Combined breast surgery and abdominoplasty

Combined breast surgery and abdominoplasty: Strategies for success. Plastic and Reconstructive Surgery, May 2015, Vol. 135(5), p.849(e)-860(e).

Matarasso, A. and Smith, D.M.

http://journals.lww.com/plasreconsurg/Abstract/2015/05000/Combined_Breast_Surgery_and_Abdominoplasty__.17.aspx

Abdominoplasty and breast surgery are frequently appealing to patients as combined procedures. The practice of combining abdominoplasty with other procedures originates from abdominoplasty performed in conjunction with intraabdominal or gynecologic surgery. Initially, the focus of combined surgery was on ensuring safety and minimizing local (e.g., wound healing) complications. As surgeons began combining abdominoplasty with distant procedures such as breast surgery, because the individual procedures have little adverse impact on one another and are not altered because of the combination, concerns with systemic morbidity surpassed the initial focus on avoiding local complications. 

Breast reduction in patients with prior breast irradiation

Breast reduction in patients with prior breast irradiation: Outcomes using a central mound technique. Plastic and Reconstructive Surgery, May 2015, Vol. 135(5), p.1276-82.

Weichman, K.E., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2015/05000/Breast_Reduction_in_Patients_with_Prior_Breast.2.aspx

 Breast reduction in patients with a history of lumpectomy and irradiation is controversial because of a heightened risk of infection and wound healing complications. Persistent macromastia or asymmetry remains a problem in this patient population that is commonly not addressed. The authors studied the safety and efficacy of a central mound technique with minimal dissection for breast reduction or mastopexy in patients with a history of breast irradiation.

Methods: A case-control study of all patients undergoing bilateral breast reduction mammaplasty between 2008 and 2013 at Memorial Sloan Kettering Cancer Center was conducted. Patients who had unilateral breast irradiation and bilateral reduction using the central mound technique were included. Each patient had a control breast and an irradiated breast. Complications and outcomes were analyzed.

Results: Thirteen patients were included for analysis. Their average age was 50.23 ± 9.9 years, and average time from irradiation to breast reduction mammaplasty was 41.3 ± 48.5 months (range, 9 to 132 months). The average specimen weight of irradiated breasts was less than that of control breasts; however, this failed to reach statistical significance (254.2 ± 173.5 g versus 386.9 ± 218.5 g; p = 0.099). One patient developed fat necrosis in the previously irradiated breast and underwent biopsy. There was no incidence of nipple necrosis or breast cancer in either irradiated or nonirradiated breasts.

Conclusions: Breast reduction mammaplasty in patients who have had irradiation is feasible and can be performed safely in select cases. The central mound technique provides reliable and reproducible results and should be considered in patients with macromastia/asymmetry and a history of irradiation.

Family breast cancer "as treatable as other tumours"

Family breast cancer" as treatable as other tumours". BBC News Online, 20.5.15

http://www.bbc.co.uk/news/health-32777696

The unfolding story of cancer

The unfolding story of cancer. The Lancet, May 2015, Vol. 385(9980), p.1824

Campbell, P.T.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60915-1/fulltext?rss=yes

Few diseases provoke the visceral fear of cancer. This reaction is justified: more than 14 million people worldwide this year will be diagnosed with cancer. We have learned a great deal about the prevention, causes, treatment, biology, socioeconomics, and political implications of cancer since the time of the ancients when, in writing about treatment for breast cancer, the Egyptian Imhotep wrote “there is none”. Currently, nearly nine of ten women diagnosed with breast cancer in the UK and the USA will live 5 years or more beyond diagnosis. And there have been advances for other cancers, such as leukaemia. Indeed, cancer mortality in the past 20 years has decreased by about 20–30% in the UK and the USA. Despite these clinical and public health advances, at least 8 million people worldwide are expected to die from cancer this year.

Diagnosis and management of galactorrhea after breast augmentation

Diagnosis and management of galactorrhea after breast augmentation. Plastic and Reconstructive Surgery, May 2015, Vol. 135(5), p.1349-56.

Basile, F.V. and Basile, A.R.

http://journals.lww.com/plasreconsurg/Abstract/2015/05000/Diagnosis_and_Management_of_Galactorrhea_after.15.aspx

 A known but not fully understood complication of breast augmentation is galactorrhea. To date, all publications on this subject have been case reports. The purpose of this retrospective study was to examine a large group of consecutive patients who had undergone breast augmentation and identify the incidence of galactorrhea and galactocele, and the associated preoperative and intraoperative risk factors. The authors also evaluated the treatment algorithm used.

Current attitudes to breast reconstruction surgery for women at risk of post-mastectomy radiatherapy

Current attitudes to breast reconstruction surgery for women at risk of post-mastectomy radiotherapy:  A survey of UK breast surgeons. The Breast [in press], published online May 2015.

Duxbury, P.J., et al.

http://www.thebreastonline.com/article/S0960-9776(15)00108-3/abstract?rss=yes

Decision-making for women requiring reconstruction and post-mastectomy radiotherapy (PMRT) includes oncological safety, cosmesis, patient choice, potential delay/interference with adjuvant treatment and surgeon/oncologist preference. This study aimed to quantitatively assess surgeons' attitudes and perceptions about reconstructive options in this setting, and to ascertain if surgical volume influenced advice given.

How to compare the oncological safety of oncoplastic breast conservation surgery

How to compare the oncological safety of oncoplastic breast conservation surgery - to wide local excision or mastectomy? The Breast, May 2015 [in press]

Mansell, J., et al.

http://www.thebreastonline.com/article/S0960-9776(15)00109-5/abstract?rss=yes

Comparative studies suggest that patients treated with oncoplastic breast conservation surgery (OBCS) have similar pathology to patients treated with wide local excision (WLE). However, patients treated with OBCS have never been compared to patients treated with mastectomy. The aim of this study was to identify which control group was comparable to patients undergoing OBCS.

Evaluation of effect of self-examination and physical examination on breast cancer

Evaluation of effect of self-examination and physical examination on breast cancer. The Breast, May 2015 [in press]

Hassan, L.M., et al.

http://www.thebreastonline.com/article/S0960-9776(15)00105-8/abstract?rss=yes

Breast cancer is the number one cancer of women in the world. More than 90% of breast cancers can be cured with early diagnosis followed by effective multimodality treatment. The efficacy of screening by breast self-examination (BSE) and breast physical examination (BPx) is best evaluated using randomized screening trials.

Factors influencing time between surgery and radiotherapy

Factors influencing time between surgery and radiotherapy: A population based study of breast cancer patients. The Breast, May 2015 [in press]

Katik, S., et al.

http://www.thebreastonline.com/article/S0960-9776(15)00099-5/abstract?rss=yes

This study describes variation in the time interval between surgery and radiotherapy in breast cancer (BC) patients and assesses factors at patient, hospital and radiotherapy centre (RTC) level influencing this variation. To do so, the factors were investigated in BC patients using multilevel logistic regression. The study sample consisted of 15,961 patients from the Netherlands Cancer Registry at 79 hospitals and 19 (RTCs) with breast-conserving surgery or mastectomy directly followed by radiotherapy.

Clinical outcomes of women with breast cancer and a PALB2 mutation

Clinical outcomes of women with breast cancer and a PALB2 mutation: a prospective cohort analysis. The Lancet Oncology, June 2015, Vol. 16(6), p.638-44.

Cybulski, C., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)70142-7/fulltext?rss=yes

Mutations in PALB2 predispose to breast cancer, but the effect on prognosis of carrying a PALB2mutation has not been ascertained. We aimed to estimate the odds ratio for breast cancer in women with an inherited mutation in PALB2 and 10-year survival after breast cancer in patients who carry aPALB2 mutation.