Invited Commentary to 'Adjuvant Chemotherapy Increases the Prevalence of Fat Necrosis in Immediate Free Abdominal Flap Breast Reconstruction' by Wu J, Lin L, Chen Y, Chen J, Yang B, Li J, Huang X, Shen Z, Shao Z, Yu P
| Autor: | Zoran Marij Arnež |
|---|---|
| Přispěvatelé: | Arnež, Zm |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Adjuvant chemotherapy Mammaplasty medicine.medical_treatment Antineoplastic Agents Breast Neoplasms DIEP chemotherapy Free Tissue Flaps Cancer recurrence Palpation DIEP fat necrosis chemotherapy Biopsy medicine Humans Fat necrosis Fat Necrosis Abdominal Muscles Chemotherapy medicine.diagnostic_test business.industry medicine.disease Surgery medicine.anatomical_structure Abdomen Female Breast reconstruction business |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 67:1455-1456 |
| ISSN: | 1748-6815 |
| DOI: | 10.1016/j.bjps.2014.04.033 |
| Popis: | The authors reviewed retrospectively their experiencewith 88 consecutive breast reconstructions by free flapsfrom the abdomen and found a 36.4% prevalence of fatnecrosis (FN) in their series. They analyzed severalrisk factors for development of fat necrosis by using sta-tistical methods (univariate and multivariate logisticregression models). In the multivariate logistic regressionmodel, adjuvant chemotherapy significantly increasedthe risk of fat necrosis after immediate breast recon-struction. The authors conclude that patients should beinformed about their findings and that the beginning ofthe post-operative chemotherapy may be adjustedaccordingly.The results of this study are based on statistical analysisof the data provided by the design of the study. From thisreason the findings seem a bit “statistically fabricated” andpossibly clinically less relevant. Why so?The study was retrospective which means that only theavailable data were retrieved from the charts.It is not clear who followed these (oncologic) patients,where and how. Since all the patients were not seen atregular pre-defined intervals, it was impossible to payattention to the behavior (dimensions, hardness/softness)of the palpated lesions over time, which is crucial when noimaging/biopsy is used to define the true diagnosis of thelesion.FN was defined in this study as “any palpable firmness ofmore than 1 cm at least 3 months following reconstructionafter excluding cancer recurrence”. It remains unclear andnot explained how locally recurrent disease has been ruledout by palpation only.In Kroll’s series most of “such indurations were exam-ined by needle biopsy, then followed clinically to ensurethat they were not enlarging”. |
| Databáze: | OpenAIRE |
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