Browsing by Author "Hajj, John P."

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    Immediate Breast Reconstruction for Inflammatory Breast Carcinoma: A Scoping Review
    (Wiley, 2025) Davé, Nikhil; Hajj, John P.; Ahmed, Shahnur; Hulsman, Luci; Singh, Nikhi P.; Fisher, Carla S.; Lester, Mary E.; Hassanein, Aladdin H.; Surgery, School of Medicine
    Inflammatory breast carcinoma (IBC) is an aggressive form of breast cancer involving skin lymphatics. Breast reconstruction traditionally has been delayed in IBC. Immediate reconstruction has been described in select patients. Studies evaluating the reconstructive and oncologic safety of immediate breast reconstruction in this patient population are limited and retrospective. The purpose of this study is to assess the current body of literature on immediate breast reconstruction in IBC patients to identify knowledge gaps. A scoping review was conducted using PubMed, Scopus, Embase, and Cochrane databases. Original articles that evaluated patients diagnosed with IBC who underwent immediate breast reconstruction were included. The search yielded 821 articles, of which 9 articles containing 1429 IBC patients were included for analysis. Immediate implant-based reconstruction occurred in 12.2% (174/1429) of patients. Immediate autologous reconstruction occurred in 19.0% (272/1429). Immediate reconstruction with both autologous and implant-based techniques was 4.5% (64/1429). Reconstruction type was not reported for 63.0% (899/1429) of patients. Postoperative complications occurred in 1.8% (26/1429) of patients. Local cancer recurrence was 14.3% (3/21) at 18.9 months. The mortality rate was 32.4% (131/404) at 22 months. Performance of immediate breast reconstruction can be safely performed from a reconstructive standpoint in select patients.
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    P33. A Multi-hospital Network Analysis of Long-term Outcomes and Predictors of Lymphedema Following Immediate Lymphatic Reconstruction and Axillary Lymph Node Dissection
    (Wolters Kluwer, 2025-05-16) Hassan, Abbas M.; Hajj, John P.; Lewis, John P.; Ahmed, Shahnur; Fisher, Carla S.; Ludwig, Kandice K.; Danforth, Rachel M.; VonDerHaar, R. Jason; Bamba, Ravinder; Lester, Mary E.; Hassanein, Aladdin H.; Surgery, School of Medicine
    PURPOSE: Breast cancer-related lymphedema (BCRL) significantly affects quality-of-life after axillary lymph node dissection (ALND). Immediate lymphatic reconstruction (ILR) may reduce BCRL incidence, but long-term outcomes and predictors are unclear. This study sought to compare long-term BCRL prevalence in patients undergoing ILR with pooled estimates from ALND alone and to identify factors associated with BCRL after ILR. METHODS: We retrospectively studied consecutive patients who underwent ILR following ALND between January 2020 and March 2024 across six hospitals in the Indiana University network. Primary outcome was BCRL prevalence, defined as ≥2cm limb difference at two contiguous points. Secondary outcomes included BCRL predictors, postoperative complications, and compression garment use. RESULTS: Among 150 patients (mean age 51.2±10.6 years; BMI 29.6±7.1 kg/m²; follow-up 17.9±10.8 months) that underwent ILR, cumulative BCRL incidence was 10.7% (n=16). Compared to pooled estimates from 10,774 patients undergoing ALND alone, our ILR cohort had significantly lower BCRL rates: 2% vs. 16.5% (<12 months), 6.7% vs. 24.6% (12-24 months), and 10.7% vs. 23.6% (>24 months) (p < 0.001). Compression was used in 29% following ILR, with 64.6% (n=28) not meeting lymphedema diagnostic criteria. Breast-related complications occurred in 29.3% (n=44). Patients with obesity (56.3% vs. 38.3%, p=0.179) and postoperative radiotherapy (93.8% vs. 82.8%, p=0.260) had higher rates of lymphedema following ILR, although not statistically significant. Multivariable analysis did not identify any independent predictors of BCRL among ILR patients. CONCLUSION: ILR following ALND is associated with significantly lower rates of BCRL compared to ALND alone. The prevalence of lymphedema increases over time with longer term follow-up.
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    Prophylactic Absorbable Antibiotic Beads: Effect on Postoperative Drain Management Following Breast Reconstruction
    (Wolters Kluwer, 2025-03-03) Ahmed, Shahnur; Hajj, John P.; Bamba, Ravinder; Danforth, Rachel M.; VonDerHaar, Richard Jason; Lester, Mary E.; Hassanein, Aladdin H.; Surgery, School of Medicine