Three-dimensional nipple-areola tattooing: A new technique with superior results. Plastic and Reconstructive Surgery, May 2014, Vol. 133(5), p.1073-75.
Halvorson, E.G., et al.
http://journals.lww.com/plasreconsurg/Fulltext/2014/05000/Three_Dimensional_Nipple_Areola_Tattooing___A_New.4.aspx
Traditional coloring techniques for nipple-areola tattooing ignore the artistic principles of light and shadow to create depth on a two-dimensional surface. The method presented in this article is essentially the inverse of traditional technique and results in a more realistic and three-dimensional reconstruction that can appear better than surgical methods. The application of three-dimensional techniques or “realism” in tattoo artistry has significant potential to improve the aesthetic outcomes of reconstructive surgery.
Thursday, 8 May 2014
Quality-of-life outcomes between mastectomy alone and breast reconstruction
Quality-of-life outcomes between mastectomy alone and breast reconstruction: Comparison of patient-reported BREAST-Q and other health-related quality-of-life measures. Plastic and Reconstructive Surgery, April 2014, Vol. 133(4), p.594(e)-595(e).
Cagli, B.M.D., et al.
file://mscl-users/Users/ecnt/L&D%20Services/CKeeling/Downloads/Quality_of_Life_Outcomes_between_Mastectomy_Alone.42%20(1).pdf
For women, breast cancer remains a common and dreaded experience; it is normal for a diagnosis of breast cancer to evoke grief, anger, and intense fear. The options of breast conservation and reconstruction give women a new sense of control over their treatment and are quite successful in helping women feel comfortable with their bodies again.
Cagli, B.M.D., et al.
file://mscl-users/Users/ecnt/L&D%20Services/CKeeling/Downloads/Quality_of_Life_Outcomes_between_Mastectomy_Alone.42%20(1).pdf
For women, breast cancer remains a common and dreaded experience; it is normal for a diagnosis of breast cancer to evoke grief, anger, and intense fear. The options of breast conservation and reconstruction give women a new sense of control over their treatment and are quite successful in helping women feel comfortable with their bodies again.
Understanding the effect of breast augmentation on quality of life
Understanding the effect of breast augmentation on quality of life: Prospective analysis using the BREAST-Q.
Plastic and Reconstructive Surgery, April 2014, Vol. 133(4), p.787-95.
Alderman, A.K., et al.
http://journals.lww.com/plasreconsurg/Fulltext/2014/04000/Understanding_the_Effect_of_Breast_Augmentation_on.6.aspx
Plastic and Reconstructive Surgery, April 2014, Vol. 133(4), p.787-95.
Alderman, A.K., et al.
http://journals.lww.com/plasreconsurg/Fulltext/2014/04000/Understanding_the_Effect_of_Breast_Augmentation_on.6.aspx
The aim of this study was to prospectively evaluate patient satisfaction and quality of life with elective breast augmentation. Patients with bilateral submuscular breast augmentations prospectively completed the BREAST-Q preoperatively and 6 weeks and 6 months postoperatively; t tests compared preoperative and postoperative scores at 6 weeks and 6 months, and standard indicators of effect sizes were calculated. Logistic regression was used to evaluate the association between patient and surgical factors on satisfaction outcomes.
Breast cancer screening pamphlets mislead women
Breast cancer screening pamphlets mislead women. BMJ 2014; 348
Gigerenzer, G.
http://www.bmj.com/content/348/bmj.g2636?rss=1
Why should I have mammography? That question is regularly asked in pamphlets for screening. The answer is also regularly misleading. Women are told what they should do, but without being given the facts necessary to make informed decisions. This form of paternalism has a long tradition. In a campaign poster in the 1980s, the American Cancer Society declared: “If you haven’t had a mammogram, you need more than your breasts examined.”
Gigerenzer, G.
http://www.bmj.com/content/348/bmj.g2636?rss=1
Why should I have mammography? That question is regularly asked in pamphlets for screening. The answer is also regularly misleading. Women are told what they should do, but without being given the facts necessary to make informed decisions. This form of paternalism has a long tradition. In a campaign poster in the 1980s, the American Cancer Society declared: “If you haven’t had a mammogram, you need more than your breasts examined.”
Management of women at high risk of breast cancer
Management of women at high risk of breast cancer. BMJ 2014, 348:g2756
Armstrong, A.C. and Evans, G.D.
http://www.bmj.com/highwire/filestream/696134/field_highwire_article_pdf/0/bmj.g2756
Breast cancer is the commonest malignancy diagnosed in women worldwide and accounts for over 30% of all cancers diagnosed in women in the United Kingdom.1 The average lifetime risk of developing breast cancer for women in the United Kingdom and United States is estimated to be 12%, although this may
be an overestimate, as it is not clear what age this assumes a woman lives to and whether full adjustment has been made for those who die young from other causes. It is also unclear whether multiple breast cancers in a single woman are counted as several women with breast cancer.
Armstrong, A.C. and Evans, G.D.
http://www.bmj.com/highwire/filestream/696134/field_highwire_article_pdf/0/bmj.g2756
Breast cancer is the commonest malignancy diagnosed in women worldwide and accounts for over 30% of all cancers diagnosed in women in the United Kingdom.1 The average lifetime risk of developing breast cancer for women in the United Kingdom and United States is estimated to be 12%, although this may
be an overestimate, as it is not clear what age this assumes a woman lives to and whether full adjustment has been made for those who die young from other causes. It is also unclear whether multiple breast cancers in a single woman are counted as several women with breast cancer.
Wednesday, 26 March 2014
Anastrozole for prevention of breast cancer in high-risk postmenopausal women
Anastrozole for prevention of breast cancer in high-risk postmenopausal women: An international, double-blind, randomised placebo-controlled trial. The Lancet, March 2014, Vol. 383(9922), p.1041-48.
Cuzick, J., et al.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62292-8/abstract?rss=yes
Aromatase inhibitors effectively prevent breast cancer recurrence and development of new contralateral tumours in postmenopausal women. We assessed the efficacy and safety of the aromatase inhibitor anastrozole for prevention of breast cancer in postmenopausal women who are at high risk of the disease.
Cuzick, J., et al.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62292-8/abstract?rss=yes
Aromatase inhibitors effectively prevent breast cancer recurrence and development of new contralateral tumours in postmenopausal women. We assessed the efficacy and safety of the aromatase inhibitor anastrozole for prevention of breast cancer in postmenopausal women who are at high risk of the disease.
Breast cancer chemoprevention
Breast cancer chemoprevention: little progress in practice? The Lancet, March 2014 Vol. 383(9922), p.1018-20.
Cameron, D.A.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62555-6/fulltext?rss=yes
In The Lancet, Jack Cuzick and colleagues report the first results from IBIS-II (International Breast cancer Intervention Study II), in which 3864 postmenopausal women at high risk of breast cancer were randomly assigned to receive the potent, non-steroidal aromatase inhibitor anastrozole or placebo every day for 5 years. After a median follow-up of 5 years, 40 (2%) of 1920 women in the anastrozole group and 85 (4%) of 1944 in the placebo group had developed breast cancer (hazard ratio 0·47, 95% CI 0·32—0·68). This finding is in keeping with those of other similar studies.So far, unsurprisingly, the investigators have not recorded evidence for a difference in breast cancer or all-cause mortality: 18 deaths had been reported in the anastrozole group and 17 in the placebo group.
Cameron, D.A.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62555-6/fulltext?rss=yes
In The Lancet, Jack Cuzick and colleagues report the first results from IBIS-II (International Breast cancer Intervention Study II), in which 3864 postmenopausal women at high risk of breast cancer were randomly assigned to receive the potent, non-steroidal aromatase inhibitor anastrozole or placebo every day for 5 years. After a median follow-up of 5 years, 40 (2%) of 1920 women in the anastrozole group and 85 (4%) of 1944 in the placebo group had developed breast cancer (hazard ratio 0·47, 95% CI 0·32—0·68). This finding is in keeping with those of other similar studies.So far, unsurprisingly, the investigators have not recorded evidence for a difference in breast cancer or all-cause mortality: 18 deaths had been reported in the anastrozole group and 17 in the placebo group.
Venous thromboembolism risk in mastectomy and immediate breast reconstruction
Venous thromboembolism risk in mastectomy and immediate breast reconstruction: Analysis of the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program Data Sets. Plastic and Reconstructive Surgery, March 2014, Vol. 133(3), p.263e-273e.
Fischer, J.P., et al.
http://journals.lww.com/plasreconsurg/Abstract/2014/03000/Venous_Thromboembolism_Risk_in_Mastectomy_and.9.aspx
Venous thromboembolism, including deep venous thrombosis and pulmonary embolism, is a morbid and costly complication following surgical procedures. The authors aim to assess the added risk of venous thromboembolism in patients undergoing immediate breast reconstruction.
Fischer, J.P., et al.
http://journals.lww.com/plasreconsurg/Abstract/2014/03000/Venous_Thromboembolism_Risk_in_Mastectomy_and.9.aspx
Venous thromboembolism, including deep venous thrombosis and pulmonary embolism, is a morbid and costly complication following surgical procedures. The authors aim to assess the added risk of venous thromboembolism in patients undergoing immediate breast reconstruction.
The effect of prior abdominal surgery on abdominally based free flaps in breast reconstruction
The effect of prior abdominal surgery on abdominally based free flaps in breast reconstruction. Plastic and reconstructive surgery, March 2014, Vol. 133(3), p.247e-255e.
Roostaeian, J., et al.
http://journals.lww.com/plasreconsurg/Abstract/2014/03000/The_Effect_of_Prior_Abdominal_Surgery_on.4.aspx
The abdomen has long remained the preferred donor site in breast reconstruction. Over time, the flap has evolved to limit morbidity with reduced muscular harvest. Previous abdominal operations, however, may limit the ability to perform a muscle- or fascia-sparing flap. The purpose of this study was to evaluate outcomes in women who had prior abdominal operations and underwent abdominally based autologous breast reconstruction.
Roostaeian, J., et al.
http://journals.lww.com/plasreconsurg/Abstract/2014/03000/The_Effect_of_Prior_Abdominal_Surgery_on.4.aspx
The abdomen has long remained the preferred donor site in breast reconstruction. Over time, the flap has evolved to limit morbidity with reduced muscular harvest. Previous abdominal operations, however, may limit the ability to perform a muscle- or fascia-sparing flap. The purpose of this study was to evaluate outcomes in women who had prior abdominal operations and underwent abdominally based autologous breast reconstruction.
Mastectomy rates for ductal carcinoma in situ vary widely in UK
Mastectomy rates for ductal carcinoma in situa vary widely in UK, audit shows [news item]. BMJ 2014; 348:g2332
Mayor, S.
http://www.bmj.com/content/348/bmj.g2332?rss=1&hwoasp=authn%3A1395931440%3A4044144%3A3266341127%3A0%3A0%3AKU2BGBsYX8ly%2BjhKOx1Tkg%3D%3D
Data from the UK NHS Breast Cancer Screening Programme show significant variation between hospitals in the number of women with ductal carcinoma in situ undergoing mastectomy when lumpectomy would normally be indicated, shows an audit reported last week at the European Breast Cancer Conference.
Mayor, S.
http://www.bmj.com/content/348/bmj.g2332?rss=1&hwoasp=authn%3A1395931440%3A4044144%3A3266341127%3A0%3A0%3AKU2BGBsYX8ly%2BjhKOx1Tkg%3D%3D
Data from the UK NHS Breast Cancer Screening Programme show significant variation between hospitals in the number of women with ductal carcinoma in situ undergoing mastectomy when lumpectomy would normally be indicated, shows an audit reported last week at the European Breast Cancer Conference.
Breast cancer screening offers few benefits to women over 70
Breast cancer screening offers few benefits to women over 70, finds study [research news]. BMJ 2014; 348:g2333.
Wise, J.
http://www.bmj.com/highwire/filestream/691661/field_highwire_article_pdf/0/bmj.g2333
Extending the Netherlands’ breast cancer screening programme to include women over the age of 70 did not lead to a fall in the number of advanced stage breast cancers detected, even though the number of early stage tumours detected rose, an evaluation has found. The study’s leader, Gerrit-Jan Liefers, a surgical oncologist and head of the geriatric oncology research group at Leiden University Medical Centre, said that if the programme were effective he would expect the incidence of advanced stage cancer to decrease, because any cancer would have been detected at an earlier stage. The study’s finding “implies that the effect of
screening in elderly women is limited and leads to a large proportion of overdiagnosis,” he said.
Wise, J.
http://www.bmj.com/highwire/filestream/691661/field_highwire_article_pdf/0/bmj.g2333
Extending the Netherlands’ breast cancer screening programme to include women over the age of 70 did not lead to a fall in the number of advanced stage breast cancers detected, even though the number of early stage tumours detected rose, an evaluation has found. The study’s leader, Gerrit-Jan Liefers, a surgical oncologist and head of the geriatric oncology research group at Leiden University Medical Centre, said that if the programme were effective he would expect the incidence of advanced stage cancer to decrease, because any cancer would have been detected at an earlier stage. The study’s finding “implies that the effect of
screening in elderly women is limited and leads to a large proportion of overdiagnosis,” he said.
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.
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.
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]).
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.
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.
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.
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.
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.
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.
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.
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