2023
Breast implant capsule-associated squamous cell carcinoma: A systematic review and individual patient data meta-analysis
Yeow M, Ching A, Guillon C, Alperovich M. Breast implant capsule-associated squamous cell carcinoma: A systematic review and individual patient data meta-analysis. Journal Of Plastic Reconstructive & Aesthetic Surgery 2023, 86: 24-32. PMID: 37666057, DOI: 10.1016/j.bjps.2023.08.002.Peer-Reviewed Original ResearchMeSH KeywordsBreastBreast ImplantationBreast ImplantsBreast NeoplasmsCarcinoma, Squamous CellFemaleHumansMiddle AgedConceptsIndividual patient dataSCC diagnosisPatient dataSystematic reviewJoanna Briggs Institute critical appraisal toolsDisease-free survivalMajority of patientsSquamous cell carcinomaRisk of biasRisk of malignancyCritical appraisal toolExtracapsular spreadMean followOverall survivalMedian ageMedian timeCell carcinomaBreast implantationImplant removalPatientsBreast augmentationUS FoodDrug AdministrationBreast implantsAppraisal tool
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 graftingWorse overall health status negatively impacts satisfaction with breast reconstruction
Mehta SK, Olawoyin O, Chouairi F, Duy PQ, Mets EJ, Gabrick KS, Le NK, Avraham T, Alperovich M. Worse overall health status negatively impacts satisfaction with breast reconstruction. Journal Of Plastic Reconstructive & Aesthetic Surgery 2020, 73: 2056-2062. PMID: 32972879, DOI: 10.1016/j.bjps.2020.08.093.Peer-Reviewed Original ResearchConceptsBREAST-Q scoresPatient-reported outcomesOverall health statusBreast reconstructionOverall healthASA classificationHealth statusGeneral linear modelAnesthesiologists physical status classificationYale-New Haven HospitalWorse overall health statusBREAST-Q outcomesHealth-related qualityPhysical status classificationNew Haven HospitalEffect of ASAASA 1Independent predictorsPatient factorsPostoperative satisfactionBreast surgeryPatient satisfactionASA 2PatientsRelevant covariatesManagement of recurrent bilateral multifocal pseudoangiomatous stromal hyperplasia (PASH)
Xu X, Persing SM, Allam O, Park KE, Mozaffari MA, Lannin DR, Bossuyt V, Alperovich M. Management of recurrent bilateral multifocal pseudoangiomatous stromal hyperplasia (PASH). The Breast Journal 2020, 26: 1814-1817. PMID: 32562297, DOI: 10.1111/tbj.13950.Peer-Reviewed Original ResearchConceptsPseudoangiomatous stromal hyperplasiaStromal hyperplasiaBilateral mastectomyReduction mammoplastyTwo-stage implant-based breast reconstructionImplant-based breast reconstructionExcellent aesthetic outcomesPain reliefBreast enlargementStandard treatmentBreast reconstructionFocal excisionReconstructive surgeryRare caseConservative optionsAesthetic outcomeHyperplastic conditionsMastectomyHyperplasiaMammoplastyMacromastiaPatientsSurgeryExcisionBreastPatients 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 scoresMicrosurgery in the sickle cell trait population: is it actually safe?
Abraham PF, Allam O, Park KE, Alperovich M. Microsurgery in the sickle cell trait population: is it actually safe? BMJ Case Reports 2020, 13: e234924. PMID: 32381529, PMCID: PMC7222880, DOI: 10.1136/bcr-2020-234924.Peer-Reviewed Original ResearchConceptsSickle cell traitCell traitSickle cell disease patientsSickle cell trait patientsPoor vascular flowPostoperative day 2Indocyanine green angiographySickle cell diseaseMicrovascular free flapsSickle cell disease populationVenous congestionDisease patientsGreen angiographyVenous anastomosisCell diseaseMicrovascular compromiseDisease populationFree flapPatent anastomosisDay 2Flap transferVascular flowArterial Doppler signalsPatientsOperating roomImpact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction
Le NK, Gabrick KS, Chouairi F, Mets EJ, Avraham T, Alperovich M. Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction. The Breast Journal 2020, 26: 1695-1701. PMID: 32337778, DOI: 10.1111/tbj.13849.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsFemaleHumansMammaplastyPatient SatisfactionQuality of LifeSocial ClassSurvivorshipConceptsPatients' socioeconomic statusQuality of lifeBreast reconstructionBreast cancerSocioeconomic statusCancer treatmentPatient-reported outcome measuresSingle academic centerInitial cancer treatmentBreast cancer treatmentPopulation health risk factorsHealth risk factorsLow socioeconomic statusHigher socioeconomic statusStudy time periodBaseline comorbiditiesCancer stageRisk factorsOutcome measuresAnalysis of covariancePatient experienceAcademic centersPatientsSignificant positive correlationSatisfaction domains
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 ResearchMeSH KeywordsAgedBreast NeoplasmsFemaleHumansMammaplastyMastectomyMedicareRetrospective StudiesUnited StatesConceptsYale-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 prevalenceComplication Profiles by Mastectomy Indication in Tissue Expander Breast Reconstruction
Chouairi F, Gabrick KS, Avraham T, Markov NP, Alperovich M. Complication Profiles by Mastectomy Indication in Tissue Expander Breast Reconstruction. Plastic & Reconstructive Surgery 2019, Publish Ahead of Print: &na;. PMID: 30730496, DOI: 10.1097/prs.0000000000005423.Peer-Reviewed Original ResearchConceptsMastectomy flap necrosisTwo-stage implant breast reconstructionImplant breast reconstructionFlap necrosisBreast reconstructionHigh riskProphylactic mastectomyTherapeutic mastectomyMastectomy indicationExact testTissue expander breast reconstructionCLINICAL QUESTION/LEVELYale-New Haven HospitalPermanent implant reconstructionExpander breast reconstructionTimes higher riskFisher's exact testNew Haven HospitalSignificant differencesBreast reconstruction proceduresBinary logistic regressionReconstructive complicationsBreast groupPerioperative complicationsComplication ratePersistent 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
Impact of incidental findings in preoperative CTA imaging for autologous breast reconstruction
Gabrick KS, Godier-Furnemont A, Chouairi F, Avraham T, Alperovich M. Impact of incidental findings in preoperative CTA imaging for autologous breast reconstruction. Journal Of Plastic Reconstructive & Aesthetic Surgery 2018, 72: 789-794. PMID: 30501967, DOI: 10.1016/j.bjps.2018.11.015.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsComputed Tomography AngiographyFemaleHumansIncidental FindingsMammaplastyPerforator FlapConceptsAutologous breast reconstructionCTA findingsCT angiographyIncidental findingBreast reconstructionPatient careYale-New Haven HospitalPreoperative CT angiographyNew Haven HospitalMetastatic diseaseMedical managementFurther imagingAdditional imagingGynecologic proceduresReconstructive microsurgeonsPatientsImaging reportsPerforator mappingCareBiopsyImagingFindingsReportMastectomyAngiographyEvolution 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 chargesTreatment of Nipple-Sparing Mastectomy Necrosis Using Hyperbaric Oxygen Therapy
Alperovich M, Harmaty M, Chiu ES. Treatment of Nipple-Sparing Mastectomy Necrosis Using Hyperbaric Oxygen Therapy. Plastic & Reconstructive Surgery 2015, 135: 1071e-1072e. PMID: 25724049, DOI: 10.1097/prs.0000000000001229.Peer-Reviewed Original Research
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