{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T11:08:10Z","timestamp":1778411290939,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: In the setting of breast surgery, indocyanine green angiography (ICGA) allows estimating the perfusion of cutaneous tissues during surgical interventions, in order to reduce vascularization-related complications. This study has a dual objective: to evaluate the correlation between preoperative factors and the level of skin vascularization, measured by ICGA, in patients undergoing subcutaneous mastectomy for breast cancer; and to establish any relationship between low intraoperative vascularization and the onset of postoperative complications. Methods: This is a preliminary, non-randomized, prospective clinical study that includes 46 female patients undergoing subcutaneous mastectomy with reconstruction for breast cancer between February 2022 and July 2024. The relationship between vascularization and the following preoperative variables was assessed: smoking, previous breast surgeries, prior radiotherapy, neoadjuvant or prior chemotherapy\/anti-Her2 therapy, and the thickness of breast subcutaneous tissue evaluated through mammography. For the analysis, three ICGA procedures were performed, using 0.125 mg\/kg of indocyanine green (ICG) for each procedure before the surgical incision (V1), at the end of the demolition phase (V2), and at the end of the reconstruction phase (V3). The results of this analysis were finally correlated with the occurrence of any postoperative complications. Results: Vascularization was conventionally classified as \u201clow\u201d and \u201cgood\u201d using a cutoff of 33%. Previous surgeries on the ipsilateral breast and neoadjuvant or prior chemotherapy\/anti-Her2 therapy were found to be predictive factors of \u201clow\u201d vascularization (p = 0.031). Patients with \u201clow\u201d vascularization at time V3 showed a significantly higher risk of developing complications (p = 0.038). Incision length emerged as an independent predictor of complications, with a 23% increase in risk per additional centimeter (p = 0.006), independent of perfusion level. Conclusions: This study supports the use of ICGA as a useful tool to improve outcomes in patients undergoing subcutaneous mastectomy with prosthetic reconstruction for breast cancer. The results of this preliminary work are encouraging, and recruiting a larger number of patients could provide more significant data.<\/jats:p>","DOI":"10.3390\/jpm15060242","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T03:54:18Z","timestamp":1749527658000},"page":"242","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Indocyanine Green Angiography to Predict Complications in Subcutaneous Mastectomy: A Single-Center Experience"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3826-874X","authenticated-orcid":false,"given":"Letizia","family":"Cuniolo","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"},{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dafne","family":"Anastasia","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Genoa, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Murelli","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"},{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cornacchia","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Depaoli","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Gipponi","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Margarino","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Boccardo","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simonetta","family":"Franchelli","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Pesce","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amandine","family":"Causse D\u2019agraives","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Allievi","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Cossu","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Genoa, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"De Cian","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"},{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1279-5299","authenticated-orcid":false,"given":"Piero","family":"Fregatti","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, 16132 Genoa, Italy"},{"name":"Breast Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.clbc.2022.12.021","article-title":"Predicting Mastectomy Skin Flap Necrosis: A Systematic Review of Preoperative and Intraoperative Assessment Techniques","volume":"23","author":"Pagliara","year":"2023","journal-title":"Clin. 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