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 graftingManagement 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 room
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
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 recurrenceCost 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 charges
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 cohortReply
Alperovich M, Choi M, Karp NS. Reply. Plastic & Reconstructive Surgery 2014, 133: 716e. PMID: 24776578, DOI: 10.1097/prs.0000000000000126.Peer-Reviewed Original Research
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