The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Stefan-Andrei Coman

Stefan-Andrei Coman

Follow Up Case on Breast Reconstruction with ADM

Breast cancer is the most common type of cancer found in women after skin cancer. It is also the second cause of cancer death in women after lung cancer. The incidence of breast cancer has decreased in the last decade due to the discontinuation of hormone replacement therapy in postmenopausal women The majority of women with breast cancer are in an early stage at the moment of detection and are eligible for breast conservation therapy and receive some form of systemic or local adjuvant therapy like chemotherapy or radiotherapy depending on the histological type of the tumor.
Acellular dermal matrices or ADM for short are processed dermis that can be used as an adjuvant to local flap reconstruction or as the primary material for reconstruction of the nipple. In this article we discuss the case of a 42 year old woman with breast carcinoma who underwent mastectomy and breast reconstruction with silicone gel implant and ADM and answered a set of questions created to optimize the patient journey from diagnosis to reconstruction and follow-up.

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A Clinical Case Study of Synchronous Breast Cancer

The following article represents a clinical case study of a synchronous breast cancer in a 47 year old woman with no prior significant comorbidities. Up to 10% of all breast cancers can be synchronous (usually found with the help of breast MRI). The occurrence of bilaterally is considerable with invasive lobular carcinoma. The patient observed
after self-palpating her breast a nodule in the infero-external quadrant of the right breast. During almost 4 months the patient underwent punch biopsy of the right breast, lumpectomy and finally double mastectomy with immediate reconstruction using Mentor implants and AMD. The histopathological result showed ductal carcinoma in situ in the right breast and lobular carcinoma in situ in both breasts. Postoperatively the patient is free of cancer, but under clinical and imagistic surveillance.

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Reconstruction after Big Nasal Tumors

This article comes as a presentation of the clinical experience in the plastic surgery department. Gather the experience of 3 clinical cases, more representative, with different histopathological tumors, of important dimensions that occupied a large part of the facial anatomical unit, the nose. The article is structured by presenting the risk factors that are the causes of malignant lesions and by recalling the therapeutic options and general principles of addressing large lesions. Malignant lesions that occur most frequently in the nose are reviewed. We consider that it is a serious health problem, with various consequences, of a functional nature, which can affect the airways and aesthetically that can lead to a reconsideration of self-respect and the perception of the affected person towards his peers. The approach of the cases was done sequentially. The first surgical stage involved the excision of the lesion with the oncological safety limit, the defect being larger than the lesion and the more elaborate therapeutic options on the reconstruction scale. The first operative stage ended each time with covering the defect with a graft to have the confirmation of the histopathological examination, free of the tumor. The second stage of the treatment involved lifting the flap and accommodating it. The last surgical stage involved the sectioning of the pedicle and its reintegration into the donor area.

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