breast reconstruction: upon diagnosis…
DESCRIPTION
Breast Reconstruction: Upon Diagnosis…. Michael J Bass, MD, JD www.drmichaeljbass.com 859-543-1024. Disclosures. None I need some. Support Provided By. Lifecell AlloDerm Strattice. Lecture Layout. - PowerPoint PPT PresentationTRANSCRIPT
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Breast Reconstruction:Upon Diagnosis…
Michael J Bass, MD, JDwww.drmichaeljbass.com
859-543-1024
![Page 2: Breast Reconstruction: Upon Diagnosis…](https://reader036.vdocument.in/reader036/viewer/2022062315/56816688550346895dda3b65/html5/thumbnails/2.jpg)
Disclosures
• None• I need some
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Support Provided By
• Lifecell– AlloDerm– Strattice
![Page 4: Breast Reconstruction: Upon Diagnosis…](https://reader036.vdocument.in/reader036/viewer/2022062315/56816688550346895dda3b65/html5/thumbnails/4.jpg)
Lecture Layout
• Dr. Michael Bass – state of breast cancer in the U.S., preoperative analysis, timing of care
• Dr. Monica Hall – implant-based versus autologous breast reconstruction
• Dr. Theresa LeVan – autologous fat grafting breast reconstruction
• Dr. Michael Bass – satisfaction surveys and outcomes analysis
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Part 1 Layout
• Incidence of breast cancer• Trends in breast cancer• Risk by age• Preoperative assessment• Preoperative considerations
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Incidence of Breast Cancer
• CDC 2008: 210,203 breast cancer diagnoses– 40,589 deaths
• White > Black > Hispanic > Asian > American Indian
• Kentucky: 117-121:100,000, third quartile among states
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Diagnosis Trends in U.S.: 1999-2008
• Decreased by 1.2% per year among white women.
• Remained level among black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander women.
http://www.cdc.gov/cancer/breast/statistics/trends.htm
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Mortality Trend in U.S.: 1999-2008
• Decreased by 2.0% per year among women overall by:– 2.1% per year among white women– 1.4% per year among black women– 1.5% per year among Hispanic women
• Remained level among American Indian/Alaska Native women and Asian/Pacific Islander women.
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Risk by age
Expected Survival Before Diagnosis10 Years 20 Years 30 Years
Current Age30 0.43 1.86 4.1340 1.45 3.75 6.8750 2.38 5.60 8.6660 3.45 6.71 8.65
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Preoperative Analysis
• Color – skin and nipple areolar complex (NAC)
• Breast shape• Ptosis of NAC and
breast tissue• Volume
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Preoperative Analysis
• Patient measurements– BMI– Height– Weight– Suprasternal notch to
nipple, clavicle to nipple, nipple to inframammary fold, breast base diameter
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Preoperative Analysis
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Preoperative Considerations
• Type of breast cancer– DCIS, Invasive Ductal, Lobular, Medullary, Tubular,
Mucinous (Colloid)• Neoadjuvant chemotherapy• Radiation• What treatments have been started
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When To See A Plastic Surgeon
• Immediately after the diagnosis is made• Patients gain comfort in reconstructive
counseling• Photos, biometric analysis, and coordinating
care with other physicians from the very beginning
• Women’s Health and Cancer Rights Act of 1998 (29 U.S.C. 1185)