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Breast Reconstruction: Upon Diagnosis…

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.

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Breast Reconstruction: Upon Diagnosis…

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  1. Breast Reconstruction:Upon Diagnosis… Michael J Bass, MD, JD www.drmichaeljbass.com 859-543-1024

  2. Disclosures • None • I need some

  3. Support Provided By • Lifecell • AlloDerm • Strattice

  4. 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

  5. Part 1 Layout • Incidence of breast cancer • Trends in breast cancer • Risk by age • Preoperative assessment • Preoperative considerations

  6. 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

  7. 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

  8. 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.

  9. Risk by age Expected Survival Before Diagnosis 10 Years 20 Years 30 Years Current Age 30 0.43 1.86 4.13 40 1.45 3.75 6.87 50 2.38 5.60 8.66 60 3.45 6.71 8.65

  10. Preoperative Analysis • Color – skin and nipple areolar complex (NAC) • Breast shape • Ptosis of NAC and breast tissue • Volume

  11. Preoperative Analysis • Patient measurements • BMI • Height • Weight • Suprasternal notch to nipple, clavicle to nipple, nipple to inframammary fold, breast base diameter

  12. Preoperative Analysis

  13. Preoperative Considerations • Type of breast cancer • DCIS, Invasive Ductal, Lobular, Medullary, Tubular, Mucinous (Colloid) • Neoadjuvant chemotherapy • Radiation • What treatments have been started

  14. 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)

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