Breast Reconstruction: Upon Diagnosis Michael J Bass, MD, JD
www.drmichaeljbass.com 859-543-1024
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Disclosures None I need some
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Support Provided By Lifecell AlloDerm Strattice
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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
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Part 1 Layout Incidence of breast cancer Trends in breast
cancer Risk by age Preoperative assessment Preoperative
considerations
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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
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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/tre nds.htm
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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.
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Risk by age Expected Survival Before Diagnosis 10 Years20
Years30 Years Current Age 300.431.864.13 401.453.756.87
502.385.608.66 603.456.718.65
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Preoperative Analysis Color skin and nipple areolar complex
(NAC) Breast shape Ptosis of NAC and breast tissue Volume
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Preoperative Analysis Patient measurements BMI Height Weight
Suprasternal notch to nipple, clavicle to nipple, nipple to
inframammary fold, breast base diameter
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Preoperative Analysis
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Preoperative Considerations Type of breast cancer DCIS,
Invasive Ductal, Lobular, Medullary, Tubular, Mucinous (Colloid)
Neoadjuvant chemotherapy Radiation What treatments have been
started
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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 Womens Health and Cancer Rights Act of 1998
(29 U.S.C. 1185)