• Korean Journal of Acupuncture
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• 제28권4호
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• pp.101-112
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• 2011

Objectives : This study was done to investigate the degree of the pulse wave parameter of post-mastectomy women and to identify the relationships between each of them. Methods : Data were obtained from public health center in Busan Metropolitan city. Participants were 82 post-mastectomy women aged 31-82. the data collection was from Oct, 1, 2010 to Oct, 31, 2010. the data were analyzed with descriptive statistics, one-way ANOVA, Duncan test. A p-value less than .05 was considered significant by 2-tailed test. All statistical analyses were performed with SPSS/Win(ver 12.0). Results : As for the difference in the pulse wave by the general characteristics. The pulse energy was showed highly in the order of Chon, Quan and Chuk of left and right pulse respectively. In the pulse energy of left Quan and right Chon, the case of both mastectomy was showed highly and in the pulse energy of left Chuk, the case of right mastectomy was showed highly. Left and right pulse energy of menopause female were significantly higher than normal range except left Chon and Chuk. In h1, h2, h4, h5, t1, t2, AP and Aw, the pulse energy of left Chon was showed the largest significantly. In As, the pulse energy of right Chon was showed the smallest and in Ad, right Chuk was showed the largest. In RAI, right and left Chuk was showed the highest respectively. Conclusions : From these result, we can see that there are relation between women's age, area of operation breast and menopause after mastectomy in pulse wave. The result of this study will become basic data necessary for the Oriental Medicine treatment to reduce or prevent women's functional difficulties, symptomatology after mastectomy.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.433-440
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• 2019

Background Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients' habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.

• 대한물리치료과학회지
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• 제7권2호
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• pp.439-457
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• 2000

The causes, risk factors and sequelae of mastectomy were studied, and the physical therapy approaches on post-mastectomy was discussed in this study. It was found that the patients taken mastectomy have experienced pins and needles in muscle, weakening of muscle, pains, deterioration of motion in joint region and activities of daily living, psychiatric sequelae, and etc even after the conservertive therapies like the chemical therapy, radiotherapy, immunotherapy, and hormone therapy. However, few study on the physical therapy approaches for patients with breast cancer has been carried in Korea at present. The followings were proposed as the physical therapy approaches. 1. Shoulder joint motion approach to relax the limit of range of motion 2. Control of breathing exercise for dealing with removal of the pectorailis muscle 3. Method to reduce the edema of arms for tackling the cut of lymph node 4. Method to reduce pains, pins and needles 5. Support home exercise program after discharging from hospital, sexual life and pregnancy, and activities of daily living training method.

• 종양간호연구
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• 제7권1호
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• pp.47-55
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• 2007

Purpose: The purpose of this study was to examine the effects of foot massage as a nursing intervention on the anxiety and pain of the mastectomy patients. Method: This research was quasi-experimental study of a total of 28 patients with 14 in the experimental group and 14 in the control group. For the experimental group, foot massage for 30 minutes was given by a foot-massage specialist. Anxiety and pain were measure once before the foot massage and five times after the massage. The collected data were analyzed by repeated ANOVA and t-test using the SPSS 12.0 program. Result: There was a statistically significant decrease in anxiety and pain in the experimental group compared to the control group over 5 different times. Conclusion: The foot massage was effective on anxiety and pain in mastectomy patients in this study. Therefore, foot massage would be usefully utilized as a nursing intervention for mastectomy patients.

• Archives of Plastic Surgery
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• 제46권3호
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• pp.262-266
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• 2019

Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.

• 종양간호연구
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• 제8권2호
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• pp.86-92
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• 2008

Purpose: This study was designed to investigate the body-image and quality of life in breast cancer patients with mastectomy. Methods: Data were obtained by self-reported questionaries from 110 patients undergone mastectomy from August 1 to 31, 2007. And data were analyzed using SPSS/PC WIN 12.0 program and frequency, percentage, mean, minimum, maximum, t-test, ANOVA, Scheffe test, Pearson's Correlation Coefficient were used. The results of the study were as follows; 1) Mean of Body image of the subjects was $52.54{\pm}6.67$ (range of scale; 17 to 85). Mean of quality of life was $118.01{\pm}34.37$ (range of scale; 0 to 10). 2) There was no significant difference with the score of body image by demographic and disease-related characteristics of subjects. 3) There was significant difference with the score of quality of life by the work type and economic status of subjects. 4) Relationship between body image and quality of life showed moderately strong positive correlation (r=0.408, p<0.0001). Conclusion: Mean of body image and of quality of life in mastectomy patients were moderate. Relationship between body image and quality of life showed moderately strong positive correlation. Therefore, for improving the quality of life, it is needed to improve body image in breast cancer patients with mastectomy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.539-545
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• 2013

Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (${\leq}10$) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Conclusions: Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.

• 종양간호연구
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• 제3권2호
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• pp.103-111
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• 2003

The purpose of this study was to identify the effect of imagery therapy on "coping mechanism and type C personality of the women with mastectomy. To achieve this purpose, 2 hours sessions of imagery therapy were given to the patients with breast cancer twice a week for 6 weeks. The period of data collection was from July, 7th to August, 12th 2002. The participants were 30 patients, 15 experimental group, 15 control group who were treated at the G University hospital in J City. This study was designed using a quasi-experimental approach with non-equivalent Pre test-Post test Design. The themes for the Imagery Therapy Program were composed of Leuner's(1969) 12 Imagery Themes: flower, green-field, stream, mountain, house, woods, significant figures, rose, lion, ideal self-image, cave and volcano. The data were analyzed with ${\chi}2-test$ and MANOVA using the SPSS program. The course of image change of the 12 imagery themes was analyzed by content analysis. The results of this study are as follows: First Hypothesis, 'The score of type C personality in the women with mastectomy who received imagery therapy will be significantly lower than that of the control group' was supported(p<.05). Second Hypothesis, 'The score of coping mechanism' in the women with mastectomy who received imagery therapy will be significantly higher than that of the control group' was rejected. In conclusion, imagery therapy is suggested as an effective nursing intervention to change type C personality of the women with mastectomy, but not effective to improve coping mechanism. Therefore, the program for the women with mastectomy should be developed to change their coping mechanism, method of problem solving and Quality of life.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.366-373
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• 2014

Background The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis. However, the nipple-areolar complex (NAC) in Asian patients is more pigmented and scars easily. Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer. Methods We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size. Four incision types are described: peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision. Results 281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy. The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%). The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients. The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived. 24% of the patients (68/281) underwent subsequent nipple reconstruction. Conclusions Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin. This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result in Asian women without neglecting oncological safety.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.509-515
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• 2017

Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio=7.81; 95% confidence interval, 1.38 to 44.23; P=0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.