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Abstract

With the steady increase in the incidence of breast cancer in women, treatment that includes not only tumor removal but also breast reconstruction is becoming a more relevant issue for oncologic and plastic surgeons. Mastectomy recently evolved as a form of primary prevention of hereditary breast cancer, commonly performed in combination with simultaneous reconstruction. A case of 44-year-old woman who underwent right mastectomy with adjuvant radiotherapy is presented. Due to the patient’s positivity for BRCA1 mutation and her wishes, a risk-reducing mastectomy with nipple-areola complex preservation and bilateral deep inferior epigastric artery perforator flap reconstruction were performed in one-stage. In selected cases this method appears to be the best possible procedure for simultaneous preventative and reconstructive management in patients with genetically determined breast cancer who have undergone mastectomy with radiotherapy.
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Bibliography

1. Wojciechowska U., Didkowska J., Michałek I., et al.: Cancer in Poland in 2018. Polish National Cancer Registry, Warsaw 2020.
2. Kuchenbaecker K.B., Hopper J.L., Barnes D.R., et al.: Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017; 317: 2402–2416. doi: 10.1001/jama.2017.7112
3. Ulatowski Ł., Kaniewska A.: The Use Of The Diep Flap In The Modern Reconstructive Surgery. Pol J Surg. 2015; 87 (9): 472–481. doi: 10.1515/pjs-2015-0091
4. Bletsis P., Bucknor A., Chattha A., et al.: Evaluation of Contralateral and Bilateral Prophylactic Mastectomy and Reconstruction Outcomes: Comparing Alloplastic and Autologous Reconstruction. Ann Plast Surg. 2018 Apr; 80 (4): 144–149. doi: 10.1097/SAP.0000000000001358
5. Nestle-Krämling C., Kühn T.: Role of Breast Surgery in BRCA Mutation Carriers. Breast Care. 2012; 7: 378–382. doi: 10.1159/000343717
6. Rocco N., Montagna G., Criscitiello C., et al.: Nipple Sparing Mastectomy as a Risk-Reducing Procedure for BRCA-Mutated Patients. Genes. 2021; 12 (2): 253. doi: 10.3390/genes12020253
7. Daar D.A., Abdou S.A., Rosario L., et al.: Is There a Preferred Incision Location for Nipple-Sparing Mastectomy? A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2019 May; 143 (5): 906e– 919e. doi: 10.1097/PRS.0000000000005502
8. Chirurgiczne leczenie zmian nowotworowych piersi. Konsensus Polskiego Towarzystwa Chirurgii Onkologicznej. Eds. Z.I. Nowecki, A. Jeziorski. Biblioteka chirurga onkologa. Tom 5. Via Medica, Gdańsk 2016.
9. Ulatowski Ł., Noszczyk B.: BREAST-Q questionnaire: tool for evaluation of quality of life following breast reconstruction with DIEP/SIEA flap. Pol J Surg. 2018; 90 (4): 16–20. doi: 10.5604/01.3001.0012.0758
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Authors and Affiliations

Łukasz Ulatowski
1
Piotr Gierej
1
Maria Molska
1

  1. Department of Plastic Surgery, Medical Centre for Postgraduate Education, Professor W. Orlowski Memorial Hospital, 231st Czerniakowska Street, 00-416 Warsaw, Poland
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Abstract

The use of hyperbaric oxygen therapy (HBOT) is an accepted method of supporting wound healing in human medicine. Yet, because of the risk of complications associated with HOBT, a safer modification of the therapy, known as L-HOBT (lower pressure and lower oxygen concen- tration), is increasingly used nowadays. Therefore, due to the lack of literature reports regarding the clinical use of L-HBOT in animals, the authors decided to present the results of L-HBOT supportive treatment of postoperative wounds after hemimastectomy compared to classic treat- ment. The study group included 12 bitches divided into two groups: group A (assisted L-HBOT) and group B (classic treatment). In addition to conventional treatment, the supportive therapy included 1.5 hours of hyperbaric chamber therapy for 5 consecutive days, starting 24 hours after surgery (1500hPa pressure and 26% oxygen concentration in the chamber). The patients were followed and evaluated throughout the course of the treatment by two independent doctors. The results of the treatment revealed no negative clinical impact of L-HOBT supportive therapy on the body of the animals. At the same time, postoperative wounds after L-HOBT healed faster and with fewer postoperative complications compared to the control group. This resulted in a shorter treatment period, terminating with an earlier skin suture removal.

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Authors and Affiliations

W. Łunkiewicz
Z. Kiełbowicz
K. Kalisiak
K. Tuliński
P. Prządka

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