The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction

The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: An analysis of long-term surgical outcomes, aesthetic results and satisfaction over 13 years. Plastic and Reconstructive Surgery, October 2014, Vol. 134(4), p.588-95.

Cordeiro, P.G., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/10000/The_Impact_of_Postmastectomy_Radiotherapy_on.4.aspx

Postmastectomy radiation therapy is increasingly indicated in patients with node-positive breast cancer. The authors prospectively evaluated long-term outcomes in patients with two-stage implant-based reconstruction and postmastectomy radiation therapy to the permanent implant.

Invisible risks, emotional choices

Invisible risks, emotional choices: Mammography and medical decision making. NEJM, 2014; 371: 1549-52.

Rosenbaum, L.

http://www.nejm.org/doi/full/10.1056/NEJMms1409003?af=R&rss=currentIssue

Putting it all together: Managing pain in autologous and implant-based breast reconstruction

Putting it all together: Managing pain in autologous and implant-based breast reconstruction. Plastic and Reconstructive Surgery, October 2014, Vol. 134 (4S-2), p. 120S-125S.

Wilson, A.J., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2014/10002/Putting_It_All_Together___Managing_Pain_in.19.aspx

Appropriate pain management in breast reconstruction improves outcomes and patient satisfaction. The purpose of this study is to review the current methodology and paradigms in pain management following breast reconstruction. Methods: A review of the scientific literature was performed. The protocols used at our institution were further examined and contrasted in the context of this published literature. Results: Pain following breast reconstruction is multifactorial and patient specific. Pain can originate from the mastectomy alone, from the donor site, or from tissue expansion. Counseling a patient is of upmost importance. The armamentarium to address pain includes narcotic analgesics, nonnarcotic analgesics, local anesthesia, and other nontraditional regimens. Each of these methods has an evidence-based efficacy and patient selection factors for application. Conclusions: The data contained herein provide a review of perioperative pain management following autologous and implant-based breast reconstruction.

Patient activated controlled expansion for breast reconstruction using controlled carbon dioxide inflation

Patient activated controlled expansion for breast reconstruction using controlled carbon dioxide inflation: Confirmation of a feasibility study. Plastic and Reconstructive Surgery, October 2014, Vol. 134(4), p.503e-511e.

Connell, T.

http://journals.lww.com/plasreconsurg/Fulltext/2014/10000/Patient_Activated_Controlled_Expansion_for_Breast.2.aspx

Women with breast cancer or those at high risk of developing breast cancer because of familial history of the disease or genetic mutations are frequently indicated for therapeutic or prophylactic mastectomy. Prosthetic reconstruction of the breast with placement of tissue expanders followed by implants offers favorable aesthetic and psychological results while adding only minimal additional surgical intervention. This study describes the confirmatory phase of an earlier feasibility trial that involved seven women who successfully underwent patient-activated controlled expansion for breast reconstruction with 10 AeroForm patient-controlled tissue expanders.

Methods: A prospective, open-label, single-arm, single-surgeon confirmatory study in Perth, Australia, evaluated outcomes of two-stage breast reconstruction using the investigational device. Each subject administered a preset 10-cc dose of carbon dioxide gas using a remote dosage controller, three times each day, with a 3-hour lockout between doses until full expansion was achieved.

Results: Thirty-three women with breast cancer, family history, or predisposition because of the BRCA1 or BRCA2 gene mutation underwent pedicled latissimus dorsi flap procedures with placement of 61 carbon dioxide–based tissue expanders. The mean number of days for subjects to achieve desired expansion was 17 ± 5. Operating the dosage controller was described by the surgeon as very easy in 94 percent of the cases and by 97 percent of the subjects. No serious adverse events were reported.

Conclusion: This study confirms that the AeroForm breast tissue expander has demonstrated the ability to provide, relative to saline expanders, a needle-free, patient-controlled, convenient, and time-saving method of tissue expansion.

Skirt size ups breast cancer risk

Skirt size ups breast cancer risk [UK study].  Health news from NHS Choices

http://feedly.com/#subscription%2Ffeed%2Fhttp%3A%2F%2Ffeeds.feedburner.com%2FNhsChoicesBehindTheHeadlines%3Fformat%3Dxml

The study was carried out by researchers from the Universities of London and Manchester, and was funded by the Medical Research Council, Cancer Research UK and the National Institute of Health Research, as well as the Eve Appeal.

The study was published in the peer-reviewed medical journal BMJ Open. As the name suggests, this is an open-access journal, so the study can be read for free online.

The paper was widely covered in the UK media. Coverage was fair, if uncritical.

Several headlines gave the impression that going up a single skirt size would raise breast cancer risk by 33%. Such a rise in risk would only be expected if a person went up a dress size every decade from their mid-twenties to when they were over 50 years old – the youngest age of the women recruited to the study.

Several media sources included useful comments from independent experts.

Current status of hormone therapy in patients with hormone receptor positive advanced breast cancer

Current status of hormone therapy in patients with hormone receptor positive (HR+) advanced breast cancer. The Breast, October 2014 [in press]

Dalmau, E., et al.

http://www.thebreastonline.com/article/S0960-9776(14)00171-4/abstract?rss=yes

The natural history of HR+ breast cancer tends to be different from hormone receptor-negative disease in terms of time to recurrence, site of recurrence and overall aggressiveness of the disease.