Monday 24 February 2014

Total breast reconstruction using the thoracodorsal artery perforator flap without implant

Total breast reconstruction using the thoracodorsal artery perforator flap without implant. Plastic and reconstructive surgery, Feb. 2014, vol. 132(2), p.251-4.

Santanelli, F., et al.  

http://journals.lww.com/plasreconsurg/Abstract/2014/02000/Total_Breast_Reconstruction_Using_the.7.aspx

The thoracodorsal artery perforator flap was described mainly for partial breast reconstruction by Hamdi. The purpose of this article is to describe the use of the pedicled thoracodorsal artery perforator flap for total autologous breast reconstruction without using an implant.

Defining nipple displacement and the prevention and treatment of the high-riding nipple

Defining nipple displacement and the prevention and treatment of the high-riding nipple. Plastic and reconstructive surgery, Jan. 2014, Vol. 133(1), p.64e-66e.

Swanson, E.

http://journals.lww.com/plasreconsurg/Fulltext/2014/01000/Defining_Nipple_Displacement,_and_the_Prevention.42.aspx

Spear et al. propose a new classification to evaluate the postoperative high-riding nipple. This ratio uses as its landmarks the nipple level, the inframammary fold, and the superior breast margin, based on a method reported previously by Mallucci and Branford. The method is not compared to existing classifications that measure the nipple level (as opposed to a treatment algorithm). The authors use the term “nipple displacement” synonymously with nipple malposition. Nipple displacement, however, is defined more precisely as the vertical distance between the nipple level and the level of maximum breast projection.

Neoadjuvant chemotherapy for breast cancer

Neoadjuvant chemotherapy for breast cancer: any progress? The Lancet Oncology, Feb. 2014, Vol. 15(2), p.131-2.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70584-9/fulltext?rss=yes

Colleoni, M. and Goldhirsch, A.

Neoadjuvant chemotherapy is a well established approach to treatment of locally advanced breast cancer. Preoperative therapy allows breast-conserving surgery in many patients and provides prognostic information that could guide the choice of treatments to maximise the degree of response (ie, towards pathological complete remission [pCR]).

Medications for risk reduction of primary breast cancer in women

Medications for risk reduction of primary breast cancer in women: US preventative services task force recommendation statement. Annals of internal medicine, Nov. 2013, Vol. 159(10), p.698-708.

Moyer, V.A., et al.

http://annals.org/article.aspx?articleid=1770699

The USPSTF reviewed evidence on the effectiveness, adverse effects, and subgroup variations of medications to reduce the risk for breast cancer—specifically, the selective estrogen receptor modulators tamoxifen and raloxifene. The USPSTF also reviewed a meta-analysis of placebo-controlled trials to understand the relative benefits and harms of tamoxifen and raloxifene. The USPSTF recommends against the routine use of medications, such as tamoxifen or raloxifene, for risk reduction of primary breast cancer in women who are not at increased risk for breast cancer.

Factors associated with the development of chronic pain after surgery for breast cancer

Factors associated with the development of chronic pain after surgery for breast cancer: A prospective cohort from a tertiary center in the United States. The breast, Jan/Feb. 2014, Vol. 20(1), p.9-14.

De Oliveira, G.S., et al.

http://onlinelibrary.wiley.com/doi/10.1111/tbj.12207/full

Chronic pain has been shown to affect up to 60% of patients undergoing surgery for breast cancer. Besides younger age, other risk factors for the development of chronic pain have not been consistent in previous studies. The objective of the current investigation was to detect the prevalence and risk factors for the development of chronic pain after breast cancer surgery by examining a patient population from a tertiary cancer center in the United States.

Aromatase inhibitor associated musculoskeletal symptoms are associated with reduced physical activity among breast cancer survivors

Aromatase inhibitor associated musculoskeletal symptoms are associated with reduced physical activity among breast cancer survivors. The breast journal, Jan/Feb 2014, Vol. 20(1), p.22-28.

Brown, J.C., et al.

http://onlinelibrary.wiley.com/doi/10.1111/tbj.12202/full

Physical activity (PA) has numerous health benefits for breast cancer survivors. Recent data suggest that some breast cancer survivors treated with aromatase inhibitors may experience aromatase inhibitor associated musculoskeletal symptoms. It is unknown whether aromatase inhibitor associated musculoskeletal symptoms are associated with reduced PA and what other risk factors are associated with such PA reductions. We conducted a cross-sectional study at a large university-based breast cancer clinic among breast cancer survivors prescribed an aromatase inhibitor.

Predictors of nipple ischemia after nipple sparing mastectomy

Predictors of nipple ischemia after nipple sparing mastectomy. The breast journal, Jan/Feb 2014, Vol. 20(1), p.69-73.

Carlson, G.W., et al.

http://onlinelibrary.wiley.com/doi/10.1111/tbj.12208/full

Nipple sparing mastectomy (NSM) has become an accepted approach in selected cases of breast cancer and prophylactic mastectomy. Various surgical techniques have been described and nipple ischemia has been a common complication. Potential risk factors for nipple ischemia after NSM are examined. To examine predisposing factors for nipple ischemia after NSM. Prospective evaluation of 71 consecutive NSM in 45 patients from 2009 to 2011 was performed.


Unusual nonrefractile eosinophilic crystal in breast ducts in a patient with invasive mucinous carcinoma

Unusual nonrefractile eosinophilic crystal in breast ducts in a patient with invasive mucinous carcinoma. The breast journal, Jan/Feb 2014, Vol. 20(1), p.84-86.

Quddus, M.R., et al.

http://onlinelibrary.wiley.com/doi/10.1111/tbj.12210/full

A 72-year-old, G4P2 white woman presented with a recent abnormal mammogram showing a nodule at 8 o'clock of her right breast and indeterminate calcification in the subareolar region. An initial stereotactic core followed by wide local excision and sentinel node biopsy showed a pT1aN0(sn)M(na) low-grade invasive mucinous carcinoma. In dilated benign ducts, adjacent to the carcinoma, numerous eosinophilic, nonrefractile crystals were identified.

Breast conserving surgery versus mastectomy for early-stage breast cancer

Breast conserving surgery versus mastectomy for early-stage breast cancer: Could patient choice lead to an inferior outcome? [Letter].  The breast journal, Jan/Feb 2014, Vol. 20(1), p.97-99.

Silva, E.

http://onlinelibrary.wiley.com/doi/10.1111/tbj.12220/full

In recent years, an increasing number of reports have dwelled on the impact and necessity of patient choice in the treatment of early stage breast cancer. Some have questioned whether women can or cannot make an informed choice when conflict arises between a woman's choice and her physician's recommendation.

Muscle-sparing TRAM flap does not protect breast reconstruction

Muscle-sparing TRAM flap does not protect breast reconstruction from post-mastectomy radiation damage compared with the DIEP flap.  Plastic and reconstructive surgery, Feb 2014, Vol. 132(2), p.223-33.

Garvey, P.B., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/02000/Muscle_Sparing_TRAM_Flap_Does_Not_Protect_Breast.4.aspx

Irradiation to free flaps following immediate breast reconstruction has been shown to compromise outcomes. The authors hypothesized that irradiated muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flaps experience less fat necrosis than irradiated deep inferior epigastric perforator (DIEP) flaps.