [7][8][9][10][11][12][13][14][15][16][17][18][19] A single case series was excluded because of inadequate data. 20 Therefore, a total of 25 articles were included in the qualitative analysis.…”

Section: Methodsmentioning

confidence: 99%

Management of Primary Necrotizing Fasciitis of the Breast: A Systematic Review

Konik

Huang

2020

Plast Surg (Oakv)

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Purpose: Necrotizing fasciitis (NF) is a life-threatening infection that involves spreading necrosis of the subcutaneous tissue and fascia that affects the extremities, abdominal wall, and perineum. Primary infection of the breast is a rare occurrence. Shah et al described the first case of primary breast NF and recommended radical “pseudotumor” excision and delayed skin closure months after resolution. Numerous other cases reported were successfully managed with different strategies. We aimed to summarize management options for primary breast NF through a systematic review of the literature. Methods: A systematic review of English literature was performed using PubMed. A total of 58 abstracts were reviewed. Data were abstracted from 25 cases that met inclusion criteria. Results: A total of 25 cases of primary NF of the breast without an inciting event were found within the literature. Common initial operations included total mastectomy (36.0%), excisional debridement (32.0%), and partial mastectomy (12.0%). A total or radical mastectomy was completed for definitive source control in 13 (52.0%) cases. A total of 18 cases underwent reconstruction. Split-thickness skin grafts (44.4%) and delayed primary closures (33.3%) were the most common methods of reconstruction. Conclusion: Majority of cases with primary breast NF are managed with a total mastectomy to gain source control. Reconstruction using split-thickness skin grafts was most common. Other options included delayed primary closure, full thickness skin grafts, local tissue rearrangement, and pedicle flap reconstruction. Reconstruction should be patient dependent, but the whole arsenal of the reconstructive ladder may be used.

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Section: Methodsmentioning

confidence: 99%

Management of Primary Necrotizing Fasciitis of the Breast: A Systematic Review

Konik

Huang

2020

Plast Surg (Oakv)

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“…Type II is linked to Streptococcus , Staphylococcus aureus or Staphylococcus epidermidis , and is generally explosive. Clostridial expression belongs to Type III, which has a low incidence 12 . These bacterial infections may have been related to bacterial location and the high mortality following NSTI in patients with breast implants or breast cancer-related surgery.…”

Section: Microbiota In Breast and Its Potential Sourcesmentioning

confidence: 99%

“…In addition to chemotherapy and targeted therapy, more encouraging investigations have indicated that specific microbiota may affect anti-cancer immunotherapy. Dysbiosis, prevalent in non-responders to anti-programmed death receptor (PD-1) therapy, may cause inflammation and the arrest of T cell differentiation into CD8 + effector cells, and has been associated with a significant reduction in the proportion of Sphingomonas 12 , 60 , 61 . Oral Bifidobacterium can increase tumor cell control and contributes to interferon (IFN)-γ production by CD8+ tumor-specific T cells, and further increases the activation of intratumoral dendritic cells to improve anti-programmed death ligand (PD-L1) efficacy 60 , 62 .…”

Section: Gut Microbiome and Drug Metabolism In Breast Cancermentioning

confidence: 99%

Tumor-related Microbiome in the Breast Microenvironment and Breast Cancer

Wang¹,

Sun²,

Xu³

2021

J. Cancer

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Despite the significant progress in diagnosis and treatment over the past years in the understanding of breast cancer pathophysiology, it remains one of the leading causes of mortality worldwide among females. Novel technologies are needed to improve better diagnostic and therapeutic approaches, and to better understand the role of tumor-environment microbiome players involved in the progression of this disease. The gut environment is enriched with over 100 trillion microorganisms, which participate in metabolic diseases, obesity, and inflammation, and influence the response to therapy. In addition to the direct metabolic effects of the gut microbiome, accumulating evidence has revealed that a microbiome also exists in the breast and in breast cancer tissue. This microbiome enriched in the breast environment and the tumor microenvironment may modulate effects potentially associated with carcinogenesis and therapeutic interventions in breast tissue, which to date have not been properly acknowledged. Herein, we review the most recent works associated with the population dynamics of breast microbes and explore the significance of the microbiome on diagnosis, tumor development, response to chemotherapy, endocrine therapy, and immunotherapy. To overcome the low reproducibility of evaluations of tumor-related microbiome, sequencing technical escalation and machine deep learning algorithms may be valid for standardization of assessment for breast-related microbiome and their applications as powerful biomarkers for prognosis and predictive response in the future.

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“…Prior to surgery, a surgical wound culture can be performed to guide the choice of antibiotic therapy. During surgery, special care must be taken (covering the exposed area with compresses and administration of broad-spectrum antibiotic for therapeutic purposes) 9 .…”

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confidence: 99%