• Journal of Hospice and Palliative Care
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• v.6 no.2
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• pp.164-171
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• 2003

Purpose : The purpose of this study was to provide information for developing a rehabilitation intervention that improves adaptation and the quality of life after mastectomy by investigating the level of physical function and fatigue in mastectomy patients. Methods : The subjects were 63 patients selected from St. Mary's Kangnam hospital Data were collected from March to June, 2003. Physical function was measured by the range of motion of the shoulder joint, shoulder function, and physical symptoms. fatigue was measured by using the Brief Fatigue Inventory (BFI). Results : The range of motion on the affected side was significantly lower than that in the healthy side. Shoulder function score was highest in the item of 'pull on pants', and lowest in the item of 'back zipper'. Physical symptom score was highest in the item of 'numbness', and lowest in the item of 'Itching sensation'. The highest item interfered by fatigue was 'normal work (includes both work outside the home and daily chores)'. Conclusion : The result of this study suggests that effective rehabilitation intervention for mastectomy patients should be needed to improve physical function, and reduce fatigue.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.748-752
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• 2014

Background Gynecomastia is benign enlargement of breast tissue in males and is fairly common. Mastectomy not only helps in improving the shape of anterior chest, but can also improve the location of nipple. Therefore, a principle element of mastectomy design is defining the normal location of nipple based on major anatomical reference points. Here, the nipple location was compared for before and after gynecomastia surgery. In addition, the same was also compared between male patients undergoing gynecomastia surgery and control group of subjects without gynecomastia. Methods We retrospectively analyzed gynecomastia patients who underwent conventional subcutaneous mastectomy. Preoperative and postoperative anatomical landmark distances and chest circumferences were measured and compared to the same anthropometric data from 20 healthy adult male controls. Results Nipple locations were compared among 13 patients and 20 controls. The mean weight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 out of 5. In the patient group, the slopes for the height-distance from the sternal notch to the nipple and chest circumference-distance between the mid-line of the sternum and the nipple were 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122 and 0.177, respectively; these differences were statistically significant (P<0.05). Conclusions Nipple positions were considerably lower in patients with gynecomastia than in control subjects. Subcutaneous mastectomy was associated with mild elevations, but postoperative locations were still lower compared to controls. Further efforts are needed to improve the location of postoperative nipple-areola complex in patients with gynecomastia.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.534-541
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• 2018

Background Nipple-areolar complex (NAC) reconstruction following curative mastectomy is traditionally performed as a second-stage procedure several months after initial breast reconstruction. The recent literature has documented the increasing popularity of immediate nipple reconstruction carried out simultaneously during autologous reconstruction. The aim of this study was to evaluate the surgical outcomes and patient satisfaction with immediate breast and nipple reconstruction performed in a single stage after skin-sparing mastectomy. Methods All patients who underwent a skin-sparing mastectomy with immediate latissimus dorsi flap breast and NAC reconstruction as a single-stage procedure from 2007 to 2015 were included. Patient demographics, oncologic details, and surgical outcomes were recorded. The BREAST-Q questionnaire was administered to patients to assess the impact and effectiveness of this reconstructive strategy. Results During the study period, 34 breast and NAC reconstructions in 29 patients were performed at Cork University Hospital. The majority of our patient cohort were non-smokers (93.1%) and did not receive adjuvant radiotherapy. Postoperative complications were infrequent, with no cases of partial necrosis or complete loss of the nipple. The response rate to the BREAST-Q was 62% (n=18). Patients reported high levels of satisfaction with the reconstructed breast ($62{\pm}4$), nipple reconstruction ($61{\pm}4.8$), overall outcome ($74.3{\pm}5$), and psychosocial well-being ($77.7{\pm}3.2$). Conclusions Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi reconstruction was demonstrated to be a safe and aesthetically reliable procedure in our cohort, yielding high levels of psychological and physical well-being. A single-stage procedure promotes psychosocial well-being involving issues that are intrinsically linked with breast cancer surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4845-4851
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• 2016

Background and Objectives: As one of the most common treatments for breast cancer, mastectomy has adverse effects on the quality of sexual life and sexual functioning in the impacted women. Various strategies have therefore been proposed to resolve their sexual problems. The present study was conducted to determine the effect of sexual rehabilitation using the PLISSIT model in post-mastectomy breast cancer survivors. Materials and Methods: The present quasi-experimental study was conducted on a population of post-mastectomy breast cancer survivors and their husbands. Sample size was calculated as 50 each for intervention and non-intervention groups. The former received sexual counseling based on the PLISSIT model consisting of four levels of intervention: permission, limited information, specific suggestion and intensive therapy, presented in four 90-minute sessions. Data were collected using the Sexual Quality of Life-Female (SQOL-F) questionnaire and the Female Sexual Function Index (FSFI). Results: No significant differences were observed in the mean quality of sexual life scores between the intervention and control groups (P>0.05) before the intervention; however, a significant difference emerged between the groups after the intervention (P<0.01). Thus the mean score for sexual functioning in the intervention group was $26.3{\pm}3.76$ before and $30.0{\pm}4.38$ after the intervention (P<0.0001). In the control group, however, the difference between the pre- and post-intervention mean scores was not statistically significant (P=0.713). Conclusion: The present study showed that nurses can use the PLISSIT model in conjunction with chemotherapy and radiotherapy to teach coping and problem-solving skills to women with breast cancer and their husbands and to encourage their participation in group programs for expressing their feelings and attitudes about their current sex life and thus help enhance quality of sexual life and sexual functioning in this group.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.19 no.2
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• pp.75-90
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• 2015

Objectives The purposes of this study was to develope a Qi gong exercise that suits characteristics of post mastectomy women, and to evaluate the effect of Qi gong exercise on immune response, blood circulation index, pulse wave parameter and heart rate variability. Methods This study was applied to total 35 post mastectomy women, including 17 for experiment group and 18 for control group. The Qi gong exercise was composed of total 24 times of 90 minutes per each time, twice a week, and 12 weeks and it was conducted by the oriental medicine professor who was an expert of Qi gong exercise. Results 1. Two group comparison revealed that the experimental group had significantly improved immune response(p<.021), HR(beats/min)(p<.001), ESV(ml/beat)(p=.038), ESI($ml/beat/m^2$)(p=.040), ECO (L/min)(p=.019), ECI($L/min/m^2$)(p=.023), ECRI($dyne^*sec/cm$)(p=.015), Left Kwan($div^3$)(p=.021), Right Kwan($div^3$)(p=.038), Mean HRV(cycle/min)(p<.001), SDNN(ms)(p=.043), RMSSD(ms)(p=.040), and TP(log $ms^2$)(p=.039). 2. Two group comparison revealed that the experimental group had significantly decreased ECR ($dyne^*sec^*cm^{-5}$) (p=.034), Left RAI(p=.044), Right RAI(p=.042), and pNN50(%)(p=.038). Conclusions These results from Qi gong exercise program can be used as basic data for development of health promotion program for Post Mastectomy Women.

• Journal of Convergence for Information Technology
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• v.10 no.5
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• pp.188-197
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• 2020

This study was to investigate the effects of joint mobilization with two different electrotherapy methods on shoulder external rotation range of motion and pain in mastectomy patients. Thirty mastectomy patients were divided into STMG (joint mobilization+pain scrambler therapy, n=15) and TENMG (joint mobilization+transcutaneous electrical nerve stimulation, n=15). The measurements were performed shoulder external rotation range of motion (ROM), pain (VAS). In both groups, there was a significant difference in the shoulder external rotation ROM, pain after intervention (p <.05). STMG was more decrease in VAS score than TENMG (p <.05). There was no significant difference in shoulder external rotation ROM between the two groups. In order to decrease the pain of mastectomy patients, it was confirmed that STMG was more effective than TENMG.. It is thought that a control group is added to confirm various differences, and more subjects are needed.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.193-196
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• 2008

Purpose: TRAM flap reconstruction has settled down as a common method for breast reconstruction after mastectomy. There are a few surgical contraindication in TRAM flap surgery. Previous abdominal liposuction has been a relative contraindication in TRAM flap surgery. The authors present 2 patients of successful breast reconstruction using pedicled TRAM flaps, who previously underwent abdominal liposuction. Methods: Case 1: A 48-year-old woman with a right breast cancer visited for mastectomy and breast reconstruction. Her past surgical history was notable for abdominal liposuction 15 years ago. Skin sparing mastectomy and breast reconstruction with a pedicled TRAM flap was performed. Case 2: A 45-year-old woman with a left breast cancer visited us for mastectomy and autologous breast reconstruction. 3 years ago, she had an abdominal liposuction and augmentation mammaplasty in other hospital. Nipple sparing mastectomy and breast reconstruction was done using pedicled TRAM flap. Results: One year after the reconstruction, partial fat necrosis was developed in one case but there was no skin necrosis or donor site complication in both patients. Conclusion: As aesthetic surgery becomes more popular, increasing numbers of patients who have a prior abdominal liposuction history want for autologous tissue breast reconstruction. In these patients, TRAM flap surgery will be also used for breast reconstruction. But, the warning of fat necrosis and the use of preoperative Doppler tracing to evaluate the abdominal perforator may be beneficial to patients who had abdominal liposuction recently.

• Archives of Plastic Surgery
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• v.36 no.4
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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.

• Fashion & Textile Research Journal
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• v.22 no.1
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• pp.76-86
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• 2020

The study surveyed patients undergoing a mastectomy to understand their experience and requirements on artificial breasts and sales status. We retrieved 149 of the 150 surveyed questionnaires; subsequently, 144 questionnaires, excluding missing values, were used in the analysis. According to the results of the study, about 67% of respondents said that artificial breasts were not used after undergoing a mastectomy, and more than half of the breast cancer patients were not aware of the importance of artificial breasts. Breast cancer patients wearing artificial breast felt uncomfortable and hot during daily activities as well as experienced difficulty in size selection and purchase price burdens. The three most responded brands were selected based on the results of the survey that also investigated the sales status of the commercial artificial breast. Company A was selling artificial breast to reflect the consumer's functional requirements, and Company C was selling artificial breast with various kinds of reduced weight. However, it is thought that consumers will have less choice since artificial breasts have more limited forms than various types. Therefore, it is believed that the patient needs artificial breasts that satisfy the shape of various types of mastectomy. This study can be used as basic data for artificial breast development studies.

• Archives of Plastic Surgery
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• v.40 no.5
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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.