Information requirements of young women with breast cancer treated with mastectomy or breast conserving surgery: A systematic review
Recio-Saucedo
A, Gerty S et al.
Online
Publication (February 2016Volume 25, Pages 1–13)
Young
women with breast cancer have poorer prognosis, greater lifetime risk of local
recurrence, contralateral recurrence, and distant disease, regardless of
surgery received. Here we systematically review published evidence relating to
the information requirements and preferences of young women diagnosed with
early-stage breast cancer offered a choice between mastectomy and Breast
Conservation Surgery (BCS). Findings will inform the development of a surgical
decision aid for young women.
The Profunda Artery Perforator Flap: Investigating the Perforasome Using Three-Dimensional Computed Tomographic Angiography
Wong,
C et al
Plastic
& Reconstructive Surgery: November 2015 - Volume 136 - Issue 5 - p 915–919
Background:
The profunda artery perforator flap has been emerging as an alternative method
of autologous breast reconstruction. This flap uses upper posterior thigh
tissue. The profunda artery perforator perforasome is investigated using
three-dimensional computed tomographic angiography.
Methods: Ten cadaveric thighs were dissected centered over the profunda artery
perforator. The perforator was injected with contrast medium and the flap was
then subjected to computed tomographic scanning using a GE Lightspeed 16-slice
scanner. The three-dimensional images were viewed, and measurements were
obtained using Aquarius software, including horizontal and vertical extensions
of the flap and areas of perfusion. Clinical examples are presented.
Results: A profunda artery perforator
(occasionally two) was consistently found in the upper medial thigh region,
posterior to the gracilis muscle. The area of vascularity shown by the spread
of contrast extends inferiorly beyond the usual lower border of the profunda
artery perforator flap, which is usually 7 cm wide. In injected cadaveric
flaps, the mean horizontal dimension was 16.7 cm and the mean vertical
dimension was 16.5 cm. The mean area perfused was 8812 cm2. Conclusions: The
profunda artery perforator flap is a vascularly sound flap, and is a good
option for autologous breast reconstruction. Advantages include a reliable
pedicle, no position changes required, and possibly an improved donor-site
contour from a thigh lift. It is an excellent alternative to abdominally based
free flaps and can also be used in conjunction with other flaps for further
volume enhancement.
