Thursday 26 July 2012

BCCT.core - Can a computer program be used for the assessment of aesthetic outcome after breast reconstructive surgery?

BCCT.core - Can a computer program be used for the assessment of aesthetic outcome after breast reconstructive surgery? The breast, August 2012, Vol. 21(4), p.597-600.


Preuss, J., et al.


Aesthetic outcome is as an important endpoint of breast cancer treatment and is associated with better psychological recovery and improved quality of life. Researchers in Portugal have developed a computerised program, BCCT.core, to objectively assess aesthetic outcome of conservation breast treatment photographs. This study aimed to investigate the correlation between the Harris Scale and the BCCT.core program in patients who have undergone mastectomy and reconstruction for breast cancer.

Breast surgeons performing immediate breast reconstruction with implants

Breast surgeons performing immediate breast reconstruction with implants - Assessment of resource-use and patient-reported outcome measures. The breast, August 2012, Vol. 21(4), 590-596.


Robertson, S., et al.


http://www.thebreastonline.com/article/PIIS0960977612000045/abstract?rss=yes


Oncoplastic surgery, including immediate breast reconstruction (IBR), is expanding as a result of public demand. IBR in women with breast carcinoma is resource intense and the reconstruction is often completed concurrently with adjuvant oncological treatment. A series of 223 patients with implant-based IBRs, performed by breast surgeons 2005–2008, were analysed for use of resources and outcome.

Angiosarcoma of the breast

Angiosarcoma of the breast: A difficult surgical challenge.  The breast, August 2012, Vol. 21(4), p.584-589.


Hui, A., et al.


http://www.thebreastonline.com/article/PIIS0960977612000021/abstract?rss=yes


Breast angiosarcoma presents following radiotherapy after breast conserving surgery, in the setting of chronic lymphoedema after axillary dissection or as a primary tumour. The Peter MacCallum Cancer Centre has significant experience due to large breast and sarcoma units and as a primary radiotherapy centre. Our aims were to evaluate the management and locoregional and distant outcomes after breast angiosarcoma.

Ultrasound and fine needle aspiration cytology of axillary lymph nodes in breast cancer

Ultrasound and fine needle aspiration cytology of axillary lymph nodes in breast cancer: To do or not to do? The breast, August 2012, Vol. 21(4), p.578-583.


Leenders, M.W.H., et al.


http://www.thebreastonline.com/article/PIIS0960977612000902/abstract?rss=yes


The purpose of our study was to evaluate the accuracy of axillary ultrasound and ultrasound-guided fine needle aspiration cytology in the preoperative diagnosis of axillary metastases.

Pregnancy-associated breast cancers

Pregnancy-associated breast cancers: Do they differ from other breast cancers in young women?  The breast, August 2012, Vol. 21(4), p.550-555.


Genin, A.S., et al.


http://www.thebreastonline.com/article/PIIS0960977612000847/abstract?rss=yes


The impact of pregnancy in the physiopathology of pregnancy-associated breast cancer (PABC) is still unclear.
We compared the characteristics of PABCs and breast cancers not associated with pregnancy (non-PABCs) in terms of their loco-regional invasion and histological phenotype.

Factors predicting the non-sentinel lymph node involvement in breast cancer patients

Factors predicting the non-sentinel lymph node involvement in breast cancer patients with sentinel lymph node metastases. The breast, August 2012, Vol. 21(4), p.518-523.


Boler, D.E., et al.


http://www.thebreastonline.com/article/PIIS0960977612000392/abstract?rss=yes


In a significant proportion of patients, the sentinel lymph node (SLN) is the only involved axillary node. The goal of the present study was to identify predictive factors associated with a positive SLN and with a positive non-SLN in patients in whom axillary lymph node dissection was performed.

The neoadjuvant net

The neoadjuvant net: A patient- and surgeon-friendly device to facilitate safe breast-conserving surgery in patients who underwent neoadjuvant treatment.  The breast, August 2012, Vol. 21(4), p.499-502.


Taffurelli, M., et al.


http://www.thebreastonline.com/article/PIIS096097761100436X/abstract?rss=yes


The primary goal of the study was to describe an innovative and helpful tool in defining the minimal surgical margins necessary during breast-conserving surgery after neoadjuvant treatment: the Neoadjuvant Net . The secondary endpoint was to assess its usefulness in achieving postoperative disease-free margins and reducing Ipsilateral Breast Tumor Recurrences. 

SPEC/CT scans allow precise anatomical location of sentinel lymph nodes in breast cancer

SPEC/CT scans allow precise anatomical location of sentinel lymph nodes in breast cancer and redefine lymphatic drainage from the breast to the axilla.  The breast, August 2012, Vol. 21(4), p.480-486.


Uren, R.F., et al.


http://www.thebreastonline.com/article/PIIS096097761100405X/abstract?rss=yes


Historical studies of lymphatic drainage of the breast have suggested that the lymphatic drainage of the breast was to lymph nodes lying in the antero-pectoral group of nodes in the axilla just lateral to the pectoral muscles. The purpose of this study was to confirm this is not correct.

Updated follow up of patients treated with the oncoplastic 'crescent' technique for breast cancer

Updated follow up of patients treated with the oncoplastic 'crescent' technique for breast cancer. The breast, August 2012, Vol. 21(4), p.475-479.


Aljarrah, A., et al.


http://www.thebreastonline.com/article/PIIS0960977611004024/abstract?rss=yes


Conservative treatment of lower pole breast cancer in small or medium sized breasts could be attended with poor cosmetic outcomes. The purpose of this study was to assess the results of the “Crescent” Oncoplastic technique in this indication.

The effect of introducing an in-theatre intra-operative specimen radiography system

The effect of introducing an in-theatre intra-operative specimen radiography system on the management of palpable breast cancer within a single unit. The breast, August 2012, Vol. 21(4), p.459-463.


Layfield, D.M., et al.


http://www.thebreastonline.com/article/PIIS0960977611003778/abstract?rss=yes


Intra-operative specimen radiography (IOSR) is used to screen specimens during breast-conserving surgery and attempt to identify incompletely excised lesions. Universal use of IOSR during surgery for impalpable breast cancer is advocated by current guidelines. This study evaluates the role of IOSR during breast-conserving surgery for palpable breast cancer.

Sentinel lymph node biopsy using indigo carmine blue dye

Sentinel lymph node biopsy using indigo carmine blue dye and the validity of '10% rule' and '4 nodes rule.'  The breast, August 2012, Vol. 21(4), p.455-458.


Nagao, T., et al.


http://www.thebreastonline.com/article/PIIS096097761100378X/abstract?rss=yes


This is the study which assessed sentinel lymph node biopsy (SNB) using indigo carmine blue dye and the validity of the ‘10% rule’ and ‘4 nodes rule’. Patients (302) were performed SNB using the combined radioisotope (RI)/indigo carmine dye method. Excised SLNs were confirmed whether they were stained and numbered in order of RI count and the percentage of radioactivity as compared to the hottest node was calculated. 

Accuracy of needle biopsy of breast lesions visible on ultrasound

Accuracy of needle biopsy of breast lesions visible on ultrasound: Audit of fine needle versus core needle biopsy in 3233 consecutive samplings with ascertained outcomes. The breast, August 2012, Vol. 21(4), p.449-454.


Brancato, B., et al.


http://www.thebreastonline.com/article/S0960-9776(11)00375-4/abstract


Core needle biopsy (CNB) has progressively replaced fine needle aspiration cytology (FNAC) in the diagnosis of breast lesions. Less information is available on how these tests perform for biopsy of ultrasound (US) visible breast lesions. This study examines the outcomes of CNB and FNAC in a large series ascertained with surgical histology or clinical-imaging follow-up.

Lymphatic mapping after previous breast surgery

Lymphatic mapping after previous breast surgery.  The breast, August 2012, Vol. 21(4), p.444-448.


Maaskant-Braat, A.J.G., et al.


http://www.thebreastonline.com/article/PIIS0960977611003742/abstract?rss=yes


To assess the feasibility of lymphatic mapping and determine the lymphatic drainage pathways in patients previously treated with breast conserving therapy.

Enhancing the clinical pathway for patients undergoing axillary lymph node dissection

Enhancing the clinical pathway for patients undergoing axillary lymph node dissection.  The breast, August 2012, Vol. 21(4), p.440-443.


Barry, M., et al.


http://www.thebreastonline.com/article/PIIS0960977611003699/abstract?rss=yes


Day-case axillary lymph node dissection (ALND) is not standard practice. Here we assess the feasibility of converting this traditional inpatient procedure to an outpatient procedure without compromising the quality or continuity of patient care, identify barriers to introducing an enhanced clinical pathway based on this conversion, and report strategies employed to overcome these barriers.

Breast cancer early detection methods for low and middle income countries

Breast cancer early detection methods for low and middle income countries, a review of the evidence. The breast, August 2012, Vol. 21(4), p.428-434.


Corbex, M., et al.


http://www.thebreastonline.com/article/PIIS0960977612000033/abstract?rss=yes


Organized national mammographic screening has been adopted as the gold standard for breast cancer early detection in western countries; however it may not be the most cost-effective approach to early detection in low and middle income countries (LMC) as it is very demanding in terms of human and financial resources. Moreover, its benefit to harm ratio has been questioned lately, particularly in women <50 years, the age group which produces the majority of breast cancer cases in LMC.

Alcohol and breast cancer

Alcohol and breast cancer. The breast, August 2012, Vol. 21(4), p.426-427.

Seitz, H.K.

Ethanol consumption is a major health problem worldwide and is responsible for more than 200 diseases. The World Health Organization has calculated that alcohol accounts for approximately 1.8 million deaths per year (3.2% of all deaths) including addiction, liver cirrhosis and cancer. Epidemiology has convincingly shown that chronic alcohol ingestion is a significant risk factor for the development of cancer of the upper alimentary tract (oropharynx, larynx and oesophagus), for the colorectum, the liver and the female breast. Recently, the International Agency for Research on Cancer has identified all alcoholic beverages as carcinogenic to humans and acetaldehyde as a carcinogen. Compared to other organs, the breast seems especially sensitive towards the carcinogenic action of ethanol as breast cancer risk starts already at very low daily ethanol consumption without any threshold. As ethanol use is widespread and breast cancer is the most frequent cancer in women in USA and in Europe, alcohol as a risk factor for breast cancer is of public concern. In contrast to the liver and the upper gastrointestinal tract, mechanisms by which ethanol stimulates mammary carcinogenesis are still unclear, complex and not well understood.

Inverted-T skin-reducing mastectomy with immediate implant reconstruction

Inverted-T skin-reducing mastectomy with immediate implant reconstruction using the submuscular-subfascial pocket. Plastic and reconstructive surgery, July 2012, Vol. 130(1), p.31-41.


Salgarello, M., et al.


http://journals.lww.com/plasreconsurg/Abstract/2012/07000/Inverted_T_Skin_Reducing_Mastectomy_with_Immediate.7.aspx


The inverted-T skin-reducing mastectomy with implant reconstruction represents a very effective reconstructive and cosmetic option in patients with macromastia. However, in this subset of patients, the risk of skin flap necrosis, especially at the T-junction, is significant. In this setting, complete implant coverage with viable tissue beneath the mastectomy skin flaps is essential to reduce morbidity. In this article, the authors retrospectively review their series of 16 skin-reducing mastectomy and immediate one-stage implant reconstructions using the submuscular-subfascial pocket, analyzing the reconstructive issues and cosmetic outcomes.

Post-mastectomy breast reconstruction in the irradiated breast

Post-mastectomy breast reconstruction in the irradiated breast: A comparative study of DIEP and latissimus dorsi flap outcome. Plastic and reconstructive surgery, July 2012, Vol. 130(1), p. 10-18.


Lindegren, A., et al.


http://journals.lww.com/plasreconsurg/Abstract/2012/07000/Postmastectomy_Breast_Reconstruction_in_the.2.aspx


Autologous tissue transfer is often indicated to achieve improved tissue quality during breast reconstruction after radiotherapy. The authors evaluated satisfaction with postmastectomy breast reconstruction among irradiated patients. The aim was to compare deep inferior epigastric perforator (DIEP) and latissimus dorsi flaps regarding satisfaction with aesthetic outcome between patients and plastic surgeons.

Inferiorly based parenchymal flap mammaplasty

Inferiorly based parenchymal flap mammaplasty: A safe, reliable, and versatile technique for breast reduction and mastopexy. Plastic and reconstructive surgery, July 2012, Vol. 130(1), p.116e-125e.


Bonomi, S., et al.


http://journals.lww.com/plasreconsurg/Abstract/2012/07000/Inferiorly_Based_Parenchymal_Flap_Mammaplasty___A.41.aspx


 Breast reduction and mastopexy are among the most frequent procedures in aesthetic breast surgery. Many approaches have been described, and various types of dermaglandular pedicles for the nipple-areola complex have been used. The authors present a technique suitable for either mastopexy or breast reduction whereby the superior or superomedial pedicle supplying the nipple-areola complex is combined with an inferior dermaglandular flap to restore the upper pole fullness, thereby improving breast shape and projection.

Pre-operative needle biopsy of sentinel lymph nodes

Pre-operative needle biopsy of sentinel lymph nodes using intradermal microbubbles and contrast enhanced ultrasound in patients with breast cancer.  AJR, August 2012, Vol. 199(2), p.465-470.


Sever, A.R., et al.


http://www.ajronline.org/content/199/2/465.abstract?rss=1


The purpose of this study was to assess whether sentinel lymph nodes that undergo targeted needle biopsy after identification by contrast-enhanced ultrasound (CEUS) using intradermally injected microbubbles results in more node-positive breast cancer patients being diagnosed preoperatively. Furthermore, we sought to determine whether the addition of CEUS to gray-scale sonography of the axilla reduces the number of patients having axillary lymph node  dissection as a second procedure.

Triple receptor-negative breast cancer

Triple receptor-negative breast cancer: Imaging and clinical characteristics.  AJR, August 2012, Vol. 199(2), p.458-464.

Krizmanich-Conniff, K.Z., et al.

http://www.ajronline.org/content/199/2/458.abstract?rss=1

The objective of our study was to retrospectively evaluate the imaging findings of patients with breast cancer negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2)—so-called “triple receptor–negative cancer”—and to compare the mammographic findings and clinical characteristics of triple receptor–negative cancer with non–triple receptor–negative cancers.


High-risk breast lesions at imaging guided needle biopsy

High-risk breast lesions at imaging guided needle biopsy: Usefulness of MRI for treatment decision. AJR, August 2012, Vol.119(2), p.W240-W250.

Londero, V., et al.

http://www.ajronline.org/content/199/2/W240.abstract?rss=1

The purpose of this study is to evaluate the role of MRI for characterization of high-risk breast lesions diagnosed at imaging-guided needle biopsy.

Benefit of exercise in lowering breast cancer risk

Benefit of exercise in lowering breast cancer risk is lost in postmenopausal women who had gained weight. [News item] BMJ 2012, 344 (published 26 June 2012).

Mayor, S.

Link to article (log in with your Athens username)

Physical activity reduces women’s risk of breast cancer except among postmenopausal women who gained substantial weight during adulthood, shows a US study.

Reoperation rates after breast conserving surgery for breast cancer among women in England

Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics. BMJ 2012, 345 (published 12 July 2012).

Jeevan, R., et al.

Click to access full text

To examine whether rate of reoperation after breast conserving surgery is associated with patients’ characteristics and investigate whether reoperation rates vary among English NHS trusts.

Mammography screening has little or no effect on breast cancer deaths

Mammography screening has little of no effect on breast cancer deaths, Swedish data indicate. [News article] BMJ 2012, 345 (published 17 July 2012).

Mayor, S.

Link to article (log in with your Athens username)

Mammography screening has little or no effect on mortality from breast cancer in women aged 40-69, shows an analysis of Swedish figures published this week. But commentators argue that trends in breast cancer deaths cannot be used to evaluate screening in isolation from developments in diagnostic methods and treatment.

Tuesday 10 July 2012

Local breast cancer recurrence after mastectomy and immediate breast reconstruction

Local breast cancer recurrence after mastectomy and immediate breast reconstruction for invasive cancer: A meta-analysis

Gieni, M., et al.

http://www.thebreastonline.com/article/PIIS0960977611004218/abstract?rss=yes

The main priorities in the surgical treatment of patients with breast cancer are to achieve cure, local control and prevent recurrence. It is increasingly important to address quality of life and self-image with women undergoing surgical intervention for breast cancer. There is a lack of consensus as to the oncologic safety of immediate breast reconstruction (IBR). The purpose of this paper is to systematically review the literature and compare the frequency of recurrence in patients with and without IBR following mastectomy for breast cancer.

Comparison of immediate implant placement versus the staged tissue expander technique in breast reconstruction

Comparison of immediate implant placement versus the staged tissue expander technique in breast reconstruction. Plastic and reconstructive surgery, June 2012, Vol. 129(6), p.909e-918e.

Roostaeian, J., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/06000/Comparison_of_Immediate_Implant_Placement_versus.5.aspx

Tissue expansion is currently the most common method used in prosthetic breast reconstruction. Skin-sparing mastectomy techniques have facilitated immediate placement of a permanent implant. Proposed benefits to immediate implants include less time and fewer operations to complete reconstruction. Whether it leads to poorer outcomes remains unknown. The authors compared immediate implant-based and staged tissue expander breast reconstruction.

The three dermoglandular flap support in reduction mammaplasty

The three dermoglandular flap support in reduction mammaplasty. Plastic and reconstructive surgery, July 2012, Vol. 130(1), p.1e-10e.

Pascone, M., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/07000/The_Three_Dermoglandular_Flap_Support_in_Reduction.6.aspx

Bilateral breast reduction is an established procedure performed to relieve the physical pain and psychological discomfort associated with heavy, pendulous breasts. Numerous techniques have been developed over the years with several refinements to obtain safe nipple-areola complex transposition and harmonious breast shape.