• Journal of the Korean Society of Clothing and Textiles
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• v.25 no.4
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• pp.697-706
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• 2001

There are approximately 1,000 patients who undergo mastectomies each year in Korea. However, there is no company who manufactures mastectomy brassieres and breast prosthesis in Korea. The purpose of this study is to evaluate the wearing conditions of the imported mastectomy brassieres with breast prosthesis and to develop the better-fitted and comfortable mastectomy brassieres in reasonable price. 254 patients participated in this survey. In the results of our survey, 117 out of the 254 patients were wearing mastectomy brassieres and breast prostheses, which have been imported mostly from USA. The degree of satisfaction at wearing mastectomy brassieres was low. The patients generally feel hot when wearing mastectomy brassieres, specially in summer and also pointed out the heavy weight of breast prosthesis and the discomfort in wearing mastectomy brassiere for a long period of time.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.53-58
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• 2016

Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%-10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy. Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy. Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%). Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.118-130
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• 2012

Background: Women receiving mastectomy usually prefer a single-stage surgical procedure without the need for additional surgery. Hence, nipple sparing mastectomy was introduced, and the follow-up data on the aesthetic outcome and recurrence of breast cancer were investigated in this study. Materials and Methods: The study subjects comprised 22 patients who received nipple-sparing mastectomy and immediate breast reconstruction using the free transverse abdominal rectus abdominis myocutaneous flap between June of 2007 and June of 2012. The patients' aesthetic outcomes were measured with 2 methods for the objective result: Breast size measurements and breast volume calculation both at preoperative phase and postoperative 1 years phase. Also, the patients' satisfaction was evaluated at postoperative 1 year with the self-assessment questionnaire. Follow up check for assessing cancer recurrence was performed for an average period of postoperative 1063 days. Results: First, in objective aesthetic outcome, there were no significant differences between the preoperative and postoperative results on both the breast size and the volume. Second, the patient satisfaction analysis scores were graded as very good in 15 patients (68.2%), and as good in 6 patient (27.3%). Most of the patients were very satisfied with our surgery method. Last, there was no local or distant recurrence in these 22 patients during the follow-up period. Conclusion: In this study, the nipple-sparing mastectomy achieved satisfactory results for the breast scar and shape with a single-stage surgical procedure, and the cancer recurrence rate was not significantly different from that of the conventional mastectomy. Besides, the nipple-sparing mastectomy is more cost-effective than the conventional mastectomy since it reduces the need for additional procedures. However, we think that it is necessary to determine the long-term outcomes about the recurrence rate.

• Asian Oncology Nursing
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• v.7 no.1
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2079-2084
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• 2013

Background: Breast cancer is the most prevalent cancer among Iranian women and mastectomy comprises 81% of surgeries for treatment of breast cancer. Mastectomy may create feelings such as deformation or impairment in patients, cause body-image disorder, and reduce sexuality and sexual activity which in turn may entail mental disorders. The study aimed to elaborate coping processes. Materials and Methods: A grounded theory method was used in conducting this study. Twenty Iranian participants undergoing mastectomy were recruited with purposive sampling. An open, semi-structured questionnaire were developed. Obtaining consent, conversations were recorded and immediately transcribed after each session. Data analysis was carried out with the constant comparative method using the Strauss Corbin approach. Results: Analyzing the collected data, the study came up with seven main categories which affected the coping process in patients with breast cancer, namely: reactions to mastectomy; loss and death contest; reconstruction of evaluation system; consent for undergoing mastectomy; reactions and troubles after loss; confrontation of loss and health; and reorganization and compatibility with changes. Conclusions: The results of the study indicated: when patients become informed of their breast cancer and the necessity of undergoing mastectomy as the treatment, they probably pass through seven categories to adapt after mastectomy. Having insight about them is likely to contribute medical personnel in leading patients to the highest degree of feeling healthy.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.246-252
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• 2018

Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. Methods A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. Results The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was $0.71{\pm}0.23$. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of $0.66{\pm}0.11$. The 25 patients who underwent a contralateral procedure had a ratio of $0.96{\pm}0.30$. The adjusted ratio of the final flap weight to the initial flap weight was $0.66{\pm}0.12$. Conclusions Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.

• Archives of Plastic Surgery
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• v.44 no.6
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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.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.63-68
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• 2011

Purpose: Mastectomy is one of the operative procedures of female to male transsexuals. It is aimed to excise all of breast tissues and to reconstruct male chest wall, areola, and nipple. Breast sizes are varied by developmental status and their hormonal therapy. There are several approaches for mastectomy. This study is aimed to suggest appropriate mastectomy methods according to breast size in the female to male transgenders. Methods: We retrospectively analysed 46 patients of female to male transgenders. Breast size was categorized by their inner wear size. In A cup size, mastectomy was done with periareolar approach. In C cup size, inframammary fold approach subcutaneous mastectomy was performed. In B cup size, periareolar approach was used for grade A or B ptosis patient, and inframammary fold approach was choosen for the patient with grade C ptosis. Results: Subcutaneous mastectomy was done through semicircular periareolar approach for 26 patients. There were 2 cases of major complications that should be corrected by hematoma evacuation. Circumareolar approach was used for 5 patients, and a case of nipple-areolar complex necrosis was observed. Two cases of another complications which were irregularity of breast and wound disruption could be corrected. Inframammary fold approach was selected for 15 patients. There was a case of wound disruption, so revision surgery whould be done. Four cases of breast irregularity was corrected spontaneously, and 2 cases of partial necrosis of nipple-areolar complex were corrected with secondary healing. Patient satisfaction score for periareolar, cicumareolar, and inframmammary fold approach were 4.5, 4.2 and 4.1, respectively. Some major and minor complications were observed, but satisfactory results could be secured. Conclusion: Semicircular periareolar incision looked adequate for A cup size patient, circumareolar incision was suitable for B cup size with grade A or B ptosis. In B cup size with grade C ptosis patient and C cup patients, inframammary fold incision looked suitable for optimal results.

• Archives of Plastic Surgery
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• v.46 no.5
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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.

• Asian Oncology Nursing
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• v.8 no.2
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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.