ORCID Profile
0000-0003-4940-4674
Current Organisations
The University of Newcastle
,
Northern Breast Care
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Publisher: Elsevier BV
Date: 2014
Publisher: BMJ
Date: 12-2020
Abstract: Breast abscesses are a common surgical problem, typically occurring secondary to lactation mastitis. Recurrent subareolar abscesses are rarely reported and may be poorly recognised as a presentation of squamous metaplasia of lactiferous ducts, known eponymously as ‘Zuska’s disease’. Other synonyms include subareolar breast abscess and lactiferous or mammary fistulas. Recognition of this painful entity is crucial for optimal outcomes since typical breast abscess management of recurrent aspiration or incision and drainage can lead to recurrence and chronic complications, such as fistula formation.
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.SURGE.2022.01.004
Abstract: A Phyllodes Tumour (PT) is an uncommon fibroepithelial lesion, with three histological grades - benign, borderline and malignant. PTs cause significant challenges in diagnosis, management and prognostication. Recent publications have clarified the definitions and prognostication of PTs. Contemporary data currently challenge international guidelines on PT management. We performed an in-depth literature review to develop a best-practice management algorithm for PTs. Diagnostic recommendations are that neither current imaging techniques, nor fine-needle biopsies, can reliably diagnose a PT. Core needle biopsy is the optimal diagnostic technique. Indeterminate or suspicious lesions are recommended to undergo an excisional biopsy due to the inherently heterogeneous nature of PTs. Management guidelines are that benign PTs should be completely excised, although an involved margin is acceptable in select situations. Borderline PTs should have a clear margin on excision due to their higher risk of recurrence, as well as the potential for a recurrence to progress to a malignant PT. In malignant PTs, a margin of 3 mm is acceptable as there is no reduction in recurrence risk if margins are >3 mm. Routine axillary surgery is not indicated in PTs, with axillary surgery only indicated in a histologically-confirmed positive axilla. Adjuvant treatment recommendations are that borderline and malignant PTs should be discussed at MDT, with radiotherapy considered in both. Chemotherapy should be discussed in malignant PT patients. In summary, we have developed an up-to-date simple algorithm to guide the surgeon's management of patients diagnosed with PTs and reduce excessive surgery.
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 04-2023
Publisher: Hindawi Limited
Date: 18-05-2020
DOI: 10.1111/TBJ.13890
Publisher: Elsevier BV
Date: 12-2020
Publisher: BMJ
Date: 06-2023
Abstract: The Wise-pattern skin-sparing mastectomy (SSM) is well known for its efficacy in large ptotic breasts, and its safety in facilitating immediate breast reconstruction. An unfortunate sequalae for all SSM techniques is mastectomy skin flap necrosis (MSFN) with a reported range of occurrence of 5%–30%. For the Wise pattern, the common area of wound dehiscence or necrosis is the T-junction. Different techniques have been described in the management of MSFN—ranging from primary closure to local and distant flaps. Full thickness MSFN results in wound breakdown and can expose a prosthesis, subsequently closure must be obtained with potential for the prosthesis to be explanted. To date, there has been no reports in the literature of the usage of a rhomboid flap in an SSM with immediate prepectoral implant. We discuss our experience in the usage of this local cosmetic flap to avoid prosthesis loss and have reviewed the literature regarding MSFN, the application of the rhomboid (Limberg) flap in breast surgery and its applicability in MSFN to preserve underlying prosthesis.
Publisher: Gavin Publishers
Date: 22-04-2022
Publisher: Gavin Publishers
Date: 14-03-2022
No related grants have been discovered for Adam Ofri.