• Archives of Plastic Surgery
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• 제36권4호
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• pp.503-506
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• 2009

Purpose: Unilateral breast reconstruction after mastectomy confront the challenges of recreating a natural appearing breast mound and achieving symmetricalness of the breasts. If the patient's remaining breast is large compared to reconstructed breast, the most common procedure is reduction mammoplasty of the large breast side. The authors experienced a new method of breast reconstruction using the excess breast tissue from the contralateral breast after breast reduction. Methods: The excess tissue from the contralateral breast after vertical reduction mammoplasty with superior pedicle and remaining lower breast tissue were transferred to the mastectomy site breast through the subcutaneous tunnel on the chest wall. The main blood supplies of the flap are perforator branches of the 4th, 5th and 6th anterior intercostal artery. After elevating and detaching the flap on the lower lateral area of the breast, the turn overed flap is fixed on the upper portion of the chest wall of the mastectomy site. Results: On two cases of the breast reconstructions, remaining excess breast tissue from reduction mammoplasty was transferred to the contralateral breast side as pedicles. Both patient and operator were satisfied with the outcome of the reconstruction as the breasts were symmetrical and natural shape. Conclusion: We have performed unilateral breast reconstruction using the excess breast tissue after reduction mammoplasty of the contralateral breast. As Oriental women's breasts are relatively smaller than that of Caucasian women, delayed breast reconstruction cases of Oriental women with large breasts(macromastia) seem to be ideal for this procedure.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.553-558
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• 2013

Background Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Methods Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. Results During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Conclusions Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

• 여성건강간호학회지
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• 제9권4호
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• pp.379-389
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• 2003

Purpose: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. Method: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. Result : Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. Conclusion: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.

• 한국식품영양학회지
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• 제11권2호
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• pp.171-178
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• 1998

K14 환자는 유방암 수술, 방사선 치료, 피부이식 수술, 무릎 관절통의 기왕력이 있는 고령의 여성 호흡 곤란증 환자로서 문진과 진찰, 혈압, 비만도 측정, 임상병리, 흉부 X-선, 심전도와 심초음파, 폐기능 검사 등 체계적인 심폐기 질환의 진단 결과 비난증과 고혈압, 좌심실 비대, 만성 폐질환의 소견이 있어 심폐기능 모두에서 문제성이 발견되었다. 검사 결과들의 정밀한 판독법 및 장기-치료 관찰 결과를 임상문헌과 함께 고찰하였다.

• 대한암한의학회지
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• 제12권1호
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• pp.67-73
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• 2007

Breast cancer is common in West and Incidence of breast cancer has increased in Korea. According as conventional western medical treatment, breast cancer patient received MRM(modified radical mastectomy) and anti cancer chemotherapy. In this case report, We introduce a case of breast cancer patient who showed lung metastasis(metastatec adenocarcinoma) after MRM(modified radical mastectomy) 4 years before the diagnosis of relapse. After lung metastasis of breast cancer, the patient received 4th chemotherapy and refused to get more conventional western medical treatment including chemotherapy. After 24 month of traditional oriental medical treatment using allegen removed Rhus Verniciflua Stokes(ARV), however, the size of cancer mass decreased and the patient showed improved condition. Further case study will be needed in order to determine the effect of ARV on breast cancer patient.

• Radiation Oncology Journal
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• 제26권1호
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• pp.10-16
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• 2008

목적: 조기 유방암에서 유방보존치료와 유방절제술의 치료 성적을 비교하고, 예후 인자를 알아보고자 하였다. 대상 및 방법: 1994년 9월부터 2002년 12월까지 본원에서 근치적 수술을 받은 병리학적 병기 $T1{\sim}2N0$ 유방암 환자 1,200명을 후향적으로 분석하여 유방보존치료와 유방절제술을 사이의 차이를 비교해 보았다. 결과: 분석에 포함된 1,174명의 환자 중 601명이(51.2%) 유방보존치료를 받았고 573명이(48.8%) 유방절제술을 받았다. 유방절제술을 받은 군에서 유의하게 종양의 크기가 컸고, 다발성(multicentricity), 에스트로겐 및 프로게스테론 수용체 음성 등의 인자가 더 많은 경향을 보였다. 유방보존치료 및 유방절제술을 받은 환자의 10년 생존율은 각각 91.96%와 91.01%였고(p=0.1274), 10년 무병생존율은 각각 80.48%와 84.95%(p=0.8795)로 유의한 차이를 보이지 않았다. 결론: 조기 유방암에서 유방보존치료 내지는 유방절제술을 받은 군 사이에 환자 특성의 차이는 일부 있었으나 생존율에서 유의한 차이를 보이지 않았다.

• 한국임상수의학회지
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• 제19권4호
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• pp.440-442
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• 2002

A fourteen-year-old mongrel female dog that was 22 kg and had two large mammary tumor lesions was admitted to the Animal Teaching Hospital of Chonbuk National University. Two large mammary tumor lesions were observed in the right caudal thoracic and the left inguinal mammary glands, which were sized 6 cm and 5 cm in diameter, respectively. These tumor lesions were removed by block mastectomy, then large skin defect of 7 cm diameter in caudal abdominal wall were recoverd by classic Z-plasty in both medial thigh. Classic Z-plasty was designed with 60 in angle and, with 6 cm in length of central limb in right medial thigh and 4 cm in left, respectively. This patient had been recoverd to normal gait and behavior at 20 days after the plastic operation.

• 기본간호학회지
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• 제8권2호
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• pp.172-188
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• 2001

Purpose: The purpose of this research was to test the effectiveness of the nursing intervention, mutual goal setting, for patients who have had a mastectomy. Special reference was given to King's goal attainment theory and a theoretical framework for establishing an effective nursing strategy to enhance patient recovery is suggested. Method: This research employed a quasi-experimental design which consisted of pretest-posttest non-equivalent control and experimental groups. Data were collected from 37 patients who had a mastectomy and were hospitalized in the Department of Surgery of Y Medical Center from January 2001 to May 2001. The experimental group received the nursing intervention, mutual goal setting four times from the day before the operation to the fifth day after the operation while the control group received only routine nursing care. As postoperative recovery indicators, ROM of arm joints, arm circumference, pain, physical symptoms, oxygen saturation stress, anxiety and body image were measured. Result: The test results are as follows : 1) there were statistically significant differences between the experimental and control groups in extension and internal rotation of the shoulder Joint and flexion of the wrist joint. 2) there was no significant difference between the two groups in arm circumference. 3) there were no significant differences between the two groups in pain, physical symptoms, or oxygen saturation. 4) there were no significant differences between the two groups in stress, anxiety, or body Image. On the basis of research results, the following are recommended : 1) The effectiveness of nursing intervention in the acute recovery period as well as long term effects need to be investigated. 2) There is a need to develop an instrument to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• The Korean Journal of Pain
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• 제34권1호
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• pp.106-113
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• 2021

Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.601-607
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• 2015

Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.