Thursday 13 September 2012

The template technique for breast mound planning

The template technique for breast mound planning when using abdominal flaps for breast reconstruction. The Breast, October 2012, Vol. 21(5), p.686-689.

Tregaskiss, A., et al.

http://www.thebreastonline.com/article/PIIS0960977612000379/abstract?rss=yes

Delayed breast reconstruction with abdominal flaps typically involves a process of ‘trial and error’ when moulding the flap into a satisfactory breast mound. This moulding process is crucial to the final aesthetic result. We present a template technique to preoperatively plan the skin envelope of each reconstruction.

High prevalence of neuroendocrine carcinoma in breast lesions

High prevalence of neuroendocrine carcinoma in breast lesions detected by the clinical symptom of bloody nipple discharge. The Breast, October 2012, Vol. 21(5), p.652-656.

Kawasaki, T., et al.

http://www.thebreastonline.com/article/PIIS0960977612000227/abstract?rss=yes

Bloody nipple discharge (BND) is an important clinical symptom in breast disorders, especially cancers. However, the association between this symptom and breast neuroendocrine carcinomas (NECs) has not been sufficiently investigated or well understood.

Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy

Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision.  The Breast, October 2012, Vol. 21(5), p.641-645.

Kim, J., et al.

http://www.thebreastonline.com/article/PIIS0960977612001300/abstract?rss=yes

The present study tried to identify factors predictive of upstaging from ultrasound-guided core needle biopsy (CNB)-diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision.

Predictors of invasive breast cancer and lymph node involvement in ductal carcinoma in situ

Predictors of invasive breast cancer and lymph node involvement in ductal carcinoma in situ initially diagnosed by vacuum-assisted breast biopsy: experience of 733 cases. The Breast, October 2012, Vol. 21(5), p.635-640.

Trentin, C., et al.

http://www.thebreastonline.com/article/PIIS0960977612001270/abstract?rss=yes

We retrospectively analyzed 733 patients with preoperatively diagnosed DCIS, investigating the association of clinical–radiological variables with invasive component and nodal involvement. 

Radiotherapy as sole adjuvant treatment for older patients with low-risk breast cancer

Radiotherapy as sole adjuvant treatment for older patients with low-risk breast cancer. The Breast, October 2012, Vol. 21(5), p.629-634.

Walker, G.A., et al.

http://www.thebreastonline.com/article/PIIS0960977612001269/abstract?rss=yes

Partly as a result of screening, increasing numbers of older patients are presenting with ‘low risk’ breast cancer: tumours from which the likelihood of breast cancer death is minute; even so, these patients have a measurable risk of local recurrence if conservative surgery is not followed by some form of adjuvant treatment. 

Intramammary lymph nodes

Intramammary lymph nodes: a question seeking for an answer, or an answer seeking for a question? The Breast, October 2012, Vol. 21(5), p.615-620.

Troupis, T., et al.

http://www.thebreastonline.com/article/S0960-9776(12)00118-X/abstract

Intramammary lymph nodes have not received for a long time enough attention from the medical literature and thus many of their characteristics are not sufficiently explored. Their incidence at various studies ranges between 0, 7 and 48%. They may be found in all breast quadrants but usually at the Upper Outer Quadrant (UOQ).

Increasing the time to expander-implant exchange after postmastectomy radiation therapy

Increasing the time to expander-implant exchange after postmastectomy radiation therapy reduces expander-implant failure. Plastic & reconstructive surgery, Sept 2012, Vol. 130(3), p.503-509.

Peled, A.W., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/09000/Increasing_the_Time_to_Expander_Implant_Exchange.2.aspx

Increased rates of complications can occur when postmastectomy radiation therapy is required after immediate expander-implant breast reconstruction. The sequence and timing of tissue expansion and implant exchange with regard to postmastectomy radiation therapy may impact complication rates.

Once is not enough

Once is not enough: withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of infection.  Plastic & reconstructive surgery, Sept 2012, Vol. 130(3), p.495-502.

Clayton, J.L., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/09000/Once_Is_Not_Enough___Withholding_Postoperative.1.aspx

There has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors' university hospital instituted antibiotic prescribing guidelines based on the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted in breast reconstruction patients.

Lives saved by breast cancer screening

Lives saved by breast cancer screening outnumber cases of overdiagnosis.  BMJ 2012; 345: e6155.

Hawkes, N.

http://www.bmj.com/highwire/filestream/602388/field_highwire_article_pdf/0/bmj.e6155.full.pdf


A Europe-wide review of breast cancer screening has concluded that the benefits in lives saved outweigh the risks of overdiagnosis. The analysis, carried out by a working group from nine European countries, showed that for every 1000 women between the ages of 50 and 69 who are screened, between seven and nine lives are saved and four women are “overdiagnosed.”

Monday 3 September 2012

Sonographic appearance of invasive ductal carcinoma of the breast

Sonographic appearance of invasive ductal carcinoma of the breast according to histologic grade. AJR, Sept 2012, Vol. 119(3), p.W402-W408.

Blaichman, J., et al.

http://www.ajronline.org/content/199/3/W402.abstract?rss=1

The purpose of this study was to compare the efficacy of the sonographic features in the BI-RADS lexicon for predicting malignancy grade of invasive ductal breast carcinoma in women assigned a BI-RADS category of 4 or 5.

Bilateral axillary ectopic breast tissue

Bilateral axillary ectopic breast tissue.  The Lancet, 2012; 380: 835.

Seifert, F., et al.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60316-X/fulltext?rss=yes

A 14-year-old girl presented with progressively growing bilateral painful axillary tumours (). Histopathology showed slightly hyperplastic glandular tissue without cytological atypia within the reticular dermis and fatty tissue (). The glandular epithelium stained positive for oestrogen and progesterone receptors (), which led to the diagnosis of ectopic breast tissue.