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 prevalencePersistent disparities in breast cancer surgical outcomes among hispanic and African American patients
Mets EJ, Chouairi FK, Gabrick KS, Avraham T, Alperovich M. Persistent disparities in breast cancer surgical outcomes among hispanic and African American patients. European Journal Of Surgical Oncology 2019, 45: 584-590. PMID: 30683449, DOI: 10.1016/j.ejso.2019.01.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAsianBlack or African AmericanBreast NeoplasmsChemotherapy, AdjuvantComorbidityDiabetes MellitusFemaleHealth Status DisparitiesHispanic or LatinoHospitals, High-VolumeHospitals, UniversityHumansHypertensionMammaplastyMastectomyMiddle AgedNeoadjuvant TherapyObesityPostoperative ComplicationsRadiotherapy, AdjuvantSmokingTreatment OutcomeWhite PeopleConceptsAfrican American patientsAmerican patientsNeoadjuvant chemotherapyComplication ratePost-surgical complication rateHigher overall complication rateHigh rateHigher comorbidity burdenOverall complication ratePrior abdominal surgeryASA class IIIMastectomy flap necrosisRecords of patientsNipple-sparing mastectomyUniversity-affiliated hospitalCancer surgical outcomesHistory of radiationBreast cancer profilesComorbidity burdenReconstructive complicationsPrior radiationOncologic characteristicsPatient demographicsAbdominal surgeryBreast mastectomy
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
2017
Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple‐Sparing Mastectomy?
Frey JD, Alperovich M, Levine JP, Choi M, Karp NS. Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple‐Sparing Mastectomy? The Breast Journal 2017, 23: 415-420. PMID: 28097778, DOI: 10.1111/tbj.12760.Peer-Reviewed Original ResearchConceptsPack-year smoking historyNipple-sparing mastectomyComplete NAC necrosisHistory of smokingSmoking historyReconstructive complicationsNAC necrosisHigh riskNipple-areola complex necrosisNew York University Langone Medical CenterPack-year historyMastectomy flap necrosisActive smokersFlap necrosisRisk factorsMedical CenterReconstructive outcomesComplicationsMastectomyNecrosisNonsmokersOutcomesSmokersSmokingPatients
2016
“Breast in a Day”
Choi M, Frey JD, Alperovich M, Levine JP, Karp NS. “Breast in a Day”. Plastic & Reconstructive Surgery 2016, 138: 184e-191e. PMID: 27465178, DOI: 10.1097/prs.0000000000002333.Peer-Reviewed Original ResearchConceptsPermanent implant reconstructionNipple-sparing mastectomyMastectomy flap necrosisImplant reconstructionAcellular dermal matrixComplication rateFlap necrosisMajor mastectomy flap necrosisMinor mastectomy flap necrosisDermal matrixImplant sizeCLINICAL QUESTION/LEVELPercent of reconstructionsCommon major complicationPrior radiation therapyGreater complication rateLow complication rateNipple-sparing mastectomiesBody mass indexCommon minor complicationAverage implant sizeMajority of implantsOverall complicationsNipple necrosisMinor complications
2015
Oncologic outcomes after nipple‐sparing mastectomy: A single‐institution experience
Frey JD, Alperovich M, Kim JC, Axelrod DM, Shapiro RL, Choi M, Schnabel FR, Karp NS, Guth AA. Oncologic outcomes after nipple‐sparing mastectomy: A single‐institution experience. Journal Of Surgical Oncology 2015, 113: 8-11. PMID: 26628318, DOI: 10.1002/jso.24097.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomySkin-sparing mastectomyOncologic outcomesLong-term oncologic outcomesAverage patient ageCommon histologic typePercent of patientsLocoregional recurrence rateSingle institution experienceAverage tumor sizeChest wall recurrenceInvasive ductal carcinomaLocoregional recurrencePatient ageHistologic typeDuctal carcinomaRecurrence rateTumor sizeAverage patientPatientsTherapeutic indicationsMastectomyRecurrenceOutcomesComplex recurrenceNipple‐sparing Mastectomy and Sub‐areolar Biopsy: To Freeze or not to Freeze? Evaluating the Role of Sub‐areolar Intraoperative Frozen Section
Alperovich M, Choi M, Karp NS, Singh B, Ayo D, Frey JD, Roses DF, Schnabel FR, Axelrod DM, Shapiro RL, Guth AA. Nipple‐sparing Mastectomy and Sub‐areolar Biopsy: To Freeze or not to Freeze? Evaluating the Role of Sub‐areolar Intraoperative Frozen Section. The Breast Journal 2015, 22: 18-23. PMID: 26510917, DOI: 10.1111/tbj.12517.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyIntraoperative frozen sectionNipple-sparing mastectomiesNipple-areolar complexPermanent paraffin sectionsFrozen sectionsParaffin sectionsBreast cancer resectionRecords of patientsFrozen section resultsCancer resectionDuctal carcinomaProphylactic mastectomyResidual pathologyBreast reconstructionPermanent biopsyMastectomyBiopsyReconstructive planningSeparate proceduresResectionPatientsCarcinomaBreastCost Analysis of Intraoperative Subareolar Frozen Section During Nipple-Sparing Mastectomy
Alperovich M, Reis SM, Choi M, Karp NS, Frey JD, Chang JB, Axelrod DM, Shapiro RL, Guth AA. Cost Analysis of Intraoperative Subareolar Frozen Section During Nipple-Sparing Mastectomy. Annals Of Surgical Oncology 2015, 23: 490-493. PMID: 26438436, DOI: 10.1245/s10434-015-4882-8.Peer-Reviewed Original ResearchConceptsIntraoperative frozen sectionSubareolar biopsyNipple-areolar complexFrozen sectionsOperating roomNipple-sparing mastectomyOccult cancerOperative resectionHealthcare chargesPathology resultsBiopsyPatient recordsFirst cost analysisRoutine useEarly detectionInstitutional frequencyMastectomyBreastCost analysisFinancial chargesBreast Reconstruction Using Contour Fenestrated AlloDerm
Frey JD, Alperovich M, Weichman KE, Wilson SC, Hazen A, Saadeh PB, Levine JP, Choi M, Karp NS. Breast Reconstruction Using Contour Fenestrated AlloDerm. Plastic & Reconstructive Surgery Global Open 2015, 3: e505. PMID: 26495218, PMCID: PMC4596430, DOI: 10.1097/gox.0000000000000482.Peer-Reviewed Original ResearchMinor mastectomy flap necrosisMastectomy flap necrosisBreast reconstructionAcellular dermal matrixFlap necrosisReconstructive outcomesInfection outcomesInfection rateSignificant independent risk factorsDermal matrixImplant-based breast reconstructionPermanent implant reconstructionIndependent risk factorNipple-sparing mastectomyLow infection rateUse AlloDermIntravenous antibioticsImplant coverageRisk factorsImplant reconstructionPatientsAlloDermOutcomesNecrosisInfection
2014
Reconstructive Approach for Patients With Augmentation Mammaplasty Undergoing Nipple-Sparing Mastectomy
Alperovich M, Choi M, Frey JD, Karp NS. Reconstructive Approach for Patients With Augmentation Mammaplasty Undergoing Nipple-Sparing Mastectomy. Aesthetic Surgery Journal 2014, 34: 1059-1065. PMID: 25028736, DOI: 10.1177/1090820x14541958.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyReconstructive complicationsNipple-areola complexNAC necrosisComplete NAC necrosisPartial NAC necrosisPrevious breast augmentationMastectomy flap necrosisNew York University Langone Medical CenterImplant-based reconstructionMicrovascular free flapsBreast cellulitisNSM reconstructionPrevious augmentationPrior augmentationPatient characteristicsFlap necrosisMedical recordsMinimal complicationsPartial necrosisProphylactic managementCapsular contractureFisher's exactBreast cancerLarge cohortNipple-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
2013
Nipple-Sparing Mastectomy in Patients with a History of Reduction Mammaplasty or Mastopexy
Alperovich M, Tanna N, Samra F, Blechman KM, Shapiro RL, Guth AA, Axelrod DM, Choi M, Karp NS. Nipple-Sparing Mastectomy in Patients with a History of Reduction Mammaplasty or Mastopexy. Plastic & Reconstructive Surgery 2013, 131: 962-967. PMID: 23629078, DOI: 10.1097/prs.0b013e3182865ad2.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyAuthors' institutionMean body mass indexCLINICAL QUESTION/LEVELMastectomy flap necrosisSubset of patientsNipple-sparing mastectomiesBody mass indexBreast cancer recurrenceLatissimus dorsi flapPresence of cancerNipple-areola complexMass indexProphylactic indicationsFlap necrosisMean agePatient populationBiopsy resultsMastectomy patientsTherapeutic resectionCancer recurrenceNipple viabilityReconstructive outcomesMastectomyReduction mammaplastyMicrosurgical Breast Reconstruction for Nipple-Sparing Mastectomy
Tanna N, Broer PN, Weichman KE, Alperovich M, Ahn CY, Allen RJ, Choi M, Karp NS, Saadeh PB, Levine JP. Microsurgical Breast Reconstruction for Nipple-Sparing Mastectomy. Plastic & Reconstructive Surgery 2013, 131: 139e-147e. PMID: 23358009, DOI: 10.1097/prs.0b013e3182789b51.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyMicrosurgical breast reconstructionBreast reconstructionNipple necrosisMastectomy skin flap necrosisFree flap breast reconstructionNew York University Medical CenterCLINICAL QUESTION/LEVELSuperior gluteal artery perforator flapThorough preoperative evaluationGluteal artery perforator flapImmediate breast reconstructionLow complication rateNipple-sparing mastectomiesProfunda artery perforatorSkin flap necrosisBody mass indexFlap breast reconstructionMastectomy specimen weightBreast cancer historyHigh patient satisfactionMajority of flapsChoice of incisionArtery perforator flapMastectomy skin flaps