Subcutaneous mastectomy ? surgical techniques and complications in 176 women

Ringberg, Anita

doi:10.1007/bf00184396

Cited by 10 publications

(7 citation statements)

References 25 publications

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“…Subcutaneous mastectomy in the 1960s was often used for benign diseases. 3 The very first attempt of a subcutaneous mastectomy with nipple preservation in breast cancer patients was attempted in the United Kingdom in 1974, with the results of the study published in 1984 by Hinton et al 4 Further research publications in 1976 by Smith et al 5 report the involvement of the nipple and areola in carcinomas of the breast. In that time, reconstruction after subcutaneous mastectomy was performed with implants that yielded poor results, leading to the abandonment of this procedure for 20 years.…”

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confidence: 97%

Skin and Nipple-Areola Complex Sparing Mastectomy in Breast Cancer Patients

Stanec

Žic

Budi

et al. 2014

Annals of Plastic Surgery

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Skin and nipple-areola complex sparing mastectomy (SNSM) and primary reconstruction have been popular for breast cancer treatment in the last decade. An advantage of the SNSM technique is the removal of all breast tissue as a radical surgical procedure while preserving native breast integrity, nipple-areola complex (NAC), and submammary fold. This retrospective 15-year clinical study analyzes medical records from our breast surgery database collected at our department between 1997 and 2012. A total number of 3757 patients were treated for breast cancer; 411 (10.9%) patients had a skin-sparing mastectomy with the median (range) length follow-up of 63 months. This is the longest follow-up for SNSM in breast cancer patients; 3.7% of patients who underwent SNSM developed disease local recurrence, whereas occult NAC involvement with cancer occurred in 7.7% and local recurrence in the NAC in 1.2%. Partial necrosis of the NAC developed in 9.4% and total necrosis in 0.7% of operated breasts. All disease recurrences occurred in the first 10 years of the follow-up period. Local recurrence developed as first recurrence event has longer median cancer-specific survival time of 70 months than those with only distant metastases with 50 months and locoregional plus distant metastases with 35.5 months. The "Omega" pattern incision combines an oncological radical procedure with a lower incidence of skin flap necrosis. Patients reconstructed with autologous tissue were the group most satisfied. SNSM is an oncological safe procedure for breast cancer treatment with low recurrence in properly selected patients.

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confidence: 97%

Skin and Nipple-Areola Complex Sparing Mastectomy in Breast Cancer Patients

Stanec

Žic

Budi

et al. 2014

Annals of Plastic Surgery

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“…Se opina también que la posición submuscular previene la contaminación periprotésica por bacterias del sistema ductal mamario 45 . La implantación subcutánea de prótesis de silicona lisas, para reconstrucción mamaria, se asocia a una incidencia muy alta de contractura capsular severa 36,46,47 . Según Ringberg 47 , la posición del implante es el factor relacionado más significativamente con la contractura capsular en la reconstrucción tras mastectomía subcutánea.…”

Section: Posición Anatómica De La Prótesisunclassified

“…La implantación subcutánea de prótesis de silicona lisas, para reconstrucción mamaria, se asocia a una incidencia muy alta de contractura capsular severa 36,46,47 . Según Ringberg 47 , la posición del implante es el factor relacionado más significativamente con la contractura capsular en la reconstrucción tras mastectomía subcutánea. Al evaluar 176 mujeres sometidas a dicha intervención, la mayoría recibiendo prótesis de silicona lisas, apreció la contractura en el 80% de las subcutáneas y en el 31% de las submusculares.…”

Section: Posición Anatómica De La Prótesisunclassified

“…Al evaluar 176 mujeres sometidas a dicha intervención, la mayoría recibiendo prótesis de silicona lisas, apreció la contractura en el 80% de las subcutáneas y en el 31% de las submusculares. La cobertura muscular puede proporcionar una barrera física entre la prótesis y los conductos mamarios contaminados, seccionados bajo el pezón 36,47 .…”

Section: Posición Anatómica De La Prótesisunclassified

“…Entre los que han reducido su incidencia destacan los siguientes: prótesis llenadas con suero fisiológico 40 ; prótesis de gel de silicona cohesivo 41 ; prótesis con cobertura de poliuretano o de silicona texturada 3 ; posición submuscular de la próte-sis [45][46][47] ; drenajes aspirativos 35 ; administración local de esteroides 51 o de agentes antibacterianos, tales como solución de povidona-yodada 52 o diversos antibióti-cos 53 ; administración oral de vitamina E 35 ; y ejercicios postoperatorios de compresión y desplazamiento de la prótesis 35 . Young y Watson 37 , tras una revisión de la literatura y de su experiencia, consideran que la variable más importante en la prevención de la contractura capsular es la posición del implante, que tendría mayor influencia que las características de su superficie.…”

Section: Prevención Y Tratamientounclassified

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Reacción tisular a las prótesis mamarias: Contractura capsular periprotésica

Escudero

Guarch

Lozano

2005

Anales Sis San Navarra

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RESUMENLas prótesis mamarias de silicona provocan el desarrollo de una envoltura fibrosa o cápsula periprotésica. La contractura de la cápsula, por retracción del tejido fibroso, es la complicación más frecuente e importante de estos implantes. Produce un endurecimiento de grado variable y, en los casos avanzados, deformidad de la mama. Se ha relacionado estrechamente con el tipo de superficie del implante (lisa o texturada) y con la disposición de las fibras de colágeno, habiéndose sugerido que la formación de una cápsula continua, con fibras de colágeno dispuestas paralela y circularmente alrededor de las prótesis lisas, promueve el desarrollo de fuerzas contráctiles concéntricas, que traccionando al unísono producirían la contractura. Con las prótesis texturadas microporosas se ha demostrado una incidencia significativamente más baja de contractura capsular en comparación con las lisas. Se considera que el crecimiento tisular dentro de la estructura microporosa origina fuerzas contráctiles multidireccionales, con tendencia a neutralizarse entre ellas cuando su efecto se suma sobre el implante. La cápsula de estos implantes presenta una zona basal compuesta de múltiples capas de fibras de colágeno alineadas paralelamente, la cual podría contraerse. Sin embargo, la adherencia de las prótesis texturadas microporosas podría contrarrestar las fuerzas contrác-tiles.Palabras clave. Prótesis mamarias. Cápsula periprotésica. Contractura capsular. ABSTRACTSilicone breast prostheses prompt the development of a fibrous casing or periprosthetic capsule. Capsular contracture, due to retraction of the fibrous tissue, is the most frequent and important complication of these implants. It produces varying degrees of hardening and, in advanced cases, deformity of the breast. It has been closely related to the type of surface of the implant (smooth or textured) and with the alignment of the collagen fibers, and it has been suggested that the formation of a continuous capsule, with collagen fibers aligned in parallel and circularly around the smooth prostheses, promotes the development of concentric contractile forces that pulling in unison give rise to contracture. With microporous textured prostheses a significantly lower incidence of capsular contracture has been shown in comparison with smooth prostheses. It is believed that tissue growth within the microporous structure gives rise to multidirectional contractile forces, with a tendency to neutralize one another when their effect is added over the implant. The capsule of these implants presents a base zone composed of multiple layers of collagen fibers aligned in parallel, which might contract. However, the adherence of the microporous textured prostheses might counteract the contractile forces.

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Bilateral breast cancer

Fracchia

Borgen

1991

Seminars in Surgical Oncology

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Bilateral breast cancer has a cumulative incidence of 7% to 20% in patients with primary operable breast cancer, and the majority of these lesions are metachronous. A consensus on the management of the contralateral breast has been elusive. Much of the confusion arises from the fact that there exist marked differences of opinion regarding the impact of a second primary breast cancer on the overall prognosis. The risk of developing a contralateral breast cancer is influenced by the age of the patient, the presence of in situ disease, lobular histology of this new lesion, multicentricity, exposure to certain types of ionizing irradiation, and, possibly, family history of breast cancer. Management options include observation (clinical and mammographic surveillance), contralateral biopsy, and, rarely, prophylactic mastectomy. It is hoped that trials of breast cancer prevention, employing drugs such as tamoxifen, will identify agents capable of abrogating the risk of contralateral breast cancer and improve the ultimate outcome.

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Subcutaneous mastectomy ? surgical techniques and complications in 176 women

Cited by 10 publications

References 25 publications

Skin and Nipple-Areola Complex Sparing Mastectomy in Breast Cancer Patients

Skin and Nipple-Areola Complex Sparing Mastectomy in Breast Cancer Patients

Reacción tisular a las prótesis mamarias: Contractura capsular periprotésica

Bilateral breast cancer

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