Postoperative courses of breast reconstruction using inferior adipofascial tissue repair

PurposeQuality-of-life (QOL) has been reported to affect the prognosis of many types of cancer, and several studies used various QOL assessment tools to determine the relationship between QOL and cancer prognosis. In this study, QOL-Questionnaire for Cancer Patients Treated with Anti-Cancer Drugs-the Breast (QOL-ACD-B) was modified to be suitable for preoperative chemotherapy (POC) and was named the QOL-ACD-BP.MethodsA total of 300 patients were treated with POC after being diagnosed with breast cancer between February 2007 and December 2016 at our institute. We evaluated novel evaluation scale for QOL (QOL-ACD-BP) before and after POC in a retrospective manner.ResultsIn the multivariate analysis with overall survival, the high QOL before [p = 0.048, hazard ratio (HR) 0.441] or after POC (p = 0.030, HR 0.273) was an independent factor.ConclusionOur study shows that QOL after POC may also affect prognosis and supported the importance of maintaining QOL in cancer treatment. In patients with breast cancer treated with POC, QOL-ACD-BP, which is a new QOL evaluation index, was found to be a useful tool for predicting the patients’ prognosis.Electronic supplementary materialThe online version of this article (10.1007/s00432-018-2670-0) contains supplementary material, which is available to authorized users.

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“…As it covers all cancers, QOL-ACD-B as a breast cancer disease-specific scale is available (Otsuka et al 2015) (Supplementary Table 1).…”

Section: Methodsmentioning

confidence: 99%

Novel evaluation scale for QOL (QOL-ACD-BP) in preoperative chemotherapy for breast cancer

Takada

Kashiwagi

Goto

et al. 2018

J Cancer Res Clin Oncol

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“…Six studies were considered eligible and were included in this systematic review . From the six studies identified, five were retrospective case–control studies and one was a prospective cohort study (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Half of the identified studies were conducted in the UK. The remaining three studies were conducted in several other different geographic contexts . All six studies were single‐institution studies.…”

Section: Resultsmentioning

confidence: 99%

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Quality of life after oncoplastic breast‐conserving surgery: a systematic review

Aristokleous

Saddiq

2019

ANZ Journal of Surgery

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Background: Oncoplastic breast-conserving surgery (OBCS) has gained increasing attention as a treatment option for early breast cancer patients, aiming to achieve the best possible breast symmetry with concomitant oncological safety. This paper aims to systematically review the current literature on patient quality of life (QoL) after OBCS compared with QoL after breast-conserving surgery (BCS) alone. Methods: MEDLINE via Ovid, CINAHL via EBSCO and PsycINFO via OvidSP were searched to retrieve all relevant studies. The reference lists of identified eligible studies were manually examined to search for additional eligible studies. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme. Results: A total of six articles met the inclusion criteria. Most of the studies used validated patient-reported outcome measures for assessing QoL with good response rates. However, only one study was of sufficiently good quality to provide good evidence (P < 0.05) in favour of OBCS, while the remainder were of low to moderate quality with differences in outcomes that were not statistically significant. Conclusion: The review found that the current evidence base is limited and not adequate enough to support or to reject the assumption that OBCS is associated with improved QoL when compared with QoL post-BCS. However, the majority of studies show that OBCS is associated with a trend towards better patient QoL. The impact of OBCS on patient QoL needs to be more adequately investigated. Large prospective cohort studies to assess the impact of OBCS on QoL compared with QoL post-BCS are strongly recommended.

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“…Forty five months of mean followup showed satisfactory cosmetic results. Otsuka et al [18] performed inframammary adipofascial tissue repair (IATR) on 25 patients with breast cancer in inferior site. They used a tongue shaped flap to repair the defect.…”

Section: Discussionmentioning

confidence: 99%

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

Elzawawy

Kelada

Alkarmouty

2016

European Journal of Surgical Oncology (EJSO)

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Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

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Postoperative courses of breast reconstruction using inferior adipofascial tissue repair

Abstract: All patients with IATR were treated with irradiation, and no image findings of a partial or total necrosis of the flap recognized 1 year after examination. They produced good cosmetic results; however, they could not elevate the QOL score on the whole.

Cited by 12 publications

References 13 publications

Novel evaluation scale for QOL (QOL-ACD-BP) in preoperative chemotherapy for breast cancer

Novel evaluation scale for QOL (QOL-ACD-BP) in preoperative chemotherapy for breast cancer

Quality of life after oncoplastic breast‐conserving surgery: a systematic review

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

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