The authors discuss the development of breast reconstruction following mastectomy in Czechoslovakia and present their first case of bilateral reconstruction employing the technique of the TRAM flap. In addition, they explore the possibility of eliminating high-risk parenchyma during with contralateral reconstruction.

• MeSH
• břišní svaly transplantace   MeSH
• chirurgické laloky metody   MeSH
• dospělí MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• mastektomie modifikovaná radikální rehabilitace   MeSH
• transplantace kůže metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Breast cancer is the leading cause of neoplasm mortality among women. Several prevention strategies have been implemented to early detect and prevent the cancer occurrence. The most effective protocol includes prevention mastectomy for the high-risk patients. In our study, we have compared the efficacy of subcutaneous mastectomy (SCM) and skin sparing mastectomy (SSM) in long-term follow up. METHODS: We have included 201 female patients who have been treated at our department over the course of 20 years between 2000 and 2019. All the patients were at high risk of developing breast cancer and therefore were indicated for the prophylactic mastectomy. The main indication was the presence of the mutation in the BRCA1 or BRCA2 cluster, however, even in the lack of such mutation, the family history was sufficient for the mastectomy indication. Patients underwent either SCM, SSM or areola sparing mastectomy (ASM), and were allocated to aforementioned groups, respectively. We have collected the data regarding the reconstruction method along with age, weight, height, body mass index (BMI) and presence of predisposing genetic mutations such as BRCA positivity. RESULTS: The patients who underwent SSM compared to those who underwent SCM were of higher age, with higher BMI and body mass. The patients in SSM group had statistically significantly higher BMI than in ASM. There was no difference in efficacy between patients who underwent SSM and SCM. The majority of patients (91.5%) were positive for BRCA1 or BRCA2 mutation. In our study, only four patients were tested negative for known breast cancer inducing mutation (three in SCM and one in SSM). The most common reconstruction method was an abdominal flap and breast implant. CONCLUSIONS: Prophylactic mastectomy is a reliable strategy for significantly reducing the number of breast cancer incidence in high-risk patients regardless of the selected method of mastectomy. These operations allow for the subsequent reconstruction with the whole spectrum of reconstructive options.

• Klíčová slova
• BRCA2, Breast cancer, Cancer prevention, breast cancer, skin sparing mastectomy, subcutaneous mastectomy,
• MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• mastektomie metody   MeSH
• nádory prsu * genetika   prevence a kontrola   chirurgie   MeSH
• retrospektivní studie MeSH
• subkutánní mastektomie * metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The authors are describing the technique of the partial mastectomy for the breast cancer in this work, as used in the Masaryk oncological institute. For easy understanding they are adding illustrations of the singular phases of this operation. They are also discussing the indications and are showing a short historical review of the authors having published the results of this surgery.

• MeSH
• lidé MeSH
• segmentální mastektomie metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: Mutations in the BRCA1 or BRCA2 genes increase the lifetime risk of developing breast cancer to 68-72% by the age of 80. One of the modalities to manage the risk is a prophylactic mastectomy. Bilateral nipple-sparing mastectomy specifically offers the most favorable esthetic outcomes but the evidence for its oncological safety remains limited. Thus, we aimed to compare the occurrence of breast cancer between nipple-sparing mastectomy and surveillance groups of BRCA1 or BRCA 2 mutations carriers. MATERIALS AND METHODS: BRCA1 or BRCA2-positive patients undergoing bilateral prophylactic nipple-sparing mastectomy at our department were identified. Only those unaffected by breast cancer were eligible. Each patient was pair-matched with a BRCA1 or BRCA2-positive patient of equal age from the surveillance group. Breast cancer incidence in both groups was recorded and the results were compared. RESULTS: None of 105 patients who underwent NSM between 2009 and 2019 at a single institution with a mean follow-up time of 50 months developed breast cancer over this time period. One patient in this group died of an unrelated cause. Nine patients from 105 in the match-paired surveillance group were diagnosed with breast cancer during a mean follow-up time of 58.3 months, however, none of them died. CONCLUSION: To the best of our knowledge, this is the largest single-center study of risk-reducing bilateral NSM in healthy BRCA1 or BRCA2 mutation carriers. Based on our results and those of other series, we conclude that NSM in its current form appears to be at least equally as safe as other types of mastectomy for preventing breast cancer in BRCA1 or BRCA2 mutation carriers. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

• Klíčová slova
• BRCA, Nipple-sparing mastectomy, Prophylactic mastectomy,
• MeSH
• lidé MeSH
• mutace MeSH
• nádory prsu * genetika   prevence a kontrola   chirurgie   MeSH
• protein BRCA1 genetika   MeSH
• protein BRCA2 genetika   MeSH
• prsní bradavky chirurgie   MeSH
• subkutánní mastektomie * metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• BRCA1 protein, human MeSH Prohlížeč
• BRCA2 protein, human MeSH Prohlížeč
• protein BRCA1 MeSH
• protein BRCA2 MeSH

Introduction: Symptomatic calcifications of the breast or skin after breast cancer surgery and adjuvant radiotherapy are a rare entity, with only a few case reports published worldwide, reducing the patient's quality of life, whilst asymptomatic calcifications are a common finding on imaging methods. Case presentation: Herein, we present a rare case report of calcifications after mastectomy and post-mastectomy radiation therapy causing chronic inflammation with ulceration and fistula formation, with a two-step surgical approach consisting of excision with linear suture and excision with the reconstruction using a thoraco-epigastric flap. Conclusions: To our knowledge, this is the first publication proving the feasibility of this therapy in patients with symptomatic dystrophic calcifications of the skin or the breast. Moreover, the article provides an up-to-date review of published studies about symptomatic calcifications after breast cancer surgery and radiotherapy with a focus on the time of the clinical manifestation from the radiotherapy and the used radiotherapy scheme.

• Klíčová slova
• breast cancer, calcifications, mastectomy, radiotherapy,
• MeSH
• adjuvantní radioterapie MeSH
• kalcinóza * etiologie   chirurgie   MeSH
• kvalita života MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• mastektomie škodlivé účinky   metody   MeSH
• nádory prsu * radioterapie   chirurgie   MeSH
• prsy chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

The purpose of this study was to compare the radiation dose to organs at risk for deep-inspiration breath hold (DIBH) and free-breathing (FB) radiotherapy in patients with lef-sided breast cancer undergoing adjuvant radiotherapy after partial mastectomy. Methods: One hundred patients with left-sided breast cancer underwent DIBH and FB planning computed tomography scans, and the 2 techniques were compared. Dose-volume histograms were analyzed for heart, left anterior descending coronary artery (LAD), and left lung. Results: Radiation dose to heart, LAD, and left lung was significantly lower for DIBH than for free breathing plans. The median mean heart dose for DIBH technique in comparison with FB was 1.21 Gy, and 3.22 Gy respectively; for LAD, 4.67 versus 24.71 Gy; and for left lung 8.32 Gy versus 9.99 Gy. Conclusion: DIBH is an effective technique to reduce cardiac and lung radiation exposure.

• Klíčová slova
• deep−inspiration breath hold radiotherapy−breast cancer−cardiovascular toxicity−adjuvant radiotherapy,
• MeSH
• celková dávka radioterapie MeSH
• jednostranný karcinom prsu * diagnostické zobrazování   radioterapie   chirurgie   MeSH
• lidé MeSH
• mastektomie MeSH
• nádory prsu * radioterapie   chirurgie   MeSH
• plánování radioterapie pomocí počítače MeSH
• segmentální mastektomie MeSH
• zadržování dechu MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

In women at high risk of developing breast cancer, bilateral prophylactic mastectomy (BPM) 1 significantly reduces the risk; simultaneously, breast reconstruction preserves body integrity. Given the complex and personal nature of such surgical procedures, patient assessment of satisfaction and health-related quality of life (HRQoL) 2 is essential in evaluation of surgical outcomes. With this review, we aim to organize the current knowledge on patient-reported outcomes (PROs) 3 in bilateral prophylactic surgery. Literature search was conducted using the databases Google Scholar, PubMed, and Web of Science to address the following questions, which can help clinicians and women undergoing the procedures navigate their healthcare decision-making process: How does BPM with reconstruction influence cancer-related distress? How does the surgery impact patient satisfaction and HRQoL? How do preoperative PROs differ from postoperative outcomes? Does the type of BPM and the type of reconstruction impact patient satisfaction and HRQoL? Furthermore, we summarize available patient-reported outcome measures (PROMs) 4 that can be administered to women undergoing BPM with reconstruction. In addition, we discuss possible future directions for PRO research in prophylactic breast surgery.

• Klíčová slova
• Bilateral prophylactic mastectomy, Breast reconstruction, Health-related quality of life, Hereditary breast cancer, Patient-reported outcomes, Satisfaction,
• MeSH
• hodnocení výsledků péče pacientem MeSH
• kvalita života MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• mastektomie metody   MeSH
• nádory prsu * prevence a kontrola   chirurgie   MeSH
• profylaktická mastektomie * metody   MeSH
• spokojenost pacientů MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• adaptace psychologická * MeSH
• lidé MeSH
• mastektomie psychologie   MeSH
• nádory prsu psychologie   chirurgie   MeSH
• pooperační komplikace psychologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The authors present a group of nine patients after mastectomy. Breast reconstruction was performed by transposition (3) or by free transplantation (6) of a TRAM flap. Based on a review of literary reports, and on their own experience, the authors consider this procedure to be a reliable and effective method of breast reconstruction.

• MeSH
• chirurgické laloky metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mamoplastika metody   MeSH
• mastektomie * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• BREAST *, MASTECTOMY *, SURGERY, PLASTIC *, TRANSPLANTATION, AUTOLOGOUS *,
• MeSH
• autologní transplantace * MeSH
• lidé MeSH
• mamoplastika * MeSH
• mastektomie * MeSH
• plastická chirurgie * MeSH
• plastické hmoty * MeSH
• prsy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• plastické hmoty * MeSH