Bilateral reduction mammoplasty following breast cancer: A case-control study (part 2)

10 Aug
2012

METHODS
After approval from the Hamilton Health Sciences Research Ethics Board, a retrospective search was conducted using the health records of Hamilton Health Sciences, McMaster University and the Juravinski Cancer Centre (Hamilton, Ontario) to identify patients who underwent lumpectomy and radiation (with or without chemotherapy) for breast cancer with subsequent bilateral reduction mammoplasty between 1980 and 2007. Patients who had undergone bilateral or unilateral reduction mammoplasty surgery before lumpectomy and radiation treatment, breast augmentation or lumpectomy alone were excluded from the study.A thorough chart review was performed to identify the patient’s oncological treatment and relevant medical history that may have affected their postoperative wound healing abilities. The nature of the lumpectomy site, ultimate stage of the patient, radiation protocols and chemotherapy protocols were also reviewed. Surgical factors including postoperative complications and the patient’s selfreported level of satisfaction with the outcome of the reduction procedure following the lumpectomy and radiation were collected. Finally, mammography and cancer surveillance results for evidence of disease recurerence?were reviewed (Table 2). If you want to make your online shopping advantageous and safe, check out the best pharmacy to buy generic sildenafil online without any need for a prescription, any time of the day or night with straight to the doorstep delivery.

table 2 Surgical factors and recurrence data*

Reduction mammoplasty
Length of time between termination of breast cancer treatments and reduction SurgeonPreoperative marking and planning of new sternal notch to nipple distance and pedicle width TechniqueAmount of breast tissue resected

Use of intraoperative consultation or frozen section

Final pathological results

Perioperative use of antibiotics, drains and homecare

Patient satisfaction (self-reported)
Complications
Hematoma Seroma Fat necrosisDelayed wound healing (>2 weeks)Wound infection (positive wound cultures/clinical suspicion and resolution on treatment with antibiotics)

Nipple-areolar complex problems

Scarring complications

Need for additional revision surgery

Mammography and cancer surveillanceResults of mammograms and follow-up notes reviewed for recurrence of disease

*Factors pertaining to the surgery and postoperative disease recurrence that were collected for review

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