Browsing by Author "Balci, Fatih Levent"

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LASER-ASSISTED-INDOCYANINE-GREEN-ANGIOGRAPHY VERSUS CONVENTIONAL ASSESSMENT TO PREDICT OR LOCATE NECROTIC AREAS ON MASTECTOMY FLAPS: A PROSPECTIVE CLINICAL TRIAL
(ISTANBUL UNIV, FAC MEDICINE, PUBL OFF, 2019-01-01) Balci, Fatih Levent; Uras, Cihan
Objective: The aim of this study was to determine whether laser-assisted-indocyanine-green-angiography (LA-ICGA) could accurately predict flap necrosis in comparison to conventional clinical assessment and visually identify its location during immediate reconstruction following a nipple-sparing mastectomy (NSM). Methods: Twenty-one patients with breast cancer were prospectively enrolled to undergo NSM with immediate implant reconstruction. In 19 cases LA-ICGA numbers were used to show the level of laser absorption of hypo-perfused areas on the mastectomy flaps. Those numbers were compared to conventional assessment to assess the predictive value of LA-ICGA. Results: Of the 19 mastectomy flaps, 3 (15.8\%) examples of partial skin flap necrosis with an LA-ICGA value of <= 7 was observed. The sensitivity, specificity, false-positive rate, and accuracy of LA-ICGA were 43\%, 100\%, 57\%, and 79\%, respectively. Patients with an LA-ICGA value of <= 7 were found more likely to develop mastectomy flap necrosis, whereas patients aged >60 or, a history of smoking, a BMI >30, or intraoperative use of tumescence solution containing epinephrine were more likely to have an LA-ICGA score <= 7 which is not clinically reliable in predicting necrosis. Conclusion: Our results indicate that a low LA-ICGA score <= 7 is the only significant factor in predicting mastectomy flap necrosis. LA-ICGA could accurately show the location of necrosis.
Oncologic safety of nipple-sparing mastectomy in patients with short tumor-nipple distance
(WILEY, 2019-01-01) Balci, Fatih Levent; Kara, Halil; Dulgeroglu, Onur; Uras, Cihan
Background There is a tendency to avoid nipple-sparing mastectomy (NSM) when a tumor-nipple distance (TND) is NSM with immediate reconstruction are oncologically safe when TND is NSM followed by immediate reconstruction for breast cancer were retrospectively analyzed. Patients who are negative for nipple-base in either frozen-section or paraffin histopathology were included. MRI was used to obtain TNDs to compare local-recurrence-free and disease-free survival in group I (TND <2 cm) and group II (TND >= 2 cm). Disease-free survival rates were determined to assess the outcome. Results Of the 214 cases with malignancy on MRI, 21 cases diagnosed with pure ductal carcinoma in situ were excluded. Among the 193 NSM cases diagnosed with invasive cancer, TND was <2.0 cm in 59 (30.56\%) cases and >= 2.0 cm in 134 (69.43\%) cases. No significant differences were found between groups in regards to ER, PR, HER2-neu status, and nodal involvement (P = 0.34, P = 0.41, P = 0.54, and P = 0.12 respectively). In a median follow-up time of 62 months (range