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Accuracy for cytological evaluation in the detection of breast cancer among patients with pathologic nipple discharge:a PRISMA-compliant meta-analysis

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Chinese Medical Journal 2020年第4期133卷 435-443页

作者： Xiao-Qian Li Feng Xu Chu-Qi Lei Jie Li Hong-Chuan Jiang Department of General Surgery Beijing Huai-Rou HospitalCapital Medical UniversityBeijing 101400China Department of Breast Surgery Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China

Background:nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying *** studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge,but the results have been highly *** we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast ***:A systematic literature search was performed(Medline/PubMed,Embase,Cochrane Library databases,and Google Scholar)to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple *** independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October *** were only included in the meta-analysis if they met predetermined *** characteristics of each study and the data they yielded were *** assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria(MINORS)and the Quality Assessment of Diagnostic Accuracy Study 2(QUADAS-2).Heterogeneity was tested via Cochran Q test and the I2 statistic using Stata 12.0 and Meta-DiSc 1.4 software,and meta-analysis was ***:A total of 286 articles were identified,of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis.A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63%(95%confidence interval[CI]:53%-72%),specificity 95%(95%CI:87%-98%),positive likelihood ratio 12.35(95%CI:4.87-31.34),and negative likelihood ratio 0.39(95%CI:0.30-0.50).The diagnostic odds ratio was 31.88(95%

关键词： Breast carcinoma Cytology Diagnosis Meta-analysis nipple discharge

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Expander implantation for correction of high-riding nipple with enlarged nipple-areola complex using revision mastopexy: A case report

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World Journal of Clinical Cases 2020年第9期8卷 1674-1678页

作者： Feng Qin Nan-Ze Yu Elan Yang Ang Zeng Yan Hao Lin Zhu Xiao-Jun Wang Department of Plastic Surgery Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China

BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast ***,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged *** SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged *** were used and multi-stage techniques were *** one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast *** The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.

关键词： High-riding nipple Enlarged areola Expander Mastopexty Breast ptosis Case report

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Immediate nipple Reconstruct!on Following Breast Reduction

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Chinese Medical Sciences Journal 2020年第1期35卷 92-94页

作者： Zifei Li Jie Luan Chenglong Wang Shangshan Li Breast Plastic and Reconstructive Surgery Center Plastic Surgery HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100144China

Necrosis of nipple-areola complex is one of the major complications of breast reduction in *** present a case study of a 32-year-old patient with severe gigantomastia,who required an immediate nipple reconstruction du... 详细信息

关键词： nipple reconstruction breast reduction gigantomastia

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The Effect of the Moufarrege Total Posterior Pedicle Reduction Mammaplasty on the Erogenous Sensation of the nipple

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Surgical Science 2019年第4期10卷 127-140页

作者： Richard Moufarrege Mohammed El Mehdi El Yamani Laura Barriault Ahmed Amine Alaoui Faculty of Medicine Université de Montréal Montreal Canada Department of Plastic Surgery Université de Montréal Montreal Canada

Traditional reduction mammoplasties have the simple concern to guarantee the survival of the nipple areola complex after surgery. Little has been done to take care of essential functions in the nipple, especially the erogenous sensation. We have conducted a retrospective study on a cohort of 573 female patients operated using the Total Posterior Pedicle of Moufarrege between 1985 and 1995 to evaluate its effect on the erogenous sensation of the nipple. This study demonstrated the preservation of the erogenous sensation of the nipple in a high proportion of these patients. The physiology of this preservation is explained in regard of the technique details in Moufarrege mammoplasty compared to other techniques. The Moufarrege Total Posterior Pedicle would therefore be a highly reliable reduction technique to ensure the preservation of the erogenous sensation of the nipple.

关键词： Erogenous Sensation of the nipple Moufarrege Mammaplasty Total Posterior Pedicle Mammaplasty Reduction Mammaplasty Erogenous Sensation

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Trillium Flap for Postmastectomy Neo-nipple Reconstruction (A Novel Technique)

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Modern Plastic Surgery 2020年第1期10卷 9-16页

作者： Ahmed Abdelmoez Alsayed Independent Researcher Al-Hokail Khobar Saudi Arabia

Introduction: Breast cancer cases, mastectomy and following reconstruction procedures are growing in numbers. Despite being lifesaving, mastectomies have a destructive psychological impact on the patients. On the other hand, breast reconstruction improves psychological damages within the same population. Various techniques for nipple reconstruction were described in literature. Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. Objectives: To come up with an innovative design for reconstructing a neo-nipple post mastectomy, that is superior to other popular flaps. Results: The Trillium flap design has less visible and easily camouflaged scars, is geometry-based, specific, well-detailed and flexible to produce a tailored nipple with any desired height and diameter and ensures the flaps good vascularity and the neo-nipple projection sustainability. Conclusion: Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. The results shown in the study are for experimental procedures done on human tissue samples of excised flaps from abdominoplasties and brachioplasties. Further application on actual cases is needed with monitoring of neo-nipple projection sustainability on the long term.

关键词： Trillium Flap Breast nipple NAC Reconstruction Neo-nipple Mastectomy

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The Long Term Follow-Up Results of the Direct nipple Ureteroneocystostomy Technique: A Prospective Study

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Open Journal of Urology 2013年第4期3卷 179-184页

作者： Abdullah Demirtas Nurettin Sahin Emre Can Akinsal Mehmet Ali Ergul Mehmet Caniklioglu Oguz Ekmekcioglu Atila Tatlisen Department of Urology Erciyes University Medical Faculty Kayseri Turkey

Objective: To evaluate the long term follow-up results of the direct nipple ureteroneocystostomy technique. Materials and Methods: We studied a total of 16 patients (19 renal units) who underwent direct nipple ureteroneocystostomy. The mean age was 43 years and 3 patients had bilateral disease. In five units the ureters had been ligated during gynecological surgery, 11 renal units were obstructive and three units were reflexive megaureters. The ureters were spatulated for about 2 cm and folded back. nipples 2 to 2.5 cm long were prepared. In two cases the ureters were thin-walled (2 mm or less) and they were not spatulated but folded back onto themselves. In one case the ureter could not be everted since it had a thick and fibrotic wall. The distal 2 to 2.5 cm segment of this ureter was directly inserted in to the bladder. Postoperative follow-up was at 3 month intervals for the first year at 6 month intervals for 2 - 3 years and yearly thereafter. At the time of follow-up serum creatinine, urine culture, ultrasound, intravenous urography, voiding cystoureterography, nuclear renal scintigraphy and cystometric evaluations were performed. The functions of 11 and 15 renal units were evaluated scintigraphically and stereologically, respectively, in the both preoperative and postoperative first year follow-up. The Wilcoxon Signed Ranks test was used for statistical evaluation and p < 0.05 was considered statistically significant. Results: Mean follow-up was 49 months. Three renal units had Grade III reflux (two of them during voiding) and one unit had Grade IV reflux. At follow-up this patient developed in the ureteral stricture. No patients had urinary tract infection, pyelonephritis or ureteral stricture follow-up period. Between the preoperative and postoperative first year, there was an increase in postoperative split renal function based on renal scintigraphy but this difference was not statistically significant. The stereologically calculated decrease in pelvicalic

关键词： Megaureter nipple Technique Ureter Vesicoureteral Reflux

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Aesthetic Outcome after nipple Sparing Mastectomy for Cancer Patient Egyptian Pattern

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Advances in Breast Cancer Research 2017年第2期6卷 68-80页

作者： Ahmed Farahat Tarek Hashem Abdalwahab R. Abdalwahab Tamer M. Manie Nelly H. Alieldin Hassan Abdallah Department of Surgical Oncology National Cancer Institute Cairo University Cairo Egypt Department of Statistics National Cancer Institute Cairo University Cairo Egypt

Background: Recent advances in breast reconstruction and the introduction of oncoplastic techniques have resulted in significant improvement in quality of life and psychological well-being of most patients. nipple sparing mastectomy is a surgical technique that removes breast tissue while preserving the native skin envelope, infra-mammary fold and the NAC, which allows immediately reconstructed breasts to have an excellent cosmetic outcome. Aim: Our primary end point was for objective assessment of aesthetic outcome after NSM via more accurate new method and subsiding bias in that assessment and the secondary end point was for evaluating the influence of incision choice and recommending which incision is the best for each patient putting in mind cup size, degree of ptosis and body mass index of Egyptian patients. Methods: Starting January 2013 to November 2015, 74 patients with breast cancer underwent NSM with immediate reconstruction using LD flap with or without implant augmentation. Results: Incisions used are elliptical (37.8%), lateral (27%), peri-areolar (21.6%) and infra-mammary (13.5%). In 81.1% of the patients, the procedure was performed using extended LD flaps only, while in the remaining 18.9% the flaps were augmented using implant insertion. Axillary dissection was done in 68.9% of patients and SLN in 24.3% of patients. Overall aesthetic results were done by patient self-assessment, assessment by the surgeon, assessment by professional plastic breast surgeon and assessment by onco-plastic surgeon, and this was followed by statistical analysis of the agreement between the plastic surgeon and the onco-plastic surgeon. Conclusion: NSM is safe, feasible and offers adequate oncologic results along with excellent cosmetic outcome. Choice of incision and reconstruction should be tailored to suit each patient. Breast cancer patients can benefit from sound resection and enjoy a sense of wholeness.

关键词： nipple Sparing Mastectomy Approach Incision Aesthetic Assessment

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Adenoma of the nipple, Mimicking Paget’s Disease of the Breast: Report of a Case

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Advances in Breast Cancer Research 2014年第3期3卷 96-99页

作者： Ahmed Abbas Ali Al-Zaher Ali El Arini Ikram Chaudhry Department of Surgery King Fahad Specialist Hospital Dammam KSA

nipple adenoma is a rare benign condition that simulates malignancy. A 37-year-old woman presented with unilateral bloody nipple discharge for 1-year duration followed by severe nipple erosion. As biopsy revealed nipple adenoma and therefore, complete local excision was done. The final histopathology showed florid papillomatosis which was adequately excised. nipple adenoma although rare entity this should be included in the differential diagnosis of any nipple erosion such as carcinoma and Paget’s disease of the breast specially when associated with bloody discharge in premenopausal women.

关键词： nipple Adenoma Benign Breast Lesion Florid Papillomatosis of the nipple

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Extramammary Paget’s Disease Covered the Left nipple and Areola

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International Journal of Clinical Medicine 2012年第1期3卷 65-68页

作者： Ikuko Abe Kazuyoshi Sugiyama Masaru Suda Fumie Igari Koji Senuma Atsushi Arakawa Mitsue Saitoh Fujio Kasumi 不详

We present a case of a 71-year-old woman suffering from mammary Paget,s disease and having a 10-years history of an irregular, widespread erosion accompanied by itching and burning on the skin of her left chest, extending to the breast. The erosion had steadily enlarged and had become increasingly tender. The nipple and areola of the left breast disappeared and could not be recognized. No abnormality of the right nipple, areola, and covering skin and no supernumerary nipple were seen. Mammography and ultrasonography could not be performed because of severe pain and erosive wetness. Histopathology of a surgical biopsy specimen showed epidermal infiltration by large, round, clear atypical cells scattered individually or in small clusters and distributed horizontally throughout the epidermis. The cytoplasm of these large cells was pale and vacuolated and was equivalent to that in nipple cells in Paget,s disease, and a diagnosis of mammary Paget,s disease was made. We performed total mastectomy of the left breast with wide excision of the Paget lesion of the left chest and axillary lymph node sampling. Histological examination of the specimen showed typical distribution of Paget,s cells;however no ductal carcinoma in situ was found in the mammary ducts and invasive growth was not recognized beyond the basal membrane of the lesion. From this evidences, we established a diagnosis of large, irregulaly shaped unusual mammary Paget,s disease, not of breast cancer origin, covering the left breast, areola, and nipple.

关键词： Mammary Paget S Disease Extramammary Paget’S Disease nipple Areola

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Usefulness of Free nipple-Areola Complex Graft for nipple Malposition after nipple Sparing Mastectomy

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Modern Plastic Surgery 2012年第4期2卷 87-90页

作者： Kyoichi Matsuzaki Department of Plastic and Reconstructive Surgery Kawasaki Municipal Tama Hospital Kawasaki Japan

Purpose: This article identifies the advantage and disadvantage of a free nipple areola complex graft (FNACG) for nipple malposition which resulted from tissue-expander insertion and subsequently replaced with an implant after nipple sparing mastectomy (NSM). Methods: The subjects were three such patients treated using FNACG and who were followed up for at least one year postoperatively. The surgical outcome was assessed for symmetry of nipple-areola position, graft take, depigmentation, and shrinkage. Results: In all patients, the graft was accurately transferred to a position to achieve symmetry with the unaffected breast, and there was complete graft take in the areola by simple surgical design and techniques. No depigmentation of the areola was observed. The size of the areola was almost unchanged after grafting in two patients, but areolar shrinkage occurred in one other patient. There was complete graft take in the nipple in one patient and no depigmentation of the nipple was observed. Necrosis occurred at the tip of the nipple in two other patients. These patients had depigmentation, and the height of nipples decreased in proportion to the level of necrosis. Conclusion: FNACG can be a useful method if its advantages and disadvantages are well considered.

关键词： High-Riding nipple nipple Areola Complex Graft nipple Sparing Mastectomy nipple Malposition nipple Transposition

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