2020
Surgical Outcomes of Mastectomy with Immediate Autologous Reconstruction Followed by Radiation
Heller DR, Zhuo H, Zhang Y, Parikh N, Fusi S, Alperovich M, Lannin DR, Higgins SA, Avraham T, Killelea BK. Surgical Outcomes of Mastectomy with Immediate Autologous Reconstruction Followed by Radiation. Annals Of Surgical Oncology 2020, 28: 2169-2179. PMID: 32974699, DOI: 10.1245/s10434-020-09122-0.Peer-Reviewed Original ResearchConceptsPostmastectomy radiation therapyLarge institutional cohortProbability of complicationsImmediate autologous reconstructionAutologous reconstructionMultivariable analysisInstitutional cohortFlap outcomesRadiation-related complicationsRisk of complicationsChest wall asymmetryMethodsMedical recordsNodal radiationMedian followNeoadjuvant chemotherapyPrimary endpointResultsOne hundredSurgical outcomesFat necrosisFlap complicationsImmediate reconstructionReoperationRadiation therapyComplicationsFat graftingPatients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction
Mehta SK, Sheth AH, Olawoyin O, Chouairi F, Gabrick KS, Allam O, Park KE, Avraham T, Alperovich M. Patients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction. The Breast Journal 2020, 26: 1931-1936. PMID: 32529691, DOI: 10.1111/tbj.13936.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesPsychiatric diagnosisBreast reconstructionBinary logistic regressionAutologous reconstructionReconstructive modalityWorse patient-reported outcomesLogistic regressionBREAST-Q surveysBREAST-Q scoresAutologous breast reconstructionGeneral linear modelQuality of lifeModalities of reconstructionChi-squared testPsychiatric wellASA classificationIndependent predictorsTertiary hospitalInsurance statusImplant reconstructionRisk populationsPatientsDiagnosisModule scores
2019
Breast reconstruction patterns and outcomes in academic and community practices within a single institution
Gabrick K, Alperovich M, Chouari F, Mets EJ, Reinhart M, Dinis J, Avraham T. Breast reconstruction patterns and outcomes in academic and community practices within a single institution. The Breast Journal 2019, 26: 924-930. PMID: 31788914, DOI: 10.1111/tbj.13693.Peer-Reviewed Original ResearchConceptsYale-New Haven HospitalBreast reconstructionMore patientsSingle institutionPlastic surgeonsCommercial insuranceHigh rateRetrospective chart reviewPrevalence of diabetesSimilar complication ratesNipple-sparing mastectomyHigher infection rateAP cohortChart reviewComplication rateCP cohortPostoperative outcomesPreoperative historySurgery ratesPsychiatric comorbidityInsurance statusAutologous reconstructionPractice patternsMedicaid patientsGreater prevalence
2018
Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy
Frey JD, Stranix JT, Chiodo MV, Alperovich M, Ahn CY, Allen RJ, Choi M, Karp NS, Levine JP. Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy. Plastic & Reconstructive Surgery 2018, 141: 1086-1093. PMID: 29659449, DOI: 10.1097/prs.0000000000004271.Peer-Reviewed Original ResearchMeSH KeywordsAdultBreastBreast NeoplasmsFemaleFree Tissue FlapsHumansMammaplastyMastectomy, SubcutaneousMiddle AgedNipplesPatient SatisfactionPerforator FlapPostoperative CarePostoperative ComplicationsReoperationRetrospective StudiesTransplantation, AutologousTreatment OutcomeUltrasonography, DopplerConceptsNipple-sparing mastectomyFree flap reconstructionSkin paddleFlap reconstructionAutologous reconstructionRevision proceduresMuscle-sparing transverse rectus abdominis myocutaneous flapFree flap autologous breast reconstructionAutologous free flap reconstructionTransverse rectus abdominis myocutaneous flapGreater body mass indexCLINICAL QUESTION/LEVELPercentage of flapsProfunda artery perforatorRectus abdominis myocutaneous flapAutologous breast reconstructionBody mass indexInferior epigastric perforatorGreater mean numberMass indexFlap weightMastectomy weightComparing outcomesBreast reconstructionMastectomy reconstruction
2014
Nipple-Sparing Mastectomy in Patients with Prior Breast Irradiation
Alperovich M, Choi M, Frey JD, Lee ZH, Levine JP, Saadeh PB, Shapiro RL, Axelrod DM, Guth AA, Karp NS. Nipple-Sparing Mastectomy in Patients with Prior Breast Irradiation. Plastic & Reconstructive Surgery 2014, 134: 202e-206e. PMID: 25068341, DOI: 10.1097/prs.0000000000000321.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyNipple-areola complex necrosisPrior breast irradiationMastectomy flap necrosisHigh-risk procedureBreast irradiationFlap necrosisComplete nipple-areola complex necrosisNipple-sparing mastectomy patientsHigh-risk patientsBody mass indexLatissimus dorsi flapMicrovascular free flapsSignificant differencesMastectomy cohortComplex complicationsImplant explantationMass indexMastectomy patientsCapsular contracturePartial necrosisAutologous reconstructionComplete necrosisIrradiated groupFree flap