WorldWideScience

Sample records for breast implants

  1. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery ... wait 1 to 3 months before the permanent breast implant is placed during the second stage. In the ... from your chest and replaces it with a breast implant. This surgery takes 1 to 2 hours. Before ...

  2. BREAST IMPLANT SURFACE DEVELOPMENT

    OpenAIRE

    Valencia Lazenco, Anai Alicia

    2015-01-01

    Bilateral breast augmentation is one of the most common cosmetic surgical procedures carried out on women in the western world. Breast augmentation involves increasing the volume of a woman‘s breasts through surgery by placing a silicone implant in the subglandular or subpectoral cavity. Although a capsule forms inevitably around breast implants as a natural part of healing, it can cause significant morbidity if the capsule becomes firm and contracted, a condition known as breast capsular con...

  3. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...

  4. Breast fibromatosis associated with breast implants.

    Science.gov (United States)

    Seo, Yoon Nae; Park, Young Mi; Yoon, Hye Kyoung; Lee, Sun Joo; Choo, Hye Jung; Ryu, Ji Hwa

    2015-09-01

    Fibromatosis refers to an extra-abdominal desmoid tumor or aggressive fibromatosis. Breast fibromatosis can develop in association with the capsule around a breast implant, although reports of cases of fibromatosis associated with breast implants are rare. As the demand for breast augmentation has increased, it is important to understand the diseases associated with breast implants. In the present report, we describe a case of breast fibromatosis that developed adjacent to a breast implant and demonstrated a relatively well-defined border even though it invaded the surrounding structures. We also explore the specific imaging features for diagnosing breast fibromatosis in association with implants by reviewing previous literature.

  5. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...

  6. The ruptured PIP breast implant

    International Nuclear Information System (INIS)

    Public concern erupted about the safety of Poly Implant Prothèse (PIP) breast implants when it was revealed in 2011 that they contained an inferior, unlicensed industrial-grade silicone associated with a high rate of rupture. There followed national guidance for UK clinicians, which led to a considerable increase in referrals of asymptomatic women for breast implant assessment. In this review we discuss possible approaches to screening the PIP cohort and the salient characteristics of a ruptured implant

  7. The Evolution of Breast Implants.

    Science.gov (United States)

    Gabriel, Allen; Maxwell, G Patrick

    2015-10-01

    Breast augmentation remains one of the most common procedures performed in the United States. However, shape, feel, safety, and longevity of the implants remain important areas of research. The data provided by manufacturers show the safety and efficacy of these medical devices. Clinicians should strive to provide ongoing data and sound science to continue to improve clinical outcomes in the future. This article explores the evolution of breast implants with special emphasis on the advancement of silicone implants.

  8. Evaluation of breast silicone implants.

    Science.gov (United States)

    Brenner, R James

    2013-08-01

    While clinical evaluation of breast implants and their complications can identify capsule contracture and rupture of saline implants, the identification of silicone implant failure is best accomplished by silicone specific protocols for MRI with orthogonal acquisition. Such imaging can also help resolve other clinical problems. Following a brief overview of the history and development of commercial use of silicone implants and alternatives, this article outlines the approach toward optimal imaging and expected results.

  9. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten;

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether...... untreated ruptures are associated with changes over time in magnetic resonance imaging findings, serologic markers, or self-reported breast symptoms. A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic...... breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations...

  10. Silicone breast implants and platinum.

    Science.gov (United States)

    Wixtrom, Roger N

    2007-12-01

    Platinum, in a specific form, is used as a catalyst in the cross-linking reactions of the silicone gel and elastomer in breast implants. After manufacture, it remains in the devices at low-parts-per-million levels. Potential concerns have been raised as to whether this platinum might diffuse from silicone breast implants into the body and result in adverse health effects. The weight of evidence indicates that the platinum present is in its most biocompatible (zero valence) form, and the very minute levels (<0.1 percent) that might diffuse from the implants do not represent a significant health risk to patients. PMID:18090821

  11. An Uncommon Presentation of Breast Implant Rupture.

    Science.gov (United States)

    Koh, Eugene; Watson, David I; Dean, Nicola R

    2016-05-01

    Late periprosthetic seroma has lately been concerning for breast implant-associated anaplastic large cell lymphoma. The authors present an uncommon presentation of breast implant rupture with a seroma and skin rash forming 2 years after insertion of the implant. PMID:27579243

  12. [Management of breast cancer in a woman with breast implants].

    Science.gov (United States)

    Remacle, S; Lifrange, E; Nizet, J-L

    2015-01-01

    The incidence of breast cancer, currently one woman on eight, also concerns patients who underwent augmentation surgery. Breast implants have already been the subject of numerous publications concerning the risk of inducing breast cancer or of delaying its diagnosis; however, no significant causal relationship has been established. The purpose of this article is to assess the diagnostic and therapeutic consequences when breast cancer is identified in a patient with breast implants.

  13. [Evaluation of asymetric implants in breast cancer].

    Science.gov (United States)

    Fitoussi, A; Couturaud, B; Laki, F; Alran, S; Salmon, R J

    2005-10-01

    Since more than twenty years, methods of breast reconstruction using implants have continued to evolve in order to improve their aesthetic results. Shapes and materials of these implants have also evolved to obtain contours similar to that of the natural opposite breast. Therefore it can be considered that the use of asymmetric implants is the last step in implant technology before using made to measure implants. Asymmetric implants allow obtaining different contours in harmony to the different breast shapes according to the side, left or right, of the reconstructed breast which maximise the naturalness of the result. Such implants have an axis directed towards the exterior and lower part of the chest wall, are wider than high with a thinner part on their inner edge and a concave rear side moulding the curves of the chest wall. In our own experience, we placed more than 500 asymmetric implants. When analysing retrospectively the medical records of 156 patients, no distinctive features were observed when compared to symmetric classic implants in easiness in the surgical procedure or in complications except a slightly higher rate of seroma formation. When compared to usual implants the main benefits of asymmetric implants are: to offer a wider breadth, to slope down gently on their upper and inner sides according to their concave rear side, and therefore to better match subtle curves of a normal breast. Moreover such contours allow a distribution of the volume which fit better to the usual natural breast configuration of patients who underwent surgery for breast carcinoma. At last, such implants are easy to place and a very low rate of secondary rotation has been observed. In summary, for all these reasons, asymmetric implants, can be considered to be the class one in the choice of implants for breast reconstruction after breast surgery. PMID:16198040

  14. Cutaneous Silicone Granuloma Mimicking Breast Cancer after Ruptured Breast Implant

    Directory of Open Access Journals (Sweden)

    Waseem Asim Ghulam El-Charnoubi

    2011-01-01

    Full Text Available Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.

  15. Immunopathologic effects of silicone breast implants.

    OpenAIRE

    S.S. Teuber; Yoshida, S H; Gershwin, M E

    1995-01-01

    Silicone-gel breast implants have been associated with a myriad of autoimmune and connective tissue disorders by anecdotal reports and small observational series. To date, no prospective epidemiologic studies have been done to substantiate these observations, but an increasing body of literature is being developed and older studies are being recognized that point to immunotoxic or inflammatory effects of these breast implant components. The development of disease due to implants would depend ...

  16. Is a radiolucent breast implant needed

    International Nuclear Information System (INIS)

    Over 1 million American women have undergone augmentation mammoplasty. The silicone implants used create numerous technical difficulties during mammography. An American College of Radiology mammography phantom was used to assess the effect prototype implants have on resolution of microcalcifications and masses. Implants filled with silicone gel and/or saline had equal radiodensity and obscured all phantom artifacts. Implants filled with peanut oil and sunflower oil had equal radiolucency and allowed visualization of microcalcifications and several masses. The implant filled with gelatin was of intermediate radiodensity. A more radiolucent breast implant is possible, and further research is needed to define the best filter material and test its biocompatibility

  17. Magnetic resonance imaging of breast implants.

    Science.gov (United States)

    Shah, Mala; Tanna, Neil; Margolies, Laurie

    2014-12-01

    Silicone breast implants have significantly evolved since their introduction half a century ago, yet implant rupture remains a common and expected complication, especially in patients with earlier-generation implants. Magnetic resonance imaging is the primary modality for assessing the integrity of silicone implants and has excellent sensitivity and specificity, and the Food and Drug Administration currently recommends periodic magnetic resonance imaging screening for silent silicone breast implant rupture. Familiarity with the types of silicone implants and potential complications is essential for the radiologist. Signs of intracapsular rupture include the noose, droplet, subcapsular line, and linguine signs. Signs of extracapsular rupture include herniation of silicone with a capsular defect and extruded silicone material. Specific sequences including water and silicone suppression are essential for distinguishing rupture from other pathologies and artifacts. Magnetic resonance imaging provides valuable information about the integrity of silicone implants and associated complications.

  18. Dyspnea Associated with Silicone Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Katherine Rider

    2015-08-01

    Full Text Available We present a case of a 48-year-old woman with a significant history of atopy. She presented with a 1-month history of dyspnea on exertion. Pulmonary function testing was normal, with no obstruction or reversibility post-bronchodilation. Bilateral breast implant rupture was detected on further investigation for a left upper lobe nodule, and the patient underwent bilateral implant removal. There was an improvement in her respiratory symptoms. Systemic symptoms, labeled as “Autoimmune/Inflammatory Syndrome Induced by Adjuvants,” are known to be associated with breast implants, with 14% of women in a cohort developing autoimmune disease secondary to their implants. An improvement in symptoms has been demonstrated following breast implant removal.

  19. Reconstructive breast implantation after mastectomy for breast cancer

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R;

    2005-01-01

    BACKGROUND: Clinical reports have raised concern about local complications following breast implantation used in reconstructive or cosmetic surgery, but there is a shortage of epidemiological studies in this area. OBJECTIVE: To assess in a prospective epidemiological manner the occurrence of short......-term local complications in a nationwide implantation registry. DESIGN, SETTING, AND PARTICIPANTS: The Danish Registry for Plastic Surgery of the Breast prospectively collects preoperative, perioperative, and postoperative information on Danish women undergoing breast augmentation. Through the registry, we...... collected data on short-term local complications among 574 women who underwent postmastectomy reconstruction with breast implants from June 1, 1999, through July 24, 2003. MAIN OUTCOME MEASURES: Complication incidence rates. RESULTS: Thirty-one percent of the women who underwent initial implantation...

  20. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten;

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had......%, and a specificity of 97%. Correspondingly, the predictive value of a positive MRI examination was 99% and the predictive value of a negative MRI examination was 79%. CONCLUSIONS: We conclude that MRI is highly accurate for identification of silicone breast implant rupture, with a high sensitivity and specificity...

  1. Imaging of common breast implants and implant-related complications: A pictorial essay.

    Science.gov (United States)

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  2. Imaging of common breast implants and implant-related complications: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Amisha T Shah

    2016-01-01

    Full Text Available The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  3. Delayed breast reconstruction with implants after invasive breast cancer does not impair prognosis

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Düring, Maria; Henriksen, Trine Foged;

    2008-01-01

    We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women......We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women...

  4. Silicone Gel-Filled Breast Implants: Updated Safety Information

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Silicone Gel-Filled Breast Implants: Updated Safety Information Share ... Español When the Food and Drug Administration allowed silicone gel-filled breast implants back on the market ...

  5. Silicone breast implants and connective tissue disease

    DEFF Research Database (Denmark)

    Lipworth, Loren; Holmich, Lisbet R; McLaughlin, Joseph K

    2011-01-01

    The association of silicone breast implants with connective tissue diseases (CTDs), including systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and fibromyalgia, as well as a hypothesized new "atypical" disease, which does not meet established diagnostic criteria for any known...... CTD, has been extensively studied. We have reviewed the epidemiologic literature regarding an association between cosmetic breast implants and CTDs, with particular emphasis on results drawn from the most recent investigations, many of which are large cohort studies with long-term follow-up, as well...... as on those studies that address some of the misinformation and historically widespread claims regarding an association between breast implants and CTDs. These claims have been unequivocally refuted by the remarkably consistent evidence from published studies, as well as numerous independent meta...

  6. Immunopathologic effects of silicone breast implants.

    Science.gov (United States)

    Teuber, S S; Yoshida, S H; Gershwin, M E

    1995-01-01

    Silicone-gel breast implants have been associated with a myriad of autoimmune and connective tissue disorders by anecdotal reports and small observational series. To date, no prospective epidemiologic studies have been done to substantiate these observations, but an increasing body of literature is being developed and older studies are being recognized that point to immunotoxic or inflammatory effects of these breast implant components. The development of disease due to implants would depend on the interaction of genetic host factors so that only a few patients would potentially be at risk. Based on the example of other chemically mediated disorders, such as scleroderma in association with silica exposure, latency periods of more than 30 years before disease develops may be possible. Herein we review studies on silicone and immunity. PMID:7785255

  7. Breast implants under siege: an historical commentary.

    Science.gov (United States)

    Fisher, J C; Brody, G S

    1992-01-01

    Despite 3 decades of rapidly expanding application of polydimethylsiloxane as a relatively safe implantable biomaterial, the American public is being told by a vocal minority that its use in the breast implant may be dangerous. Most of the furor has been generated by consumer advocates with support of a handful of scientists who have expressed opinions, not well supported by facts, about the risks of these devices. These anxieties have been fueled in the public's mind by a media more interested in sensationalism than disciplined reporting. The controversy has complicated the regulatory process and has become politicized in the halls of State Legislatures and Congress. Remarkably, this controversy has not involved the many other biomedical applications of silicone. How has this controversy gathered momentum? What role has the government played and how have the professional, scientific, corporate, and patient communities responded to public concern? This discussion places the breast implant battle into an historical perspective. PMID:10171114

  8. Interference of breast implants with echocardiographic image acquisition and interpretation

    Directory of Open Access Journals (Sweden)

    Movahed Mohammad-Reza

    2007-02-01

    Full Text Available Abstract Echocardiography is one of the most important diagnostic testing in cardiology. The presence of a breast implant overlying heart can cause significant impairment of the echocardiographic acoustic window. Breast implants are increasing in popularity in the USA and the Federal Drug and Food Administration (FDA just approved silicone implants again. In this review, the impact of silicone breast implant on the echocardiographic image acquisition and interpretation is discussed.

  9. High-grade Angiosarcoma Associated with Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Nicolas R. Smoll, MBBS

    2013-04-01

    Full Text Available Summary: Since the serendipitous discovery that implanted polymers cause sarcomas in rats, much research has been conducted to prove or disprove a link between silicone breast implants and/or polymer-based materials and breast cancer. In light of an initial report that 35% of rats implanted with a variety of polymers developed fibrosarcomas, we report a case of primary angiosarcoma found in a patient presenting with bilateral rupture of gel-filled breast implants.

  10. Silicone Breast Implant and Automatic Implantable Cardioverter Defibrillator: Can They Coexist? A Case Report

    Science.gov (United States)

    Arik, Zaretski

    2016-01-01

    Summary: We present a case of a silicone breast implant rupture after insertion of an automatic implantable cardioverter defibrillator (AICD). A 51-year-old woman presented to our plastic surgery clinic to exchange her silicone breast implants. The patient underwent cosmetic mastopexy and breast augmentation in 2008. Because of recurrent myocardial infarctions and chronic heart failure, she underwent an insertion of an AICD in 2014 in which the left breast implant was hit. In this report, we discuss the first case of an AICD insertion, disrupting a breast implant. This case report illustrates the rare but real possibility of breast implant rupture after even minor surgical manipulation of the breast area. PMID:27622117

  11. Capsular Contracture In Silicone Breast Implants: Insights From Rat Models.

    Science.gov (United States)

    Vieira, Vilberto J; D'Acampora, Armando; Neves, Fernanda S; Mendes, Paulo R; Vasconcellos, Zulmar A DE; Neves, Rodrigo D'Eça; Figueiredo, Claudia P

    2016-09-01

    Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is a frequent complication in breast augmentation and reconstructive surgery, that requires invasive intervention. The inflammatory response to implanted mammary prostheses appears to be directly associated to capsular contracture. This review discusses the evidences from rat models studies, on the role of inflammation and fibrosis in capsular contraction and its relation to silicone breast implants surface.

  12. Lightweight breast implants: a novel solution for breast augmentation and reconstruction mammaplasty.

    Science.gov (United States)

    Govrin-Yehudain, Jacky; Dvir, Haim; Preise, Dina; Govrin-Yehudain, Orel; Govreen-Segal, Dael

    2015-11-01

    Breast augmentation and reconstruction mammaplasty have been in practice for decades and are highly prevalent surgeries performed worldwide. While overall patient satisfaction is high, common long-term effects include breast tissue atrophy, accelerated ptosis and inframammary fold breakdown. Increasing evidence attributes these events to the durative loading and compressive forces introduced by the breast implants. Mechanical challenges exceeding the elastic capacity of the breast tissue components, eventually lead to irreversible tissue stretching, directly proportional to the introduced mass. Thus, it is suggested that, contrary to long-standing dogmas, implant weight, rather than its volume, stands at the basis of future tissue compromise and deformation. A novel lightweight implant has been developed to address the drawbacks of traditional breast implants, which demonstrate equivalence between their size and weight. The B-Lite(®) breast implant (G&G Biotechnology Ltd., Haifa, Israel) design allows for a reduction in implant weight of up to 30%, while maintaining the size, form, and function of traditional breast implants. The CE-marked device can be effectively implanted using standard of care procedures and has been established safe for human use. Implantation of the B-Lite(®) breast implant is projected to significantly reduce the inherent strains imposed by standard implants, thereby conserving tissue stability and integrity over time. In summary, this novel, lightweight breast implant promises to reduce breast tissue compromise and deformation and subsequent reoperation, further improving patient safety and satisfaction.

  13. Permanent Breast Seed Implant Dosimetry Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Brian M., E-mail: Brian.Keller@sunnybrook.ca [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Ravi, Ananth [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Sankreacha, Raxa [Carlo Fidani Regional Cancer Center, Mississauga, ON (Canada); Pignol, Jean-Philippe [Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada)

    2012-05-01

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose-volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V{sub 90}, V{sub 100}, V{sub 150}, and V{sub 200} were as follows: 98.8% {+-} 1.2% (range, 94.5-100%); 97.3% {+-} 2.1% (range, 90.3-99.9%), 68.8% {+-} 14.3% (range, 32.7-91.5%); and 27.8% {+-} 8.6% (range, 15.1-62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V{sub 100} changed from 85.6% to 88.4% (p = 0.004) and the mean V{sub 200} changed from 36.2% to 48.3% (p < 0.001). Skin toxicity was associated with maximum skin dose (p = 0.014). Conclusions: Preplanning dosimetry should aim for a V{sub 90} of approximately 100%, a V{sub 100} between 95% and 100%, and a V{sub 200} between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 Multiplication-Sign 1-cm{sup 2} surface area, should be limited to 90% of the

  14. Permanent Breast Seed Implant Dosimetry Quality Assurance

    International Nuclear Information System (INIS)

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose–volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V90, V100, V150, and V200 were as follows: 98.8% ± 1.2% (range, 94.5–100%); 97.3% ± 2.1% (range, 90.3–99.9%), 68.8% ± 14.3% (range, 32.7–91.5%); and 27.8% ± 8.6% (range, 15.1–62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V100 changed from 85.6% to 88.4% (p = 0.004) and the mean V200 changed from 36.2% to 48.3% (p 90 of approximately 100%, a V100 between 95% and 100%, and a V200 between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 × 1-cm2 surface area, should be limited to 90% of the prescription dose to minimize delayed skin toxicity.

  15. Magnetic resonance imaging of trilucent TM breast implants

    International Nuclear Information System (INIS)

    AIM: To demonstrate the magnetic resonance imaging (MRI) appearances of intact and ruptured Trilucent TM implants with imaging and surgical correlation. The appearances of the implant transponder artefact are also described MATERIALS AND METHODS: A retrospective review of the MRI findings in 34 patients with bilateral subpectoral Trilucent TM breast implants (Lipomatrix, Inc./Collagen Aesthetics International Inc., Neuchatel, Switzerland) was performed. Patients under implant surveillance and those with suspected implant rupture formed the study group. Imaging findings were correlated with surgical appearances. RESULTS: Surgical correlation was available in 53% of patients. Fifty per cent (18/36) of implants were intact at surgery, 50% (18/36) of implants were ruptured. Of the 18 ruptured implants, 17 were intracapsular ruptures and one an extracapsular rupture. The sensitivity of MRI for detection of intracapsular rupture in Trilucent TM breast implants was 82% specificity 76%, positive predictive value 78%, negative predictive value 81% and accuracy 79% in this study group. No case of implant rupture was obscured by the transponder artefact. Four implants were found to have 'pseudocapsules' at surgery (5·9%), the implants were intact with fluid present between the implant and capsule. Only one pseudocapsule was demonstrated on MRI. CONCLUSION: Magnetic resonance imaging is currently the most accurate technique for diagnosis of implant rupture in Trilucent TM breast implants. Transponder artefact does not appear to interfere with the assessment of implant rupture. Elson, E. M. et al. (2002)

  16. Investigations of silicone breast implants with the NMR-MOUSE.

    Science.gov (United States)

    Krüger, Mirko; Schwarz, Annett; Blümich, Bernhard

    2007-02-01

    Silicone breast implants are used for breast augmentation and breast reconstruction. The issues of concern associated with such implants are: (a) the quality control of each implant before implantation, and (b) the detection of implant bleeding after implantation. We have studied the use of the Nuclear Magnetic Resonance-MObile Universal Surface Explorer (NMR-MOUSE) for the nondestructive testing of (a) the quality of implant shells, and (b) changes in implant gel due to leakage of body fluid into the implant. Depth profiles measured nondestructively through implant shells at different positions of each implant by the Profile NMR-MOUSE assured good reproducibility of the quality and thickness of different shell layers. The leakage of implants upon rupture was mimicked by observing changes in the transverse NMR relaxation time of the implant gel upon ingress of physiological saline solution and safflower oil through the rupture. Results demonstrate that nondestructive testing with unilateral NMR is a potential method for use in the quality control of implants and for the screening of implants for rupture after implantation. PMID:17275616

  17. The Effect of Breast Implants on Mammogram Outcomes.

    Science.gov (United States)

    Kam, Kelli; Lee, Esther; Pairawan, Seyed; Anderson, Kendra; Cora, Cherie; Bae, Won; Senthil, Maheswari; Solomon, Naveenraj; Lum, Sharon

    2015-10-01

    Breast cancer detection in women with implants has been questioned. We sought to evaluate the impact of breast implants on mammographic outcomes. A retrospective review of women undergoing mammography between March 1 and October 30, 2013 was performed. Demographic characteristics and mammogram results were compared between women with and without breast implants. Overall, 4.8 per cent of 1863 women identified during the study period had breast implants. Median age was 59 years (26-93). Women with implants were younger (53.9 vs 59.2 years, P breast tissue (72.1% vs 56.4%, P = 0.004) than those without. There were no statistically significant differences with regards to Breast Imaging Recording and Data System 0 score (13.3% with implants vs 21.4% without), call back exam (18.9% with vs 24.1% without), time to resolution of abnormal imaging (58.6 days with vs 43.3 without), or cancer detection rate (0% with implants vs 1.0% without). Because implants did not significantly affect mammogram results, women with implants should be reassured that mammography remains useful in detecting cancer. However, future research is required to determine whether lower call back rates and longer time to resolution of imaging findings contribute to delays in diagnosis in patients with implants.

  18. [Evaluation of asymmetric implants in breast augmentation surgery].

    Science.gov (United States)

    Fitoussi, A D; Couturaud, B

    2005-10-01

    Since more than 30 years, the quality of breast implants has continued to evolve in order to improve the aesthetic results of prosthetic augmentation. Shapes and materials of these implants have also evolved to obtain stronger and more reliable prostheses almost similar to the natural breast. Therefore it can be considered that the use of asymmetric implants is the last step in implant technology before using made to measure implants. Asymmetric implants allow obtaining different contours in harmony to the different breast shapes capable to reproduce faithfully, in all dimensions, the anatomy of the female breast, including the differences between each side which maximise the naturalness of the result. Such implants have an axis directed towards the exterior and lower part of the chest wall, are wider than high with a thinner part on their inner edge and a concave rear side moulding the curves of the chest wall. In our own experience, we placed between 2002 and 2004, asymmetric implants in 100 patients. Such implants were easy to place and no secondary rotation was observed. The control of secondary displacements even in case of prosthesis change seems to be linked to their concave rear side, roughness and asymmetry. When analysing retrospectively the medical records, no distinctive features were observed when compared to symmetric classic implants in easiness in the surgical procedure or in complications except a slightly higher rate of seroma formation. However asymmetric implants are less appropriate in case of major breast ptosis, patients being unsatisfied by the "too natural" breast shape. Moreover a high risk of secondary rotation seems to be real in such cases. In summary, for all these reasons, asymmetric implants, are gradually considered to be a first-rank choice for implants in breast augmentation cosmetic surgery. PMID:16198044

  19. Psychological characteristics of Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Lipworth, Loren; Kjøller, Kim; Hölmich, Lisbet R;

    2009-01-01

    An excess of suicide among women with cosmetic breast implants compared with controls has consistently been reported in epidemiologic studies. We have evaluated psychological characteristics among 423 Danish women with cosmetic breast implants, compared with 414 controls. Odds ratios (OR) with 95......% confidence intervals (CI) for self-reported psychological symptoms were calculated using multiple logistic regression. Substantial excesses of all studied symptoms before implant surgery were reported among women with breast implants compared with women with other cosmetic surgery, whereas ORs for virtually......, the corresponding ORs for these 3 psychological symptoms after surgery were 0.9 (95% CI = 0.6-1.4), 1.0 (95% CI = 0.7-1.5), and 1.0 (95% CI = 0.6-1.5), respectively. In conclusion, women with cosmetic breast implants reported preoperative psychological symptoms indicative of depressive disorders substantially more...

  20. Mortality and suicide among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Jacobsen, Poul Harboe; Hölmich, Lisbet R; McLaughlin, Joseph K;

    2004-01-01

    disorders as measured by admission to a psychiatric hospital among women seeking cosmetic surgery. METHODS: Cohort study of 2761 women who underwent cosmetic breast implant surgery at private clinics of plastic surgery or public hospitals, 7071 women who underwent breast reduction surgery at public......BACKGROUND: Epidemiologic studies indicate that women with cosmetic breast implants have a significantly increased risk of suicide. Our objectives were to examine mortality among Danish women who underwent cosmetic breast implant surgery and to evaluate the baseline prevalence of psychopathological...... hospitals, and 1736 women who attended private clinics for cosmetic surgery other than breast implantation, between 1973 and 1995. Causes of death through 1999 were identified through the Danish Mortality Files. Information on admission to psychiatric hospitals prior to cosmetic surgery was obtained from...

  1. Study of the radiation effect in breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Moreno T, L. R.; Ramirez R, A., E-mail: lumor2000@yahoo.com.mx [Universidad Autonoma Metropolitana, Unidad Azcapotzalco, Departamento de Ciencias Basicas, Av. San Pablo No. 180, Col. Reynosa Tamaulipas, 02200 Mexico D. F. (Mexico)

    2013-10-01

    This breast cancer is one of the most important death causes in women. Among the more frequently medical treatment for advanced breast cancer is the mastectomy. This situation leads to silicone implants as an esthetic option. There have been cases in patients with implants where cancer was frequently detected, in which a conventional radiotherapy is required. In this work is presented a study of the probable adverse effects caused by the application of high power X-rays (6-10 MV) to the silicone implants and to the surrounding tissues. In the research carried out at the clinic, none Bolus effect was detected in patients with implants. Our results prescribe that in the case of patients with implants and frequent breast cancer, the removal of implants is not necessary due radiotherapy works directly in the damaged tissues. (Author)

  2. The clinical implications of poly implant prothèse breast implants: an overview.

    Science.gov (United States)

    Wazir, Umar; Kasem, Abdul; Mokbel, Kefah

    2015-01-01

    Mammary implants marketed by Poly Implant Prothèse (PIP) were found to contain industrial grade silicone and this caused heightened anxiety and extensive publicity regarding their safety in humans. These implants were used in a large number of patients worldwide for augmentation or breast reconstruction. We reviewed articles identified by searches of Medline, PubMed, Embase, and Google Scholar databases up to May 2014 using the terms: "PIP", "Poly Implant Prothèse", "breast implants" and "augmentation mammoplasty" "siloxanes" or "silicone". In addition the websites of regulating bodies in Europe, USA, and Australia were searched for reports related to PIP mammary implants. PIP mammary implants are more likely to rupture than other implants and can cause adverse effects in the short to the medium term related to the symptoms of rupture such as pain, lumps in the breast and axilla and anxiety. Based on peer-reviewed published studies we have calculated an overall rupture rate of 14.5% (383/2,635) for PIP implants. However, there is no evidence that PIP implant rupture causes long-term adverse health effects in humans so far. Silicone lymphadenopathy represents a foreign body reaction and should be treated conservatively. The long-term adverse effects usually arise from inappropriate extensive surgery, such as axillary lymph node dissection or extensive resection of breast tissue due to silicone leakage.

  3. Sjögren’s syndrome after silicone breast implantation

    Science.gov (United States)

    Akyol, Lütfi; Önem, Soner; Özgen, Metin; Sayarlıoğlu, Mehmet

    2015-01-01

    Sjögren’s syndrome, an autoimmune disease characterized by lymphocytic infiltration of the lacrimal and salivary glands, leads to dryness of the mouth and eyes. Herein, we present a case of Sjögren’s syndrome that developed after silicone breast implantation. A cause-effect relationship between breast implantation and Sjögren’s syndrome has not been established. However, the possibility of such an association should be considered when a patient with silicone implants is admitted to the hospital for treatment of Sjögren’s syndrome.

  4. Silicone Breast Implants: A Rare Cause of Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Imam H. Shaik

    2015-01-01

    Full Text Available Pleural effusions are one of the rarest complications reported in patients with silicone gel filled breast implants. The silicone implants have potential to provoke chronic inflammation of pleura and subsequent pulmonary complications such as pleural effusion. Herein, we report a 44-year-old female who presented with left sided pleural effusion, six weeks after a silicone breast implantation surgery. The most common infectious, inflammatory, and malignant causes of pleural effusion were excluded with pleural fluid cytology and cultures. With recurrent effusion in the setting of recent surgery, the chemical reaction to silicone breast implants was sought and exploration was performed which revealed foreign body reaction (FBR to silicone material. The symptoms dramatically improved after the explantation.

  5. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction.

    Science.gov (United States)

    Kobraei, Edward M; Cauley, Ryan; Gadd, Michele; Austen, William G; Liao, Eric C

    2016-05-01

    There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches.

  6. Chemical fingerprinting of silicone-based breast implants.

    Science.gov (United States)

    Keizers, Peter H J; Vredenbregt, Marjo J; Bakker, Frank; de Kaste, Dries; Venhuis, Bastiaan J

    2015-01-01

    With millions of women worldwide carrying them, silicone-based breast implants represent a large market. Even though silicone breast implants already have a history of use of more than 50 years, the discussion on their safety has not yet come to an end. To improve safety assessment, regulatory authorities should have the availability of a set of tests to be able to determine parameters of implant identity and quality. Therefore, the gels and envelopes of various brands and types of silicone-based breast implants have been subjected to infrared, Raman and NMR spectroscopy. We show that by using a combination of complementary spectroscopic techniques breast implants of various origins can be distinguished on typical chemical hallmarks. It was found that typical silicone-based implants display a surplus of vinyl signals in the gel, cyclosiloxane impurities are tolerable at low levels only and a barrier layer is present in the implant envelope. The techniques presented here and the results obtained offer a good starting point for market surveillance studies. PMID:25459933

  7. Chemical fingerprinting of silicone-based breast implants.

    Science.gov (United States)

    Keizers, Peter H J; Vredenbregt, Marjo J; Bakker, Frank; de Kaste, Dries; Venhuis, Bastiaan J

    2015-01-01

    With millions of women worldwide carrying them, silicone-based breast implants represent a large market. Even though silicone breast implants already have a history of use of more than 50 years, the discussion on their safety has not yet come to an end. To improve safety assessment, regulatory authorities should have the availability of a set of tests to be able to determine parameters of implant identity and quality. Therefore, the gels and envelopes of various brands and types of silicone-based breast implants have been subjected to infrared, Raman and NMR spectroscopy. We show that by using a combination of complementary spectroscopic techniques breast implants of various origins can be distinguished on typical chemical hallmarks. It was found that typical silicone-based implants display a surplus of vinyl signals in the gel, cyclosiloxane impurities are tolerable at low levels only and a barrier layer is present in the implant envelope. The techniques presented here and the results obtained offer a good starting point for market surveillance studies.

  8. The double capsules in macro-textured breast implants.

    Science.gov (United States)

    Giot, Jean-Philippe; Paek, Laurence S; Nizard, Nathanael; El-Diwany, Mostafa; Gaboury, Louis A; Nelea, Monica; Bou-Merhi, Joseph S; Harris, Patrick G; Danino, Michel A

    2015-10-01

    Breast implants are amongst the most widely used types of permanent implants in modern medicine and have both aesthetic and reconstructive applications with excellent biocompatibility. The double capsule is a complication associated with textured prostheses that leads to implant displacement; however, its etiology has yet to be elucidated. In this study, 10 double capsules were sampled from breast expander implants for in-depth analysis; histologically, the inner capsular layer demonstrated highly organized collagen in sheets with delamination of fibers. At the prosthesis interface (PI) where the implant shell contacts the inner capsular layer, scanning electron microscopy (SEM) revealed a thin layer which mirrored the three-dimensional characteristics of the implant texture; the external surface of the inner capsular layer facing the intercapsular space (ICS) was flat. SEM examination of the inner capsule layer revealed both a large bacterial presence as well as biofilm deposition at the PI; a significantly lower quantity of bacteria and biofilm were found at the ICS interface. These findings suggest that the double capsule phenomenon's etiopathogenesis is of mechanical origin. Delamination of the periprosthetic capsule leads to the creation of the ICS; the maintained separation of the 2 layers subsequently alters the biostability of the macro-textured breast implant.

  9. Long-term health status of Danish women with silicone breast implants

    DEFF Research Database (Denmark)

    Breiting, Vibeke B; Hölmich, Lisbet R; Brandt, Bodil;

    2004-01-01

    undergone breast reduction surgery and with 149 women from the general population. Breast implant and reduction surgeries were performed from 1973 to 1988 at one public hospital and one private plastic surgery clinic. Among women with breast implants, the average implantation time was 19 years, 60 percent...

  10. Microbial Load Analysis in Silicone Gel Breast Implants

    Directory of Open Access Journals (Sweden)

    Glaucia Cristina Mello Santos

    2010-06-01

    Full Text Available Silicone breast implants consist of biomaterials widely used in breast reconstitution surgeries or in mammary augmentation for esthetic reasons. A preliminary stage of the implant production process is vulcanization, which consists of heating the implant to 165±5°C for approximately 9 hours. The aim of this work was to evaluate the bioburden of silicone breast implants prior to the vulcanization process and the decline in bioburden due to this process, and to confirm the sterility of the gel contained in the membrane. Breast implant production stages were evaluated by microbial counting in different steps, according to the USP 32 methodology. To evaluation of decrease in microbial load, spores strips were introduced inside the implant, and after vulcanization cycles the strips were removed from the implant. The strips were transferred to tubes containing TSB, followed by incubation for 7 days at 30-35°C. The results obtained showed that the level of microbial contamination of gel implants is relatively low, and that vulcanization allowed for the inactivation of up to 108 spores. This study led us to the conclusion that vulcanization leaded to sterility of the gel inside the product. Thus, the final sterilizing process contributed to an increase in the Sterility Assurance Level 1. Keywords: Silicone. Breast implant. Sterilization. Dry heat. Vulcanization. Bioburden. RESUMO Análise da Carga Microbiana de Implantes Mamários de Silicone Os implantes mamários de silicone constituem-se em biomateriais que têm sido amplamente utilizados em cirurgias para reconstituição da mama ou para o aumento do tamanho da mama por motivos estéticos. Uma etapa preliminar do processo produtivo do implante é a vulcanização, que consiste no aquecimento do implante a 165±5°C por aproximadamente 9 horas. O objetivo deste estudo foi avaliar a carga microbiana dos implantes mamários de silicone antes do processo de vulcanização, o decaimento da carga

  11. Local complications after cosmetic breast implant surgery in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; McLaughlin, Joseph K; Pakkanen, Matti;

    2004-01-01

    Concerns regarding potential health effects of silicone breast implants have recently shifted from long-term illnesses to postoperative local complications. In this study, occurrence of local complications and treatment procedures were evaluated in a population of 685 Finnish women who received c...

  12. Implantable magnetic nanocomposites for the localized treatment of breast cancer

    Science.gov (United States)

    Kan-Dapaah, Kwabena; Rahbar, Nima; Soboyejo, Wole

    2014-12-01

    This paper explores the potential of implantable magnetic nanocomposites for the localized treatment of breast cancer via hyperthermia. Magnetite (Fe3O4)-reinforced polydimethylsiloxane composites were fabricated and characterized to determine their structural, magnetic, and thermal properties. The thermal properties and degree of optimization were shown to be strongly dependent on material properties of magnetic nanoparticles (MNPs). The in-vivo temperature profiles and thermal doses were investigated by the use of a 3D finite element method (FEM) model to simulate the heating of breast tissue. Heat generation was calculated using the linear response theory model. The 3D FEM model was used to investigate the effects of MNP volume fraction, nanocomposite geometry, and treatment parameters on thermal profiles. The implications of the results were then discussed for the development of implantable devices for the localized treatment of breast cancer.

  13. Cancer risk among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Friis, Søren; Hölmich, Lisbet R; McLaughlin, Joseph K;

    2006-01-01

    -up of our earlier cohort study of Danish women with cosmetic breast implants by 7 years, yielding 30 years of follow-up for women with longest implant duration. The study population consisted of women who underwent cosmetic breast implant surgery at private clinics of plastic surgery (n = 1,653) or public...... hospitals (n = 1,110), and a control group of women who attended private clinics for other plastic surgery (n = 1,736), between 1973-95. Cancer incidence through 2002 was ascertained using the Danish Cancer Registry. Risk evaluation was based on computation of standardized incidence ratios (SIR) and Cox...... were found when directly comparing women who had implants at private clinics with women who attended private clinics for other plastic surgery, with rate ratios for cancer overall, breast cancer and non-melanoma skin cancer of 1.1 (95% CI = 0.8-1.6), 0.7 (95% CI = 0.4-1.3) and 1.5 (95% CI = 0...

  14. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival

    International Nuclear Information System (INIS)

    Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects. We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco–Oakland, in Seattle–Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnosed with early or unstaged first primary breast cancer between 1983 and 1989, treated with mastectomy. The women were followed for a median of 12.4 years (n = 4968). Breast implant usage was validated by medical record review. Cox proportional hazards models were used to estimate hazard rate ratios for survival time until death due to breast cancer or other causes for women with and without breast implants, adjusted for relevant patient and tumor characteristics. Twenty percent of cases received postmastectomy breast implants, with silicone gel-filled implants comprising the most common type. Patients with implants were younger and more likely to have in situ disease than patients not receiving implants. Risks of breast cancer mortality (hazard ratio, 0.54; 95% confidence interval, 0.43–0.67) and nonbreast cancer mortality (hazard ratio, 0.59; 95% confidence interval, 0.41–0.85) were lower in patients with implants than in those patients without implants, following adjustment for age and year of diagnosis, race/ethnicity, stage, tumor grade, histology, and radiation therapy. Implant type did not appear to influence long-term survival. In a large, population-representative sample, breast implants following mastectomy do not appear to confer any survival disadvantage following early-stage breast cancer in women younger than 65 years old

  15. Long-term cosmetic outcome after breast implantation

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Breiting, Vibeke B; Fryzek, Jon P;

    2007-01-01

    All women who underwent breast augmentation at 1 public and 1 private clinic in Denmark from 1973 to 1988, and available for follow-up, were invited to participate in a clinical study including a self-administered questionnaire, medical record abstraction, and a clinical examination. One hundred...... of the women (62%) had clinically significant capsular contracture, and only half of the study women were found to have satisfactory overall breast appearance at examination. In contrast, the majority of women reported satisfaction with their implant surgery (60%). The women tended to grade themselves more...

  16. And the Breast is History: Issues Surrounding FDA Regulation of Silicone Breast Implants

    OpenAIRE

    Simme, Jodi L.

    1995-01-01

    The breast implant crisis has raised serious issues for women. On one hand, it is difficult to argue against giving women the right to choose, especially when the choice involves their own bodies. Restricting freedom in that realm is politically unpopular these days. On the other hand, women have been harmed by the lack of conclusive health information and by deceptive and coercive messages sent by media, implant manufacturers and plastic surgeons. For women to benefit from their right to cho...

  17. Use of silicone implants in reconstructive plastic surgery for breast cancer

    Directory of Open Access Journals (Sweden)

    D. D. Pak

    2012-01-01

    Full Text Available The paper considers procedures for reconstructive plastic operations, by using silicone implants, in patients with breast cancer. It analyzes 592 primary breast repairs and evaluates their aesthetic effects and complications. The surgical procedures are described.

  18. Cosmetic Breast Implants Linked to Suicide Risk

    Institute of Scientific and Technical Information of China (English)

    Patricia; Reaney; 陶秀耘

    2003-01-01

    选注者言:本文信息极为丰富。首先,我们得知当今美国的三大整容外科是:eyelid surgery,breast reduction and nose reshaping。其次,文章告诉读者,去年(2002年)美国施行隆胸手术的妇女达25万之众;再次,就是本文的标题所言,要求进行隆胸手术的女性中的自杀者比例高于不要求隆胸者。而且,更值得注意的是:If women have a psychological problem and they are given breast implantsthey will still have that problem.(假如一个女性存在心理问题,而且进行了隆胸手术,她们的心理问题依旧存在。)

  19. The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis

    OpenAIRE

    Schiff, Michal; Algert, Charles S; Ampt, Amanda; Sywak, Mark S.; Roberts, Christine L

    2014-01-01

    Background Cosmetic breast augmentation (breast implants) is one of the most common plastic surgery procedures worldwide and uptake in high income countries has increased in the last two decades. Women need information about all associated outcomes in order to make an informed decision regarding whether to undergo cosmetic breast surgery. We conducted a systematic review to assess breastfeeding outcomes among women with breast implants compared to women without. Methods A systematic literatur...

  20. Classical Hodgkin Lymphoma Arising Adjacent to a Breast Implant.

    Science.gov (United States)

    Ryan, Ciara; Ged, Yasser; Quinn, Fiona; Walker, Jan; Kennedy, John; Gillham, Charles; Pittaluga, Stefania; McDermott, Ronan; Vandenberghe, Elisabeth; Grant, Cliona; Flavin, Richard

    2016-08-01

    Breast implant-associated lymphoma has recently gained wide recognition. Anaplastic large cell lymphoma (ALCL) is the most frequently diagnosed subtype in this setting but the spectrum is broadening. A 66-year-old woman developed swelling and itch around her saline implant 6 years after its insertion. Imaging revealed a fluid collection surrounding the implant with an adjacent mass. Microscopy showed sclerotic tissue punctuated by discrete cellular nodules comprising small lymphocytes, eosinophils and interspersed large atypical Hodgkin Reed-Sternberg (HRS)-like cells. The HRS-like cells stained positively for CD30 and CD15 by immunohistochemistry. Small T-lymphocytes formed rosettes around HRS-like cells. Appearances were consistent with classical Hodgkin lymphoma (HL). Multiplex polymerase chain reaction demonstrated no clonal rearrangements of immunoglobulin or T-cell receptor genes, however, a t(14;18)(q32;q21)BCL2-JH translocation involving the major breakpoint region of the bcl2 gene was present. Staging positron emission tomography-computed tomography scan revealed FDG-avid masses in the right axilla and pelvis. Subsequent pathological examination identified low-grade follicular lymphoma (FL) with a t(14;18) translocation at these sites. To our knowledge, this is the first case of HL arising adjacent to a breast implant. An awareness of this diagnosis is important as classical HL, with its prominent mixed inflammatory background, may be overlooked as a reactive process when histologically assessing capsulectomy specimens. It is also important in the differential diagnosis for implant-associated ALCL as both contain large atypical CD30-positive cells highlighting the need for full immunohistochemical and molecular workup in such cases. This case also adds to the large body of literature regarding the association between HL and FL. PMID:26888955

  1. Long-term safety and effectiveness of style 410 highly cohesive silicone breast implants

    DEFF Research Database (Denmark)

    Hedén, Per; Bronz, Giorgio; Elberg, Jens Jørgen;

    2009-01-01

    of 163 subjects (approximately 70% had augmentation [n = 112], 15% had reconstruction [n = 25], and 15% had revision [n = 26]) underwent a physical examination followed by breast magnetic resonance imaging (MRI) for rupture detection. These subjects had been implanted for 5 to 11 years with at least one...... Style 410 shaped gel breast implant before examination. The secondary end points included lactation, reproductive and breast disease history before and after implantation, and quality-of-life measurements and complications after implantation. RESULTS: The implant rupture rate was 1.7% a median of 8...... years after implantation. Capsular contracture was the most common complication noted at the physical examination, occurring for 5.3% of implants, and there were no cases of grade 4 capsular contracture. The postimplantation rates for lactation and reproductive problems and breast disease were lower...

  2. Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants.

    Science.gov (United States)

    Malowany, Janet I; Kundu, Uma; Santiago, Lumarie; Krishnamurthy, Savitri

    2015-01-01

    Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

  3. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    NARCIS (Netherlands)

    N. Lindenblatt (Nicole); K. El-Rabadi (Karem); T. Helbich (Thomas); H. Czembirek (Heinrich); M. Deutinger (Maria); H. Benditte-Klepetko (Heike)

    2014-01-01

    textabstractBackground:Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI) of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Methods:Fi

  4. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Science.gov (United States)

    Seng, Piseth; Alliez, Antoine; Honnorat, Estelle; Menard, Amelie; Casanova, Dominique; Stein, Andreas

    2014-01-01

    Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France. PMID:26793446

  5. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  6. Self-reported musculoskeletal symptoms among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Kjøller, Kim; Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P;

    2004-01-01

    No epidemiological evidence of an association between silicone breast implants and connective tissue disease has been found. Based on case reports, it has been hypothesized that silicone breast implants may be associated with a unique rheumatic symptom cluster termed "atypical connective tissue d...

  7. Idiopathic pseudoaneurysm in a patient with breast implants

    DEFF Research Database (Denmark)

    Khorasani, Hoda; Eiberg, Jonas; Bigaard, Janne

    2016-01-01

    Aneurysms and pseudoaneurysms of the internal mammary artery (IMA) are rare and the etiology uncertain although iatrogenic causes have been described. A 64-year-old woman suffered hematoma and bleeding from a pseudoaneurysm probably originating from a branch of the right IMA 16 years after breast...... implant surgery. After clinical assessment, the patient underwent surgery with resection of the aneurysm and ligation of the arterial branch. No early postoperative complications were reported. Pseudoaneurysms in small vessels such as the IMA or its branches are not well described in the literature...

  8. Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up

    OpenAIRE

    Castel, Nikki; Soon-Sutton, Taylor; Deptula, Peter; Flaherty, Anna; Parsa, Fereydoun Don

    2015-01-01

    Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six month...

  9. Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast 103Pd seed implant

    Science.gov (United States)

    Afsharpour, Hossein; Pignol, Jean-Philippe; Keller, Brian; Carrier, Jean-François; Reniers, Brigitte; Verhaegen, Frank; Beaulieu, Luc

    2010-08-01

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast 103Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D90 reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D10 increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

  10. Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast {sup 103}Pd seed implant

    Energy Technology Data Exchange (ETDEWEB)

    Afsharpour, Hossein; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de recherche en cancerologie de l' Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, QC G1R 2J6 (Canada); Pignol, Jean-Philippe; Keller, Brian [Department of Radiation Oncology, Sunnybrook and Women' s Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Carrier, Jean-Francois [Departement de Radiologie, Radio-Oncologie et Medecine Nucleaire, Hopital Notre-Dame de CHUM, 1560 Sherbrooke E, Montreal, QC H2L 4M1 (Canada); Reniers, Brigitte; Verhaegen, Frank, E-mail: beaulieu@phy.ulaval.c [Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht (Netherlands)

    2010-08-21

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast {sup 103}Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D{sub 90} reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D{sub 10} increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

  11. Silicone-selective multishot echo-planar imaging for rapid MRI survey of breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Yasuo; Kumita, Shinichiro; Kumazaki, Tatsuo [Nippon Medical School, Department of Radiology, Tokyo (Japan); Aoki, Ritsu [Nippon Medical School, Department of Plastic Surgery, Tokyo (Japan)

    2007-07-15

    The purpose of this study was to assess the usefulness of silicone-selective multishot echo-planar imaging (EPI) for the rapid magnetic resonance imaging (MRI) survey of breast implants. Twenty patients with bilateral breast implants underwent MRI. The use of inversion recovery and magnetization transfer pulses led to silicone-selective images. The rapid MRI survey required only 43 s, which accurately distinguished between silicone and non-silicone materials in the implants, and therefore induced the final MRI sequences appropriate for the detailed characterization of the implants. In 5 of the 20 patients, the rapid MRI survey showed implanted materials that were not indicated from clinical information. This silicone-selective multishot EPI allows a rapid survey of breast implants, which is useful to avoid unnecessary sequences in these patients. (orig.)

  12. A review of the use of silicone implants in breast surgery.

    Science.gov (United States)

    Chao, Albert H; Garza, Ramon; Povoski, Stephen P

    2016-01-01

    Breast implant surgery is one of the most commonly performed procedures in the field of plastic surgery. While silicone implants are now routinely used in breast surgery, they have previously been the subject of controversy. This was particularly true in the U.S., where there was a moratorium on their use from 1992 to 2006. Following subsequent scientific validation of their safety, silicone implants have re-gained widespread acceptance for clinical use. Modern implant design has aimed to optimize aesthetic outcomes while minimizing implant-related complications, such as capsular contracture and device rupture. One of the most significant advances has been the use of highly cohesive silicone which, through extensive cross-linking, maintains its shape within the body in the presence of physiologic forces. Overall, silicone breast implants are associated with a high degree of patient satisfaction and low rates of complications. Further independent research is necessary to better establish long-term outcomes.

  13. Idiopathic pseudoaneurysm in a patient with breast implants

    Science.gov (United States)

    Khorasani, Hoda; Eiberg, Jonas; Bigaard, Janne

    2016-01-01

    Aneurysms and pseudoaneurysms of the internal mammary artery (IMA) are rare and the etiology uncertain although iatrogenic causes have been described. A 64-year-old woman suffered hematoma and bleeding from a pseudoaneurysm probably originating from a branch of the right IMA 16 years after breast implant surgery. After clinical assessment, the patient underwent surgery with resection of the aneurysm and ligation of the arterial branch. No early postoperative complications were reported. Pseudoaneurysms in small vessels such as the IMA or its branches are not well described in the literature. Proper diagnosis with imaging is of importance in order to determine treatment as each case is unique. Some cases can be managed conservatively. PMID:27470014

  14. Inferior dermoglandular flap for autologous breast remodeling following explantation of breast implants in ptotic breasts: a case report and literature search

    Directory of Open Access Journals (Sweden)

    Umar Daraz Khan

    2015-04-01

    Full Text Available Explantation following aesthetic mammoplasty without implant replacement is quite uncommon and often leaves the patient worse off than prior to mammoplasty. A case is presented here in which patient's own tissue was used as an inferior dermoglandular flap for autologous breast remodeling. Inferior dermal flap has been described for breast reconstruction and simultaneous augmentation mammoplasty with mastopexy for prosthesis cover in the lower pole of the breast, but its use following explantation without implant replacement has not been described for breast remodeling and volume conservation.

  15. Algorithm and techniques for using Sientra's silicone gel shaped implants in primary and revision breast augmentation.

    Science.gov (United States)

    Schwartz, Michael R

    2014-07-01

    With the 2006 Food and Drug Administration approval of round silicone gel breast implants in the United States, there still remained a lack of versatility in implant options. The approval of Sientra's shaped cohesive implants in 2012 brought with it the innovations needed to address varying patient needs. Because access to shaped devices is still fairly recent in the United States, some surgeons remain uncomfortable with implementing shaped cohesive gel implants into their practice. The author outlines surgical techniques and algorithms from experience with the Sientra shaped device, covering the preoperative stage, measurements (base diameter, sternal notch to nipple, tissue pinch, and nipple to inframammary fold), ideal first candidates, operative techniques, and complication avoidance, as well as important factors for shaped-implant selection, including chest base diameter, implant height, implant volume, and implant projection for the patient's desired outcome. With experience, surgeons will find new utility with shaped implants for a variety of patients in their practices.

  16. Adverse health outcomes in offspring of mothers with cosmetic breast implants : A review

    NARCIS (Netherlands)

    Kjoller, Kim; Friis, Soren; Lipworth, Loren; McLaughlin, Joseph K.; Olsen, Jorgen H.

    2007-01-01

    Background: To assess whether maternal cosmetic breast implants are associated with adverse health outcomes among offspring, the authors examined published findings of epidemiologic studies that addressed this hypothesis. Methods: Four epidemiologic studies, ail from Scandinavia, were identified. Wo

  17. Five-year Safety Data for Eurosilicone’s Round and Anatomical Silicone Gel Breast Implants

    Directory of Open Access Journals (Sweden)

    Franck Duteille, MD

    2014-04-01

    Conclusions: Eurosilicone S.A.S. prospective study involving 1010 Eurosilicone silicone gel breast implants in both round and shaped profiles demonstrated a low rupture rate and an excellent safety profile through 5 years.

  18. Radiotherapy for breast cancer is not associated with increased risk of cied implantation

    DEFF Research Database (Denmark)

    Johansen, J. B.; Rehammar, J. C.; Jorgensen, O. D.;

    2015-01-01

    Introduction: Radiotherapy is an important treatment in early stage breast cancer but it is claimed that radiotherapy causes damage to the cardiac conduction system and increases the risk implantation of CIED (pacemaker or ICD). However, this paradigm is based on smaller series of case reports. Due...... to the anatomy, radiotherapy will potential mainly affect the conduction system in left sided breast cancer. The aim of this study was to evaluate risk of implantation of a CIED subsequent to radiotherapy for breast cancer by comparing left- versus right sided radiotherapy in a nationwide cohort. Methods: From...... the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to radiotherapy. The rate...

  19. Silicone gel breast implant adverse event reports to the Food and Drug Administration, 1984-1995.

    OpenAIRE

    Brown, S.L.; Parmentier, C M; Woo, E K; Vishnuvajjala, R L; Headrick, M L

    1998-01-01

    OBJECTIVES: To characterize the adverse event reports on silicone gel breast implants (SGBIs), including death reports, submitted to the Food and Drug Administration (FDA) from 1984 through 1995 and to analyze changes in the type and complexity of reports following extensive media coverage of breast implants. METHODS: The authors analyzed mandatory and voluntary reports from the adverse events reporting system for medical devices at the FDA. RESULTS: In 1988, adverse event reports related to ...

  20. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Ooi ASH

    2016-09-01

    Full Text Available Adrian SH Ooi,1,2 David H Song1 1Section of Plastic and Reconstructive Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA; 2Department of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, Singapore Abstract: Implant-based procedures are the most commonly performed method for ­postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. Keywords: implant infection, risk reduction, acellular dermal matrix

  1. Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation

    Directory of Open Access Journals (Sweden)

    Sur Monalisa

    2009-04-01

    Full Text Available Abstract Background Primary non-Hodgkin lymphoma (NHL of the breast represents 0.04–0.5% of malignant lesions of the breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL is a rare T-cell lymphoma typically seen in children and young adults with the breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the breast described in the literature. Eight of these cases occurred in proximity to breast implants, four in relation to silicone breast implant and three in relation to saline filled breast implant with three out of the eight implant related cases having previous history of breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML, the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude

  2. Use of gentamicin collagen sponges for the treatment of periprosthetic breast implant infection

    NARCIS (Netherlands)

    O. Lapid

    2011-01-01

    The infection of a breast implant or tissue expander is a major complication with significant psychological and medical ramifications. The incidence has been reported to range from 1.1% in cosmetic augmentations to as high to 24% in a series of reconstructive cases. Gentamicin Surgical Implant is a

  3. Breast implant rupture and connective tissue disease: a review of the literature

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Lipworth, Loren; McLaughlin, Joseph K;

    2007-01-01

    Large-scale epidemiologic studies to date have not found any credible association between silicone breast implants and either well-defined connective tissue diseases or undefined or atypical connective tissue diseases. It has been hypothesized that implant rupture could prompt an immunologic reac...... reaction giving rise to autoimmune or related diseases. In this article, the authors review the available literature on implant ruptures and connective tissue disease....

  4. Peri-implant galactocele following vacuum-assisted core biopsy of the breast: a cautionary tale

    OpenAIRE

    Taylor, Donna; Kulawansa, Sagarika Thushanthi; McCallum, Dugald Dalziel; Saunders, Christobel

    2013-01-01

    A lactating woman in her early 40s with a strong family history of breast cancer presented with a markedly swollen breast days after having a vacuum-assisted core biopsy performed to sample indeterminate microcalcifications in her left breast. Ultrasound showed a large peri-implant fluid collection which yielded milky fluid on aspiration consistent with galactocele formation. Histology of the core specimens revealed a fragment of fibrous capsule suggesting that the core biopsy had created a f...

  5. Aging of retrieved gel breast implants: a comparison between two product generations.

    Science.gov (United States)

    Bodin, F; Jung, C; Dieval, F; Chakfe, N; Wisniewski, S; Bruant Rodier, C; Heim, F

    2015-06-01

    In order to get a marketing authorization, breast implants (BI) must meet a number of standard requirements. French and European standards ISO 14607 list a number of official tests to be performed before an implant can be used clinically. However, the BI material characteristics evolution over implantation time remains a research field which is unexplored. The goal of the present study is to compare the mechanical ageing of two breast implant generations and assess if the use of one generation rather than the other is advantageous in terms of durability. For that purpose, 21 explanted BI were analyzed in terms of biomechanical characteristics and compared. Twelve BI were textured anatomic specimens of 5th generation and 10 BI were round textured specimens of 4th generation. All the specimens were produced by the same manufacturer. Implantation time ranged from 3 to 130 months. Both the shell and the gel of every specimen were analyzed. Results show that the mechanical properties go down with the implantation time for all the implants. Moreover, the shell of round implants appear to be less resistant than the shell of anatomic specimens with 25% lower rupture forces. With regard to the gel, whatever the specimen, results show that the properties change with implantation time. The color changes from transparent to milky to finally become yellow, while the cohesion goes down especially for the round specimens. Globally, the study brings out that BI get degraded with implantation time and provides information which could help predicting the durability of the implant.

  6. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

    Science.gov (United States)

    Ooi, Adrian SH; Song, David H

    2016-01-01

    Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

  7. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions.

    Science.gov (United States)

    Ooi, Adrian Sh; Song, David H

    2016-01-01

    Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

  8. An Alternative Technique for Immediate Direct-to-Implant Breast Reconstruction—A Case Series

    Science.gov (United States)

    Hedges, Kellee

    2016-01-01

    Background: The practice of breast reconstruction continues to evolve with the introduction of new technologies. The authors describe a unique approach allowing immediate direct-to-implant reconstruction that can be performed on an outpatient basis. Methods: After a nipple-sparing mastectomy, acellular dermal matrix (ADM)-covered implants are placed in a prepectoral position in an immediate reconstruction. Assessment of results was performed via a retrospective review of demographic and procedural data. Results: Forty-five patients (79 breasts), mean age 46.8 years, were treated with direct-to-implant reconstruction using ADM-wrapped implants placed above the muscle with mean follow-up of 23.1 months (median 22 mo). Mean body mass index was 24.3, and 15 patients (33.3%) were current or former smokers. Twenty-seven patients (60%) had prior breast surgery with 22 (49%) exposed to chemotherapy and 34 (76%) radiation. Procedure time averaged 155 minutes and hospital length of stay averaged 0.6 days. Complications included flap necrosis in 22 cases (28%), seroma in 12 (15%), infection in 8 (10%), rippling in 28 (35%), and contracture in 8 (10%). In 14 breasts (18%), postoperative wound complications (flap necrosis or infection) led to implant loss. Conclusions: The availability of ADM and cohesive gel implants has allowed us to perform above-the-muscle implant breast reconstruction in reduced time and often on an outpatient basis. Complication rates were comparable to expected results of standard expander-to-implant, staged breast reconstruction. This technique is a viable option delivering clinically and aesthetically acceptable results in select patients. PMID:27536500

  9. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim;

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...... an MRI examination. Twenty-four of 109 implants were clinically diagnosed with possible rupture or rupture. Eighteen of the 24 implants were ruptured according to the MRI examination (75%). Eighty-five implants were clinically classified as intact, and 43 of these were actually ruptured at MRI (51...... to identify implant rupture, neither the sensitivity nor the specificity is acceptable....

  10. Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective.

    Science.gov (United States)

    Ben-David, Merav; Granot, Hila; Gelernter, Ilana; Scheflan, Michael

    2016-01-01

    Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts, heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50Gy. For plans excluding IMN coverage, mean Dmean for right and left reconstructed breasts was 49.09Gy (98.2% of the prescribed dose) and 48.51Gy (97.0%), respectively. For plans including IMNs, mean Dmean was 49.15Gy (98.3%) for right and 48.46Gy (96.9%) for left reconstructed breasts; the mean IMN Dmean was 47.27Gy (right) and 47.89Gy (left). Heart Dmean was below 1.56Gy for all plans. Mean total lung volume receiving a dose of ≥ 20Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.

  11. Physico-chemical characteristics of coated silicone textured versus smooth breast implants differentially influence breast-derived fibroblast morphology and behaviour.

    Science.gov (United States)

    Valencia-Lazcano, Anai A; Alonso-Rasgado, Teresa; Bayat, Ardeshir

    2014-12-01

    Capsule formation is an inevitable consequence of silicone breast implantation. Clinically challenging dense fibrocollagenous capsular contractures occur at different rates between smooth compared to textured surfaces. Host response is influenced by several factors including implant surface texture, chemistry and interactions between cells and the extracellular matrix (ECM). Specific coatings can modify the physico-chemical properties of implant surfaces eliciting specific cellular reactions. Therefore, we evaluated the physico-chemical characteristics of coated smooth versus textured silicone breast implants on breast-derived fibroblast morphology and behaviour using (a) confocal laser microscopy, (b) Raman spectroscopy and (c) the effect of four unique protein and glycosaminoglycan (GAG) coatings (aggrecan, collagen I, fibronectin and hyaluronic acid) on breast-derived fibroblast attachment, proliferation, morphology, spreading, cytotoxicity and gene expression. Collagen I, fibronectin and hyaluronic acid coatings exhibited satisfactory fibroblast adhesion (pimplants demonstrated improved cell proliferation than uncoated surfaces (pbreast fibroblasts following the application of specific coatings on breast implant surfaces.

  12. Estimation of breast implant volumes: error assessment of the subjective judgment method

    Directory of Open Access Journals (Sweden)

    Henseler, Helga

    2016-01-01

    Full Text Available Background: The degree of error in subjective estimation of breast implant volume remains unknown. Methods: Nine silicone breast implants were used by 16 examiners for subjective, blinded, implant volume estimation. The figures on the stamps were taken as the true breast implant volumes for comparison. The examiners were divided into two groups of equal size: experienced examiners (consultant breast surgeons and unexperienced examiners (trainees. Fourteen examiners repeated the tests after about 2 weeks.Results: In both groups of doctors, the implant volumes were underestimated by a mean ± standard deviation of 61.6 ± 58.1 cc (21.9% ± 20.1% in the first test and 37.9 ± 59.1 cc (13.6% ± 20.7% in the second test. The absolute deviation independent of volume overestimation or underestimation was 77.3 ± 36.9 cc (27.2% ± 12.8% in the first test and 58.1 ± 41.3 cc (20.6% ± 14.6% in the second test. In terms of absolute figures, the experienced examiners showed significantly better results than did the unexperienced examiners during the first test. The unexperienced examiners showed increasing deviations with increasing implant volumes. The degree of estimation error was lower in the second test.Conclusions: These blinded subjective estimations of breast implant volume exhibited limited accuracy and reproducibility. Estimation errors were quantified and increased with increasing implant volumes. Experienced examiners performed considerably better than unexperienced examiners, and results of the second test were better in both groups. The subjective volume estimations deviated from the true volumes by around 70 cc (underestimated by around 50 cc.Level of evidence: Level III

  13. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    Directory of Open Access Journals (Sweden)

    Lindenblatt N

    2014-07-01

    Full Text Available Nicole Lindenblatt,1 Karem El-Rabadi,2 Thomas H Helbich,2 Heinrich Czembirek,3 Maria Deutinger,4 Heike Benditte-Klepetko5 1Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland; 2Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna - General Hospital Vienna, 3Department of Radiology, Hospital Wiener Privatklinik, 4Department of Plastic and Reconstructive Surgery, Hospital Rudolfstiftung, Vienna, Austria; 5Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands Background: Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Methods: Fifty consecutive patients with 85 silicone gel implants were included in the study. The mean age of the patients was 51 (range 21–72 years, with a mean duration of implantation of 3.8 (range 1–28 years. All patients underwent clinical examination and breast MRI. Intraoperative implant rupture was diagnosed by the operating surgeon. Results: Nineteen of the 50 patients suffered from clinical symptoms. An implant rupture was diagnosed by MRI in 22 of 85 implants (26%. In seven of 17 removed implants (41%, the intraoperative diagnosis corresponded with the positive MRI result. However, only 57% of these patients were symptomatic. Ultrasound imaging of the harvested implants showed signs of interrupted inner layers of the implant despite integrity of the outer shell. By microsurgical separation of the different layers of the implant shell, we were able to reproduce this phenomenon and to produce signs of implant rupture on MRI. Conclusion: Our results show that rupture of only the inner layers of the implant shell with integrity of

  14. Anaplastic large cell lymphoma (ALCL) and breast implants: breaking down the evidence.

    Science.gov (United States)

    Ye, Xuan; Shokrollahi, Kayvan; Rozen, Warren M; Conyers, Rachel; Wright, Penny; Kenner, Lukas; Turner, Suzanne D; Whitaker, Iain S

    2014-01-01

    Systemic anaplastic large cell lymphoma (ALCL) is a distinct disease classification provisionally sub-divided into ALCL, Anaplastic Lymphoma Kinase (ALK)(+) and ALCL, ALK(-) entities. More recently, another category of ALCL has been increasingly reported in the literature and is associated with the presence of breast implants. A comprehensive review of the 71 reported cases of breast implant associated ALCL (iALCL) is presented indicating the apparent risk factors and main characteristics of this rare cancer. The average patient is 50 years of age and most cases present in the capsule surrounding the implant as part of the periprosthetic fluid or the capsule itself on average at 10 years post-surgery suggesting that iALCL is a late complication. The absolute risk is low ranging from 1:500,000 to 1:3,000,000 patients with breast implants per year. The majority of cases are ALK-negative, yet are associated with silicone-coated implants suggestive of the mechanism of tumorigenesis which is discussed in relation to chronic inflammation, immunogenicity of the implants and sub-clinical infection. In particular, capsulotomy alone seems to be sufficient for the treatment of many cases suggesting the implants provide the biological stimulus whereas others require further treatment including chemo- and radiotherapy although reported cases remain too low to recommend a therapeutic approach. However, CD30-based therapeutics might be a future option.

  15. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim;

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...

  16. The Impact of Breast Implant Location on the Risk of Capsular Contraction

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Sørensen, Jens Ahm

    2016-01-01

    developing CC with subglandular compared to submuscular placement of the breast implant. METHODS: A total of 1,283 studies were identified from December 2003 to December 2013 by PUBMED and MEDLINE searches and a manual search strategy. Two levels of screening resulted in 10 studies suitable for meta......-analysis, providing data on a total of 17,520 breast implants. All statistical calculations were performed with Review Manager (RevMan) version 5.2.7. RESULTS: Random-effect (RE) pooled relative risk (RR) and confidence intervals (CI) were calculated for capsular contraction. The risk of developing capsular....... CONCLUSION: This analysis demonstrated a more than 2-fold increase in the risk of capsular contraction with subglandular compared to submuscular breast implant location.Clinical Question: Risk....

  17. Silicone granuloma from ruptured breast implants as a cause of cervical lymphadenopathy.

    Science.gov (United States)

    Borghol, K; Gallagher, G; Skelly, B L

    2016-09-01

    A 56-year-old woman with a 10-year history of bilateral silicone breast implants presented to the ear, nose and throat outpatient clinic with a 2-month history of a right-sided neck lump. She was found to have a 1.3cm supraclavicular lymph node that gave the clinical impression of being reactive. Ultrasonography guided fine needle aspiration was inconclusive and initial review of subsequent computed tomography failed to identify a cause. This was followed by excisional biopsy of the lymph node, which revealed a silicone granuloma that was linked to a ruptured right-sided breast implant placed ten years previously. This case highlights the importance for otolaryngologists to consider silicone granuloma among the differential diagnoses of cervical lymphadenopathy in patients with a history of silicone breast implants. Recognising this differential diagnosis could avoid undue anxiety for patient and clinician regarding more serious pathology.

  18. Interstitial implantation as a radiation boost for high risk patients treated with breast conservation therapy

    International Nuclear Information System (INIS)

    Purpose: As part of a prospective institutional protocol for breast conservation treatment which employed aggressive therapy to the tumor-bearing quadrant, interstitial implantation was the preferred method of boost after 50.4 Gy whole breast irradiation for 'high risk' patients with tumor margins ≤ 2 mm. An analysis of clinical outcomes with respect to local tumor control and breast cosmesis was performed. Patients and Methods: From 1982-1994, 128 patients received an implant boost and a comparison data base was drawn from a total experience of 501 treated breasts. The median age of the implanted patients was 51 yrs and the median follow-up was 75 mos (range 10-150 mos). The implant target volume was determined by clinical assessment of post-operative induration and pre- and post-excisional mammograms. All implants were constructed in accordance with a pre-planning algorithm designed to maximize dose homogeniety within a prescription isodose goal of 50 cGy/hr. Local control and cosmetic outcome were evaluated with respect to extent of tumor, histopathology, margin status, extent of surgery, and systemic adjuvant therapy. Implant quality was assessed using four calculated parameters: strand separation product (SSP), planar separation product (PSP), global separation product (GSP), and dose homogeneity index (DHI). The mean implant volume was 47.9 ± 20.2 cc, the mean prescribed dose rate was 46.2 ± 8.5 cGy/hr and the mean total implant dose was 1993.8 ± 151.0 cGy. The final excision margin was positive, >0<1 mm, 1-2 mm, and indeterminate in 50%, 19%, 21%, and 15%, respectively. Results: Cosmetic outcome was good/excellent in 91% of patients which was not statistically different from non-implant patients. Logistic regression analysis revealed that re-excision, elevated SSP, and decreased DHI were associated with adverse cosmesis. There were 10 local failures in the implanted patients (4 within the prescribed isodose volume, 5 at the periphery and 1 elsewhere in

  19. Application of "CD-4" Theory for Determining the Width of Implant in Breast Augmentation

    Institute of Scientific and Technical Information of China (English)

    Jie Cai; Yang Zhou

    2015-01-01

    Background:The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation.The aim of this study was to introduce a new method to determine the width of the implant (W) and explain the reasons to do so in details.Methods:From January 2006 to June 2014,the authors have found and applied "CD-4" theory to determine the width of breast implant (W) in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 560 patients."CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold.W =CD-4 (or 3.5) cm.Results:The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm.Their CDs are from 14.5 cm to 17 cm.About 78% of the patients have got followed up from 1 month to 5 years postoperatively.Except for four patients who got unilateral capsular contractions,all the other patients are satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm,and lateral borders of the breast are on the area of the AAL.Conclusions:W (width of the implant) =CD-4 (cm) when doing dual plan Ⅰ or Ⅱ breast augmentation.For the very thin patient,4 should be 3.5.

  20. Application of "CD−4" Theory for Determining the Width of Implant in Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Jie Cai

    2015-01-01

    Full Text Available Background: The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation. The aim of this study was to introduce a new method to determine the width of the implant (W and explain the reasons to do so in details. Methods: From January 2006 to June 2014, the authors have found and applied "CD −4" theory to determine the width of breast implant (W in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL on the lateral chest wall through the horizontal level on inferior mammary fold. W = CD − 4 (or 3.5 cm. Results: The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm. Their CDs are from 14.5 cm to 17 cm. About 78% of the patients have got followed up from 1 month to 5 years postoperatively. Except for four patients who got unilateral capsular contractions, all the other patients are satisfied with their nature new breast shapes and volumes. Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL. Conclusions: W (width of the implant = CD − 4 (cm when doing dual plan I or II breast augmentation. For the very thin patient, 4 should be 3.5.

  1. MRI evaluation of post-mastectomy irradiated breast implants: prevalence and analysis of complications

    International Nuclear Information System (INIS)

    Aim: To evaluate the effect of post-mastectomy radiation therapy (RT) on breast implants as detected by magnetic resonance imaging (MRI) searching for short-term complications. Materials and methods: One hundred and forty patients (total of 144 implants) were evaluated by MRI; 80 (group 1) had undergone RT, whereas the remaining 60 patients (group 2) underwent mastectomy with implant reconstruction without RT. Two radiologists evaluated MRI images searching for implant rupture signs, sub-capsular seromas, capsular contracture, soft-tissue oedema, peri-implant fluid collections. Implant ruptures were classified as severe complications; seromas and capsular contractures as moderate complications; oedema and fluid collections as mild complications. The prevalence of MRI findings in the two groups was calculated and compared by unpaired t-test. Cohen's kappa statistics was used to assess interobserver agreement. Results: Sixty-nine out of 144 (48%) implants presented pathological findings at MRI with complication rates of 47.5 and 48.4 for groups 1 and 2, respectively. Two (5%) severe complications, 10 (26%) moderate complications, and 26 (69%) mild complications occurred in group 1 and surgical treatment was performed in 10 cases. Two (6%) severe complications, seven (23%) moderate complications, and 22 (71%) mild complications occurred in group 2 and surgical treatment was performed in eight cases. No significant difference between the two groups was found (p>0.1). Almost perfect agreement between the two radiologists was found for MRI image detection (k=0.86). Conclusion: RT does not seem to cause a significant effect on breast implants in terms of complication rate in patients undergoing implant-based breast reconstruction. One-stage immediate implant-based breast reconstruction performed at the same time as mastectomy could be proposed. -- Highlights: •RT could increase complication rates of implant-based breast reconstruction (IBR). •No general consensus

  2. The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants.

    Science.gov (United States)

    Sampaio Goes, João Carlos; Munhoz, Alexandre Mendonça; Gemperli, Rolf

    2015-10-01

    This article presents an overview of the subfascial approach to primary and secondary breast augmentation with form-stable implants associated with autologous fat grafting. Although breast augmentation is a well-studied procedure, there are few previous reports concerning the subfascial technique and, especially, this technique associated with lipofilling. Consequently, the authors present their experience with a form-stable, anatomically shaped silicone gel breast implant, which has recently been approved in the United States following FDA clinical trials. Primary and secondary breast augmentations using form-stable implants resulted in satisfactory outcomes.

  3. Bilateral Breast Reconstruction with Extended Thoracodorsal Artery Perforator Propeller Flaps and Implants

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Børsen-Koch, Mikkel; Nielsen, Henrik Toft;

    2015-01-01

    We present our experience of bilateral total breast reconstruction using a double-sided extended thoracodorsal artery perforator propeller flap in a case series of 10 patients. Reconstruction was successfully achieved in all cases with few complications. The median time for surgery was 275 minutes...... (200-330), and the average implant size used was 350 cm(3) (195-650). We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium...

  4. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.;

    2015-01-01

    . Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early......-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on pacemaker implants subsequent to radiotherapy. Rate ratios (RR) of pacemaker implantation for left versus right sided breast cancer were calculated. Results: Among 18......,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a pacemaker implanted subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. The unadjusted RR was 1.02 (0.76-1.36 95% CI, p=0.91) and the RR adjusted for year, age and time since...

  5. Versatility of Capsular Flaps in the Salvage of Exposed Breast Implants

    Directory of Open Access Journals (Sweden)

    Beniamino Brunetti, MD

    2015-03-01

    Full Text Available Summary: Breast implant exposure due to poor tissue coverage or previous irradiation represents a surgical challenge both in the reconstructive and aesthetic plastic surgery practice. In case of implant extrusion or incipient exposure, the commonly suggested strategies, such as targeted antibiotic therapy, drainage and lavage of the cavity, fistulectomy, and primary closure, may be ineffective leading the surgeon to an unwanted implant removal or to adopt more invasive flap coverage procedures. Breast implant capsule, in its physiological clinical behavior, can be considered as a new reliable source of tissue, which can be used in a wide range of clinical situations. In our hands, capsular flaps proved to be a versatile solution not only to treat breast contour deformities or inframammary fold malpositions but also to salvage exposed breast implants. In this scenario, the use of more invasive surgical techniques can be avoided or simply saved and delayed for future recurrences.(Plast Reconstr Surg Glob Open 2015;3:e340; doi:10.1097/GOX.0000000000000307; Published online 30 March 2015.

  6. Online gamma-camera imaging of 103Pd seeds (OGIPS) for permanent breast seed implantation

    Science.gov (United States)

    Ravi, Ananth; Caldwell, Curtis B.; Keller, Brian M.; Reznik, Alla; Pignol, Jean-Philippe

    2007-09-01

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq 103Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  7. Online gamma-camera imaging of {sup 103}Pd seeds (OGIPS) for permanent breast seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Ravi, Ananth [Department of Medical Biophysics, University of Toronto (Canada); Caldwell, Curtis B [Department of Medical Biophysics, University of Toronto (Canada); Keller, Brian M [Medical Physics, Sunnybrook Health Sciences Centre (Canada); Reznik, Alla [Department of Medical Biophysics, University of Toronto (Canada); Pignol, Jean-Philippe [Department of Medical Biophysics, University of Toronto (Canada)

    2007-09-21

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq {sup 103}Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  8. Intrathoracic migration of a breast implant after minimally invasive cardiac surgery.

    Science.gov (United States)

    Songcharoen, Somjade Jay; McClure, Michael; Aru, Roberto G; Songcharoen, Somprasong

    2015-03-01

    The aging population, in combination with the popularity of breast augmentation with implants, presents surgeons with a growing number of cases involving women undergoing minimally invasive cardiac surgery (MICS) who have breast implants. We present an unusual complication involving the delayed migration of a subpectoral implant into the chest cavity through an iatrogenic defect after a minimally invasive mitral valve repair. This chest wall defect was ultimately repaired with a latissimus dorsi flap. Although MICS has been described in women with breast implants, the documented experience remains limited. Most authors classically recommend explantation of the prosthesis to provide access to the chest wall; however, some have later suggested preserving the implant capsule in situ while performing the cardiac procedure with gentle retraction. From our literature review and experience, we recommend that the posterior capsule should remain intact. If this is not possible, then the chest wall closure should be reinforced with either mesh, soft tissue, or both. Soft tissue options include the conversion from a subpectoral to a subglandular position to use the pectoralis major, or a latissimus dorsi muscle flap. With the increasing number of these cases along with the complexities of minimally invasive procedures, close communication and planning should be undertaken between both cardiothoracic and plastic surgeons when taking care of these patients. Above all, when faced with postoperative complications after MICS, the plastic surgeon must maintain a high index of clinical suspicion and consider the possibility of intrathoracic migration of an implant so that proper workup and planning may be initiated.

  9. [Radiological trap and oncological precautions in a patient who has undergone a permanent withdrawal of PIP breast implants].

    Science.gov (United States)

    Koutsomanis, A; Bruant-Rodier, C; Roedlich, M-N; Bretz-Grenier, M-F; Perrot, P; Bodin, F

    2015-12-01

    We report the case of a 57-year-old patient who presented radiological images similar to ruptured breast implants one year after the supposed withdrawal of the latter. This woman had benefited for the first time from cosmetic PIP breast implants in 2000. Early in 2014, she requested the removal of the implants without renewal because she was feeling pain and functional discomfort. A few months after the operation, she consulted for breast swelling in the upper pole of the breast. Radiological assessment showed liquid formations compatible with the presence of implants. At our request, the rereading of the MRI by the radiologist definitively concluded on a bilateral seroma within the persistent fibrous capsule. In the absence of symptoms, clinical monitoring had been decided. But at the recrudescence of anaplastic large cell lymphoma cases associated with breast implants, a cytological sampling was intended. In case of cytological abnormality or recurrence of the seroma, a surgical procedure should be performed. In conclusion, the removal of a breast implant without capsulectomy may result in the formation of a seroma whose images resemble those of an implant. It is always worthwhile to provide precise clinical data to the radiologist in order to help him to make informed interpretations. Every serous effusion in a breast lodge having contained a silicone implant must evoke the diagnosis of anaplastic large cell lymphoma.

  10. Innovative combination of therapeutic mammoplasty and expandable-implant breast augmentation for immediate partial breast reconstruction

    Directory of Open Access Journals (Sweden)

    A.M.H. Choo

    2016-01-01

    Conclusion: A “novel” oncoplastic technique herein termed “augmentation-therapeutic mastopexy” is described for partial breast reconstruction during the treatment of a patient with bilateral breast cancer. It enabled adequate treatment of her cancer while reshaping the breast and achieving the desired larger breast size. It should be considered in selected breast-conservation patients who wish to maintain or increase their breast size.

  11. Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders: Why Port and Shell Volumes Matter in Breast Reconstruction, Augmentation, and Revision.

    Science.gov (United States)

    Wenzel, Chad G; Wacholtz, William F; Janssen, David A; Bengtson, Bradley P

    2015-10-01

    There are significant differences in weight and volumetric characteristics between silicone and saline breast implants of which most plastic surgeons are unaware. Phase I of this study was a weight measurement focused on recording differences in the weight of saline volumes instilled versus recorded weights of saline implants and expanders. Phase II compared displaced volume differences of tissue expanders with instilled volumes. As a result of this study, surgeons should now be able to precisely calculate the volume created for breast pocket development, allowing for accurate matching of expander and final breast implant.

  12. Shaped versus Round Implants for Breast Reconstruction: Indications and Outcomes

    Directory of Open Access Journals (Sweden)

    Maurice Y. Nahabedian, MD

    2014-03-01

    Conclusions: Both shaped and round silicone gel devices can result in natural aesthetic outcomes. Shaped devices are preferred for contouring the upper pole and for optimizing breast projection. Round devices are preferred when the upper pole is not deficient and the patient desires softer breasts. Longer follow-up studies will be necessary.

  13. Investigation of the silicone structure in breast implants using ¹H NMR.

    Science.gov (United States)

    Formes, Andreas; Diehl, Bernd

    2014-05-01

    Against the background of the scandal about low-grade silicone breast implants of the French manufacturer Poly Implant Prothese (PIP), several types of implants were examined using (1)H NMR spectroscopy. The intention was to classify an implant according to its silicone structure. Therefore, the certificated raw material of the American silicone producer Nusil Technology was analyzed and used as a reference. The list of tested implants consists of implants by PFM medical, PIP, Silimed, Rofil, Eurosilicone, Mentor, Perouse Plastie, Polytech, Nagor, CUI, and McGhan. In the (1)H NMR spectrum the signal of the vinyl group, which is used to cross link silicone rubbers, is visible. It is possible to differentiate between silicones which have a vinyl terminated end group and silicones whose vinyl group is located within the chain of the polymer. The two different types of the vinyl group are one mean to classify the implants. Other categories besides the type of vinyl include the relative amount of the remaining vinyl in the implant and the chemical structure of the material used for the production of the envelope. With these characteristics the examined implants could be grouped into four types. PMID:24342752

  14. Regulatory science of new technology: tendency of medical professionals' interests on silicone breast implants.

    Science.gov (United States)

    Nakazaki, Tomomichi; Ikeda, Koji; Iwasaki, Kiyotaka; Umezu, Mitsuo

    2016-09-01

    New technology related to artificial organs is most attractive for worldwide researchers. We believe they must contribute for the future patients against untreatable diseases. Regulatory science is a new science to establish 'social acceptance' of new technology into the clinical market as soon as possible. In the history of silicone breast implants, we could recognize risks many times; however, we missed such chances to prevent a subsequent crisis. We analyzed the trend of published literature related to silicone breast implants to review the medical professionals' interests on such risks. This trend showed, despite issues of a social acceptance of silicone breast implants in a few countries, other countries' medical professionals had no interest. Our hypothesis is 'medical professionals face the government and do not have contributed to re-establish the social acceptance of new technologies for patients'. Any technology does not have the complete evidence of safety, efficacy and quality, despite regulatory authorities' review and approval with clinical evidences. medical professionals need to conduct subsequently the epidemiological study, to take a meta-analysis periodically and to create/update the guidance for their patients under their professional ethics after the marketing of new technologies. We need to take seriously the 'lesson learned' from the history of silicone breast implants for all kind of new technologies existed in the present.

  15. The clinical course of immediate breast implant reconstruction after breast cancer

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Friis, Søren; Frederiksen, Kirsten;

    2011-01-01

    The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed.......The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed....

  16. Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions.

    Science.gov (United States)

    Citron, Isabelle; Dower, Rory; Ho-Asjoe, Mark

    2016-01-01

    Acellular dermal matrix (ADM) implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI). But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime. We also outline our protocol for the management of ADM associated complications including seroma, simple and complex infection and red breast syndrome, such that the sequelae of complications are minimized and patients achieve a better long-term outcome. PMID:26816672

  17. Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions

    Directory of Open Access Journals (Sweden)

    Citron, Isabelle

    2016-01-01

    Full Text Available Acellular dermal matrix (ADM implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI. But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime. We also outline our protocol for the management of ADM associated complications including seroma, simple and complex infection and red breast syndrome, such that the sequelae of complications are minimized and patients achieve a better long-term outcome.

  18. First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer

    International Nuclear Information System (INIS)

    Purpose: A new technique of adjuvant partial breast irradiation using 103Pd permanent breast seed implants (PBSI) is presented. The procedure is performed in a single 1-hour session under local anesthesia. Methods and Materials: Patients referred to a single institution for adjuvant radiotherapy after lumpectomy for an infiltrating ductal carcinoma ≤3 cm in diameter, surgical margin ≥2 mm, no extensive in situ carcinoma, no lymphovascular invasion, and minimal or negative lymph node involvement were offered a PBSI. Results: Between May and December 2004, 31 eligible patients underwent CT scan and ultrasound simulations assessing PBSI feasibility. Fifteen were excluded because of feasibility issues, and 16 received PBSI. A minimal peripheral dose of 90 Gy was prescribed to the planning target volume corresponding to the clinical target volume identified on the CT scan plus a margin of 1 cm. The procedure was well tolerated; 56% of the patients reported no pain during the procedure, and 46% of the patients developed National Cancer Institute Common Toxicity Criteria Grade 1 acute reaction. None experienced toxicity Grade 2 or 3. Conclusions: Permanent breast seed implantation seems feasible and well tolerated on these preliminary clinical data and represents an ultimate step in the reduction of treatment fraction for partial breast irradiation

  19. A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breast cancer

    Institute of Scientific and Technical Information of China (English)

    FAN Lin-jun; JIANG Jun; YANG Xin-hua; ZHANG Yi; LI Xing-gang; CHEN Xian-chun; ZHONG Ling

    2009-01-01

    Background Breast conserving surgery (BCS) has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy (ESM) plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting.Methods From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. Results There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups (P>0.05).The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM (88.4%, 38/43) and BCS (92.6%, 50/54) patients (P>0.05). During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence-one of these patients died of multiple organ metastasis.Conclusions After considering the wide Indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants-the new surgery of choice for breast cancer-warrants serious consideration as the prospective next standard surgical procedure.

  20. Radiation testing of the AeroForm co2-based breast tissue expander implant

    International Nuclear Information System (INIS)

    Tissue expanders are used in breast reconstruction after mastectomy to stretch the remaining tissue to create space for placement of permanent breast implants. The AeroForm™ Tissue Expander, developed by AirXpanders™ Inc., contains electronic components designed to activate the release of carbon dioxide from an internal reservoir to inflate the expander. Breast cancer patients who undergo mastectomy and tissue expander/implant-based breast reconstruction may require radiation therapy at doses up to 50–60 Gy while the expander is in place. The ionizing radiation used in postmastectomy radiation therapy interacts with electronic components in medical implants, which may cause degradation in performance above certain levels. Most commercial electronic components used in medical devices, such as complementary metal-oxide semiconductor or bipolar integrated circuits can withstand radiation levels in the 50 Gy range without any performance degradation. Beyond this level, the performance may still be sufficient to guarantee functionality, but this needs to be confirmed at the system and electronic circuit level. We assessed the impact of radiation levels up to 75 Gy on 32 AeroForm™ Tissue Expanders (AirXpanders, Inc., Palo Alto, CA USA) and on the associated internal printed circuit assemblies. The electronics inside the AeroForm™ Tissue Expander implant continued to function properly after exposure to radiation levels up to 75 Gy, which is well above the maximum total dose level typically used in postmastectomy radiation therapy. Standard postmastectomy radiation therapy doses do not damage or affect the functionality of the AeroForm™ Tissue Expander

  1. The inner and outer of our thorax: silicone breast implants and pulmonary alveolar proteinosis

    OpenAIRE

    De Backer, Helene; Darquennes, K; Dooms, Christophe; Yserbyt, Jonas; Coolen, Johan; Verschakelen, Johny; Verbeken, Erik; Vrints, I; Wuyts, Wim

    2015-01-01

    Pulmonary alveolar (phospholipo)proteinosis (PAP) is a rare lung disease, predominantly autoimmune in nature. This case report describes a patient with insidious dyspnoea since 5 years and a milky appearance of her bronchoalveolar fluid, leading to the diagnosis of PAP. The onset of symptoms coincided with an exchange of her silicone breast implants. Giant cell reaction in axillary adenopathies pointed towards silicone leakage. Adjuvants, such as silicone, might boost pre-existing antigen rea...

  2. DermACELL: a novel and biocompatible acellular dermal matrix in tissue expander and implant-based breast reconstruction

    OpenAIRE

    Bullocks, Jamal M.

    2014-01-01

    Background Acellular dermal matrices present a new alternative to supporting expanders and implants for breast reconstruction in breast cancer patients following mastectomy. However, some studies have suggested that acellular dermal matrix may increase the complication rates in certain clinical settings. DermACELL acellular dermal matrix offers advanced processing in order to attempt to decrease bio-intolerance and complications. Methods Ten consecutive patients that presented for breast reco...

  3. Attitudes and treatment outcome of breast conservation therapy for stage I and II breast cancer using peroperative iridium-192 implant boost to the tumour bed

    International Nuclear Information System (INIS)

    Breast conservation therapy for early breast cancer is an established but grossly under-utilized treatment option in India for various reasons. Breast conservation therapy was offered to 200 suitable breast cancer patients between June 1993 and June 1998. Fifty-one patients (25%) opted for breast conservation and the remaining preferred mastectomy. In patients agreeing to conservation therapy, surgery was performed first along with peroperative implantation of iridium-192 to deliver a boost. Whole breast irradiation of 45 Gy was delivered 3-4 weeks after the boost. Cosmesis was assessed at the end of 6 months from completion of therapy. The main reason for refusal of breast conservation therapy was fear of recurrence in the remaining breast (60%). There were no loco-regional failures in our study at a median follow up of 42 months; one patient experienced a systemic relapse. Cosmesis was good to excellent in 80% of patients. Breast conservation therapy using peroperative iridium-192 implant provides excellent loco-regional disease control and cosmesis. The results of our study indicate that patient preference for mastectomy is an important reason for the under-utilization of breast conservation therapy in India. Copyright (2001) Blackwell Science Pty Ltd

  4. Locally advanced breast implant associated anaplastic large cell lymphoma: A case report of successful treatment with radiation and chemotherapy

    Directory of Open Access Journals (Sweden)

    Christopher Fleighton Estes

    2015-02-01

    Full Text Available The development of breast implant associated anaplastic large cell lymphoma (ALCL is a rare phenomenon. A typical presentation is an effusion associated with a breast implant. Less commonly, disease can become more advanced locoregionally or distantly. The optimal treatment schema is a topic of debate: localized ALCL can potentially be cured with implant removal alone, while other cases in the literature, including those that are more advanced, have been treated with varying combinations of surgery, chemotherapy, and external beam radiotherapy. This is a case report of breast implant ALCL with pathologically proven lymph node involvement, the fifth such patient reported. Our patient experienced a favorable outcome with radiation therapy and chemotherapy.

  5. The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Wook; Woo, Heon; Jeong, Hyeon Hak; Kim, Kyeong Ah; Kim, Chan Yong; Yoo, Suk Hyun [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-12-15

    To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22-4.17% at A point, 4.06-6.22% at B point, 0.4-0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06-5% at A point, 2.85-4.94% at B point, 0.74-1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is

  6. Stealthy role of size-driven stresses in biomechanics of breast implants capsular contracture.

    Science.gov (United States)

    Fraldi, Massimiliano; Esposito, Luca; Cutolo, Arsenio; Carotenuto, Angelo Rosario; Adamo, Ciro; Molea, Guido

    2016-12-01

    Breast Capsular Contracture (BCC) is one of the adverse complications occurring with greater incidence in breast augmentation surgical procedures. Its formation can be interpreted as the conclusive result of the physiological process known as response to a foreign body. From a biochemical standpoint, the formation of the peri-prosthetic capsule is certainly a multifactorial process: many hypotheses concerning its etiology have been suggested in the literature and a number of related pharmacological protocols have been consequently proposed to clinically treat this pathology with the aim to prevent further complications and avoid future re-interventions. However, the vast majority of these theories seems to be only partially supported by clinical outcomes and thus a shared opinion on this matter is still absent among specialists. Within this framework, by starting from clinical observations which highlighted an unexpected correlation between histo-morphological features of fibrotic capsules and overall size of breast implants, the present study investigates the hypothesis that the biomechanical interaction between prosthesis and host tissue may play a crucial role in the biological processes governing the pathological phenomenon at hand. Therefore, to shed light on the underlying mechanisms which could trigger the breast capsular contracture, both simple analytical solutions, in which elasticity and growth are simultaneously taken into account, and more accurate geometrically faithful Finite Element-based numerical simulations have been exploited. The theoretical findings demonstrate that somehow counter-intuitive radial and hoop stress fields occur at the capsula-implant interface in a way such that their combined action, independently from other possible concurrent factors, results significantly amplified for small-size breast prostheses, localized stress peaks in these cases promoting detaching and rippling phenomena actually observed in BCC clinical

  7. Optimization of permanent breast seed implant dosimetry incorporating tissue heterogeneity

    Science.gov (United States)

    Mashouf, Shahram

    Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG43 formalism, which generates the dose in homogeneous water medium. Recently, AAPM task group no. 186 (TG186) emphasized the importance of accounting for heterogeneities. In this work we introduce an analytical dose calculation algorithm in heterogeneous media using CT images. The advantages over other methods are computational efficiency and the ease of integration into clinical use. An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of the source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. The dose distributions obtained through applying ICF to TG43 protocol agreed very well with those of Monte Carlo simulations and experiments in all phantoms. In all cases, the mean relative error was reduced by at least a factor of two when ICF correction factor was applied to the TG43 protocol. In conclusion we have developed a new analytical dose calculation method, which enables personalized dose calculations in heterogeneous media using CT images. The methodology offers several advantages including the use of standard TG43 formalism, fast calculation time and extraction of the ICF parameters directly from Hounsfield Units. The methodology was implemented into our clinical treatment planning system where a cohort of 140 patients were processed to study the clinical benefits of a heterogeneity corrected dose.

  8. Phase II investigation: partial breast irradiation with high-dose brachytherapy using intratissue multicatheter implant

    International Nuclear Information System (INIS)

    Local control, side-effects, and cosmetic results were analyzed in patients with early-stage breast cancer after organpreserving surgery and adjuvant partial accelerated irradiation of the breast using high dose rate brachytherapy and intratissue multicatheter implant. The patients over 50 with solitary tumors < 3 cm invasive ductal carcinoma, differentiation grade I-III, resection R0, N0 (axillary dissection or investigation of signal lymph node) were included in the study. The irradiation was performed twice a day with a 6-hour interval at a single dose of 4 Gy. Total focal dose of 32 Gy was delivered with 8 fractions. With a mean observation period of 31 months (13-46), a local relapse was diagnosed in one patient (1.7 %). Cosmetic results were assessed as good and excellent. Immediate complications of the treatment were minimal. The method can be indicated in a selected group of patients and cannot be a standard of treatment at present.

  9. The inner and outer of our thorax: silicone breast implants and pulmonary alveolar proteinosis.

    Science.gov (United States)

    De Backer, H; Darquennes, K; Dooms, C; Yserbyt, J; Coolen, J; Verschakelen, J; Verbeken, E; Vrints, I; Wuyts, W

    2015-10-01

    Pulmonary alveolar (phospholipo)proteinosis (PAP) is a rare lung disease, predominantly autoimmune in nature. This case report describes a patient with insidious dyspnoea since 5 years and a milky appearance of her bronchoalveolar fluid, leading to the diagnosis of PAP. The onset of symptoms coincided with an exchange of her silicone breast implants. Giant cell reaction in axillary adenopathies pointed towards silicone leakage. Adjuvants, such as silicone, might boost pre-existing antigen reactions of the immune system, potentially leading to autoimmune phenomena. PMID:26083574

  10. Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Antonios Psarras

    2014-01-01

    Full Text Available Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud’s phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.

  11. Radiological and echographic aspects of breasts with silicone implants; Aspectos radiologicos e ecograficos das mamas com protese de silicone

    Energy Technology Data Exchange (ETDEWEB)

    Pace Bauab, S. de [Instituto de Radiodiagnostico Rio Preto, Sao Jose do Rio Preto, SP (Brazil)

    1994-10-01

    The silicone prosthesis, its application in breast augmentation mammoplasty and the studies about its association with auto-immune diseases and cancer, are commented. The normal and the pathologic radiologic and echographic aspects of breasts with implants are discussed, concerning to the prosthesis itself and to the adjacent parenchyma. The validity of mammographic and ultrasound mammography in the detection of cancer and of alterations of the implants are emphasized and also the importance of exams of high technical quality.(author). 16 refs, 13 figs.

  12. Cosmetic outcome with interstitial implant as part of breast-conservation therapy in rural population of Maharashtra

    International Nuclear Information System (INIS)

    In early stages of carcinoma breast, breast conservation therapy is the preferred method as it gives local control rate along with survival comparable to more radical surgery. While irradiating the tumor bed by interstitial implant, dose homogeneity is the most important parameter for achieving good cosmesis. As per ICRU (International Commission on Radiation Units and Measurement), dose homogenetity index (DHI) is defined as ratio of peripheral dose to the central dose

  13. Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

    OpenAIRE

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B.; Sheena, Yezen; Niakas, Dimitrios

    2015-01-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results ...

  14. External beam irradiation plus 192Ir implant after breast-preserving surgery in women with early breast cancer

    International Nuclear Information System (INIS)

    Purpose: To provide more information for the clinician and to analyze the impact of the boost with brachytherapy on the local disease-free survival (LDFS), disease-free survival (DFS), specific overall survival (OS), and cosmesis, a retrospective study of external radiation therapy and 192Ir implantation in early breast cancer at Institut Catala d'Oncologia has been undertaken. Patients and Methods: From 1986 to 1996, 530 patients were selected for this study with a median follow-up period of 39.5 months (range, 10-115 months). External radiation therapy (combined with brachytherapy) was administered postoperatively to the breast in all patients. Mean given dose was 48.7 Gy (range, 42-52 Gy) with external radiation therapy to the breast, and 16.8 Gy (range, 10-27 Gy) was the mean dose with brachytherapy. Variables have been tested for cosmesis. Univariate and multivariate analysis have also been carried out. Results: Mean age of the patients was 54 years (range, 28-81 years). Stages were distributed as follows: 350 patients (66%) in Stage I, 173 in Stage II (32.8%), and 7 in Stage III (1.1%). Pathologic distribution was 445 patients with infiltrating ductal carcinoma (84%), 20 patients with infiltrating lobular carcinoma (4%), and 65 patients (12%) of a miscellaneous group. OS for the entire group was 89.4% and 85.9% at 5 and 7 years respectively. Probability of DFS was 81.7% and 70.1% at 5 and 7 years. The LDFS was 94.9% and 91.7% at 5 and 7 years. The MFS probability was 85.5% and 76.9% at 5 and 7 years, respectively. Univariate analysis demonstrated that age (older than 52 years), premenopausal status, moderate and high histologic grades (Grades II-III), and presence of intraductal comedocarcinoma were prognostic factors for local relapse. Multivariate analysis for local disease-free survival demonstrated that only perineural or muscular infiltration remain as prognostic factors. Tumor dose bed of 70 Gy or higher had a negative impact in breast subcutaneous

  15. The Poly Implant Prothèse breast prostheses scandal: Embodied risk and social suffering.

    Science.gov (United States)

    Greco, Cinzia

    2015-12-01

    This article examines the 2010 scandal surrounding the use and subsequent recall of adulterated Poly Implant Prothèse (PIP) silicone breast prostheses in France. It uses a mixed method approach that includes 12 interviews with French PIP prosthesis recipients, analyses of medical literature, policy documents of French and EU regulatory agencies, and an online forum for PIP recipients. These data are used to explain how the definition of "acceptable risk" in the silicone implants controversy of the 1990s in the US influenced the PIP scandal later on in France. Additionally, PIP recipients had an embodied experience of risk that clashed with the definition of risk used by authorities and some surgeons. The coverage of re-implantation was also defined at different policy levels, leading to variation in patients' suffering. The combination of fraud and lack of recognition from part of the medical system constitutes an example of social suffering for the patients involved. The PIP scandal is a useful case for analyzing the interconnection of embodied experience and professional and public policy definitions of medical risk through the concepts of moral economy and biological citizenship.

  16. Implant breast reconstruction followed by radiotherapy: Can helical tomotherapy become a standard irradiation treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Massabeau, Carole, E-mail: cmassabeau@hotmail.com [Department of Radiation Oncology, Institut Curie, Paris (France); Fournier-Bidoz, Nathalie; Wakil, Georges; Castro Pena, Pablo; Viard, Romain; Zefkili, Sofia; Reyal, Fabien; Campana, Francois; Fourquet, Alain; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2012-01-01

    To evaluate the benefits and limitations of helical tomotherapy (HT) for loco-regional irradiation of patients after a mastectomy and immediate implant-based reconstruction. Ten breast cancer patients with retropectoral implants were randomly selected for this comparative study. Planning target volumes (PTVs) 1 (the volume between the skin and the implant, plus margin) and 2 (supraclavicular, infraclavicular, and internal mammary nodes, plus margin) were 50 Gy in 25 fractions using a standard technique and HT. The extracted dosimetric data were compared using a 2-tailed Wilcoxon matched-pair signed-rank test. Doses for PTV1 and PTV2 were significantly higher with HT (V95 of 98.91 and 97.91%, respectively) compared with the standard technique (77.46 and 72.91%, respectively). Similarly, the indexes of homogeneity were significantly greater with HT (p = 0.002). HT reduced ipsilateral lung volume that received {>=}20 Gy (16.7 vs. 35%), and bilateral lungs (p = 0.01) and neighboring organs received doses that remained well below tolerance levels. The heart volume, which received 25 Gy, was negligible with both techniques. HT can achieve full target coverage while decreasing high doses to the heart and ipsilateral lung. However, the low doses to normal tissue volumes need to be reduced in future studies.

  17. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling.

    Science.gov (United States)

    Rüegg, Eva; Cheretakis, Alexandre; Modarressi, Ali; Harbarth, Stephan; Pittet-Cuénod, Brigitte

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months' follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections. PMID:25893122

  18. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling

    Directory of Open Access Journals (Sweden)

    Eva Rüegg

    2015-01-01

    Full Text Available Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months’ follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

  19. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt;

    2016-01-01

    (RT). MATERIAL AND METHODS: All women treated for early-stage BC in Denmark from 1982 to 2005 were identified from the Danish Breast Cancer Cooperative Group. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to RT. Standardized incidence...

  20. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant

    Energy Technology Data Exchange (ETDEWEB)

    Furstoss, C.; Reniers, B.; Bertrand, M. J.; Poon, E.; Carrier, J.-F.; Keller, B. M.; Pignol, J. P.; Beaulieu, L.; Verhaegen, F. [Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Departement de Radio-Oncologie et Centre de Recherche du CHUM, Hopital Notre-Dame, 1560 rue Sherbrooke Est, Montreal, Quebec H2L 4M1 (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, CHUQ Pavillon L' Hotel-Dieu de Quebec, 11 Cote du Palais, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec G1K 7P4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands)

    2009-05-15

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of {sup 125}I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast {sup 125}I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V{sub 85}, V{sub 100}, and V{sub 200} for this kind of treatment in the target. D{sub 90} and D{sub 50} were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT

  1. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    Directory of Open Access Journals (Sweden)

    Heba G. El-Sheredy

    2016-01-01

    Full Text Available Background: Breast cancer is the most frequent malignant tumor in women worldwide. In recent years, defined reconstruction principles along with numerous surgical techniques with volume replacement have been published. Autologous breast reconstruction is more natural but leaves donor site morbidity. It provides the opportunity to restore the breast mound without the need for scars. This study aims to evaluate the complications of radiotherapy after immediate breast reconstruction with implants in breast cancer patients who submitted to skin sparing mastectomy and nipple sparing mastectomy by taking into consideration the risk factors and management at our institution. Methods: The current study prospectively included patients with invasive breast cancer admitted between January and June 2012 who were scheduled for skin sparing mastectomy or nipple sparing mastectomy and axillary dissection followed by immediate breast reconstruction with implant. Patients received adjuvant chemotherapy followed by conventional fractionated radiation. Complications were classified as either minor or major. The minor complications included capsular contracture (Baker 1-2, seroma, minor skin infection and skin dehiscence without exposure of the implant. Major complications included capsular contracture (Baker 3-4, severe infection and major wound dehiscence with implant exposure. Capsular contracture was scored according to the modified Baker classification. Results: The study included 38 patients. Of these, 28 had skin sparing mastectomy while 10 underwent nipple sparing mastectomy. The overall complication rate was 71%. We observed minor complications in 18 patients while 9 patients had major complications. Complications occurred with a median time of 13 months following radiotherapy completion. All minor complications were managed conservatively whereas all major complications required repeat surgery. No loco-regional recurrences occurred during the follow up

  2. A Direct Comparison of Alloderm-Ready to Use (RTU) and DermACELL in Immediate Breast Implant Reconstruction

    Science.gov (United States)

    Salzberg, C. Andrew

    2016-01-01

    The objective of this study was to compare the 2 leading human acellular dermal matrices in breast reconstruction with implants. This retrospective study draws on the experience of 2 expert surgeons with a history of long-standing use of the Alloderm-RTU (LifeCell Corporation, Branchburg, NJ) product who switched to the DermACELL acellular dermal matrix (LifeNet Health, Virginia Beach, Va) product. The consecutive nature of these data over this change allowed comparison between the 2 products without the confounding effects of patient selection or change in technique. The postoperative complications of seroma, infection, implant loss, and unplanned return to the operating room were studied, and no statistical differences were noted between these 2 products. The overall complications rates were low, with implant loss and infection less than 2% in 249 cases. Recommendations are for continued use of acellular dermal matrix in breast reconstruction and product selection based on price and availability. PMID:27602176

  3. Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority

    Directory of Open Access Journals (Sweden)

    Alexandre Leduey

    2015-01-01

    Full Text Available Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament, the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France. The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%, infection (22.2%, and capsular contracture (13.6%. Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

  4. Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority.

    Science.gov (United States)

    Leduey, Alexandre; Mazouni, Chafika; Leymarie, Nicolas; Alkhashnam, Heba; Sarfati, Benjamin; Garbay, Jean-Rémi; Gaudin, Amélie; Kolb, Frédéric; Rimareix, Françoise

    2015-01-01

    Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament), the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP) breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof) of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France). The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse) were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%), infection (22.2%), and capsular contracture (13.6%). Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

  5. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    International Nuclear Information System (INIS)

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  6. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    Energy Technology Data Exchange (ETDEWEB)

    Maijers, M.C.; Ritt, M.J.P.F. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Niessen, F.B. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Jan van Goyen Clinic, Department of Plastic Surgery, Amsterdam (Netherlands); Veldhuizen, J.F.H. [MRI Centre, Amsterdam (Netherlands); Manoliu, R.A. [MRI Centre, Amsterdam (Netherlands); VU University Medical Centre, Department of Radiology, Amsterdam (Netherlands)

    2014-06-15

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  7. Implantes mamarios y mastopexía: colgajos mamarios laterales y mediales, una opción técnica Breast Implants and Mastopexy: lateral and Medial Breast Flaps, a Technical Option

    Directory of Open Access Journals (Sweden)

    R. Goulart Jr.

    2012-12-01

    Full Text Available La mastopexia asociada al uso de implantes mamarios es actualmente una de las prácticas más desafiantes en Cirugía Plástica; en ella, el cirujano tiene que utilizar al máximo sus capacidades y conocimientos para decidir con exactitud la mejor relación entre el tamaño ideal del implante y el exceso de piel a retirar. El objetivo de este artículo es presentar una técnica a base de colgajos mamarios laterales y mediales (CMLM para cirugía de mastopexia con implantes mamarios en busca de una mejor definición de la mama y de una mayor duración del resultado final. Esta técnica se crea en base a la circulación mamaria y en los excedentes de tejido al final de la cirugía utilizando la marcación en T. Los resultados inmediatos han sido muy satisfactorios en términos de definición de la forma mamaria, de la solidez de la nueva estructura glandular y de la protección del implante mamario. La duración a largo plazo aún debe ser evaluada. Creemos que se trata de una técnica fácil de ejecutar, que permite un resultado estético satisfactorio, proporciona una percepción de mayor seguridad en el posicionamiento del implante, aunque somos conscientes de que su sostenibilidad y duración a largo plazo aún necesitan tiempo para una mejor evaluación.The breast implant associated with mastopexy actually is one of most difficult plastic surgeries. In fact, it is a surgery where the surgeon has to use his higher capabilities and skills in order to decide with precision the best relationship between ideal sizes of the breast implant and skin excess. The purpose in this paper is to present a breast lateral and medial flaps technique for augmentation mastopexy surgery looking for a better breast design and resistance on the final result. The technique was created on breast circulation basis, skin excess and better definition and resistance about the aesthetical breast results in the augmentation mastopexy surgery utilizing the T scar technique

  8. Complex radiological diagnosis of a breast cancer at women after augmentation mammоplasty of silicone gel implants

    Directory of Open Access Journals (Sweden)

    T. A. Shumakova

    2014-01-01

    Full Text Available One of leading problems of mammology is early diagnostics of a breast cancer. The work purpose studying of opportunities of a complex of radiological research techniques in diagnostics of a breast cancer at women after augmentation mammoplasty silicone gel implants. By results of сomplex kliniko-radiological examination of 630 women aged from 18 till 72 years (middle age made 35 ± 0.43 years with 1260 implants the breast cancer was revealed at 7 (1.1 % patients. The invasive pro-current cancer with local widespread type of body height of tumoral knot is histologically diagnosed. Sensitivity and specificity of methods of radiodiagnosis in identification of a cancer of mammary glands at women after endoprosthesis replacement made mammography – 28.6 % and 66.1 %, ultrasonography – 71.4 % and 85.7 %, magnetic resonance imaging – 85.7 % and 98.2 %, respectively. Thus, complex application of radiology research techniques raises level of diagnostics of breast cancer at patients after augmentation mammoplasty silicone gel implants that allows to choose an adequate method of treatment.

  9. Effect of implant vs. tissue reconstruction on cancer specific survival varies by axillary lymph node status in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Qian Ouyang

    Full Text Available To compare the breast cancer-specific survival (BCSS between patients who underwent tissue or implant reconstruction after mastectomy.We used the database from Surveillance, Epidemiology, and End Results (SEER registries and compared the BCSS between patients who underwent tissue and implant reconstruction after mastectomy. Cox-regression models were fitted, adjusting for known clinicopathological features. The interaction between the reconstruction types (tissue/implant and nodal status (N-stage was investigated.A total of 6,426 patients with a median age of 50 years were included. With a median follow up of 100 months, the 10-year cumulative BCSS and non-BCSS were 85.1% and 95.4%, respectively. Patients who underwent tissue reconstruction had tumors with a higher T-stage, N-stage, and tumor grade and tended to be ER/PR-negative compared to those who received implant reconstruction. In univariate analysis, implant-reconstruction was associated with a 2.4% increase (P = 0.003 in the BCSS compared with tissue-reconstruction. After adjusting for significant risk factors of the BCSS (suggested by univariate analysis and stratifying based on the N-stage, there was only an association between the reconstruction type and the BCSS for the N2-3 patients (10-year BCSS of implant vs. tissue-reconstruction: 68.7% and 59.0%, P = 0.004. The 10-year BCSS rates of implant vs. tissue-reconstruction were 91.7% and 91.8% in N0 patients (P>0.05 and 84.5% and 84.4% in N1 patients (P>0.05, respectively.The implant (vs. tissue reconstruction after mastectomy was associated with an improved BCSS in N2-3 breast cancer patients but not in N0-1 patients. A well-designed, prospective study is needed to further confirm these findings.

  10. Enhanced Survival with Implantable Scaffolds That Capture Metastatic Breast Cancer Cells In Vivo.

    Science.gov (United States)

    Rao, Shreyas S; Bushnell, Grace G; Azarin, Samira M; Spicer, Graham; Aguado, Brian A; Stoehr, Jenna R; Jiang, Eric J; Backman, Vadim; Shea, Lonnie D; Jeruss, Jacqueline S

    2016-09-15

    The onset of distant organ metastasis from primary breast cancer marks the transition to a stage IV diagnosis. Standard imaging modalities often detect distant metastasis when the burden of disease is high, underscoring the need for improved methods of detection to allow for interventions that would impede disease progression. Here, microporous poly(ε-caprolactone) scaffolds were developed that capture early metastatic cells and thus serve as a sentinel for early detection. These scaffolds were used to characterize the dynamic immune response to the implant spanning the acute and chronic foreign body response. The immune cell composition had stabilized at the scaffold after approximately 1 month and changed dramatically within days to weeks after tumor inoculation, with CD11b(+)Gr1(hi)Ly6C(-) cells having the greatest increase in abundance. Implanted scaffolds recruited metastatic cancer cells that were inoculated into the mammary fat pad in vivo, which also significantly reduced tumor burden in the liver and brain. Additionally, cancer cells could be detected using a label-free imaging modality termed inverse spectroscopic optical coherence tomography, and we tested the hypothesis that subsequent removal of the primary tumor after early detection would enhance survival. Surgical removal of the primary tumor following cancer cell detection in the scaffold significantly improved disease-specific survival. The enhanced disease-specific survival was associated with a systemic reduction in the CD11b(+)Gr1(hi)Ly6C(-) cells as a consequence of the implant, which was further supported by Gr-1 depletion studies. Implementation of the scaffold may provide diagnostic and therapeutic options for cancer patients in both the high-risk and adjuvant treatment settings. Cancer Res; 76(18); 5209-18. ©2016 AACR. PMID:27635043

  11. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    International Nuclear Information System (INIS)

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture

  12. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    Energy Technology Data Exchange (ETDEWEB)

    Ribuffo, Diego; Lo Torto, Federico [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Giannitelli, Sara M. [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Urbini, Marco; Tortora, Luca [Surface Analysis Laboratory, Department of Mathematics and Physics, University “Roma Tre”, Via della Vasca Navale 84, 00146 Rome (Italy); INFN — National Institute of Nuclear Physics, Section of Roma Tre, Via della Vasca Navale 84, 00146 Rome (Italy); Mozetic, Pamela; Trombetta, Marcella [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Basoli, Francesco; Licoccia, Silvia [Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, 00173 Rome (Italy); Tombolini, Vincenzo [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome (Italy); Cassese, Raffaele [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Scuderi, Nicolò [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); and others

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture.

  13. Expander/implant breast reconstruction before radiotherapy. Outcomes in a single-institute cohort

    Energy Technology Data Exchange (ETDEWEB)

    Aristei, C.; Palumbo, I. [Perugia Univ. (Italy). Radiation Oncology Section; Santa Maria della Misericordia Hospital, Perugia (Italy); Falcinelli, L.; Petitto, R.P.; Perrucci, E. [Santa Maria della Misericordia Hospital, Perugia (Italy). Radiation Oncology Div.; Bini, V. [Perugia Univ. (Italy). Dept. of Internal Medicine; Farneti, A. [Perugia Univ. (Italy). Radiation Oncology Section; Gori, S. [Santa Maria della Misericordia Hospital, Perugia (Italy). Medical Oncology Div.

    2012-12-15

    Background and purpose: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. Patients and methods: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. Results: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good ({kappa}-value 0.64; 95% CI: 0.48-0.79). Conclusion: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent. (orig.)

  14. Expander/implant breast reconstruction before radiotherapy. Outcomes in a single-institute cohort

    International Nuclear Information System (INIS)

    Background and purpose: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. Patients and methods: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. Results: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good (κ-value 0.64; 95% CI: 0.48-0.79). Conclusion: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent. (orig.)

  15. Multicenter study to assess potential hazards from exposure to lipid peroxidation products in soya bean oil from Trilucent breast implants.

    Science.gov (United States)

    Williams, G M; Caldwell, J; Armstrong, D; Bartsch, H; Bevan, R; Browne, R W; Chipman, J K; Iatropoulos, M J; Jeffrey, A M; Lunec, J; Nair, J; Page, D L; Reeves, B C; Richardson, A; Silverstein, B; Williams, D F

    2009-03-01

    In response to a Hazard Notice by the Medical Devices Agency of the UK in 2000 regarding the Trilucent breast implant (TBI), an expert panel was convened to implement a research program to determine whether genotoxic compounds were formed in the soybean oil filler (SOF) of TBIs and whether these could be released to produce local or systemic genotoxicity. The panel established a research program involving six laboratories. The program recruited 47 patients who had received TBIs (9 patients had received silicone implants previously). A reference group (REBI) of 34 patients who had exchanged either silicone (17 patients) implants (REBI-E) or patients (17) who were to receive primary implantation augmentation with silicone (REBI-PIA), and who were included as needed to increase either the pre- or post-explantation sample number. Of the 17 REBI-E patients, 5 had silicone implants and 12 had saline implants previously (prior to the last exchange). Investigation was undertaken before and after replacement surgery in the TBI patients and before and after replacement or augmentation surgery in the REBI patients. The pre- to post-operative sample interval was 8-12 weeks. Pre-operative samples were collected within 7 days prior to the operation. Information on a variety of demographic and behavioral features was collected. Biochemical and biological endpoints relating to genotoxic lipid peroxidation (LPO) products potentially formed in the SOF, and released locally or distributed systemically, were measured. The SOF of explanted TBIs was found to have substantial levels of LPO products, particularly malondialdehyde (MDA), and low levels of trans-4-hydroxy-2-nonenal (HNE) not found in unused implants. Mutagenicity of the SOF was related to the levels of MDA. Capsules that formed around TBIs were microscopically similar to those of reference implants, but MDA-DNA adducts were observed in capsular macrophages and fibroblasts of only TBI capsules. These cell types are not

  16. Crystalline light chain proximal tubulopathy with chronic renal failure and silicone gel breast implants: 1 case report.

    Science.gov (United States)

    Figueres, Marie-Lucile; Beaume, Julie; Vuiblet, Vincent; Rabant, Marion; Bassilios, Nader; Herody, Michel; Touchard, Guy; Noël, Laure-Hélène

    2015-01-01

    A 39-year-old female patient was admitted to explore chronic renal failure. Clinical history included silicone breast implants. Clinical examination was normal. Urinalysis revealed tubular proteinuria with Bence-Jones κ protein. Monoclonal immunoglobulin G κ and free monoclonal κ-light chains (LCs) were revealed by serum protein immunoelectrophoresis. Bone marrow aspiration with karyotype analysis and skeletal radiologic survey were normal. Kidney biopsy revealed a peculiar pattern of proximal tubular cells with hypertrophy and clarification initially diagnosed as an osmotic nephrosis. Immunofluorescence study, including immunoglobulin LCs conjugates was normal. Immunoelectron microscopy finally revealed a crystalline LC proximal tubulopathy κ. Our case presents some peculiarities: the absence of hematologic malignancy sign and the young patient's age. The silicone breast implants have been reported to be involved in the generation of monoclonal gammopathy.

  17. Skin-sparing mastectomy and immediate breast reconstruction by use of implants: An assessment of risk factors for complications and cancer control in 120 patients

    NARCIS (Netherlands)

    L.A.E. Woerdeman; J.J. Hage; M.J.C. Smeulders; E.J.T. Rutgers; C.M.A.M. van der Horst

    2006-01-01

    Background: Combined skin-sparing mastectomy and immediate reconstruction by use of an implant is increasingly accepted as a therapy for patients with breast cancer or a hereditary risk of breast cancer. Because little and contradictory evidence regarding possible risk factors for postoperative comp

  18. Complications Following Expander/Implant Breast Reconstruction Utilizing Acellular Dermal Matrix: A Systematic Review and Meta-Analysis

    OpenAIRE

    Hoppe, Ian C.; Yueh, Janet H.; Wei, Cindy H.; Ahuja, Naveen K.; Patel, Priti P.; Datiashvili, Ramazi O.

    2011-01-01

    Background: The recent increase in popularity of acellular dermal matrix assistance in immediate expander/implant breast reconstruction has led to variety of viewpoints. Many studies are published indicating an increase in complications with the use of acellular dermal matrix, while others indicate there is no increase in complications. Methods: This meta-analysis utilizes information from available studies that directly compare one specific type of acellular dermal matrix with traditional me...

  19. Cyclic volatile methylsiloxanes in human blood as markers for ruptured silicone gel-filled breast implants.

    Science.gov (United States)

    Rosendahl, Pia; Hippler, Joerg; Schmitz, Oliver J; Hoffmann, Oliver; Rusch, Peter

    2016-05-01

    The replacement of medical-grade silicone with industrial-grade silicone material in some silicone gel-filled breast implants (SBI) manufactured by Poly Implant Prothèse and Rofil Medical Nederland B.V., reported in 2010, which resulted in a higher rupture tendency of these SBI, demonstrates the need for non-invasive, sensitive monitoring and screening methods. Therefore a sensitive method based on large volume injection-gas chromatography coupled to mass spectrometry (LVI-GC/MS) was developed to determine octamethylcyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and dodecamethylcyclo-hexasiloxane (D6) in blood samples from women with intact (n = 13) and ruptured SBI (n = 11). With dichloromethane extraction, sample cooling during preparation, and analysis extraction efficiencies up to 100 % and limits of detection of 0.03-0.05 ng D4-D6/g blood were achieved. Blood samples from women with SBI were investigated. In contrast to women with intact SBI, in blood from women with ruptured SBI higher D4 and D6 concentrations up to 0.57 ng D4/g blood and 0.16 ng D6/g blood were detected. With concentrations above 0.18 D4 ng/blood and 0.10 ng D6/g blood as significant criteria for ruptured SBI, this developed analytical preoperative diagnostic method shows a significant increase of the recognition rate. Finally a higher precision (error rate 17%) than the commonly used clinical diagnostic method, mamma sonography (error rate 46%), was achieved.

  20. Over Troubled Water: An Outbreak of Infection Due to a New Species of Mycobacterium following Implant-Based Breast Surgery.

    Science.gov (United States)

    Scheflan, Michael; Wixtrom, Roger N

    2016-01-01

    Mycobacterial infection is a rare complication associated with breast surgery using implants. Over the course of 5 months, one center experienced 12 such cases, 10 of which were linked to a single surgeon. Most presented 3 to 6 weeks postoperatively with clear serous drainage from the incision, minimal local redness, no fever or other systemic signs of infection, and negative standard bacterial cultures. Patients were given empiric broad-spectrum oral antibiotic therapy. In eight cases, implants were removed and exchanged for new devices after irrigation of the pocket with antibiotics; these patients nonetheless experienced recurrent infection, which led to explantation (without immediate exchange for new implants). The last two patients proceeded straight to explantation. Because mycobacteria grow in water, the water supply and air-conditioning system were initially suspected as the source, and both were disinfected. However, this did not stop the outbreak. Eventually, the source was traced to a new species of mycobacteria isolated from a garden hot tub. These bacteria had then been unwittingly transferred to patients during surgery. A Triclosan-containing shampoo effectively ended the outbreak. This series is unique in several respects: the novelty of the pathogen, the heavy colonization of the surgeon, and the mechanism of transmission (the first occurrence of human-to-human mycobacterial transfer published in the plastic surgery literature). Surgeons who perform breast surgery with implants should be aware of the possibility of mycobacterial infection. Proactive culturing of the organism, use of antibiotics, and reoperation are essential to good outcomes. PMID:26710012

  1. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture.

    Science.gov (United States)

    Ribuffo, Diego; Lo Torto, Federico; Giannitelli, Sara M; Urbini, Marco; Tortora, Luca; Mozetic, Pamela; Trombetta, Marcella; Basoli, Francesco; Licoccia, Silvia; Tombolini, Vincenzo; Cassese, Raffaele; Scuderi, Nicolò; Rainer, Alberto

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture.

  2. Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer – case report and literature review

    Directory of Open Access Journals (Sweden)

    Nowaczyk Piotr

    2016-01-01

    Full Text Available This paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed – histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes. Following surgery the patient was qualified for further treatment – chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.

  3. The Effect of Radiation on Complication Rates and Patient Satisfaction in Breast Reconstruction using Temporary Tissue Expanders and Permanent Implants.

    Science.gov (United States)

    Anker, Christopher J; Hymas, Richard V; Ahluwalia, Ravinder; Kokeny, Kristine E; Avizonis, Vilija; Boucher, Kenneth M; Neumayer, Leigh A; Agarwal, Jayant P

    2015-01-01

    The optimal method of reconstruction following mastectomy for breast cancer patients receiving radiation therapy (RT) is controversial. This study evaluated patient satisfaction and complication rates among patients who received implant-based breast reconstruction. The specific treatment algorithm analyzed included patients receiving mastectomy and immediate temporary tissue expander (TE), followed by placement of a permanent breast implant (PI). If indicated, RT was delivered to the fully expanded TE. Records of 218 consecutive patients with 222 invasive (85%) or in situ (15%) breast lesions from the Salt Lake City region treated between 1998 and 2009 were retrospectively reviewed, 28% of whom received RT. Median RT dose was 50.4 Gy, and 41% received a scar boost at a median dose of 10 Gy. Kaplan-Meier analyses were performed to evaluate the cumulative incidence of surgical complications, including permanent PI removal. Risk factors associated with surgical events were analyzed. To evaluate cosmetic results and patient satisfaction, an anonymous survey was administered. Mean follow-up was 44 months (range 6-144). Actuarial 5-year PI removal rates for non-RT and RT patients were 4% and 22%, respectively. On multivariate analysis (MVA), the only factor associated with PI removal was RT (p = 0.009). Surveys were returned describing the outcomes of 149 breasts. For the non-RT and RT groups, those who rated their breast appearance as good or better were 63% versus 62%, respectively. Under 1/3 of each group was dissatisfied with their reconstruction. RT did not significantly affect patient satisfaction scores, but on MVA RT was the only factor associated with increased PI removal. This reconstruction technique may be considered an acceptable option even if RT is needed, but the increased complication risk with RT must be recognized.

  4. One stage implant-based reconstruction of the breast in a single patient: comparison between mesh and modified dual plane technique

    Directory of Open Access Journals (Sweden)

    Egidio Riggio

    2013-08-01

    Full Text Available Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral immediate breast reconstruction (IBR with 470 g implants, using alloplastic mesh in one side and the composed dual-plane pocket in the other. In the case described, the composed dual plane technique gave a better result in terms of absence of rippling and smoother surface at the palpation; the mesh coverage gave a better inframammary contour. Our case suggests that the modified dual-plane technique gives a satisfactory cosmetic outcome. It also reduces costs and avoids mesh-related complications. This technique should therefore be considered as an option to the mesh in implant-based breast reconstruction.

  5. Staphylococcus aureus and Staphylococcus epidermidis Virulence Strains as Causative Agents of Persistent Infections in Breast Implants.

    Directory of Open Access Journals (Sweden)

    Daniela Chessa

    Full Text Available Staphylococcus epidermidis and Staphylococcus aureus are currently considered two of the most important pathogens in nosocomial infections associated with catheters and other medical implants and are also the main contaminants of medical instruments. However because these species of Staphylococcus are part of the normal bacterial flora of human skin and mucosal surfaces, it is difficult to discern when a microbial isolate is the cause of infection or is detected on samples as a consequence of contamination. Rapid identification of invasive strains of Staphylococcus infections is crucial for correctly diagnosing and treating infections. The aim of the present study was to identify specific genes to distinguish between invasive and contaminating S. epidermidis and S. aureus strains isolated on medical devices; the majority of our samples were collected from breast prostheses. As a first step, we compared the adhesion ability of these samples with their efficacy in forming biofilms; second, we explored whether it is possible to determine if isolated pathogens were more virulent compared with international controls. In addition, this work may provide additional information on these pathogens, which are traditionally considered harmful bacteria in humans, and may increase our knowledge of virulence factors for these types of infections.

  6. Immediate Breast Reconstruction Using the Latissimus Dorsi Flap Combined with Breast Implant Optimizes Breast Shape%背阔肌瓣联合假体即刻乳房重建术优化乳房外形

    Institute of Scientific and Technical Information of China (English)

    钱琦; 朱玉兰; 朱春富

    2014-01-01

    目的:研究背阔肌瓣转移联合假体置入即刻乳房重建术在乳腺癌改良根治术患者乳房外形修复中的作用。方法分析20例背阔肌瓣转移联合假体置入即刻乳房重建术患者的临床资料,并与18例单纯假体置入即刻乳房重建术患者的临床资料进行对照研究。结果背阔肌瓣转移联合假体置入即刻乳房重建术修复乳房外形的效果显著优于单纯假体置入术(P=0.042),两组在并发症发生率等方面无显著差异(P>0.05)。结论对于乳腺癌改良根治术假体置入即刻乳房重建患者,选择背阔肌瓣转移覆盖假体,能使术后伤口愈合更佳,乳房外形更加美观,患者满意度更高。%Objective To study the effect of immediate breast reconstruction using the latissimus dorsi flap combined with breast implant on breast shape restoration in patients undergoing modified radical mastectomy. Methods A total of 38 patients with early breast cancer were divided into two groups, Experimental Group (n=20) and Control Group (n=218). All the patients accepted modified radical mastectomy. In Experimental Group, patients underwent immediate breast reconstruction with the latissimus domi flap combined with implants following mastectomy. In Control Group, patients underwent immediate breast reconstruction with breast implant only. Clinical data were collected and analyzed,retrospectively. Results The effect of breast shape optimization in Experimental Group was markedly superior to Control Group (P=0.042).There was no statistical difference in postoperative complications between the two groups. Conclusion Latissimus dorsi flap combined with implants is a reliable method which make the patients more aestheically pleasing and more satisfied for immediate breast reconstruction.

  7. Soft, Brown Rupture: Clinical Signs and Symptoms Associated with Ruptured PIP Breast Implants

    Directory of Open Access Journals (Sweden)

    Yvette Godwin, FRCS

    2014-11-01

    Conclusions: Preoperative signs can be predictive of PIP implant failure. Brown-stained implants are more prone to rupture. The presence of iodine in the gel suggests unacceptable permeability of the shell early in the implant’s life span. A noninvasive screening test to detect brown implants in situ could help identify implants at risk of failure in those who elect to keep their implants.

  8. Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model.

    Science.gov (United States)

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios

    2015-03-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

  9. Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model.

    Science.gov (United States)

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios

    2015-03-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide. PMID:25798383

  10. The micropolyurethane foam-coated Diagon/Gel4Two implant in aesthetic and reconstructive breast surgery – 3-year results of an ongoing study

    Directory of Open Access Journals (Sweden)

    Brunnert, Klaus E.

    2015-12-01

    Full Text Available Background: Breast implants are worldwide in use since 1962. Initially there were some problems with capsular contracture and the palpability of the rim of the implant. In 1968 this led to the introduction of the micropolyurethane foam-coating and then in 1970 to the first micropolyurethane foam-coated implant by F.A. Ashley. As a result of additional technical refinements in manufacturing this new implant design significantly reduced complications i.e. capsular contracture and implant rotation. Methods: This study reports a single surgeon’s experience with aesthetic and reconstructive breast surgery, in primary and secondary cases with the sole use of micropolyurethane foam-coated Diagon/gel4Two implants, partly in combination with the additional use of synthetic meshes, acellular dermal matrices and lipofilling. The trial is a prospective, single center cohort study designed to demonstrate the safety and effectiveness of the new implant design in primary and secondary aesthetic and reconstructive breast surgery. The reported data provide an interim report of the implantations performed from November 2010 to December 2013.Results: 90 patients were admitted to the study with 152 implants. The majority of the implants (n=95, 62.5% were used in reoperative cases for either oncological (n=52, 34.2% or aesthetic reasons (n=43, 28.3%. The median age of the study cohort was 45 years; the median body mass index was 21; the median observation time is 41 months. There was a very low complication rate, both short term within 6 weeks after the implantation of the silicone gel implant and in the follow up in November 2015. There were no serious complications needing explantation, no capsular fibrosis or implant rotation or rupture so far. There were only 4 minor complications (1.97%. There was 1 local recurrence 4 years after skin and nipple sparing mastectomy.Conclusion: The micropolyurethane foam-coated Diagon/gel4Two implant is a very reliable silicone

  11. MSCs and inflammation: new insights into the potential association between ALCL and breast implants.

    Science.gov (United States)

    Orciani, M; Sorgentoni, G; Torresetti, M; Di Primio, Roberto; Di Benedetto, G

    2016-02-01

    Possible association between anaplastic large cell lymphoma (ALCL) and breast implants has been suggested. In this context, formation of the periprosthetic capsule has been reported as a cause of inflammation, which plays a key role in tumor onset. Tumors take advantage of inflammation to influence and interfere with the host immune response by secreting multiple factors, and their onset and survival is in turn affected by the paracrine effects from mesenchymal stem cells (MSCs). In this study, we tried to clarify how inflammation can modify the immunobiology and the exerted paracrine effect of MSCs. MSCs derived from both inflamed (I-MSCs) and control (C-MSCs) tissues were isolated and co-cultured with an ALCL cell line. Proliferation rate and the expression of selected cytokines were tested. I-MSCs secrete higher levels of cytokine related to chronic inflammation than C-MSCs. After co-cultures with KI-JK cells, C- and I-MSCs show the same variation in the cytokine expression, with an increase of IL2, IL4, IL5, IL10, IL13, TNF-α, TGF-β, and G-CSF. Proliferation of ALCL cells was not influenced by co-cultures. Our results state that (i) inflamed microenvironment affects the immunobiology of MSCs modifying the profile of the expressed cytokines, and (ii) the paracrine effects exerted by MSCs on ALCL cells are not influenced by inflammation. Moreover, it seems that ALCL cells are able to manipulate MSCs' immunoregulatory properties to evade the host immune control. Nevertheless, this ability is not associated with inflammation and the question about BIA-ALCL is not proved by our experiments.

  12. Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients.

    Science.gov (United States)

    Matsuo, Akira; Hamada, Hayato; Takahashi, Hidetoshi; Okamoto, Ayako; Kaise, Hiroshi; Chikazu, Daichi

    2016-09-01

    It remains unclear whether dental implants are a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We retrospectively evaluated the status of dental implants in patients given intravenous bisphosphonates (BPs) in a breast cancer cohort to elucidate the risk for BRONJ at the implant site. We established a BRONJ oral monitoring program for 247 breast cancer patients given intravenous BP in our institution. The 3-year cumulative incidence rate was determined. The systemic and local risk factors of 44 patients who completed comprehensive oral examinations were evaluated by logistic regression analysis. The 3-year cumulative incidence rate of the 247 patients was 0.074 % (8/247, 95 % CI 0.0081-0.014). In the 44 orally examined patients, 6 (13.6 %: 6/44) had dental implants. Of these 6 patients, 1 developed BRONJ at the implant site. There were no significant differences in the age, total BP treatment period, number of residual teeth, time of regular oral monitoring, oral hygiene level, or dental implant insertion. Although a case of ONJ was identified, dental implants which were inserted before intravenous BP administration were not a risk factor for the development of ONJ in breast cancer patients.

  13. Combination of chemical suppression techniques for dual suppression of fat and silicone at diffusion-weighted MR imaging in women with breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Dow-Mu; Hughes, J. [Royal Marsden Hospital, Department of Radiology, Sutton (United Kingdom); Blackledge, M.; Leach, M.O.; Collins, D.J. [Institute of Cancer Research, CR UK-EPSRC Cancer Imaging Centre, Sutton (United Kingdom); Burns, S. [Nuada 3T MRI Centre, London (United Kingdom); Stemmer, A.; Kiefer, B. [Siemens Healthcare, Erlangen (Germany)

    2012-12-15

    Silicone breast prostheses prove technically challenging when performing diffusion-weighted MR imaging in the breasts. We describe a combined fat and chemical suppression scheme to achieve dual suppression of fat and silicone, thereby improving the quality of diffusion-weighted images in women with breast implants. MR imaging was performed at 3.0 and 1.5 T in women with silicone breast implants using short-tau inversion recovery (STIR) fat-suppressed echo-planar (EPI) diffusion-weighted MR imaging (DWI) on its own and combined with the slice-select gradient-reversal (SSGR) technique. Imaging was performed using dedicated breast imaging coils. Complete suppression of the fat and silicone signal was possible at 3.0 T using EPI DWI with STIR and SSGR, evaluated with dedicated breast coils. However, a residual silicone signal was still perceptible at 1.5 T using this combined approach. Nevertheless, a further reduction in silicone signal at 1.5 T could be achieved by employing thinner slice partitions and the addition of the chemical-selective fat-suppression (CHESS) technique. DWI using combined STIR and SSGR chemical suppression techniques is feasible to eliminate or reduce silicone signal from prosthetic breast implants. (orig.)

  14. A feasibility study of magnetic resonance imaging of silicone breast implants in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; Boice, John D; McLaughlin, Joseph K;

    2005-01-01

    to determine the feasibility of conducting a magnetic resonance imaging (MRI)-based study of rupture incidence. The pilot investigation included a clinical examination by a plastic surgeon, MRI scan, and self-administered questionnaire. The participation rate was 100%. Implants in our study represented a cross......-section of the different generations of implants in Finland, with implant ages varying from 4 months to 20 years. The average implant size was 215 mL, typical in Finnish cosmetic surgery. MR images were evaluated by two independent readers. The first reader diagnosed six implants with intracapsular rupture, while...

  15. PDR brachytherapy with flexible implants for interstitial boost after breast-conserving surgery and external beam radiation therapy

    International Nuclear Information System (INIS)

    Background and purpose: For radiobiological reasons the new concept of pulsed dose rate (PDR) brachytherapy seems to be suitable to replace traditional CLDR brachytherapy with line sources. PDR brachytherapy using a stepping source seems to be particularly suitable for the interstitial boost of breast carcinoma after breast-conserving surgery and external beam irradiation since in these cases the exact adjustment of the active lengths is essential in order to prevent unwanted skin dose and consequential unfavorable cosmetic results. The purpose of this study was to assess the feasibility and morbidity of a PDR boost with flexible breast implants. Materials and methods: Sixty-five high risk patients were treated with an interstitial PDR boost. The criteria for an interstitial boost were positive margin or close margin, extensive intraductal component (EIC), intralymphatic extension, lobular carcinoma, T2 tumors and high nuclear grade (GIII). Dose calculation and specification were performed following the rules of the Paris system. The dose per pulse was 1 Gy. The pulse pauses were kept constant at 1 h. A geometrically optimized dose distribution was used for all patients. The treatment schedule was 50 Gy external beam to the whole breast and 20 Gy boost. PDR irradiations were carried out with a nominal 37 GBq 192-Ir source. Results: The median follow-up was 30 months (minimum 12 months, maximum 54 months). Sixty percent of the patients judged their cosmetic result as excellent, 27% judged it as good, 11% judged it as fair and 2% judged it as poor. Eighty-six percent of the patients had no radiogenous skin changes in the boost area. In 11% of patients minimal punctiform telangiectasia appeared at single puncture sites. In 3% ((2(65))) of patients planar telangiectasia appeared on the medial side of the implant. The rate of isolated local recurrences was 1.5%. In most cases geometrical volume optimization (GVO) yields improved dose distributions with respect to

  16. A nationwide study of connective tissue disease and other rheumatic conditions among Danish women with long-term cosmetic breast implantation

    DEFF Research Database (Denmark)

    Fryzek, Jon P; Holmich, Lisbet; McLaughlin, Joseph K;

    2007-01-01

    population-based cohort study of Danish women with cosmetic breast implants (n = 2761) and comparison groups of women with other types of cosmetic surgery (n = 8807). All women were followed from January 1977 through December 2001. Hospitalization and outpatient data for CTD and ill-defined and other...... (standardized rate ratio = 1.5; 95% confidence interval = 1.4 to 1.7) cohorts. In analyses of diagnoses validated by chart review, women with cosmetic breast implants compared with those having other types of plastic surgery or consultation for plastic surgery had no statistically significant excess for any...

  17. One stage rescue procedure after capsular contracture of breast implants with autologous fat grafts collected by water assisted liposuction (“BEAULI Method”

    Directory of Open Access Journals (Sweden)

    Ueberreiter, Klaus

    2013-01-01

    Full Text Available With increasing number of patients with silicone implants for breast augmentation or reconstruction we are confronted with more and more cases of capsular contracture. Not every case is resolved by resection of the capsule and exchange of implants. Many patients rather bear the consequences of severe fibrosis than to have their implants removed. The one stage procedure of implant removal and lipofilling proved to be highly efficient with good to excellent results and high patient satisfaction. Between January 2008 and October 2012 a total of 64 patients (124 breasts with capsular fibrosis Baker III to IV were treated with autologous fat grafts collected with the body-jet by water-assisted liposuction (“BEAULI Method”. Magnetic resonance imaging (MRI of the breasts was performed in 5 patients preoperatively and 6 month postoperatively, a clinical examination and photo documentation of all patients was done on day 1 and after 4 weeks, 12 weeks and 6 months postoperatively. The procedure included implant removal and lipofilling of the subcutaneous and intramuscular space in a single procedure by means of the BEAULI Method. The average gross amount of grafted fat was 260 ml. The average drainage time was one day. The shape of the breast changed to a more natural and ptotic form. Negative side effects like oily cysts or infections were not observed. The time of the overall procedure including liposuction was 70±15 min. Reoccurring capsular contracture is one of the hazards in plastic surgery. Until now the treatment of choice after more than two failed implant changes combined with resection of the capsule is usually the final removal of implants with or without possible additional autologous tissue transfer (microvascular flaps. We could add a relatively simple and efficient procedure to resolve and improve those cases by autologous fat transfer using water-assisted liposuction and the BEAULI Method.

  18. Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

    Science.gov (United States)

    Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

    2015-11-01

    In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

  19. Direct delayed breast reconstruction with TAP flap, implant and acellular dermal matrix (TAPIA)

    DEFF Research Database (Denmark)

    Børsen-Koch, Mikkel; Gunnarsson, Gudjon L; Udesen, Ann;

    2015-01-01

    BACKGROUND: The latissimus dorsi (LD) flap is considered one of the working horses within the field of breast reconstruction and it offers several advantages. However, donor-site morbidity may pose a problem. This article describes a new and modified technique for delayed breast reconstruction...

  20. Propionibacterium acnes Augments Antitumor, Anti-Angiogenesis and Immunomodulatory Effects of Melatonin on Breast Cancer Implanted in Mice.

    Science.gov (United States)

    Talib, Wamidh H; Saleh, Suhair

    2015-01-01

    Breast cancer is one of the most invasive cancers with high mortality. The immune stimulating Propionibacterium acnes is a Gram positive bacterium that has the ability to cause inflammation and activate Th1-type cytokine immune response. Antitumor response was associated with the inflammation induced by P. acnes, but the antitumor effect of this bacterium was not evaluated in combination with other agents. The aim of this study was to test the antitumor potential of a combination of melatonin and P. acnes against breast cancer implanted in mice. Balb/C mice were transplanted with EMT6/P cell line and in vivo antitumor effect was assessed for P. acnes, melatonin, and a combination of melatonin and P. acnes. Tumor and organs sections were examined using hematoxylin/eosin staining protocol, and TUNEL colorimetric assay was used to detect apoptosis. The expression of vascular endothelial growth factor (VEGF) was measured in tumor sections and serum levels of INF-γ, and IL-4 were measured to evaluate the immune system function. To evaluate the toxicity of our combination, AST and ALT levels were measured in the serum of treated mice. The combination of melatonin and P. acnes has high efficiency in targeting breast cancer in mice. Forty percent of treated mice were completely cured using this combination and the combination inhibited metastasis of cancer cells to other organs. The combination therapy reduced angiogenesis, exhibited no toxicity, induced apoptosis, and stimulates strong Th1-type cytokine antitumor immune response. The combination of melatonin and P. acnes represents a promising option to treat breast cancer. However, carful preclinical and clinical evaluation is needed before considering this combination for human therapy. PMID:25919398

  1. Propionibacterium acnes Augments Antitumor, Anti-Angiogenesis and Immunomodulatory Effects of Melatonin on Breast Cancer Implanted in Mice.

    Directory of Open Access Journals (Sweden)

    Wamidh H Talib

    Full Text Available Breast cancer is one of the most invasive cancers with high mortality. The immune stimulating Propionibacterium acnes is a Gram positive bacterium that has the ability to cause inflammation and activate Th1-type cytokine immune response. Antitumor response was associated with the inflammation induced by P. acnes, but the antitumor effect of this bacterium was not evaluated in combination with other agents. The aim of this study was to test the antitumor potential of a combination of melatonin and P. acnes against breast cancer implanted in mice. Balb/C mice were transplanted with EMT6/P cell line and in vivo antitumor effect was assessed for P. acnes, melatonin, and a combination of melatonin and P. acnes. Tumor and organs sections were examined using hematoxylin/eosin staining protocol, and TUNEL colorimetric assay was used to detect apoptosis. The expression of vascular endothelial growth factor (VEGF was measured in tumor sections and serum levels of INF-γ, and IL-4 were measured to evaluate the immune system function. To evaluate the toxicity of our combination, AST and ALT levels were measured in the serum of treated mice. The combination of melatonin and P. acnes has high efficiency in targeting breast cancer in mice. Forty percent of treated mice were completely cured using this combination and the combination inhibited metastasis of cancer cells to other organs. The combination therapy reduced angiogenesis, exhibited no toxicity, induced apoptosis, and stimulates strong Th1-type cytokine antitumor immune response. The combination of melatonin and P. acnes represents a promising option to treat breast cancer. However, carful preclinical and clinical evaluation is needed before considering this combination for human therapy.

  2. Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study

    Directory of Open Access Journals (Sweden)

    James J. Drinane, BSci

    2013-10-01

    Conclusions: Triple antibiotic breast irrigation is not associated with a significant reduction in the incidence or severity of capsular contracture compared with sterile saline when high-quality surgical technique is used.

  3. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

    Science.gov (United States)

    Cederna, P S; Yates, W R; Chang, P; Cram, A E; Ricciardelli, E J

    1995-11-01

    Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction. PMID:8579262

  4. 乳腺癌切除即刻乳房再造术中假体的选择%Selection of breast implant during immediate breast reconstruction after mastectomy

    Institute of Scientific and Technical Information of China (English)

    陈戈; 谢春伟; 穆大力; 栾杰

    2014-01-01

    Objective:To demonstrate the selection of breast implant during an immediate breast reconstruction post-mastectomy and analyze the indication of this technique. Methods:From June 2007 to June 2012, a total of 121 patients with breast cancer received immediate breast reconstruction with breast implants. Among the 121 patients, 89 patients had simple mastectomy, while the rest under-went modified radical mastectomy in the Department of Breast Neoplasm, Nanchang No.3 Hospital. The volumes of the resected breast tissues were measured using Archimedes principle. The diameters of the tissues were also determined. Proper breast implants were se-lected according to the measured data. Results: Postoperative complications, such as implant exposure, flap necrosis, and infection, were not found. Follow-up period ranged from 6 months to 12 months. Patients answered a questionnaire that displayed their degree of satisfaction for the breast operation outcome. Results show that 89.3%of the patients (108/121) were very satisfied, 9%were (11/121) satisfied, and 1.7%(2/121) were unsatisfied. Conclusion:Immediate breast reconstruction with breast implant post-mastectomy is an ideal method for rebuilding the breast. This technique is advantageous because it prevents damage to the donor site and retains the maxi-mal elasticity of the skin for breast reconstruction. Accurate parameters of breast implants, which are important to achieve good surgical results, could be obtained using Archimedes principle.%目的:研究乳腺癌切除即刻乳房再造术中选择假体的方法,探讨即刻假体乳房再造的适应证。方法:收集2007年6月至2012年6月南昌市第三医院乳腺肿瘤科的乳腺癌切除术患者121例,其中乳腺癌改良根治术32例、单纯乳腺切除术89例。乳腺切除后根据阿基米德法计算缺失乳房体积,并测量切除组织直径,以切除组织的体积和直径为依据选择乳房假体,并置入胸

  5. Meshed acellular dermal matrix:technique and application in implant based breast reconstruction

    Institute of Scientific and Technical Information of China (English)

    Dino Zammit; Jonathan Kanevsky; Fan-Yi Meng; Tassos Dionisopoulos

    2016-01-01

    Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic surgeons. However, while the overall surgical outcome of breast reconstruction using alloderm has been a success, the economic burden on the health care system makes it a subject of frequent re-evaluations in cost-effectiveness. Prompted by the high price of $3,700 USD for a 6 cm × 16 cm area, our group proposes the meshing of AlloDerm to decrease the total amount needed for breast reconstruction, while achieving comparable surgical outcomes as using unmeshed alloderm.

  6. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Freer, Phoebe [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Lawenda, Brian [21st Century Oncology, Las Vegas, NV (United States); Alm El-Din, Mohamed A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Clinical Oncology, Tanta University Hospital, Tanta (Egypt); Gadd, Michele A.; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence

  7. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall’s tau (τβ) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4–14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome (τβ 0.6, p β 0.5, p β 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias ≥1 cm2. Grade 3–4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose (τβ 0.3–0.5, p ≤ .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence-free survival, and overall survival rate was 85% (95% confidence interval, 70–97%), 72% (95% confidence interval, 54–86%), and 87% (95% confidence

  8. Effects of Zafirlukast on the Capsular Fibrosis of Silicone Breast Implants

    Directory of Open Access Journals (Sweden)

    Emre Hocaoglu

    2014-06-01

    Methods: Forty-eight adult female Sprague-Dawley rats were divided into four groups. Smooth-surfaced, gel-filled prostheses were implanted in 36 rats. Group A: The day of the operation, 12 animals received Zafirlukast treatment for 14 weeks (oral gavage, once a day, 6 days a week, 4 mg/kg/day; Group B: 10 weeks after the operation, 12 animals received Zafirlukast treatment for 4 weeks; Group C: 12 animals were implanted but did not receive treatment; Group D: 12 animals did not have an operation, but for 14 weeks received oral gavage containing water instead of Zafirlukast. At the end of the 14 weeks, the implants with the surrounding capsules were extracted. Blind macroscopic inspectional evaluation of the capsules was performed, and microscopic capsular thickness measurements were made. Results: The mean capsular thickness was 0.033 mm (SD: 0.011 in Group A, and 0.089 mm (SD: 0.023 and 0.125 mm (SD: 0.025 in Groups B and C, respectively. Differences between Groups A and C and between Groups A and B were significant (p0.05. Similarly, Macroscopic Inspectional Fibrosis Scoring showed a significant difference between Groups A and C and a non-significant difference between Groups B and C. Conclusion: Daily prophylactic oral administration of Zafirlukast immediately after implantation significantly diminishes the development of fibrotic capsules around the silicone prostheses. [Arch Clin Exp Surg 2014; 3(3.000: 139-146

  9. Infectious complications in implant based breast surgery and implications for plastic surgeons [Infektiöse Komplikationen bei alloplastischen Brustoperationen und Implikationen für Plastische Chirurgen

    Directory of Open Access Journals (Sweden)

    Horch, Raymund E.

    2013-07-01

    Full Text Available [english] Implantation of breast prosthesis is still one of the most frequently performed breast reconstructing or contouring procedures. Infectious complications and capsular contracture are inherent problems that may have different causes which are not clearly defined yet in terms of pathophysiology. Recent findings showed bacterial contamination as a major cause of implant failure. Since this has direct implications for the surgical management we report on biofilm development on alloplastic breast prostheses, characteristics and effects after implantation of medical devices in general. This article gives a review of the current literature and discusses possible issues to solve the problem of infection after implantation of breast prosthesis. In conclusion the reinsertion of single-use devices should not be recommended and should be strictly avoided when a device related infection has occured. According to current knowledge contaminated implants should be removed, the infection then be cured and if necessary, a new prosthesis may be implanted after a regeneration period. Alternatively a change in therapy towards autologous tissue reconstruction should be considered if previous attempts with alloplastic prostheses have failed and if radiation therapy has worsened the local tissue situation in the recipient area.[german] Implantationen von Brust-Prothesen sind für Brustrekonstruktionen oder Konturierungen noch immer die am häufigsten durchgeführten Verfahren. Typische inhärente Probleme sind dabei neben infektiösen Komplikationen die Kapselkontrakturen, deren unterschiedliche Ursachen bezüglich der Pathophysiologie noch nicht eindeutig geklärt sind.Neuere Erkenntnisse weisen auf bakterielle Kontamination als eine der Hauptursachen von Implantatversagen hin. Da dies direkte Auswirkungen auf die chirurgische Behandlung hat, berichten wir über das Problem der Biofilmentwicklung auf alloplastischen Brustimplantaten sowie über deren Effekte

  10. 高频超声在硅胶乳房植入物检测中的价值%The value of hyperfrequency ultrasound in silicone breast implants

    Institute of Scientific and Technical Information of China (English)

    钟红; 张小曼; 王原路; 程宁新

    2000-01-01

    Objective To determine the value of breast hyperfrequency ultrasonography(US)in the assessment of silicone breast implants.Methods Fourteen implanted breasts of 7 women underwent hyperfrequency US and were surgically removed.Results The ultrasonographic characteristies of an intact implant was showed that shape looks like updown triangle,contour line was straight,there was noice within the implant,the anechoic structure had a band of reverberations anteriorly.The sonographic findings with intracapsular rupture were:the implant shape transformed,echogenic noise,low-level homogeneous echoes,and a contourbulge,horizountl lines.In the extracapsular rupture there were hypoechoic nodules outside the implant.Of 14 implants removed,2 were intact,3 were intraeapsuiar and 9 were extracapsular ruptures.Conclusions Hyperfrequency ultrasonography can detect the silicone breast implants intact,intracapsular and extracapsular rupture.%目的 探讨高频超声在硅胶乳房假体检测中的价值.方法 对7例妇女接受硅胶乳房假体植入术后,硅胶乳房假体破裂的14只乳房采用7.5~10.0 MHz的高频超声检测,均做了植入物清除术,获手术证实.结果 硅胶乳房假体完整的超声图像特征为:假体切面形态呈倒三角形,轮廓线平直,内部呈均匀一致的无回声表现,前壁表现为厚约1 cm的稍强回声带.硅胶乳房假体破裂超声表现为植入物形状改变,囊壁局部膨隆,囊内见细小点状回声及平行带状回声,囊外见无回声或低回声结节.14只硅胶乳房假体中,完整2只,破裂12只(囊内破裂3只,囊外破裂9只).结论 高频超声检查乳房能判断硅胶乳房假体完整或囊内破裂和囊外破裂.

  11. Colocación transpectoral superior de implantes mamarios: Relevancia técnica y anatómica Superior transpectoral insertion of breast implants: Anatomical and technical relevance

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2008-12-01

    Full Text Available Los tres planos de colocación de implantes para aumento mamario tienen particularidades claramente identificables. Cada modificación anatómica y los elementos tisulares acompañantes establecen beneficios y efectos adversos que influyen sobre el resultado final. El presente estudio tiene como objetivo la comunicación temprana de los hallazgos clínicos obtenidos con la creación de una cavidad de implantación en diferentes condiciones, utilizando una combinación de planos y haciendo énfasis en un fundamento anatómico y funcional de gran relevancia. El mejor manejo de los implantes mamarios y de otros biomateriales es el mantenimiento de su integridad y el control de su comportamiento a largo plazo. De manera prospectiva valoramos la colocación de implantes mamarios en una cavidad que es subfascial en la porción caudal de la mama y retropectoral en la porción cefálica. El aislamiento de las rutas linfáticas suprafasciales proporciona un menor riesgo de contaminación del implante. La facilidad técnica se produce al no tener que desinsertar inferior y medialmente el músculo pectoral. En los 15 casos estudiados, no se produjo ningún desplazamiento cefálico de los implantes con la contracción pectoral. Hacemos también una revisión de la sustentación anatómica y funcional del nuevo plano de implantación utilizado. El resultado es una suma de beneficios y la prevención de un frecuente efecto adverso, con lo que cumplimos el objetivo final de reducir la morbilidad e incrementar la seguridad del procedimiento.The particular benefits and adverse effects of the three different planes for breast implant placement are widely known. The search for a safer implantation cavity led to a combination of two dissection planes with different anatomical components placed in continuity. Instead of supporting its value with statistics of good outcomes, emphasis is stressed in the functional and anatomical consequences of the proposed plane of

  12. Selection of the volume and shape of mammary implant in breast augmentation%乳房假体大小与形态的选择

    Institute of Scientific and Technical Information of China (English)

    才杰; 崔鹏; 马海欢

    2012-01-01

    目的 探讨隆乳术中正确选择乳房假体大小与形态的方法.方法 通过502例隆乳术后乳房大小与形态的变化,并参考术前胸部各项测量参数,总结出选择合适的乳房假体大小与形态的方法.结果 术前胸廓的横径即H值是选择乳房假体横径的重要参数,以此推算出的乳房假体横径能满足乳间沟较明显及乳房外侧亦较丰满的要求.胸骨切迹中点S到乳头N的距离SN是选择水滴形乳房假体(解剖型乳房假体)高度的重要参数.假体直径和高度确定后,增大乳房体积主要靠增加假体突度实现.对于胸部扁平、比较消瘦者,水滴形假体是较好的选择.结论 术前胸廓的横径及乳房的大小等参数是选择乳房假体大小与形态的重要指标.圆形假体和水滴形假体具有各自的适应证.%Objective To explore the methodology of choosing the volume and shape of the mammary implant.Methods The changes of the volume and shape were analyzed in 502 cases of breast augmentation,to find out how to select the volume and shape of the mammary implant.Results The thoracic width H was the most important factor of choosing width of the implant; the SN was the important factor of choosing the height of the anatomic implant; After setting the diameter and height of the implant,a bigger breast could be achieved by increasing the projection of implants.For those very thin females with flat chest, anatomic implants were the better choice. Conclusions Thoracic width,breast volume and other data are the most important factors in choosing the mammary implant.Round and anatomic mammary implants have their specific indications.

  13. Breast reconstruction following mastectomy with implants report of 152 cases%乳腺癌术后乳房即刻再造152例报告

    Institute of Scientific and Technical Information of China (English)

    蒋宏传; 李发成; 李杰

    2008-01-01

    目的 探讨乳癌根治术后即时应用单纯假体植入、可调式双囊假体植入和自体组织移植乳房再造术的适应证及疗效.方法 101例在保留皮肤的乳腺癌改良根治术基础上于胸大肌下方植入Mentor假体再造乳房,39例在胸大肌下方植入Becker可调式假体再造乳房,10例用单蒂下腹部横行腹直肌肌皮瓣移植至乳房缺损区再造乳房.2例采用扩大的背阔肌肌皮瓣移植再造乳房.结果 随访152例3~65个月,中位时间28个月,2例13个月后肿瘤局部复发,取出假体.术后乳房外观评价优良率达94%.结论 单纯假体植入适用于乳房较小的患者,可调式假体植入乳房再造适用于乳房较大,或根治术时皮肤缺损较多的患者.%Objective A review of the results obtained from a series of consecutive patients undergoing breast reconstruction following mastectomy with full-size implant, Becker expandable implant, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap and extended latissimus dorsi musculocutanous flap (ELDF) to evaluate the indications, surgical methods and effects. Methods Immediate breast reconstructions were carried out using full-size Mentor implants following skin-sparing mastectomy in 101 patients and Becker expandable implants were used for immediate breast reconstruction in 39 patients. Unilateral pedicled TRAM flaps were used for immediate breast reconstruction in 10 and extended latissimus dorsi musculocutaneous flap (ELDF)was carried out in 2 patients. Results The patients were followed in the past 3~65 months. Tumor was locally recurrent in 2 patients, and the implant was carried out. Minor complications small local skin necrosis of nipple-areola complex and seroma formation. Satisfactory results than 94% of the patients. Conclusions Size implant is ideal for a slender, small-breast women. In patients with large breast or those who received modified mastectomy, expandable implants can be used for immediate

  14. Diagnosis and treatment of breast implant rupture%硅凝胶乳房假体破裂渗漏的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    姜南; 郝媛媛; 申丽; 王月; 徐亚红; 赵艳; 翟宏艳

    2009-01-01

    目的 探讨硅凝胶乳房假体(silieonegel breast implant,SBI)破裂的诊断、治疗和预后.方法 通过临床查体、X线透视、高频彩色多普勒超声仪检查明确诊断;经乳房下皱襞或乳晕切口入路探查并取出硅凝胶(siliconegel,SG)及其硅胶囊与纤维包膜;修整假体腔隙、同期置入SBI.结果 32例单侧(或双侧)同期SBI破裂者再次手术后,乳房形态改观满意,术后除2例发生积液外,其余均Ⅰ期愈合.结论 SBI破裂后,取出SG及其硅胶囊与纤维包膜切除后,充分清理并修整、再造包膜腔隙,同期置入SBI,可以获得满意的治疗结果.%Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.

  15. Implantes mamarios en el plano subfascial en reemplazo del bolsillo subglandular: un cambio lógico Breast implants in the subfascial plane in replacement of the subglandular pocket: a logical change

    Directory of Open Access Journals (Sweden)

    O.D. Ventura

    2006-03-01

    Full Text Available Desde 1999 hemos cambiado el plano subglandular del bolsillo de los implantes mamarios por el plano subfascial (subaponeurótico. Este plano se halla por debajo de la fascia aponeurótica del músculo pectoral mayor, serrato, oblicuo lateral y recto anterior. Este artículo considera 150 casos implantados en este plano (subfascial. Se utilizaron prótesis de superficie texturada. El abordaje fue por una incisión periareolar inferior. En todos los pacientes se consiguió una excelente cobertura del implante, al igual que una forma y movilidad natural. En ningún caso se observó el desagradable ondulado de cuadrantes superiores, conocido como rippling. Cuatro de ellos presentaron procesos capsulares contráctiles grado II de Baker (2,6%. En el postoperatorio inmediato se registró menor edema y una recuperación más rápida de lo habitual, de acuerdo a nuestra experiencia con los otros procedimientos (submuscular y subglandular. Cuando la elección del bolsillo es subglandular, el plano subfascial parecería ser el lugar lógico de la colocación de los implantes mamarios.Since 1999, the subglandular plane of the pocket has been substituted in our practise for the subfascial (subaponeurotic plane in breast implants. This plane lies underneath the aponeurotic fascia of the pectoralis major , the serratus, the lateral oblique and the rectus anterior muscles. This article describes 150 patients with implants in the subaponeurotic plane and textured surface. Patients were approached through an inferior periareolar incision. Excellent coverage of the implant, as well as natural shape and mobility were achieved in all patients. No ondulation (rippling in the upper half of the breast has been observed. Four patients (2,6% had Baker grade II capsular contracture. In the immediate post-op, less edema and faster-than-usual recovery could be seen versus our experience with other (submuscular and subglandular procedures. When a subglandular pocket is the

  16. Photon counting readout pixel array in 0.18-μm CMOS technology for on-line gamma-ray imaging of 103palladium seeds for permanent breast seed implant (PBSI) brachytherapy

    Science.gov (United States)

    Goldan, A. H.; Karim, K. S.; Reznik, A.; Caldwell, C. B.; Rowlands, J. A.

    2008-03-01

    Permanent breast seed implant (PBSI) brachytherapy technique was recently introduced as an alternative to high dose rate (HDR) brachytherapy and involves the permanent implantation of radioactive 103Palladium seeds into the surgical cavity of the breast for cancer treatment. To enable accurate seed implantation, this research introduces a gamma camera based on a hybrid amorphous selenium detector and CMOS readout pixel architecture for real-time imaging of 103Palladium seeds during the PBSI procedure. A prototype chip was designed and fabricated in 0.18-μm n-well CMOS process. We present the experimental results obtained from this integrated photon counting readout pixel.

  17. Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

    International Nuclear Information System (INIS)

    Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. ≥50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

  18. Influencia de las cargas triboeléctricas y de la contaminación sintomática de los implantes Triboelectric charges and breast implant symptomatic contamination

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2007-12-01

    Full Text Available El hallazgo ocasional de energía estática importante en un implante mamario, generó una revisión sistemática de la información disponible al respecto que restableció una secuencia de eventos y conceptos de importancia, a nuestro juicio, en la práctica clínica Los implantes mamarios son elastómeros resultantes de la polimerización industrial que pueden generar cargas electrostáticas en su superficie. El efecto triboeléctrico puede mantener suficiente energía estática como para atraer partículas de material capaces de producir una contaminación periprotésica sintomática. El desconocer esta propiedad física puede llevar a una práctica clínica de riesgo al colocar implantes mamarios. Adicionalmente se revisa la microbiología involucrada en la formación capsular periprotésica sintomática y la infección por bacterias productoras de "biofilm".An incidental finding of static energy upon the surface of a breast implant, generated a systematic search that led to a link between triboelectric charges and symptomatic periprosthetic infection. Breast implants are industrial elastomers that may result with electrostatic charges on its surface. Its propper resistivity allows silicone to maintain enough static that atracts and adheres particulate matter to become surface contamination with periprosthetic tissue reaction. Recognition of this particular physical property and its clinical implications allows for safer conditions of practice. We review microbiology involved in periprosthetic capsular formation and infection by "biofilm" producer bacteria.

  19. Reconstrucción mamaria con expansor tisular e implante: Indicaciones y experiencia en 24 casos Breast reconstruction with tissue expander: Indications and experience in 24 cases

    Directory of Open Access Journals (Sweden)

    C. Gutiérrez Gómez

    2012-12-01

    Full Text Available En la actualidad, la reconstrucción mamaria forma parte integral del tratamiento del cáncer de mama; la selección de la paciente es crítica para obtener resultados satisfactorios. El presente trabajo recoge nuestra experiencia en reconstrucción mamaria con expansión tisular e implantes, haciendo hincapié en la selección de las pacientes candidatas a este método reconstructivo. Revisamos las reconstrucciones mamarias realizadas en un período comprendido entre los años 1998 y 2008 por la misma cirujana, analizando factores como tipo de mastectomía, edad, tiempo de la reconstrucción (inmediata o diferida, causa de la mastectomía, tipo de expansor y prótesis utilizados, complicaciones y satisfacción de las pacientes. En todas excepto en una, la reconstrucción se realizó en dos tiempos operatorios; durante el primero se hizo la colocación del expansor tisular y en el segundo, el cambio por la prótesis mamaria definitiva. Se realizaron un total de 24 reconstrucciones mamarias en 19 pacientes en el período de 10 años revisado, 14 unilaterales y 5 bilaterales. Las complicaciones presentadas en este grupo de pacientes fueron del 16,6 %. El seguimiento de las pacientes fue de 2 a 10 años. Solamente en 1 caso de cuadrantectomía, se realizó la reconstrucción de forma diferida por antecedente de radioterapia (4,1 %. En nuestra opinión, la reconstrucción mamaria con expansor tisular e implante es un procedimiento seguro, reproducible y con bajo índice de complicaciones, sin el inconveniente añadido de ocasionar morbilidad en el a área donante.Nowadays, breast reconstruction is part of breast carcinoma treatment; patient's selection plays an important role in satisfactory results. The present paper reports our experience in breast reconstruction with tissue expander/implant and emphasizes the importance of choosing the candidates for this method of reconstruction. We review the breast reconstructions realized in a 10 year period

  20. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2009-03-15

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p = 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven

  1. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    International Nuclear Information System (INIS)

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven that

  2. 经脐孔缘切口置人充注式生理盐水假体隆乳术%Transumbilical breast augmentation with insertion of saline-filled breast implants

    Institute of Scientific and Technical Information of China (English)

    余力; 王健; 张波; 朱昌

    2008-01-01

    目的 探讨经脐孔缘切口行充注式生理盐水假体隆乳术的手术方法,为隆乳术提供新切口选择.方法 沿脐孔缘切口,采用特制专用器械分离皮下隧道至乳房下皱襞,然后穿进胸大肌后间隙,分离假体放置空间,先置人扩张器,充注生理盐水后,调整乳房形态以及扩张器位置.然后取出扩张器,更换为充注式生理盐水乳房假体而完成手术.结果 采用经脐孔缘切口行充注式生理盐水假体隆乳术者,均获得了良好的手术效果,无感染、血肿、假体渗水、Baker Ⅲ或Ⅳ级纤维囊挛缩等并发症发生.结论 采用生理盐水充注式乳房假体,经脐孔缘切口可以完成胸大肌下隆乳术,增加了隆乳手术切口的选择范围.%Objective To evaluate the surgical technique and procedures of transumbilieal breast augmentation with an inverse U-shape incision and insertion of saline-filled breast implants. Methods With specialized instruments, the subcutaneous tunnel was undermined to the inframammary crease after inverse U incision made along the umbilical border. The subpectoral space was dissected with a dissector after the advancement of obturator across the inframammary crease. The expander was inserted into the subpectoral pocket to be filled to obtain the high degree of symmetry of the breasts. Finally, the previous-ly prepared implants were inserted after the expander deflated and removed. Results All patients gained satisfactory results with no complications, such as hematoma, infection, implant deflation and Baker Ⅲ or Ⅳ capsular contracture. Conclusions Breast augmentation could be performed through umbilical inci-sion with the usage of saline-filled breast implant. This is an alternative of incisions in breast augmenta-tion.

  3. 600 cases feedback of implants breast by silica gel%600余例硅凝胶假体隆乳术的体会

    Institute of Scientific and Technical Information of China (English)

    蒋未台; 蒋铮铮; 蒋伯熙; 潘印

    2013-01-01

    Objective based on 600 cases feedback of implants breast by silica gel, to find a better solution for the surgery. Methods ①Choose a soft and loose breast silica gel. ②Cutting a line under mammary areola 2.5~3cm, and leave enough lacuna from ectopectoralis, implant silica gel breast after stop blood, refill suitable anaesthetic, anticatarrhals.anastaltic.etc. ③Important massage within 2 days after surgery.and positive longer massage 3 months after surgery. Results 2 breasts symmetrical,plump,soft.no effect to suckle. Capsular contracture rate is less than 1%, and satisfaction is more than 98%. Conclusion following conditions are needed to have an ideal implant breast: good breast silica gel, professional doctor.and professional massage.%目的:总结600余例硅凝胶假体隆乳术的临床经验,探讨硅凝胶假体隆乳术的最佳方案.方法:①选择外囊宽松、手感柔软、大小合适的硅凝胶乳房假体;②乳晕下缘2.5 ~ 3cm切口,胸大肌下分离足够大小的腔隙,充分止血后置入假体,腔内置入适量麻醉液、消炎药、止血药等;③术后早期(2天)、到位、持久(3个月以上)的按摩.结果:术后两乳对称、丰满、手感与形态逼真,不影响哺乳.纤维包膜挛缩发生率<1%,医患满意度>98%.结论:要隆出一对手感与形态逼真的乳房的条件是:①好的乳房假体(主要指的是形状、手感、大小合适);②医生的临床经验;③术后早期、到位、持久的按摩;此三点缺一不可.

  4. Early breast cancer: influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy

    International Nuclear Information System (INIS)

    Between December 1981 and December 1988, 329 consecutive patients with stage I and II breast cancers who underwent wide excision (n = 261) or quadrantectomy (n = 68) with (n = 303) or without (n = 26) axillary dissection were referred to radiotherapy. Final margins of resection were microscopically free from tumor involvement in all cases. Radiotherapy consisted in 40-45 Gy over 4-4.5 weeks to the breast, with (n = 168) or without (n = 161) regional nodal irradiation of 45-50 Gy over 4.5-5 weeks. A mean booster dose of 15 Gy was delivered to the primary site by iridium-192 implant in 169 patients (group 1) or by electrons in 160 patients (group 2). Twenty-seven percent (n = 88) of patients received tamoxifen for ≥ 2 years. Adjuvant chemotherapy was administered in 22% (n = 71) of patients. Groups 1 and 2 were not strictly comparable. Group 1 patients were significantly younger, had smaller tumors, were treated with cobalt at 5 x 2 Gy per week and axillary dissection was more frequently performed. Group 2 patients were more frequently bifocal and more frequently treated by quadrantectomy and tamoxifen, and irradiation used accelerator photons at 4 x 2.50 Gy per week. No difference in terms of follow-up and survival rates was observed between the two groups. For all patients the 5- and 10-year local breast relapse rates were 6.7% and 11%, respectively. No difference was observed regarding local control either by the electron or the iridium-192 implant boosts. Axillary dissection and age had an impact on the breast cosmetic outcome. Furthermore, the cosmetic results seemed to be poorer in group 1 than in group 2. This may be related to other factors; group 1 patients were treated with telecobalt and axillary dissection was more frequently performed; on the other hand, group 2 patients were treated with accelarator photons

  5. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  6. 聚丙烯酰胺水凝胶隆乳取出后同期假体置入%Instant implantation of breast after removal of polyacrylamide hydrogel for breast augmentation

    Institute of Scientific and Technical Information of China (English)

    张本寿; 徐志明; 李增男; 解潮; 徐志久; 赵读泽; 赵耀忠

    2014-01-01

    Objective To investigate the clinical indication and effect of instant reconstruction of breast after removal of polyacrylamide hydrogel injection for breast augmentation.Methods Patients had breast ultrasound,MRI check before operation,to define the distribution and level of the injections and tissue infiltration.Depending on tissue degree,capsule integrity and breast degeneration situation,three different methods were chosen,including implantation of silicone gel underneath the breast,pectoralis major or dual-plane.Results 56 patients' incision healed well.Follow-up for 6 months to 3 years showed that breast shapes were good without scars,prosthetic herniapsular,capsular contracture and other complications.Conclusions Instant reconstruction of the breast after removal of polyacrylamide hydrogel injection can improve breast shape and get satisfied effects.%目的 探讨聚丙烯酰胺水凝胶(polyacrylamide hydrogel,PAHG)注射隆乳取出术后,同期行假体置入的临床适应证与疗效.方法 对PAHG注射隆乳后发生并发症者,术前做乳腺超声、磁共振成像(MRI)检查,明确注射物分布层次和组织浸润情况,经乳晕切口行注射物及病变组织彻底清除后,根据组织浸润程度、包膜完整性、胸肌和乳腺变性情况,分别选择乳腺后、胸大肌后、双平面3种方式,同期行硅凝胶假体置入术.结果 56例切口均愈合良好,乳房对称、挺拔.术后随访6个月至3年,乳房外形良好,无瘢痕和假体疝出,无纤维包膜挛缩等并发症发生.结论 依据PAHG取出后乳房畸形特点,同期假体置入重塑乳房形态,既可改善乳房外观,又可缓解心理障碍,效果满意.

  7. Fine needle aspiration cytology in the diagnosis of complications after breast implant surgery%隆胸术后并发症的针吸细胞学诊断

    Institute of Scientific and Technical Information of China (English)

    龚萍; 佟刚强

    2012-01-01

    Objective To explore the traits of fine needle aspiration cytology (FNAC), differential diagnosis for complications after breast implant surgery and its significance for clinical diagnosis. Methods The clinical data of 10 patients undergoing breast implant diagnosed by FNAC were analyzed and summarized, in terms of clinical manifestation and FNAC trait. Results Of the ten patients, seven received polyacrylamide (PAM) as breast implants, in which one was diagnosed as breast cancer one year after surgery. Three patients had autologous fat as breast implants, and revealed differential morphological traits. Conclusion FNAC is not only efficient and scar-slight in the diagnosis of complications of breast implants, but also simple and accurate. It can be important basis for clinicians to choose the reasonable treatment solution.%目的 探讨隆胸术后并发症的针吸细胞学特点、鉴别诊断及其在临床诊断中的意义.方法 收集我院经针吸细胞学检查诊断10例病例,对其临床表现及针吸细胞学特点进行分析、总结.结果 凝胶聚丙烯酰胺水凝胶假体植入者7例,其中有1例于凝胶假体植入术后一年针吸为乳腺癌;3例为自体脂肪注入,均有较特异的形态学特点.结论 针吸细胞学诊断隆胸术后并发症快速、损伤小、操作简便并且准确率高,可以为临床医生选择合理治疗方案提供重要依据.

  8. Irradiation with external beam and interstitial radioactive implant as primary treatment for early carcinoma of the breast

    International Nuclear Information System (INIS)

    The locoregional control of 60 to 61 patients supports the results published by other centers and compares favorably with results of any surgical series. The cosmetic results are excellent with only three of 61 patients having severe fibrosis of the breast develop. No rib fractures, skin ulcerations, symptomatic radiation pneumonitis, edema of the arm or limitation of arm movement have been observed as complications. Ten of the 28 patients who have had axillary dissection had transient edema of the breast develop. Results of numerous studies suggest that primary radiotherapy without mastectomy is appropriate treatment for early carcinoma of the breast. The accessibility of the breast makes it relatively easy to deliver curative doses of radiation with minimal damage to surrounding normal tissues. The cumulative radiotherapy experience has demonstrated the gratifying results of not only maintaining a rather normal breast but also avoiding the negative physical and psychologic repercussions of the mastectomy. Radiation therapy is an alternative to Halsted's radical mastectomy

  9. Risks of Breast Implants

    Science.gov (United States)

    ... Chest Wall Deformity Chest wall or underlying rib cage appears deformed. Deflation Leakage of the saltwater (saline) ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products

  10. CONTRALATERAL PROPHYLACTIC MASTECTOMY AND SIMULTANEOUS BREAST RECONSTRUCTION WITH IMPLANTS AFTER ONE SIDED BREAST CANCER: ANALYSIS OF 12 CASES IN CONTEXT OF THE CURRENT TRENDS

    Directory of Open Access Journals (Sweden)

    Roman Romansky

    2016-08-01

    Full Text Available The contemporary tendency for increase of prophylactic surgical procedures as part of the sophisticated treatment of breast cancer is the foundation for the present study. Evaluation of risk factors for developing contralateral breast cancer, factors for an increase in prophylactic mastectomies and indications for performing those operations are briefly commented. Analysis of 12 cases of the authors surgical practice is presented regarding treatment approach from the oncological, reconstructive and aesthetic point of view. Results, complications, alternative methods, clinical importance and possible future aspects are discussed.

  11. 背阔肌皮瓣联合假体即刻乳房重建术的应用%Immediate breast reconstruction using the latissimus dorsi flap combined with implants for breast cancer

    Institute of Scientific and Technical Information of China (English)

    钱琦; 朱玉兰; 朱春富

    2013-01-01

    Objective To introduce the clinical experience of immediate breast reconstruction with the latissimus dorsi flap combined with implants following mastectomy in patients with breast cancer.Methods Twenty-six patients with early breast cancer in our department who underwent immediate breast reconstruction with the latissimus domi flap combined with implants following mastectomy were included in the study.The operative technical details,postoperative complications and patient satisfaction were analyzed retrospectively.Results Donor site seroma occurred in 6 patients(23.1%),which disappeared after repeated aspiration and pressure dressing.Capsular contracture occurred in 1 patient (3.85 %),which was improved by reoperation.There was no flap necrosis and no wound infection.Follow-up period ranged from 3 to 44 months (average 32.3 ± 7.02).Cosmetic outcome was judged excellent and good in 84.6 %.Conclusion In selected patients with breast cancer,the latissimus dorsi flap combined with implants is a reliable method with less complication and good operation effect for immediate breast reconstruction.%目的 总结背阔肌皮瓣联合假体即刻乳房重建术的临床经验.方法 回顾性分析26例早期乳腺癌患者接受改良根治同期背阔肌皮瓣转移联合假体乳房重建术的临床资料,总结手术技巧、术后主要并发症,评价术后满意度.结果 手术后背部伤口血清肿6例(占23.1%),均经穿刺抽液及加压包扎后治愈;假体包膜挛缩1例(占3.85%),再次行包膜松解术后好转;无皮瓣坏死,无伤口感染.随访3~44个月,平均(32.3±7.02)个月.全部病例无局部复发及远处转移,无上肢活动明显受限及上肢水肿或功能障碍.再造乳房按美学评分:优秀13例,良好11例,尚可2例,差0例.患者满意率84.6%.结论 对于选择性的早期乳腺癌患者,背阔肌皮瓣联合假体即刻乳房重建术是一种并发症少、手术效果良好的乳房重建方法.

  12. The evaluation of anti-angiogenic treatment effects for implanted rabbit VX2 breast tumors using functional multi-slice spiral computed tomography (f-MSCT)

    Energy Technology Data Exchange (ETDEWEB)

    Lei Zhen, E-mail: leizhen2004@163.com [Department of Anatomy, Chinese Medical University, No. 92, Beiermalu Road, Heping District, Shenyang, 110001 (China) and Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Ma Heji, E-mail: maheji9831@sina.com [Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Xu Na, E-mail: xuna821230@sohu.com [Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Xi Huanjiu, E-mail: xihuanjiu2004@yahoo.cn [Anthropology Institute, Liaoning Medical College, No. 40, Sanduan, Songpo Rd, Jinzhou, 121001 (China)

    2011-05-15

    Objective: Investigate the benefit of functional multi-slice spiral computed tomography (f-MSCT) perfusion imaging in the non-invasive assessment of targeted anti-angiogenesis therapy on an implanted rabbit VX2 breast tumor model. Method: 69 female pure New Zealand white rabbits were randomly assigned to one of the 4 groups and received treatment accordingly: control (saline), Endostar, neoadjuvant chemotherapy (Cyclophosphamide, Epirubicin and 5-Fluorouracil, CEF), combination therapy (Endostar and CEF). After 2 weeks of treatment, f-MSCT perfusion scannings were performed for all rabbits and information about blood flow (BF), blood volume (BV), mean transit time (MTT) and surface permeability (SP) was collected. After perfusion imaging, tumor tissues were sampled for immunohistochemistry and the Western blot test of VEGF protein expression. Results: (1) The VEGF expression level, measured by immunohistochemistry and Western blot, decreased by treatment group (control > Endostar > CEF > combination therapy). The same was true for the mean BF, BV, MTT and PS, which decreased from the control group to the combination therapy group gradually. The mean MTT level increased in reverse order from the control to the combination therapy group. The difference between any 2 groups on these measures was statistically significant (P < 0.05). (2) There was moderate positive correlation between VEGF expression and BE, BV, or PS level (P < 0.05) and a negative correlation between VEGF expression and MTT level for all 4 groups (P < 0.05). Conclusion: Therefore, f-MSCT can be used as a non-invasive approach to evaluate the effect of anti-angiogenic therapy for implanted rabbit VX2 breast tumors.

  13. Gossypiboma after Breast Augmentation

    OpenAIRE

    Kira Lundin; Allen, Julie E.; Lene Birk-Soerensen

    2013-01-01

    A 39-year-old woman was referred for removal of cosmetic breast implants and related siliconoma. After an exchange of breast implants at a private clinic a year previously, she had asymmetry of the right breast, persistent pain, and a generally unacceptable cosmetic result. An MRI had shown a well-defined area with spots of silicone-like material at the upper pole of the right breast. Surgical removal of presumed silicone-imbibed breast tissue was undertaken, and surprisingly a gossypiboma wa...

  14. 缓释氟尿嘧啶乳腺癌术中植入的临床应用%Intraoperative implant of sustained release fluorouracil for breast carcinoma

    Institute of Scientific and Technical Information of China (English)

    余树青

    2013-01-01

    Objective To investigate the clinical curative effect of intraoperative implant of sustained release fluorouracil for breast carcinoma.Methods The clinical data of 60 cases of breast carcinomas were aralyzed,the patients were divided into observation group and control group according to different treatment methods.Results The WBC,PLT,Cr,ALT,nausea and vomiting,incision infection and axillary effusion had no difference between the two groups (P > 0.05).The local recurrence rate,distant metastasis rate and survival rate in observation group were better than those in control group,the differences were significant (P < 0.05).Conclusions The clinical curative effect of intraoperative implant of sustained release fluorouracil for breast carcinoma is good and has good prognosis,which is worthy to be popularized.%目的 探讨乳腺癌术中植入缓释氟尿嘧啶的临床疗效.方法 分析连平县人民医院收治的60例乳腺癌患者的临床资料,根据治疗方式不同分为观察组30例和对照组30例.结果 两组乳腺癌患者红细胞、白细胞、血肌酐、丙氨酸氨基转移酶、恶心呕吐、切口感染、腋窝积液情况比较差异无统计学意义(P>0.05);观察组局部复发率、远处转移率及生存率优于对照组,差异有统计学意义(P<0.05).结论 乳腺癌术中植入缓释氟尿嘧啶临床疗效显著,预后良好,值得临床推广应用.

  15. Avaliação da biocompatibilidade de implantes mamários de silicone esterilizados por calor seco e pelo óxido de etileno Biocompatibility assessment of silicone gel breast implants sterilized by dry-heat and by ethylene oxide

    Directory of Open Access Journals (Sweden)

    Janice Campos de Azevedo

    2006-06-01

    Full Text Available Os implantes mamários de silicone têm sido empregados, tanto nas cirurgias de aumento de mama, quanto na reconstrução do tecido mamário. A segurança biológica deste tipo de implante deve ser garantida, pois, em função da esterilização estes materiais, podem sofrer alterações oriundas dos processos esterilizantes por comprometimento da estrutura química dos polímeros. O objetivo deste trabalho consistiu na avaliação da biocompatibilidade de implantes mamários preenchidos com gel de silicone, de superfície lisa e texturizada submetidos à esterilização por calor seco e óxido de etileno. Empregou-se, para tanto, método in vitro, avaliando a citotoxicidade pelo método de captura do vermelho neutro, utilizando a linhagem celular NCTC clone 929. Os resultados obtidos demonstraram não haver comprometimento da biocompatibilidade dos biomateriais submetidos aos dois processos (calor seco e óxido de etileno, assim como comprovaram a eficácia de ambos na esterilização dos implantes.Silicone breast implants have been widely used for mammary augmentation and reconstruction surgery. Biological safety of these implants can be altered by sterilization methods. This study consisted of the biocompatibility assessment of smooth and textured silicone gel breast implants sterilized by dry-heat and ethylene oxide through cell viability, employing neutral red uptake method. The NCTC clone 929 cell were employed and the results showed no cytotoxicity of implants after both sterilization processes.

  16. 经乳晕切口应用解剖型假体行筋膜后隆乳治疗轻度乳房下垂%Correction of minor breast ptosis by subfascia breast augmentation with periareolar incision and anatomic mammary implant

    Institute of Scientific and Technical Information of China (English)

    才杰; 陈波; 周洋; 马海欢

    2014-01-01

    Objective To correct the minor breast ptosis with minimal breast scar.Methods 32 cases with minor breast ptosis were corrected by subfascia breast augmentation with periareolar incision and anatomic mammary implant.Result Breast ptosis was completely or mostly corrected in all the patitents with periareola scar,avoiding the vertical breast scar.Except for short-time effusion in 2 cases,no other complication happened.Conclusions Subfascia breast augmentation with periareolar incision and anatomic mammary implant can effectively correct minor breast ptosis with minimal breast scar and less complication.%目的 探讨可以使术后乳房表面瘢痕最小化的矫正轻度乳房下垂的手术方法.方法 对32例轻度乳房下垂患者经乳晕切口行筋膜后隆乳术,全部使用解剖型乳房假体.结果 32例患者术后乳房下垂均得到完全或大部分矫正,仅留有与普通隆乳术相同的乳晕切口瘢痕,无乳房表面垂直切口瘢痕.除2例出现术后短期积液外,无其他并发症发生.结论 经乳晕切口应用解剖型假体行筋膜后隆乳术,可有效纠正轻度乳房下垂,并使乳房表面瘢痕最小化,且术后并发症较少.

  17. Capsular contracture in augmentation mammaplasty with smooth versus textured breast implants: a Meta analysis%毛面乳房假体和光面乳房假体隆乳术后包膜挛缩率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    李诗言; 林樾; 王卉丽; 谭谦

    2014-01-01

    Objective To analyze the incidence of capsular contracture in breast augmentation with smooth versus textured breast implants using a Meta method.Methods Terms such as "breast augmentation"," capsular contracture"," smooth implant"," textured implant"," breast implant" were searched in databases such as MEDLINE,EMBASE,Cochrane Library,CBM and VIP.Documents about breast augmentation with textured and smooth implants were totally collected,and the data of these trials were extracted to obtain a pooled odds ratio of capsular contracture and other complications.Meta analyses were performed by RevMan 5.2 software to estimate the combined effect values.Results Eleven clinical controlled trials were included.The results of meta analysis showed that textured implants group and smooth implant group presented the risk of capsular contracture combined OR=0.32 (95% CI,0.18 to 0.58,P=0.0002),and also presented the risk of other complications combined OR=1.31 (95% CI,0.96 to 1.77,P=0.09).Conclusions Compared with smooth implants,textured implants reduce the risk of capsular contracture after breast augmentation.%目的 利用Meta分析方法定量比较光面乳房假体和毛面乳房假体隆乳术后的包膜挛缩发生率.方法 以breast augmentation、capsular contracture、smooth implant、textured implant、隆乳、乳房假体等检索词在MEDLINE数据库、EMBASE数据库、Cochrane图书馆、中国生物医学文献数据库、维普生物数据库等检索,最大限度地收集毛面乳房假体和光面乳房假体隆乳的文献,提取其包膜挛缩和其他并发症的数据进行整合,以获得比值比(odds ratio,OR)合并值.各合并数据使用RevMan 5.2软件进行分析.结果 对11项研究毛面乳房假体和光面乳房假体的临床对照试验进行Meta分析后得出,包膜挛缩发生率的合并OR值为0.32,95%可信区间(CI)为0.18~0.58,P=0.0002.除包膜挛缩外,其他并发症发生率的合并OR值为1.31,95% CI为0.96~1

  18. A Comparative Study of CG CryoDerm and AlloDerm in Direct-to-Implant Immediate Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Jun Ho Lee

    2013-07-01

    Full Text Available Background  To date, various types of acellular dermal matrix (ADM have been developedfor clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breastreconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM thatrequires no drying process. Therefore,theoretically, it has a higher degree of preservation ofthedermalstructuresthan AlloDerm. We conducted thisstudy to compare the clinical course andpostoperative outcomes of patientswho underwent direct-to-implant breastreconstructionsusing AlloDermand thosewho did using CGCryoDerm.Methods  We performed a retrospective analysis ofthemedicalrecordsin a consecutive seriesof 50 patientswho underwent direct-to-implant breastreconstruction usingAlloDerm(n= 31or CryoDerm (n= 19. We then compared the clinical course and postoperative outcomes ofthe two groups based on the overall incidence of complications

  19. Preliminary simulation of implants breast through the accelerated partial irradiation technique: coverage rates and homogeneity; Simulacion previa de implates de mama mediante la tecnica de irradiacion parcial acelerada: indices de cubrimiento y homegeneidad

    Energy Technology Data Exchange (ETDEWEB)

    Moral Sanchez, S. C.; Paula Carranza, B. de; Erzibengoa, M.; Bragado Alvarez, L.; Guisasola Berasetegui, A.

    2013-07-01

    In this work we present and evaluate the process of pre-simulation we have drawn up when it comes to treatments of accelerated partial irradiation of breast. Previous simulation that we will allow you to have greater control over the location of catheters with respect to the area to radiate. The goodness of this procedure is evaluated through representative quality indexes of the implant. (Author)

  20. Comparison of effects between MRI imaging and Archimedes method for measurement of breast volume on immediate implant breast reconstruction%磁共振成像与阿基米德法测量乳房体积在即刻假体乳房再造中的效果比较

    Institute of Scientific and Technical Information of China (English)

    牛兆河; 徐凤磊; 王海波

    2015-01-01

    Objective To conduct the comparative study of the measurement of breast volume by MRI imaging and Archimedes method in immediate implant breast reconstruction.Methods A total of 44 patients who were diagnosed as breast cancer and undergone immediate implant breast reconstruction were selected from March 2011 to March 2013.22 cases were guided to select suitable breast implants by measuring the breast volume and correlative radial line based on MRI imaging.Control group containing 22 cases were guided to select breast implants by traditional Archimedes method and clinical experience.3 breast surgeons and plastic surgeons who did not participate in the operation were selected to judge the postoperative breast shape.Data of two groups were analyzed by using chisquare test.Results All the patients recovered smoothly after operation without infection,and the wound healed well.The breast shape was evaluated.21 cases (95.5 %) were good in test group and 1 case (4.5%) was poor;16 cases (72.7%) were good in control group and 6 cases (27.3) were poor.The comparison between the test group and control group had statistical significance (P<0.05).Conclusions The method to measure the breast volume and correlative radial line based on MRI imaging has important values for selecting breast implants in immediate implant breast reconstruction.It could be extensively used in clinical practice.%目的 探讨磁共振成像(MRI)与阿基米德法测量乳房体积在即刻假体乳房再造中的临床效果.方法 选择青岛大学附属医院乳腺中心2011年3月至2013年3月行即刻假体乳房再造的乳腺癌患者44例.其中试验组22例,采用基于MRI的乳房体积及相关径线测量方法,指导选择合适的乳房假体;对照组22例,采用传统的阿基米德法及临床经验来选择乳房假体.选择3名未参与手术的乳腺外科及整形外科医师对两组患者术后乳房形态进行评价.结果 44例患者术后恢复均顺利,无1例并

  1. SU-E-J-215: Towards MR-Only Image Guided Identification of Calcifications and Brachytherapy Seeds: Application to Prostate and Breast LDR Implant Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Elzibak, A; Fatemi-Ardekani, A; Soliman, A; Mashouf, S; Safigholi, H; Ravi, A; Morton, G; Song, WY [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Han, D [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: To identify and analyze the appearance of calcifications and brachytherapy seeds on magnitude and phase MRI images and to investigate whether they can be distinguished from each other on corrected phase images for application to prostate and breast low dose rate (LDR) implant dosimetry. Methods: An agar-based gel phantom containing two LDR brachytherapy seeds (Advantage Pd-103, IsoAid, 0.8mm diameter, 4.5mm length) and two spherical calcifications (large: 7mm diameter and small: 4mm diameter) was constructed and imaged on a 3T Philips MR scanner using a 16-channel head coil and a susceptibility weighted imaging (SWI) sequence (2mm slices, 320mm FOV, TR/ TE= 26.5/5.3ms, 15 degree flip angle). The phase images were unwrapped and corrected using a 32×32, 2D Hanning high pass filter to remove background phase noise. Appearance of the seeds and calcifications was assessed visually and quantitatively using Osirix (http://www.osirix-viewer.com/). Results: As expected, calcifications and brachytherapy seeds appeared dark (hypointense) relative to the surrounding gel on the magnitude MRI images. The diameter of each seed without the surrounding artifact was measured to be 0.1 cm on the magnitude image, while diameters of 0.79 and 0.37 cm were measured for the larger and smaller calcifications, respectively. On the corrected phase images, the brachytherapy seeds and the calcifications appeared bright (hyperintense). The diameter of the seeds was larger on the phase images (0.17 cm) likely due to the dipole effect. Conclusion: MRI has the best soft tissue contrast for accurate organ delineation leading to most accurate implant dosimetry. This work demonstrated that phase images can potentially be useful in identifying brachytherapy seeds and calcifications in the prostate and breast due to their bright appearance, which helps in their visualization and quantification for accurate dosimetry using MR-only. Future work includes optimizing phase filters to best identify

  2. Effects of soy isoflavone extracts on the growth of estrogen-dependent human breast cancer (MCF-7) tumors implanted in ovariectomized nude mice

    Institute of Scientific and Technical Information of China (English)

    WU Qian; JIN NianZu; YU Jing; ZHAO RenChen; YU ZePing; QIAO ShanLei; LU XiaoHe; ZHANG ChunWen

    2009-01-01

    In this study,we explored the effects of soy isoflavone extracts on the growth of estrogen-dependent human breast cancer (MCF-7) tumors implanted in ovariectomized athymic mice.The ovariectomized athymic mice were implanted with MCF-7 cells.They were fed with low,moderate and high doses of soy isoflavone extracts,at dietary concentrations of 6.25,12.5 and 25 g/kg,respectively.The expression of ki-67 was detected by immunohistochemistry.The pS2 expression in tumors was analyzed by real-time PCR.Estrogen level in the serum was measured by chemiluminescence enzyme immunoassay.Com-pared with the control group,dietary soy isoflavone extracts had a significant stimulatory effect on MCF-7 tumor growth in mice (P 0.05).The ki-67 and pS2 mRNA expressions in tumors were signifi-cantly increased by 6.25 and 12.5 g/kg dose of soy isoflavone extracts (P 0.05).And,estrogen level in serum of 6.25 and 12.5 g/kg dose groups was higher than that of control group (P 0.05).In conclusion,in the tested dietary concentration range soy isoflavone extracts had a stimulatory effect on tumor growth.6.25 and 12.5 g/kg doses of soy isoflavone extracts can increase the cell proliferation in tumors and induce estrogen-responsive pS2 expression.

  3. Multi-catheter interstitial brachytherapy for partial breast irradiation: an audit of implant quality based on dosimetric evaluation comparing intra-operative versus post-operative placement

    Science.gov (United States)

    Gurram, Lavanya; Joshi, Kishor; Phurailatpam, Reena; Paul, Siji; Sarin, Rajiv

    2016-01-01

    Purpose The use of multicatheter interstitial brachytherapy (MIB) for accelerated partial breast irradiation (APBI) in early breast cancer (EBC) patients outside the trial setting has increased. Hence, there is a need to critically evaluate implant quality. Moreover, there is a scarcity of reports using an open cavity technique. We report the dosimetric indices of open and closed cavity MIB techniques. Material and methods The dosimetric parameters of 60 EBC patients treated with MIB (open and closed cavity) who underwent three dimensional, computerized tomography (CT) based planning for APBI from November 2011 to July 2015 were evaluated. Coverage Index (CI), Dose Homogeneity Index (DHI), Conformity Index (COIN), Plan Quality Index (PQI), and Dose Non-uniformity Index (DNR) were assessed. Results Forty-one patients underwent open cavity and 19 patients underwent closed cavity placement of brachytherapy catheters. The median number of planes was 4 and median number of needles was 20. Median dose was 34 Gy with dose per fraction of 3.4 Gy, given twice a day, 6 hours apart. The D90 of the cavity and clinical target volume (CTV) were 105% and 89%, respectively. The median doses to the surgical clips were greater than 100%. The median CI of the cavity and CTV was 0.96 and 0.82, respectively. The DHI and COIN index of the CTV was 0.73 and 0.67. There were no significant differences in the dosimetric parameters based on whether the technique was done open or closed. Conclusions Critical evaluation of the dosimetric parameters of MIB-APBI is important for optimal results. While the open and closed techniques have similar dosimetry, our institutional preference is for an open technique which eases the procedure due to direct visualization of the tumor cavity. PMID:27257415

  4. Evaluation of an implantable MOSFET dosimeter designed for use with hypofractionated external beam treatments and its applications for breast and prostate treatments

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, Gloria P.; Kry, Stephen F.; Espenhahn, Eric; Rini, Chris; Boyles, Elyse; Mann, Greg [Medical Physics Services, LLC., Tampa, Florida 33606 and Sicel Technologies, Inc., Morrisville, North Carolina 27560 (United States); Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Sicel Technologies, Inc., Morrisville, North Carolina 27560 (United States)

    2011-08-15

    Purpose: An implantable metal-oxide semiconductor field effect transistors-based dosimeter has recently been developed for the in vivo monitoring of hypofractionated radiotherapy. This DVS-HFT dosimeter is designed for fraction sizes of 340-950 cGy and can also be used for bis in die fraction monitoring. The current work reports on the testing and evaluation of this dosimeter, including both its basic characteristics as well as its performance during simulated clinical treatment plans. Methods: The authors tested the dose rate dependence of this dosimeter (300 MU/min versus 600 MU/min), the treatment time dependence (4 min per treatment versus up to 60 min per treatment), and the dose and energy dependence (6 and 18 MV irradiations of 700-900 cGy per fraction). Additionally, they irradiated the detectors in-phantom with breast and prostate hypofractionated treatments. Results: The detectors showed no significant dose rate, treatment time, energy, or dose dependence. Furthermore, the detectors were found to perform within manufacturer tolerances for all hypofractionated treatments examined, accurately reporting the measured dose (average disagreement of - 0.65%). Conclusions: These dosimeters appear well suited for in vivo monitoring of hypofractionated radiotherapy doses, and thereby, have the potential to improve patient care.

  5. Combined treatment with areola approach for capsular contracture after breast augmentation with implants%经乳晕切口综合处理假体隆乳术后包膜挛缩

    Institute of Scientific and Technical Information of China (English)

    罗盛康; 陈光平; 汪海滨; 孙中生; 徐翔; 伍艳群

    2012-01-01

    目的 探讨经乳晕切口采用多种方法综合处理假体隆乳术后包膜挛缩的效果.方法 2005年2月至2011年6月,对94例168侧假体隆乳术后包膜挛缩进行治疗并置入假体,其挛缩程度均为Baker分类法Ⅲ、Ⅳ级.94例均采用乳晕切口,根据原假体置入腔隙及乳腺、胸大肌厚度等条件,采取重新剥离腔隙、去除或不去除包膜组织,甚至二期手术,于胸大肌或乳腺后间隙置入假体等方法综合处理,术中严格止血.结果 术后94例中46例获得门诊随访,其余病例均获得电话随访,时间6 ~37个月,平均9.9个月,术后包膜挛缩复发Ⅲ级者2例、Ⅳ级者1例,其余病例乳房外观均丰满、挺拔,柔软度较好,电话随访病例均对乳房塑形效果满意.本组病例均无血肿、感染、乳房假体破裂、乳房下垂及上移等并发症发生.结论 应用乳晕切口对假体隆乳术后包膜挛缩进行综合而有效地处理,术后包膜挛缩复发率较低,可以获得较满意的乳房塑形效果.%Objective To investigate the combined treatment with areola approach for capsular contracture after breast augmentation with implants.Methods From Feb.2005 to Jun.2011,94 cases ( 168 sides) with Baker Ⅲ and Ⅳ capsular contracture after breast augmentation with implants were treated with areola approach.The implants cavity was recreated,with or without removal of capsule.The implants were reimplanted behind pectoralis major or breast at the second stage in some patients.Results 46 cases were followed up by clinic visit and the others were followed up by telephone for 6-37 months,with an average of 9.9 months.The capsular contracture was relapsed in 2 cases as Baker Ⅲ and 1 case as Baker Ⅳ.All the other breasts got a good appearance with good soft texture and feeling.No hematoma,infection,implants rupture,breast ptosis or implant displacement happened.Conclusions Combined treatment with areola approach has a good therapeutic effect for

  6. 背阔肌肌皮瓣联合假体在乳腺癌术后二期乳房再造中的应用%Application of Latissimus Dorsi Myocutaneous Flap with Breast Implant in Delayed Breast Reconstruction after Mastectomy

    Institute of Scientific and Technical Information of China (English)

    郑厚兵; 单秀英; 陈祥锦; 张惠灏; 朱有志; 王美水; 王彪

    2015-01-01

    目的:探讨背阔肌肌皮瓣联合假体植入在乳腺癌术后二期乳房再造术中的临床应用。方法2009年至2013年,共8例乳腺癌术后年轻患者接受二期乳房再造手术。术前以排水法测定健侧乳房体积,根据患者健侧乳房形状、大小及背部组织情况,设计胸背部供区皮瓣,术中测量移植皮瓣的容积,然后根据健侧乳房和移植皮瓣的容积差,选择大小合适的乳房假体,将假体埋植于背阔肌-胸大肌后间隙,利用背阔肌肌皮瓣移植联合乳房硅胶假体进行二期乳房再造。结果本组患者术后随访6个月至4年,再造乳房外形较佳,效果满意,供区无明显并发症。结论对于年轻有生育要求的乳腺癌术后乳房缺失患者,健侧乳房较大,利用背阔肌肌皮瓣联合假体进行乳房再造,可取得良好的手术效果。%Objective To explore the application of latissimus dorsi myocutneous flap and breast implant in delayed breast reconstruction surgery after mastectomy. Methods From 2009 to 2013, 8 cases received delayed breast reconstruction operation after mastectomy. The breast volumetry measurement technique was used to determine the mass of the breast preoperatively, then the donor flap was designed at the chest-back region according to the condition of the dorsal skin and the shape of the contralateral breast. The mass of graft flap was measured intraoperatively, then the suitable implant was selected based on the difference between the volume of the contralateral breast and the graft flap. The breast implant was then placed in the interspace between the latissimus dorsi muscle and the pectoralis major muscle to reconstruct the breast (secondary phase). Results All patients were followed up for 6 months to 4 years. The overall appearance of the constructed breast were satisfactory, no significant complications were observed in the donor region. Conclusion For young patients of breast cancer with

  7. A case of synchronous multiple bilateral breast cancer after breast augmentation

    OpenAIRE

    Yamamoto, Shinya; Chishima, Takashi; Harada, Fumi; Matsubara, Yuka

    2015-01-01

    Breast cancer after breast augmentation is not rare, but cases of bilateral breast cancer after augmentation are not often reported. A 43-year-old woman attended our hospital because of a mass in her left breast. She had undergone breast augmentation by implants 4 years before at a cosmetic surgery clinic. There were operative scars in her bilateral axilla. A detailed examination revealed bilateral breast cancer, and we performed nipple-sparing mastectomy in both breasts. Sentinel lymph node ...

  8. Accelerated partial-breast irradiation with interstitial implants. The clinical relevance of the calculation of skin doses

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2007-08-15

    Purpose: To describe relative skin dose estimations and their impact on cosmetic outcome in interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 105 consecutive patients with early breast cancer were recruited in Erlangen, Germany, for this substudy of the German-Austrian APBI phase II trial. 51% (54/105) received pulsed-dose-rate (PDR), and 49% (51/105) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy every hour. Total treatment time was 3-4 days. With a wire cross on the skin surface during the brachytherapy-planning procedure the minimal, mean and maximal relative skin doses (SD{sub min%}, SD{sub max%}, SD{sub mean%}) were recorded. Endpoint of this evaluation was the cosmetic outcome in relation to the relative skin doses. Results: Median follow-up time was 38 months (range, 19-65 months). Cosmetic results for all patients were excellent in 57% (60/105), good in 36% (38/105), and fair in 7% (7/105). The SD{sub min%} (27.0% vs. 31.7%; p = 0.032), SD{sub mean%} (34.2% vs. 38.1%; p = 0.008), and SD{sub max%} (38.2% vs. 46.4%; p = 0.003) were significantly lower for patients with excellent cosmetic outcome compared to patients with a suboptimal outcome. SD{sub mean%} (37.6% vs. 34.2%; p = 0.026) and SD{sub max%} (45.4% vs. 38.2%; p = 0.008) were significantly higher for patients with good cosmetic outcome compared with the patients with excellent results. Conclusion: The appraisal of skin doses has been shown to be relevant to the achievement of excellent cosmetic outcome. Further investigations are necessary, especially on the basis of CT-based brachytherapy planning, to further improve the treatment results of multicatheter APBI. (orig.)

  9. Breast reconstruction: State of the arts

    International Nuclear Information System (INIS)

    Radical mastectomy is still required in many cases, such as inflammatory breast cancer, multicentric breast cancer, large tumour volume and small breast size. In this setting, immediate breast reconstruction is more and more offered for breast cancer patients. But such plastic surgery is still debated, owing to risks of implant complications when postoperative radiotherapy of chest wall is mandatory in locoregional breast cancer management. Here, the review is focused on different type of immediate breast reconstruction and on risk of implants complications with or without postoperative radiotherapy. (authors)

  10. The effect of latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer%早期乳腺癌术后背阔肌肌瓣联合即刻假体植入乳房重建的疗效

    Institute of Scientific and Technical Information of China (English)

    王昌亮

    2015-01-01

    Objective:To explore the feasibility,therapeutic effect,safety and postoperative cosmetic effect of latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer.Methods:20 patients with early breast cancer from April 2013 to August 2013 were treated with breast cancer modified radical mastectomy and the latissimus dorsi muscle flap transfer combined with immediate silicone prosthesis implanted between pectoris major and minor for breast reconstruction.Results:20 patients received adjuvant chemotherapy and there was no local recurrence or distant metastasis during the follow-up period,and the patients were satisfied with the appearance and texture of the reconstructive breast.16 cases(80%) was optimal,3 cases(15%) was good,1 case(5%) was common in postoperative cosmetic effect evaluation. Conclusion:Latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer had short time,simple operation,good effect and patient satisfaction,which was safe and reliable operation and worthy of popularizing.%目的:探讨早期乳腺癌行改良根治术后,取背阔肌部分肌瓣转移联合硅胶假体一期植入即时乳房重建的可行性、治疗效果、安全性和术后美容效果。方法:2013年4月-2013年8月收治早期乳腺癌患者20例,均行乳腺癌改良根治术,带状背阔肌肌瓣转移联合硅胶假体植入胸大、小肌之间行乳房再造。结果:20例患者均接受辅助化疗,随访期间均未发现局部复发或远处转移,再造乳房外形、质地满意。术后美容效果评价优16例(80%),良3例(15%),一般1例(5%)。结论:早期乳腺癌术后背阔肌肌瓣联合即刻假体植入乳房重建时间短、操作简便、效果良好,患者满意,是安全可靠值得推广的手术方法。

  11. Preparation and in vitro characterization of poly (epsilon-caprolactone-based tamoxifen citrate-loaded cylindrical subdermal implant for breast cancer

    Directory of Open Access Journals (Sweden)

    Hiremath Jagadeesh

    2011-01-01

    Full Text Available In the present study cylindrical poly(epsilon-caprolactone (PCL-based biodegradable polymeric tamoxifen citrate-loaded subdermal implants were prepared by laboratory-based modified melt extrusion technique. The prepared implants were evaluated for their physicochemical parameters. Drug content in implants by high-performance liquid chromatographic (HPLC method, differential scanning calorimetry (DSC, X-ray diffraction (XRD and scanning electron microscope (SEM studies of tamoxifen citrate-loaded implants. Determination of in vitro hydrolytic degradation of polymeric and tamoxifen citrate-loaded implants and in vitro drug release was carried out by using indigenously developed dissolution apparatus. DSC and XRD studies proved that the drug is entrapped in the implant. The highest rate of hydrolytic degradation (weight loss was observed in blank implants when compared to tamoxifen citrate-loaded implants. The studies proved that the developed method have potential in terms of industrial feasibility.

  12. Improvement of registration accuracy in accelerated partial breast irradiation using the point-based rigid-body registration algorithm for patients with implanted fiducial markers

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Minoru; Yoshimura, Michio, E-mail: myossy@kuhp.kyoto-u.ac.jp; Sato, Sayaka; Nakamura, Mitsuhiro; Yamada, Masahiro; Hirata, Kimiko; Ogura, Masakazu; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto 606-8507 (Japan); Sasaki, Makoto; Fujimoto, Takahiro [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507 (Japan)

    2015-04-15

    Purpose: To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations. Methods: Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods. Results: In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration. Conclusions: For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

  13. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  14. Breast reconstruction after mastectomy

    Directory of Open Access Journals (Sweden)

    Daniel eSchmauss

    2016-01-01

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  15. 假体隆乳术后严重包膜挛缩处理结合假体置入%Breast Prosthesis Implantation Combining with Correction for Capsular Contracture after Augmentation Mammoplasty

    Institute of Scientific and Technical Information of China (English)

    陈光平; 罗盛康

    2015-01-01

    Objective To explore the correction for serious capsular contracture after augmentation mammoplasty and the indication of breast prosthesis implantation. Methods From June 2006 to March 2014, 45 cases with serious capsular contracture after breast augmentation (Bilateral, level Ⅳ of Baker classification method) were treated and received breast prosthesis implantation at the same period or at stage Ⅱ. Via breast areola approach, the capsular tissue was kept or removed based on the circumstances, retro-mammary space or posterior pectoralis major space was stripped for prosthesis placing. Results Among all the cases, 38 cases received breast prosthesis at stage I, other 7 cases proceeded the second period of breast prosthesis 6 months later. Postoperative incisions were healed by first intension. Thirty-nine cases were followed up for 6-58 months (mean 13.5 months) successfully and the follow-up rate was 87.9%. Level Ⅳ of capsular contracture was still observed in 7 cases 4 months after the surgery, then the breast prosthesis was removed with no implantation again. The breast shape of remaining cases was good with soft handfeel. Conclusion For serious breast capsular contracture after augmentation mammoplasty, effective processing of the envelope with prosthesis imbedding according to the situation could obtain a better postoperative breast appearance and feel.%目的:探讨假体隆乳术后严重包膜挛缩的处理方法及乳房假体置入的适应征。方法2006年6月至2014年3月,对45例假体隆乳术后严重包膜挛缩(双侧乳房均为Baker分类法Ⅳ级)进行治疗,并进行同期或二期乳房假体置入。手术均采用乳晕切口入路,并根据情况保留或去除包膜组织,在乳腺后间隙或胸大肌后间隙置入假体。结果38例患者均一期置入乳房假体,7例于术后6个月行二期乳房假体置入。术后切口均一期愈合,39例获门诊随访,随访率86.7%,随访时间6~58

  16. Clinical effects of breast implant on congenital mammary dysplasia with mild pigeon chest deformity%先天乳腺不发育伴轻度鸡胸行隆乳术治疗的临床效果评价

    Institute of Scientific and Technical Information of China (English)

    许柯; 刘飞; 郭正东; 林海波; 杨卫国; 洪浩; 梁智

    2010-01-01

    Objective To evaluate the clinical effect of breast implant on congenital mammary dysplasia with mild pigeon chest deformity. Methods From January 2003 to July 2009,10 cases of female mammary dysplasia (between 20 to 31 years of age) underwent breast implant surgery. Subpectoral placement and transaxillary incision were selected. The surgeon marked the range of the operation on the skin, made a 3-4 cm incision in the armpit, separated the tissue until the pectoral lateral margin, cut the pecto-ralis fascia and bluntly created a suitable pocket under the pectoralis major for the implant. After the implant was placed in the pocket, the incision was closed. Results Ten cases of breast implant surgery did not pose the complications of local skin necrosis, infection, implant shift, heart and lungs dysfunction after one year follow-up. The appearance of anterior chest wall deformity was markedly improved. Conclusions The application of breast implant surgery in the treatment of congenital mammary dysplasia with mild pigeon chest deformity should be promoted, because of the double surgical effect of easy performing, minimal surgical damage, perfect breast shape and concealed deformity.%目的 评价隆乳术治疗先天乳腺不发育、乳腺发育不良及胸大肌发育不良伴轻度鸡胸畸形临床效果.方法 对10例先天乳腺不发育、乳腺发育不良及胸大肌发育不良伴轻度鸡胸的女性行隆乳术.先在体表标出剥离范围及畸形部位,经双腋窝切口,直达皮下组织,向内分离至胸大肌外侧缘,于胸大肌后间隙,置入硅凝胶乳房假体.结果 10例于隆乳术后,随访1年,均未见发生局部感染、假体移位、心肺功能异常等并发症,前胸壁鸡胸畸形外观有明显改善.结论 应用隆乳术治疗先天性乳腺不发育、乳腺发育不良及胸大肌发育不良并伴有轻度鸡胸,操作方便、手术损伤小、效果满意.既美化乳房外观又掩饰了鸡胸畸形,具有双重手术效果,值得推广.

  17. 乳腺癌术中植入氟尿嘧啶植入剂的安全性研究%The safety of the clinical application of fluorouracil implants hi patients with breast cancer

    Institute of Scientific and Technical Information of China (English)

    覃怀成; 孔勇; 钟先荣; 汪祖来; 陈希纲

    2011-01-01

    目的:探索进展期乳腺癌术中手术部位植入氟尿嘧啶植入剂化疗的安全性,寻找预防乳腺癌局部复发的新途径.方法:63例Ⅱ期乳腺癌患者随机分为术中植入氟尿嘧啶植入剂组(实验组)和对照组,实验组在胸大肌及腋窝植入氟尿嘧啶植入剂.观察植药后白细胞及丙氨酸氨基转移酶(ALT)、胆红素和肌酐变化.切口引流液的量.皮下积液,局部溃疡及有无淋巴漏等.结果:实验组与对照组的白细胞及ALT、胆红素和肌酐变化,皮下积液,局部溃疡及有无淋巴漏的发生率以及切口引流量差异无显著性;两组术后第l天血白细胞计数、ALT、胆红素和肌酐较治疗前有明显升高(P0.05).结论:乳腺癌术中植入氟尿嘧啶植入剂安全可靠.是术后局部区域性化疗的有效途径.%Objective To investigate the safety of local chemotherapy with fluorouracil implants in patients with breast cancer who were receiving modified radical mastectomy.Methods Sixty-three patients with breast cancer who were to receive modified radical mastectomy were divided into fluoromacil group and control group.Patients in control group received routine therapy, and patients in fluorouracil group received fluorouracil implants implanted in major pectoral muscle and axillary fossa.The counting of leucocyte, bilirubin, ALT, Cr, the drainage of the incision, the incidence of subcutaneous fluid, local ulceration were observed.Results There were no significant differences in the counting of leucocyte, bilirubin, ALT, Cr, the drainage of the incision, the incidence of subcutaneous fluid, and local ulceration between the two groups (P > 0.05), but there existed significant changes after the surgery in the two groups (P < 0.05).Conclusion The application of fluorouracil implants in patients with breast cancer is safe, effective, and convenient, and might become a new promising method to prevent postoperative local recurrence of breast cancer.

  18. Augmentation Mammaplasty Using Implants: A Review

    Directory of Open Access Journals (Sweden)

    Susumu Takayanagi

    2012-09-01

    Full Text Available One of the techniques for augmentation mammaplasty is the procedure using implants. Eventhough this technique has been used for many years, there are still several controversial issuesto be discussed and overcome for patient safety. In this review article, capsular contracture,leak or rupture of the implants, possible systemic disease, relation with breast cancer, andrecent problems with Poly Implant Prothese implants are described and discussed.

  19. Breast reconstruction with silicone implants and acellular dermal matrix in women with Poland syndrome%硅胶假体及脱细胞真皮辅助女性Poland综合征患者的乳房再造

    Institute of Scientific and Technical Information of China (English)

    张琼阁; 王喜梅; 郭丽丽; 万程; 董海江

    2014-01-01

    BACKGROUND:Women with Poland syndrome are often accompanied by breast dysplasia and even agenesis, absence of breast and breast deformity. For such patients, we can implement different operations according to the degree of deformity, for remodeling the breast and improving chest shape. OBJECTIVE:To explore the clinical effects of breast reconstruction with silicone implants and acellular dermal matrix in Poland patients with breast deformity. METHODS:A retrospective analysis of six female cases of Poland syndrome was conducted, including four patients with unilateral (bilateral) breast agenesis, hypoplasia of the ipsilateral (bilateral) pectoralis major muscle, less tissue volume than the healthy side who were subjected to implantation of silicone breast prostheses, and two patients with unilateral breast agenesis, agenesis of the pectoralis major muscle and ribs, poor and adhered chest wal soft tissue who were subjected to implantation of silicone breast prosthesis and acellular dermal matrix combined with latissimus dorsi myocutaneous flap. RESULTS AND CONCLUSION:Six patients at day 4 after operation presented with edema, among whom, one appeared to have wound exudate. But al the six patients were healed. Then, the patients were fol owed up for 1-12 months. Outline of breast prosthesis could be touched in three cases, and one case presented with moderate hardness of the breast. However, there were no breast nodules and pain, no scar hyperplasia of the breast. Breast was uniform in appearance, with no wrinkle. These findings confirm that the silicone breast prosthesis with acellular dermal matrix is easy to operate, can reduce intraoperative injury, decrease the difficulty of the operation and al eviate the suffering of patients, which can obtain better clinical effects in the strict grasp of indications.%背景:女性Poland综合征患者同时伴有乳房发育不全甚至不发育,乳房缺失及乳房畸形等,可根据畸形程度实施背阔肌肌瓣

  20. Gossypiboma after Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Kira Lundin

    2013-01-01

    Full Text Available A 39-year-old woman was referred for removal of cosmetic breast implants and related siliconoma. After an exchange of breast implants at a private clinic a year previously, she had asymmetry of the right breast, persistent pain, and a generally unacceptable cosmetic result. An MRI had shown a well-defined area with spots of silicone-like material at the upper pole of the right breast. Surgical removal of presumed silicone-imbibed breast tissue was undertaken, and surprisingly a gossypiboma was found in its place, which had not been identified on the MRI. Gossypiboma is the condition of an accidentally retained surgical sponge. This complication is also known as a textiloma, gauzoma, or muslinoma and is well described in other surgical specialties. However, it is extremely rare after plastic surgery, and this case illustrates the need for continued attention to the surgical count of sponges and instruments.

  1. Breast Imaging after Breast Augmentation with Autologous Tissues

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Kyu Won; Seo, Bo Kyung; Shim, Eddeum; Song, Sung Eun; Cho, Kyu Ran [Dept. of Radiology, Korea University Anam Hospital, Seoul (Korea, Republic of); Yoon, Eul Sik [Korea University Ansan Hospital, Ansan (Korea, Republic of); Woo, Ok Hee [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2012-06-15

    The use of autologous tissue transfer for breast augmentation is an alternative to using foreign implant materials. The benefits of this method are the removal of unwanted fat from other body parts, no risk of implant rupture, and the same feel as real breast tissue. However, sometimes there is a dilemma about whether or not to biopsy for calcifications or masses detected after the procedure is completed. The purpose of this study is to illustrate the procedures of breast augmentation with autologous tissues, the imaging features of various complications, and the role of imaging in the diagnosis and management of complications and hidden breast diseases.

  2. Symmetrization Management in Breast Reconstruction with Implant after Tissue Expansion%组织扩张后行假体乳房再造的对称性处理

    Institute of Scientific and Technical Information of China (English)

    李比; 夏有辰; 张洁; 潘柏林; 马建勋

    2015-01-01

    Objective To explore different techniques for bilateral symmetry in breast reconstruction with implant after tissue expansion. Methods From June 2006 to June 2014, 48 patients received breast reconstruction with implant after tissue expansion. The following symmetrization procedures were used during breast reconstruction. (1) Expander was chosen according to controlateral size and was placed 2 to 3 cm lower than controlateral IMF and then over-expand. (2) The implant was chosen according to the expander, the sizer or the data from 3D photography. (3) Ipsolateral fat transfer, latissimus dorsi muscle flap transplantation, NAC transposition, and contralateral breast reduction, mastopexy, augmentation were used for symmetrization. Results All the patients were followed up for 6 to 48 months, mean 11.9 months. Bilateral symmetry were achieved through these procedures and all patients were satisfied with the results. Conclusion Accurate measurement of the breast, the appropriate choice of the expander and implant, and symmetrization procedures of both side are necessary for better symmetry in breast reconstruction.%目的:探讨组织扩张后使用假体进行乳房再造过程中,可使两侧乳房对称的方法。方法2006年6月至2014年6月,对48例患者行组织扩张后假体乳房再造,在再造过程中采用对称性处理,方法包括:①选择直径与健侧乳房基底直径相近的扩张器,对称位置埋置,下极位置低于对称下皱襞2~3 cm,超量注水扩张;②依据扩张器注水容积,模拟假体容量及健侧乳房的三维摄像数据选择大小、形态适合的假体;③采用包括患侧的自体颗粒脂肪注射移植、背阔肌肌瓣移植、乳头乳晕移位,健侧乳房缩小、假体置入增大、上提固定等对称性修整手术。结果本组患者术后随访6~48个月,平均11.9个月。术后双侧乳房均达到基本对称,患者对再造效果满意。结论对乳

  3. Application of CD-4 theory in determining the width of implant in breast augmentation%CD-4理论在隆乳术中确定乳房假体宽度中的应用

    Institute of Scientific and Technical Information of China (English)

    才杰; 周洋; 孙诚

    2016-01-01

    目的 探讨CD-4理论在隆乳术中确定乳房假体宽度的应用价值.方法 对630例经腋窝切口或乳晕切口行双平面Ⅰ型或Ⅱ型隆乳的患者,成功应用CD-4理论来确定乳房假体的宽度(W).曲线距离(CD)为经乳房下皱襞水平测得的从胸骨中线到腋前线的水平曲线距离.W=CD-4.0 cm或3.5 cm.结果 630例的圆形或水滴形乳房假体的W为10.5~12.5 cm不等,CD为14.5~17.0 cm不等.78.09%的隆乳患者获得了术后1个月到6年的随访,除了5例发生单侧包膜挛缩外,其余隆乳者对新乳房的形态大小都感满意.新乳房内侧的乳房间距为1~2.5 cm,乳房外侧缘均在腋前线区域.结论 在行双平面Ⅰ型或Ⅱ型隆乳术中乳房假体W=CD-4.0 cm,而对于非常消瘦的隆乳者应改为W=CD-3.5 cm.%Objective To introduce a new method ("CD-4"theory) to determine the width (W) of the implant and to explain the reasons why to do so in details.Methods From January 2006 to August 2015,the authors have found and applied "CD-4" theory to determine the width (W) of breast implant in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 630 patients."CD" was defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold (IMF).W =CD-4.0 cm or 3.5 cm.Results The 630 patients were treated by using both round and anatomic implants with width from 10.5 cm to 12.5 cm.Their CDs were from 14.5 cm to 17 cm.78% of the patients were followed up from 1 month to 5 years.Except for 5 patients were unilateral capsular contractions,all the other patients were satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras were between 1-2.5 cm and lateral borders of breast were on the area of the anterior axillary line (AAL).Conclusions Width of the implant is equal to CD-4.0 cm

  4. Rab25基因对乳腺癌裸鼠移植瘤生长的影响%Effects of Rab25 gene on the growth of implanted tumor of breast cancer in nude mice

    Institute of Scientific and Technical Information of China (English)

    张小彬; 陆云飞; 沈桂鑫; 吴非

    2014-01-01

    目的:建立一系列Rab25表达水平不同的乳腺癌细胞裸鼠移植瘤模型,观察不同水平Rab25表达对乳腺癌裸鼠移植瘤的影响。方法:通过分别上调及沉默Rab25基因在乳腺癌细胞中的表达,建立Rab25表达水平不同的乳腺癌细胞的裸鼠移植瘤模型,测量肿瘤体积,绘制肿瘤生长曲线,检测肿瘤组织中Rab25表达差异。结果:Rab25转染组较干扰组、原株细胞组及空质粒组对裸鼠细胞致瘤能力明显增强。转染组裸鼠瘤体中Rab25 mRNA表达明显增强,而干扰组瘤体Rab25 mRNA表达明显减弱。结论:Rab25为促癌基因,其高表达可直接增强乳腺癌细胞的增殖侵袭能力,而RNA干扰技术有可能为乳腺癌的肿瘤靶向和基因治疗提供新的思路。%Objective To establish nude mice models with implanted tumor of breast cancer cells with different expressing levels of Rab25 gene , and to observe the effects of Rab25 gene on the growth of implanted tumor. Methods Nude mice models with implanted tumor of breast cancer cells with different expressing levels of Rab25 gene were constructed through up-regulating or silencing the expression of Rab25 gene in breast cancer cells. The size of implanted tumor was measured, the growth curve of tumor was portrayed, and the expression of Rab25 gene in tumor tissues was detected. Results The tumorigenic effect on nude mice was the strongest and the highest in Rab25 up-regulating group , as compared to those in Rab25 interference group , original cells group, and Rab25 empty plasmid group. The expression of Rab25 mRNA in interference group was significantly reduced. Conclusions Rab25 is a cancer-promoting gene , its high expression could directly enhance the proliferation of breast cancer cells. RNA interference technology had the potential to provide new ideas for tumor targeting and gene therapy for breast cancer.

  5. Experimental model of capsular contracture in silicone implants

    Directory of Open Access Journals (Sweden)

    Bastos Érika Malheiros

    2003-01-01

    Full Text Available The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.

  6. 保留乳头乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的临床分析%Clinical analysis of breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer

    Institute of Scientific and Technical Information of China (English)

    崔世恩; 凌飞海; 黄志华; 马士辉; 郑书楷; 李晓薇

    2014-01-01

    Objective To investigate clinical efficacy of breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer. Methods 16 patients with breast cancer were selected as observation group, who received treatment in our hospital from December 2011 to October 2013. Breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer was taken to treat the cases. 16 patients with breast cancer treated in the same period was selected as control group, who taked traditional modified radical mastectomy without breast reconstruction. Survival, recurrence, morbidity and quality of life of both groups were compared by follow-up. And cosmetic effect of observation group was also investigated. Results The surgery of both groups were all successful,without serious complications. The survival rate of observation group was 100%, and there were no local recurrence and distant metastasis. Compared with the control group, recurrence and survival rate had no significant difference(P > 0.05). Quality of life scores of observation group was (77.2±4.3)points,and the indicator was significantly better than the control group(P<0.05).Cosmetic effect of observation group was 93.75%. Conclusion Breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer has a good clinical efficacy. Patients affirm its safety and cosmetic effect, so it is worthy of promotion.%目的:探讨保留乳头、乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的临床效果。方法选择2011年12月~2013年10月我院16例乳腺癌患者作为观察组,该组病例采取保留乳头、乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的方案治疗,选择同期收治的16例乳腺癌患者作对照,该组病例

  7. Simvastatin Reduces Capsular Fibrosis around Silicone Implants.

    Science.gov (United States)

    Chung, Kyu Jin; Park, Ki Rin; Lee, Jun Ho; Kim, Tae Gon; Kim, Yong-Ha

    2016-08-01

    Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 μm in the simvastatin group and 491.2 μm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction. PMID:27478339

  8. Practical Use of the Extended No Action Level (eNAL) Correction Protocol for Breast Cancer Patients With Implanted Surgical Clips

    International Nuclear Information System (INIS)

    Purpose: To describe the practical use of the extended No Action Level (eNAL) setup correction protocol for breast cancer patients with surgical clips and evaluate its impact on the setup accuracy of both tumor bed and whole breast during simultaneously integrated boost treatments. Methods and Materials: For 80 patients, two orthogonal planar kilovoltage images and one megavoltage image (for the mediolateral beam) were acquired per fraction throughout the radiotherapy course. For setup correction, the eNAL protocol was applied, based on registration of surgical clips in the lumpectomy cavity. Differences with respect to application of a No Action Level (NAL) protocol or no protocol were quantified for tumor bed and whole breast. The correlation between clip migration during the fractionated treatment and either the method of surgery or the time elapsed from last surgery was investigated. Results: The distance of the clips to their center of mass (COM), averaged over all clips and patients, was reduced by 0.9 ± 1.2 mm (mean ± 1 SD). Clip migration was similar between the group of patients starting treatment within 100 days after surgery (median, 53 days) and the group starting afterward (median, 163 days) (p = 0.20). Clip migration after conventional breast surgery (closing the breast superficially) or after lumpectomy with partial breast reconstructive techniques (sutured cavity). was not significantly different either (p = 0.22). Application of eNAL on clips resulted in residual systematic errors for the clips’ COM of less than 1 mm in each direction, whereas the setup of the breast was within about 2 mm of accuracy. Conclusions: Surgical clips can be safely used for high-accuracy position verification and correction. Given compensation for time trends in the clips’ COM throughout the treatment course, eNAL resulted in better setup accuracies for both tumor bed and whole breast than NAL.

  9. Bilateral Poly Implant Prothèse Implant Rupture: An Uncommon Presentation

    Directory of Open Access Journals (Sweden)

    Peter Mallon

    2013-07-01

    Full Text Available Summary: A woman in her 50s underwent delayed bilateral Poly Implant Prothèse implant reconstruction following mastectomy for breast cancer. Symptoms of implant rupture developed 43 months after surgery with an erythematous rash on her trunk. The rash then spread to her reconstructed breast mounds. Initial ultrasound scan and magnetic resonance imaging were normal; however, subsequent magnetic resonance imaging demonstrated left implant rupture only. In theater, following removal of both implants, both were found to be ruptured. The rash on her trunk resolved within 3 weeks in the postoperative period. Chemical analyses of silicone in both implants confirmed a nonauthorized silicone source; in addition, the chemical structure was significantly different between the left and right implant, perhaps explaining the variation in presentation.

  10. Immediate breast reconstruction with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy for young patients with early breast cancer%双侧乳腺切除加假体植入一期乳房重建治疗青年早期乳腺癌患者

    Institute of Scientific and Technical Information of China (English)

    唐欣; 张艳君; 李捷; 郑一琼; 刘蕾; 高影; 李席如

    2012-01-01

    目的 探讨保留皮肤和乳头乳晕复合体的双侧乳腺切除及假体植入一期乳房重建在青年早期乳腺癌治疗中的临床应用.方法 回顾性分析2006年1月至2011年3月接受保留皮肤及乳头乳晕复合体双侧乳腺切除加假体植入一期乳房重建术的21例青年早期乳腺癌患者临床资料.结果 21例患者手术成功,术后美容效果优良.随访12~72个月(中位随访期为34个月),无局部复发和远处转移.结论 对青年早期乳腺癌患者,在切除患乳同时预防性切除对侧乳房,即行保留皮肤和乳头乳晕复合体的双侧乳腺切除加一期假体植入重建乳房,美容效果好,临床疗效满意.%Objective To evaluate the application of immediate breast reconstruction (1BR) with silicon prosthetic implants following bilateral nipple preserving subcutaneous mastectomy in treatment of young patients with early breast cancer. Methods We retrospectively analyzed the clinical data of 21 patients with breast cancer who underwent IBR with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy from January 2006 to March 2011. Results The operations were successful and excellent cosmetic results were obtained in all cases. No local recurrence or remote metastasis was found during the follow-up of 12-72 months (median 34 months). Conclusion For the young patients with breast cancer, the mastectomy on the affected side together with prophylactic excision of the contralateral side, i. e. IBR with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy can obtain satisfactory cosmetic and clinical results.

  11. Influencia de las cargas triboeléctricas y de la contaminación sintomática de los implantes Triboelectric charges and breast implant symptomatic contamination

    OpenAIRE

    G. Peña Cabús

    2007-01-01

    El hallazgo ocasional de energía estática importante en un implante mamario, generó una revisión sistemática de la información disponible al respecto que restableció una secuencia de eventos y conceptos de importancia, a nuestro juicio, en la práctica clínica Los implantes mamarios son elastómeros resultantes de la polimerización industrial que pueden generar cargas electrostáticas en su superficie. El efecto triboeléctrico puede mantener suficiente energía estática como para atraer partícula...

  12. Carmustine Implant

    Science.gov (United States)

    Carmustine implant is used along with surgery and sometimes radiation therapy to treat malignant glioma (a certain type of ... Carmustine implant comes as a small wafer that is placed in the brain by a doctor during surgery to ...

  13. Goserelin Implant

    Science.gov (United States)

    Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is ... treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin- ...

  14. The comparison of modified Lejour method and the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis%改良Lejour法与传统双环法联合假体矫正乳房下垂方法比较

    Institute of Scientific and Technical Information of China (English)

    吴振; 贺洁; 周蔚; 付莹莹; 徐岩; 王大勇

    2015-01-01

    目的:对乳房提升术改良Lejour法的效果予以评价,并与传统双环法联合假体矫正乳房下垂的效果进行比较.方法:对1例乳房下垂患者,先用传统双环法联合假体进行矫正,效果改善不明显而瘢痕明显,术后半年采用改良Lejour法,重塑乳房外观.结果:术后随访3个月,采用改良Lejour法后切口瘢痕不明显,满意度高.结论:本例乳房松弛明显,就本例而言,采用改良Lejour法比传统双环法联合假体矫正乳房下垂效果要好,术后乳房形态好、瘢痕轻.%Objective To evaluate the effect of modified Lejour method for breast lift,and to compare with the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis. Methods The patient had received treatment with the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis six months ago, the effects are not ideal and the scar of incision are obvious.Now we reshaped the breast appearance by modified Lejour method. Results The patient was followed up for 3 months,we found that the scar were not obvious,and the patient was high satisfied. Conclusion In this case,the patient with severe mastoptosis received better effects by modified Lejour method compared with the traditional double-ring periareolar incisions joint breast implants technique,the appearance of breast are ideal and there are less scar.

  15. A rare case of silicone mammary implant infection by Streptomyces spp. in a patient with breast reconstruction after mastectomy: taxonomic characterization using molecular techniques

    DEFF Research Database (Denmark)

    Manteca, Angel; Pelaez, Ana Isabel; del Mar Garcia-Suarez, Maria;

    2009-01-01

    A Streptomyces sp. isolated from a patient who had had breast reconstruction after a mastectomy was identified at the species level by comparative sequence analysis of 16S ribosomal DNA (rDNA) and the hypervariable alpha-region of the 16S rDNA....

  16. Sci—Fri PM: Topics — 02: Evaluation of Dosimetric Variations in Partial Breast Seed Implant (PBSI) due to Patient Arm Position (Up vs. Down)

    Energy Technology Data Exchange (ETDEWEB)

    Watt, E [Department of Physics and Astronomy, University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Long, K [Tom Baker Cancer Centre, Calgary, AB (Canada); Husain, S [Tom Baker Cancer Centre, Calgary, AB (Canada); Department of Oncology, University of Calgary, Calgary, AB (Canada); Meyer, T [Department of Physics and Astronomy, University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Department of Oncology, University of Calgary, Calgary, AB (Canada)

    2014-08-15

    The planning for PBSI is done with the patient's ipsilateral arm raised, however, anatomical changes and variations are unavoidable as the patient resumes her daily activities, potentially resulting in significant deviations in implant geometry from the treatment plan. This study aims to quantify the impact of the ipsilateral arm position on the geometry and dosimetry of the implant at eight weeks, evaluated on post-plans using the MIM Symphony™ software (MIM Software, Cleveland, OH). The average dose metrics for the three patients treated at the TBCC thus far using rigid fusion and contour transfer for the arms up position were 76% for the CTV V100, 61% for the PTV V100, and 37% for the PTV V200; and for the arms down position 81% for the CTV V100, 64% for the PTV V100, and 42% for the PTV V200. Qualitative analysis of the post-implant CT for one of the three patients showed poor agreement between the seroma contour transferred from the pre-implant CT and the seroma visible on the post-implant CT. To obtain a clinically accurate plan for that patient, contour modifications were used, yielding improved dose metric averages for the arms-up position for all three patients of 87% for the CTV V100, 68% for the PTV V100, and 39% for the PTV V200. Overall, the data available shows that dosimetric parameters increase with the patient's arm down, both in terms of coverage and in terms of the hot spot, and accrual of more patients may confirm this in a larger population.

  17. Surgical intervention and capsular contracture after breast augmentation

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R;

    2005-01-01

    Epidemiologic data on local complications after breast augmentation are scarce. In particular, few prospectively collected data are available on modern breast implants on this issue. Using data from the Danish Registry for Plastic Surgery of the Breast, the authors examined determinants of surgery......-requiring complications and capsular contracture grades III to IV among 2277 women who underwent cosmetic breast implantation from June 1999 through April 2003. During an average follow-up period of 1.6 years after implantation, 4.3% of these women (3% of implants) required secondary surgery as a result of short...... surgical practices and modern implants used for breast augmentation produce fewer short-term complications than procedures and devices of the past. This prospective study indicates that surgical procedures are more important predictors for local (short-term) complications than implant or patient...

  18. Sterile Acellular Dermal Collagen as a Treatment for Rippling Deformity of Breast

    OpenAIRE

    Brittany Busse; Hakan Orbay; Sahar, David E.

    2014-01-01

    Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal...

  19. Un nuevo tratamiento de la prótesis de mama expuesta A new way to treat the exposed breast implant

    Directory of Open Access Journals (Sweden)

    P. Benito Duque

    2011-03-01

    Full Text Available Presentamos el caso de una paciente tratada mediante mastectomía subcutánea bilateral y sometida a reconstrucción mediante la implantación de prótesis mamarias subpectorales. A los 15 días de la intervención, la paciente se presentó con una prótesis expuesta. Fue posible cubrirla mediante cierre directo con los tejidos locales, y en el espacio de implantación de la prótesis, colocamos una lámina de colágeno reabsorbible con gentamicina. No hemos encontrado descrita la utilización de estas láminas en el manejo de prótesis o expansores mamarios expuestos o infectados. La aplicación local de estas láminas permite concentraciones locales elevadas de antibiótico que pueden ser eficaces sobre bacterias habitualmente resistentes, al tiempo que permiten una administración del antibiótico sin molestias para la paciente.We report the case of a patient who underwent a bilateral subcutaneous mastectomy and was reconstructed with mammary implants. Fifteen days after surgery, the patient presented an implant exposition. It was possible to close the wound with local tissues, and placing a gentamicin-collagen sponge in the same pocket of the implant. We have found no references concerning the use of absorbable gentamicin-collagen sponges for the management of implants or expanders when they have become exposed or infected. The local application of gentamicincollagen sponge affords elevated regional concentrations of antibiotic that may act on bacteria usually considered to be resistant with less discomfort for the patient.

  20. Combination of acellular allogenic dermis with silicone prosthesis implant to correct secondary deformities of the breast after operation%脱细胞异体真皮联合硅凝胶假体植入矫正乳房术后继发畸形

    Institute of Scientific and Technical Information of China (English)

    白明; 曾昂; 张海林; 赵茹; 刘志飞; 王智; 龙笑; 崔雅宁; 乔群

    2011-01-01

    Objective To evaluate the early clinical outcome and efficacy of combination of acellular allogenic dermal matrix with silicone gel implant to correct secondary deformities following removal of polyacrylamide hydrogel ( PAHG) for breast augmentation.Methods A total of 10 patients (20 breasts) who had had breast augmentation by PAHG injection were admitted in our hospital from January 2008 to May 2010. The injected PAHG was removed. then the silicone gel implant was placed for breast reconstruction . the acellular allogenic dermal matrix was inserted to replenish the insufficient pectoralis major muscle and mammary tissue, and the inframammary fold was created by encapsulation of the lower third of the implant. Results The follow-up of 12 months showed all the 10 patients were satisfied with the breast appearance and no infection. seroma. implant malposition or other complications happened. Conclusions Acellular allogenic dermal matrix combined with silicone gel implant can avoid severe breast deformity from removal of injected PAHG. Ideal outcome can be achieved with stringent adherence to the indications for this procedure.%目的 探讨利用脱细胞异体真皮联合硅凝胶假体植入矫正乳房因聚丙烯酰胺水凝胶取出术造成的继发畸形,并对其早期临床效果做出评价.方法 2008年1月至2010年5月期间,共有10例注射式隆乳术后患者在本院进行了脱细胞异体真皮联合硅凝胶假体植入术.脱细胞异体真皮被用于修补和填充胸大肌及乳腺腺体组织缺损,包裹硅凝胶假体的下1/3,以重建乳房下皱襞.结果 术后随访12个月,乳房外形满意,无感染、积液等并发症.结论 应用脱细胞异体真皮联合硅凝胶假体植入可避免取出乳房内聚丙烯酰胺水凝胶后造成的严重乳房畸形.在严格把握适应证的前提下,可以取得较好的临床效果.

  1. Analysis of the National Surgical Quality Improvement Program Database in 19,100 Patients Undergoing Implant-Based Breast Reconstruction: Complication Rates With Acellular Dermal Matrix

    OpenAIRE

    Shuster, Marina

    2015-01-01

    Background: The use of acellular dermal matrices has become increasingly popular in immediate and delayed tissue expander/implant–based breast reconstruction. However, it is unclear whether their use is associated with increased postoperative complication rates. Using the American College of Surgeons National Surgical Quality Improvement Program database, the authors assessed baseline differences in demographics and comorbidities with and without acellular dermal matrix and determined whether...

  2. 乳腺癌保留皮肤改良根治并即刻假体再造与传统改良根治术的疗效比较%Comparison of therapeutic effects of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy on breast cancer

    Institute of Scientific and Technical Information of China (English)

    全红; 李杰; 刘军; 李发成; 蒋宏传

    2011-01-01

    Objective To compare the therapy efficiency of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy in breast cancer. Methods The data of 530 female patients with early of stage 0 to Ⅲ a breast cancer was retrospectively analyzed, from January 2004 to Decembet 2008. Among the patients,91 patients operated with skin sparing mastectomy and immediate implanting breast reconstruction ( Group of immediate implanting reconstruction), and 439 patients were with modified radical mastectomy (Group of modified radical mastectomy ). By comparing complications, local recurrence, distant metastases and mortality rates between the two groups, the research was done to evaluate the therapy efficiency. Results In the group of immediate implanting reconstruction,84 patients completed follow-up with the median follow-up time of 35 months ( 14-72 months) while the local recurring rate was 2. 4%, distant metastasis rate was 8. 3% and mortality rate was 6. 0%. In the group of modified radical mastectomy, 398 patients completed follow-up with the median follow-up time of 36 months ( 12-74 months) while the local recurring rate was 3.3%, distant metastasis rate was 9. 5% and mortality rate was 6. 5%. Therefore there was no obvious statistic difference between the two groups in local recurring rate, distant metastasis rate and mortality rate (P > 0. 05 ). Evaluation of aesthetic results was done in the 84 patients after immediate implanting reconstruction for 12 months which was 93% as good or excellent by surgeons while 87% by patients. Surgeons and patients were both satisfied with the breast appearance. Conclusions For patients with early stage breast cancer, combining standard postoperative therapy, skin sparing mastectomy and immediate implanting reconstruction could achieve the same effect as the traditional modified radical mastectomy, while reconstruction would bring about better appearance and higher quality of life.%目的

  3. Breast reconstruction with an expander prosthesis following mastectomy does not cause additional persistent pain

    DEFF Research Database (Denmark)

    Klit, Anders; Mejdahl, Mathias Kvist; Gärtner, Rune;

    2013-01-01

    Few studies have examined the prevalence of persistent pain after breast reconstruction with an implant after tissue expansion in comparison to mastectomy without breast reconstruction. Our primary objective was to evaluate the prevalence of persistent pain after breast reconstruction...... with a subpectoral implant after tissue expansion in a population-based study. Secondary objectives were to evaluate sensory disturbances, lymphoedema and functional impairment....

  4. ALK1-Negative Anaplastic Large Cell Lymphoma of the Breast from a Nonprosthesis Cyst

    Directory of Open Access Journals (Sweden)

    Christopher Mulligan, MBBS

    2014-10-01

    Full Text Available Summary: Anaplastic large cell lymphoma of the breast is a rare malignancy associated with prosthetic breast implants. We present a case of a woman with no prior history of breast implants who developed anaplastic lymphoma kinase-1 negative anaplastic large cell lymphoma on a background of a previous benign cyst aspiration.

  5. Recombinant AAV-mediated HSVtk gene transfer with direct intratumoral injections and Tet-On regulation for implanted human breast cancer

    International Nuclear Information System (INIS)

    HSVtk/ganciclovir (GCV) gene therapy has been extensively studied in tumors and relies largely on the gene expression of HSVtk. Most studies, however, have failed to demonstrate any significant benefit of a controlled gene expression strategy in cancer treatment. The Tet-On system is commonly used to regulate gene expression following Dox induction. We have evaluated the antitumor effect of HSVtk/ganciclovir gene therapy under Tet-On regulation by means of adeno-associated virus-2 (AAV-2)-mediated HSVtk gene transfer with direct intratumoral injections in mice bearing breast cancer tumors. Recombinant adeno-associated virus-2 (rAAV) was constructed and transduced into MCF-7 cell line. GCV treatment to the rAAV infected MCF-7 cells was performed by MTT assay under the doxycycline (Dox) induction or without Dox induction at a vp (viral particle) number of ≥104 /cell. The virus was administered intratumorally to nude mice that had also received GCV intraperitoneally. The antitumor effects were evaluated by measuring tumor regression and histological analysis. We have demonstrated that GCV treatment to the infected MCF-7 cells under the Dox induction was of more inhibited effects than those without Dox induction at ≥104 vp/cell. In ex vivo experiments, tumor growth of BALB/C nude mice breast cancer was retarded after rAAV-2/HSVtk/Tet-On was injected into the tumors under the Dox induction. Infiltrating cells were also observed in tumors after Dox induction followed by GCV treatment and cells were profoundly damaged. The expression of HSVtk gene in MCF-7 cells and BALB/C nude mice tumors was up-regulated by Tet-On under Dox induction with reverse transcription-PCR (RT-PCR) analysis. The antitumor effect of rAAV-mediated HSVtk/GCV gene therapy under the Dox induction with direct intratumoral injections may be a useful treatment for breast cancer and other solid tumors

  6. A new rat model of bone cancer pain produced by rat breast cancer cells implantation of the shaft of femur at the third trochanter level

    OpenAIRE

    GUI, QI; Chengcheng XU; Liang ZHUANG; Xia, Shu; Chen, Yu; Peng, Ping; Shiying YU

    2013-01-01

    Bone cancer pain remains one of the most challenging cancer pains to fully control. In order to clarify bone cancer pain mechanisms and examine treatments, animal models mimicking the human condition are required. In our model of Walker 256 tumor cells implantation of the shaft of femur at the third trochanter level, the anatomical structure is relatively simple and the drilled hole is vertical and in the cortical bone only 1–2 mm in depth without injury of the distal femur. Pain behaviors an...

  7. 硅胶假体置入及注射丰胸患者全数字化乳腺X射线摄影技术探讨%Discussion on full-field digital mammography technique in patients with silicone prosthesis implantation and injection breast augmentation

    Institute of Scientific and Technical Information of China (English)

    徐炜伟; 付丽媛; 董丽锋; 黄淑贞; 钟群; 杨熙章; 陈自谦

    2015-01-01

    目的:探讨硅胶假体置入及注射丰胸患者全数字化乳腺X射线摄影技术与方法。方法硅胶假体置入患者32例,女性,年龄25~49岁,平均年龄37.94岁。注射丰胸患者21例,女性,年龄30~45岁,平均年龄39.38岁。400例正常乳腺患者作为对照,女性,年龄18~72岁,平均年龄43.58岁。收集数字化乳腺X射线影像资料,对图像质量进行分析,并归纳总结其摄影参数。结果3组乳腺摄影图像甲级片率分别为84.38%、85.71%及91.00%。假体置入和注射丰胸摄影参数采用的kV值与正常乳腺摄影基本接近,但要得到与正常乳腺摄影相当的影像质量,需要加大mAs。在相同的压迫厚度下,假体置入与注射丰胸患者摄影mAs约是正常患者的2~3倍。结论掌握假体置入及注射丰胸患者乳腺X射线摄影的方法、技术及摄影参数能够获得高质量的影像,为正确诊断提供可靠的影像学依据。%Objective To investigate the full-field digital mammography technique and method in patients with silicone prosthesis implantation and injection breast augmentation. Methods A total of 32 patients (females) with silicone prosthesis implantation were enrolled, which aged 25-49 years old with mean age of 37.94 years old. Twenty-one patients(females) were performed by injection breast augmentation, which aged 30-45 years old with age of 39.38 years old. The 400 patients(females) with normal breast were set as control, which aged 18-72 years old with mean age of 43.58 years old. Retrospective analysis of full-field digital mammography breast data of all patients was collected and image quality was analyzed. The mammography parameters were summarized. Results The image quality ratios of class A were 84.38 %, 85.71 % and 91.00 % in silicone prosthesis implantation group, injection breast augmentation group and normal group respectively. The mammography parameter of kV in patients with

  8. 术后即刻硅胶假体乳房再造在保留乳头乳晕的乳腺癌改良根治术中的应用%Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipplesparing mastectomy

    Institute of Scientific and Technical Information of China (English)

    杜稼苓; 王颖; 路选; 孙鹤庆

    2011-01-01

    目的 探讨术后即刻胸大肌包裹硅胶假体行乳房再造在早期乳腺癌保留乳头乳晕的改良根治术中应用的可行性.方法 自2006年1月至2009年11月,扬州市第一人民医院对28例早期乳腺癌行保留乳头乳晕改良根治术后即刻采用胸大肌包裹硅胶假体的乳房再造,观察术后并发症及患者满意度.结果 术后随访13~58个月,出现假体渗漏1例,乳头感觉减退2例,包膜挛缩1例,骨转移1例,28例均存活.27例对术后乳房外形满意,满意率96.43%.结论 保留乳头乳晕的乳腺癌改良根治术后即刻硅胶乳房假体再造,在保证肿瘤治疗的前提下,同时满足了患者对保持乳房外形美观的要求.手术简便、创伤小、恢复快,在术后并发症、局部复发率及死亡率等方面与单纯乳腺癌手术相比并无差异.%Objective To investigate the feasibility of immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy in early stage breast cancer.Methods From Jan.2006 to Nov.2009,28 breast cancer patients underwent immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy.Results Among the 28 patients,27 were satisfied with the apperance of their breast after operation.Conclusions Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy not only ensures the curative effects but also beautifies the apperance of the breast.The operation has the advantages of simplity,less trauma and quick recovery.There is no difference compared with mastectomy in terms of complication,recurrence rate and mortality etc.

  9. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  10. Breast reconstruction - methods and imaging; Brustaugmentation - Methoden und Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Pfleiderer, B.; Weigel, S.; Hurtienne, B.; Heindel, W. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie

    2007-12-15

    Silicon implants are used for breast reconstruction or for cosmetic operations. The contribution outlines the role of mammography, sonography and MR for defect assessment, tumour detection and monitoring after prosthesis implantation. Instrument adjustment for mammographic screening of patients with implants is gone into. Autologic reconstruction techniques and protocols of secondary and tertiary early detection are presented. (orig.)

  11. Dual-Energy CT for Evaluation of Intra- and Extracapsular Silicone Implant Rupture

    Directory of Open Access Journals (Sweden)

    Katrina N. Glazebrook

    2016-01-01

    Full Text Available Silicone implants are commonly used for both breast augmentation and breast reconstruction. With aging of the implant, the silicone envelope may become weak or may rupture. The technique of choice for evaluation of implant integrity is breast MRI; however this may be contraindicated in some patients or the cost may be prohibitive. Dual-energy CT allows determination of density and atomic number of tissue and can provide material composition information. We present a case of extracapsular implant rupture with MRI and dual-energy CT imaging and surgical correlation.

  12. X线钼靶、高频超声及MRI对硅胶假体隆乳术后破裂的诊断价值%The Diagnosis of Mammography, High-frequency Ultrasound and MRI in Silicone Breast Implant Rupture

    Institute of Scientific and Technical Information of China (English)

    杜牧; 曹满瑞; 谢肇峰; 刘涛

    2014-01-01

    目的:探讨X线钼靶、高频超声及MRI对硅胶假体隆乳术后破裂的诊断价值。方法对28例56只乳腺硅胶假体隆乳术后患者的X线钼靶、高频超声及MRI资料进行回顾性研究,分析其影像表现及对假体囊内破裂及囊外破裂的诊断价值。结果 X线不能完整显示假体(0%),高频超声及MRI都能够完整显示假体(均为100%);对囊外破裂,X线钼靶、高频超声及MRI都能显示(均为7.1%,4/56); X线不能显示囊内破裂(0%), MRI(32.1%,18/56)对囊内破裂的检出率高于超声(21.4%,12/56)(P=0.031)。结论对硅胶假体破裂的诊断,X线钼靶并不是令人满意的方法,超声是经济高效的检查方法,而MRI是最理想的检查方法,如经济允许,MRI可列为首选。%Objective To investigate the diagnostic value of mammography, high-frequency ultrasound and MRI in silicone breast implant rupture. Methods 28 cases with 56 breasts were included in this study, and the mammography, high-frequency ultrasound and MRI findings and its diagnostic value for silicone breast implant rupture were analyzed. Results The mammography can't show the integrity of the silicone breast implant(0%,0/56), and ultrasound and MRI can show it(100%,56/56). Both mammography, ultrasound and MRI can diagnose extracapsular rupture(7.1%,4/56). Mammography can't detect intracapsular rupture (0%,0/56),and MRI(32.1%,18/56)is better than ultrasound(21.4%,12/56)in detection of intracapsular rupture(P=0.031). Conclusion In detecting silicone breast implant rupture, mammography is a satisfied way, ultrasound is an economic and efficient way, and MRI is the most ideal way and it should be the first choice if the economy allowed.

  13. Incidence and severity of short-term complications after breast augmentation

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Hölmich, Lisbet R; Fryzek, Jon P;

    2003-01-01

    The frequency and severity of local complications remain the primary safety issues with silicone breast implants. The Danish Registry for Plastic Surgery of the Breast (DPB), established in 1999, prospectively collects pre-, peri- and postoperative information regarding Danish women undergoing...

  14. 解剖型假体隆乳治疗重度乳腺发育不良%Treatment of severe mammary dysplasia by anatomic implants breast augmentation

    Institute of Scientific and Technical Information of China (English)

    李健; 贾亮亮

    2012-01-01

    Objective To evaluate the methods and results of breast augmentation with anatomic prosthesis on the treatment of severe mammary dysplasia. Methods Through axillary or areolae incision, 19 cases with severe mammary dysplasia were treated by augmentation mammoplasty with anatomic prosthesis under pec-toralis major muscle. The size, prominence, height of the anatomic prosthesis were chosen, based on data of height, chest circumference, distances of SN-N, N-N, A-IMF and individual requirements. The postoperative results were evaluated according to postoperative patients' satisfaction. Results All patients were satisfied with the dropwise-shaped breast and upward nipple. Conclusion Augmentation mammoplasty with anatomic prosthesis under pectoralis major muscle is an ideal choice for patients with severe mammary dysplasia.%目的 探讨应用解剖型假体隆乳治疗重度乳腺发育不良的方法 及效果.方法 经乳晕切口或腋窝切口,对19例重度乳腺发育不良者应用解剖型假体行胸大肌下隆乳术,依据身高、胸围、胸骨上切迹-乳头(SN-N)间距离、乳头- 乳头(N-N)间距离、乳晕-乳房下皱襞(A-IMF)间距离等测量参数,并结合求美者的要求选择假体体积、突度、高度,术后根据求美者满意度判断手术治疗效果.结果 所有求美者获随访6个月至4年,19例重度乳腺发育不良者术后乳房呈现水滴状,乳头上翘,形态逼真,求美者均满意.结论 应用解剖型假体行胸大肌下隆乳术,是治疗乳腺组织发育不良者较理想的选择.

  15. Cochlear Implants

    Science.gov (United States)

    ... on this topic can be found in our Audiology Information Series [PDF]. How does a cochlear implant ... speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. ...

  16. What Is Breast Cancer?

    Science.gov (United States)

    ... Next Topic Types of breast cancers What is breast cancer? Breast cancer starts when cells in the breast ... breast cancer? ” and Non-cancerous Breast Conditions . How Breast Cancer Spreads Breast cancer can spread through the lymph ...

  17. Transaxillary endoscopic silicone gel breast augmentation.

    Science.gov (United States)

    Strock, Louis L

    2010-09-01

    Following the return of silicone gel breast implants to the US market in 2006, augmentation with these implants has become increasingly popular. Surgeons have an array of refined techniques from which to choose when performing these procedures, many of which offer the advantage of reduced or less-obvious postoperative scarring. For obvious reasons, many patients are requesting placement of the implants through incisions that are removed from the breast area (and thereby hidden). The challenge of these approaches is to provide a level of technical control that matches what is afforded with the traditional inframammary approach. The addition of endoscopic assistance has provided a level of tissue visualization and technical control not previously possible with the transaxillary approach, with results that rival those of an inframammary procedure. In this article, the author presents his current operative technique, which has allowed for the routine placement of silicone gel breast implants through a transaxillary incision using endoscopic assistance.

  18. Growth Inhibition of Breast Cancer in Rat by AAV Mediated Angiostatin Gene

    Institute of Scientific and Technical Information of China (English)

    LI Ran; CHEN Hong; REN Chang-shan

    2007-01-01

    Objective: To observe growth inhibition effect of adeno-associated viral vectors (AAV) mediated angiostatin (ANG) gene on implanted breast cancer in rat and its mechanism. Methods: Gene transfer technique was used to transfer AAV-ANG to the tumor. Growth curves were drawn to observe the growth of breast cancer implanted in rat, and immunohistochemical method was used to detect the effects of angiostatin on microvesel density (MVD) of breast cancer implanted in rat. Results: Angiostatin inhibited the growth of breast cancer implanted in rat and decreased the microvessel density of tumor. Conclusion: Expression of an angiostatin transgene can suppress the growth of breast cancer implanted in rat through the inhibition of the growth of microvessels, surggesting that angiostatin gene transfer technique may be effective against breast cancer.

  19. Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery

    OpenAIRE

    Macadam, Sheina A; Lennox, Peter A

    2012-01-01

    Acellular dermal matrices (ADMs) were first described for use in breast surgery in 2001. Since this initial report, ADMs have become an increasingly common component of implant-based breast procedures. ADMs have shown promise for use in both aesthetic and reconstructive breast surgery; however, concerns about their use remain because of the significant costs associated with these products. The present article reviews the history of ADM use in breast surgery and the outcomes reported to date. ...

  20. Nipple-areola complex sparing mastectomy with immediate breast reconstruction using subpectoral prosthesis implantation%保留乳头乳晕复合体乳腺癌根治即刻胸大肌包裹假体植入乳房重建

    Institute of Scientific and Technical Information of China (English)

    任敏; 汪英; 王本忠; 王劲; 裴静; 徐晓军; 颜蕴文

    2010-01-01

    目的 探讨保留乳头乳晕复合体(NAC)的乳腺癌改良根治术即刻胸大肌包裹假体植入乳房重建的可行性.方法 对28例0、I、II期乳腺癌行保留皮肤的乳腺癌改良根治术后,即刻于胸大肌后方植入硅胶假体重建乳房,并根据冰冻切片结果决定是否保留NAC.结果 28例早期乳腺癌均保留了NAC,术后随访2~18个月(中位随访期:15个月),外观良好,双侧乳房对称,优良率达96.5%;均无局部复发或远处转移,无明显术后并发症.结论 保留NAC的乳腺癌改良根治术后用硅胶假体行即刻乳房重建,能达到满意的乳房美容效果,是治疗早期乳腺癌安全可行的方法.%Objective To explore the feasibility of immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after nipple-areola complex (NAC) sparing modified radical mastectomy. Methods A total of 28 patients of 0,I,II stage breast cancer were implanted with silicon gel prosthesis immediately after they underwent skin-sparing modified radical mastectomy. NAC conservation depended on frozen section result. Results NAC of all the 28 patients were conserved. During 2-18 months (median15 months) follow-up, bilateral breasts were symmetrical and in good appearance with a 96.5% excellent rate. No local recurrence, distant metastasis or obvious complications occurred. Conclusions Immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after NAC sparing modified radical mastectomy is proven to be an effective and safe method with the advantage of good appearance and shorter recovery time in early-stage breast cancer.

  1. Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this text, the authors recall the main principles and data ruling cochlear implants. Then, a first circle of technical equipment for assistance is presented. This circle includes: device setting (DS), Electrically evoked Auditory Brainstem Responses (EABR), Neural Response Telemetry (NRT), Stapedial Reflex (SR) and Electrodogram Acquisition (EA). This first cycle becomes more and more important as children are implanted younger and younger; the amount of data available with this assistance makes necessary the use of models (implicit or explicit) to handle this information. Consequently, this field is more open than ever.

  2. Breast lump

    Science.gov (United States)

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  3. Breast Diseases

    Science.gov (United States)

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  4. Cochlear Implants

    Science.gov (United States)

    ... an optimal period to develop speech and language skills. Research has shown that when these children receive a cochlear implant followed by intensive therapy before they are 18 months ... age develop language skills at a rate comparable to children with normal ...

  5. Dental Implants

    Medline Plus

    Full Text Available ... suffer from social consequences and poor nutrition. Rebuilding Bone When the supporting alveolar bone melts away , it’s gone for good, but through grafting, a skilled dental professional can recreate bone to fuse with and support an implant. This ...

  6. Cochlear implant

    Science.gov (United States)

    ... are sent along the auditory nerve to the brain. A deaf person does not have a functioning inner ear. A cochlear implant tries to replace the function of the inner ear by ... signals to the brain. Sound is picked up by a microphone worn ...

  7. Dental Implants

    Medline Plus

    Full Text Available Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide helpful facts so you ... found in nature. What Happens When You Lose a Tooth? When you lose a tooth, especially a ...

  8. Dental Implants

    Medline Plus

    Full Text Available ... an implant connects directly to the jaw bone. It’s obviously not the same as the original connection , ... may feel you don’t need to replace it, since no one can see that it’s missing ...

  9. Linguine sign in musculoskeletal imaging: calf silicone implant rupture

    Energy Technology Data Exchange (ETDEWEB)

    Duryea, Dennis; Petscavage-Thomas, Jonelle [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Frauenhoffer, Elizabeth E. [Milton S. Hershey Medical Center, Department of Pathology, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD, 20814 (United States)

    2015-08-15

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition. (orig.)

  10. Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy

    OpenAIRE

    Andree, Christoph; Munder, Beatrix; Seidenstuecker, Katrin; Richrath, Philipp; Behrendt, Philipp; Köppe, Tobias; Hagouan, Mazen; Audretsch, Werner; Nestle-Krämling, Carolin; Witzel, Christian

    2012-01-01

    Summary Background Currently about 70% of women who suffer from breast cancer undergo breast-conserving therapy (BCT) without removing the entire breast. Thus, this surgical approach is the standard therapy for primary breast cancer. If corrections are necessary, the breast surgeon is faced with irritated skin and higher risks of complications in wound healing. After radiation, an implant-based reconstruction is only recommended in selected cases. Correction of a poor BCT outcome is often onl...

  11. Cochlear implants

    OpenAIRE

    Despotović, Adrijana

    2011-01-01

    The aim of the thesis is to analyze the performance of the child with cochlear implant (CI) at language, math and movement activities. For the purpose of research exercises from all three above mentioned activities are prepared. Results of the exercises constitute the ground for the comparison of a child with CI and children with no hearing disability. Testing language skills was performed with exercises that included understanding, diction and identifying syllables. Mathematic skills...

  12. Breast Cancer

    Science.gov (United States)

    ... I found something when I did my breast self-exam. What should I do now? How often should I have mammograms? I have breast cancer. What are my treatment options? How often should I do breast self-exams? I have breast cancer. Is my daughter ...

  13. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  14. Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... NHLBI on Twitter. What Is an Implantable Cardioverter Defibrillator? An implantable cardioverter defibrillator (ICD) is a small ... pacemakers and defibrillators. Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker The image compares an ICD ...

  15. Nanotechnology and Dental Implants

    OpenAIRE

    Sandrine Lavenus; Guy Louarn; Pierre Layrolle

    2010-01-01

    The long-term clinical success of dental implants is related to their early osseointegration. This paper reviews the different steps of the interactions between biological fluids, cells, tissues, and surfaces of implants. Immediately following implantation, implants are in contact with proteins and platelets from blood. The differentiation of mesenchymal stem cells will then condition the peri-implant tissue healing. Direct bone-to-implant contact is desired for a biomechanical anchoring of i...

  16. Immediate implanting breast reconstruction with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle%应用背阔肌与胸大肌联合肌瓣及假体置入即刻乳房再造

    Institute of Scientific and Technical Information of China (English)

    牛兆河; 曹明智

    2011-01-01

    Objective To explore immediate implanting breast reconstruction after subcutaneous mastectomy by through breast lateral curved incision with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle covering the breast prosthesis. Methods 30 patients were selected in clinical stage Ⅰ or Ⅱ , and without involvement of skin and pectoral muscle. After subcutaneous mastectomy through breast lateral curved incision, by the same incision the latissimus dorsi muscle flap was removed and transferred, and the submuscular interspace was dissected, and the inferior border of the pectoralis major muscle was cut off. The pedicled latissimus dorsi and pectoralis major muscle flap were sutured and the combined muscle flap was formed to cover the breast prothesis.Results The shape and feeling were satisfactory in 30 reconstructive breasts, and 22 cases were excellent (73.3 %), and 8 cases were good (26.7 %). All the patients survived without tumor recurrence after following-up more than half a year. Conclusions The method has advantages of good cosmetic breast shape, without appendant incision, and larger breast prosthesis could be insertted. It is a good method of immediate breast reconstruction for the young women with early stage breast cancer without axillary lymph node metastasis.%目的 探讨经乳房外侧弧形切口皮下乳腺切除术后,带蒂转移背阔肌肌瓣,与胸大肌肌瓣形成联合肌瓣覆盖乳房假体,进行即刻乳房再造术的治疗效果.方法 选择临床分期为Ⅰ期或Ⅱ期,肿瘤未侵及皮肤和胸肌的乳腺癌患者共30例,经乳房外侧弧形切口皮下切除乳腺腺体并清扫腋窝淋巴结,利用同一切口,切取背阔肌肌瓣带蒂转移,分离胸大肌下间隙,切断胸大肌下缘与胸壁附着处直至胸骨边缘,将转移的背阔肌肌瓣与胸大肌断缘缝合,组成联合肌瓣,形成宽大的包裹假体的腔隙,置入假体.结果 30例再造乳房外形及手感良好,其中优22

  17. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  18. Dose determination in breast tumor in brachytherapy using Iridium-192

    International Nuclear Information System (INIS)

    Thermoluminescent dosimetry studies in vivo and in vitro aiming to determing radiation dose in the breast tumor, in brachytherapy using Iridium-192 was done. The correlation between radiation doses in tumor and external surface of the breast was investigated for correcting the time interval of radiation source implantation. (author)

  19. Chronic breast abscess due to Mycobacterium fortuitum: a case report

    Directory of Open Access Journals (Sweden)

    MacNeill Fiona A

    2011-05-01

    Full Text Available Abstract Introduction Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery. Case presentation We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with Mycobacterium fortuitum and treated with antibiotic therapy and surgical debridement. Conclusion This is a rare case of a spontaneous breast abscess secondary to Mycobacterium fortuitum infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.

  20. Breast Gangrene

    Directory of Open Access Journals (Sweden)

    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  1. Which Breast Is the Best? Successful Autologous or Alloplastic Breast Reconstruction : Patient-Reported Quality-of-Life Outcomes

    NARCIS (Netherlands)

    Eltahir, Yassir; Werners, Lisanne L. C. H.; Dreise, Marieke M.; Zeiffmans van Emmichoven, Ingeborg A.; Werker, Paul M. N.; de Bock, Geertruida H.

    2015-01-01

    Background: Breast reconstruction is an appropriate option offered to women who are diagnosed with breast cancer or gene mutations. It may be accomplished with implants or autologous procedures. This cross-sectional study evaluated the satisfaction and quality of life in addition to complications an

  2. Therapeutic Lymphangiogenesis With Implantation of Adipose‐Derived Regenerative Cells

    OpenAIRE

    Shimizu, Yuuki; Shibata, Rei; Shintani, Satoshi; Ishii, Masakazu; Murohara, Toyoaki

    2012-01-01

    Background Lymphedema is one of the serious clinical problems that can occur after surgical resection of malignant tumors such as breast cancer or intra‐pelvic cancers. However, no effective treatment options exist at present. Here, we report that implantation of adipose‐derived regenerative cells (ADRCs) can induce lymphangiogenesis in a mouse model of reparative lymphedema. Methods and Results ADRCs were isolated from C57BL/6J mice. To examine the therapeutic efficacy of ADRC implantation i...

  3. Breast lift

    Science.gov (United States)

    ... One breast that is larger than the other (asymmetry of the breasts) Uneven position of the nipples ... to achieve this important distinction for online health information and services. Learn more about A.D.A. ...

  4. Breast cancer

    Science.gov (United States)

    ... perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  5. Breast; Sein

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, C.; Garbay, J.R.; Pichenot, C.; Uzan, C.; Delaloge, S.; Andre, F.; Spielmann, M.; Arriagada, R.; Lefkopoulos, D.; Marsigli, H.; Bondiau, P.Y.; Courdi, A.; Lallemand, M.; Peyrotte, I.; Chapellier, C.; Ferrero, J.M.; Chiovati, P.; Baldissera, A.; Frezza, G.; Vicenzi, L.; Palombarini, M.; Martelli, O.; Degli Esposti, C.; Donini, E.; Romagna CDR, E.; Romagna CDF, E.; Benmensour, M.; Bouchbika, Z.; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Benider, A.; Gilliot, O.; Achard, J.L.; Auvray, H.; Toledano, I.; Bourry, N.; Kwiatkowski, F.; Verrelle, P.; Lapeyre, M.; Tebra Mrad, S.; Braham, I.; Chaouache, K.; Bouaouin, N.; Ghorbel, L.; Siala, W.; Sallemi, T.; Guermazi, M.; Frikha, M.; Daou, J.; El Omrani, A.; Chekrine, T.; Mangoni, M.; Castaing, M.; Folino, E.; Livi, L.; Dunant, A.; Mathieu, M.C.; Bitib, G.P.; Arriagada, R.; Marsigli, H

    2007-11-15

    Nine articles treat the question of breast cancer. Three-dimensional conformal accelerated partial breast irradiation: dosimetric feasibility study; test of dose escalation neo-adjuvant radiotherapy focused by Cyberknife in breast cancer; Three dimensional conformal partial irradiation with the technique by the Irma protocol ( dummy run multi centers of the Emilie Romagne area Italy); Contribution of the neo-adjuvant chemotherapy in the treatment of locally evolved cancers of the uterine cervix; Post operative radiotherapy of breast cancers (N0, pN) after neo-adjuvant chemotherapy. Radiotherapy of one or two mammary glands and ganglions areas,The breast cancer at man; breast conservative treatment; breast cancers without histological ganglions invasion; the breast cancer at 70 years old and more women; borderline mammary phyllod tumors and malignant. (N.C.)

  6. Breast reconstruction: current and future options

    Directory of Open Access Journals (Sweden)

    Paul Jr H

    2011-08-01

    Full Text Available Henry Paul Jr1, Tahira I Prendergast2, Bryson Nicholson2, Shenita White2, Wayne AI Frederick2,31Departments of Plastic Surgery, 2General Surgery, Howard University Hospital, 3Cancer Center, Howard University, Washington, DC, USAAbstract: When initiated by the devastating diagnosis of cancer, post ablative breast restoration has at its core the goal of restoring anatomic normalcy. The concepts of body image, wholeness, and overall well-being have been introduced to explain the paramount psychological influence the breast has on both individuals and society as a whole. Hence, a growing subspecialty has been established to recreate or simulate the lost breast. At least one third of breast cancer victims consider breast reconstruction. Breast reconstruction post mastectomy may be offered at the time of mastectomy or delayed post mastectomy after adjuvant therapy. This may be utilizing autologous tissues or implants and each has risks and benefits, especially when considering adjuvant therapy. In addition, there has been a move away from a traditional mastectomy to less invasive, but still curative procedures, such as skin-sparing and nipple-sparing mastectomy. These procedures provide the breast envelope to facilitate reconstruction. This paper reviews the primary issues in breast reconstruction, as well as their psychologic, oncologic, and social impact.Keywords: breast restoration, body image, breast reconstruction, mastectomy

  7. Endocurietherapy of breast cancer III

    International Nuclear Information System (INIS)

    We recently introduced the implantation of Iridium192 as a method of local treatment of breast cancer in Austria. The afterloading technique is described. This modality should be used as a boost to the 'high-risk' areas following conservative breast surgery and combined with megavoltage external irradiation. Interstitial implantation may also be used as a primary form of treatment. A report on 35 patients is presented, 25 of whom underwent a curative schedule for T1-2, N0-1 tumors. 10 patients were treated individually. The aesthetic results are very pleasing. There were no severe complications and no early local recurrences. The interpretation of the results can be only in the form of trends because of the short follow-up time of 1 year. (Author)

  8. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks ... the risk. Women who have family members with breast or ovarian cancer may wish to be tested ...

  9. Ultrasound - Breast

    Science.gov (United States)

    ... Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. In breasts that are dense, meaning there is a lot ... and less fat, many cancers can be hard to see on mammography. Many ...

  10. Implant success!!!.....simplified

    OpenAIRE

    Luthra Kaushal

    2009-01-01

    The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of “restoration-driven implant placement” ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant t...

  11. Mammography and breast sonography in transsexual women.

    Science.gov (United States)

    Weyers, S; Villeirs, G; Vanherreweghe, E; Verstraelen, H; Monstrey, S; Van den Broecke, R; Gerris, J

    2010-06-01

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  12. Mammography and breast sonography in transsexual women

    Energy Technology Data Exchange (ETDEWEB)

    Weyers, S., E-mail: steven.weyers@ugent.b [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2010-06-15

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  13. Non-microsurgical breast reconstruction

    Directory of Open Access Journals (Sweden)

    Sharma Sheel

    2007-12-01

    Full Text Available Breast reconstruction after mastectomy should aim at resulting in an aesthetic outcome that matches the patient′s expectations and without interfering in the oncologic treatment. Whether the reconstruction is performed immediately or in a delayed fashion depends on various factors, which needs detailed attention. Autologous tissue, implants or both are used in the reconstruction. This article reviews the current concepts in these, with emphasis on non-microsurgical methods of using the autologous tissue for reconstruction. Breast conservation has become an accepted practice of treatment. Reconstruction in these situations as well as in an occasion when the surgery is done for failed breast conservation is discussed in detail. The article also reviews the various methods for nipple reconstruction available.

  14. Padrão de aleitamento materno no primeiro mês de vida em mulheres submetidas a cirurgia de redução de mamas e implantes Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation

    Directory of Open Access Journals (Sweden)

    Regina Aparecida de Andrade

    2010-06-01

    Full Text Available OBJETIVO: Descrever o padrão de aleitamento materno no primeiro mês de vida da criança em mulheres que se submeteram a dois tipos de cirurgias mamárias - redução e implante - e comparar com o padrão praticado por mulheres que não se submeteram às cirurgias. MÉTODOS: Coorte prospectiva controlada com 25 mulheres submetidas a cirurgia redutora, 24 a cirurgia de implante e 25 sem cirurgia de mama, que tiveram seus filhos no Hospital Israelita Albert Einstein, São Paulo (SP. Os dados foram coletados por meio de avaliações realizadas entre 48 e 72 horas, entre os quinto e sétimo dias e 30 dias após o parto. Para análise dos dados, usaram-se os testes qui-quadrado, exato de Fisher, curva de Kaplan-Meier e regressão de Cox. RESULTADOS: A probabilidade de uma criança estar em aleitamento exclusivo no final do primeiro mês de vida foi de 29% em mulheres com cirurgia redutora e 54% nas com cirurgia de implante, e 80% nas mulheres sem cirurgia. A probabilidade do aleitamento misto estar presente neste mesmo período foi de 68% entre mães com cirurgia de redução, 32% com cirurgia de implante e apenas 16% entre as mulheres sem cirurgia mamária. O risco de uma criança estar em aleitamento não exclusivo foi cinco vezes maior entre mães do grupo submetido a redução, quando comparado àquelas do grupo sem cirurgia (p = 0,002. Para o grupo de mulheres com implante, o risco de uma criança estar em aleitamento não exclusivo foi 2,6 vezes aquele observado entre crianças cujas mães fazem parte do grupo sem cirurgia (p = 0,075. CONCLUSÃO: A cirurgia redutora de mama e de implante refletiu em menor taxa de aleitamento materno exclusivo no primeiro mês de vida da criança.OBJECTIVE: To describe the breastfeeding pattern in the first month of life in women submitted to two types of surgery - breast reduction and augmentation - and to compare it with the pattern exhibited by women who had no surgery. METHODS: Controlled prospective cohort

  15. 小切口、持续负压引流与传统切开引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的比较%The comparison betweenthe outcomes of using small cuts and continuous negative pressure drainage and the traditional incision and drainage to treat mammary abscess caused by HPG breast implants

    Institute of Scientific and Technical Information of China (English)

    郑轲; 何山; 刘兵; 刘美宏; 冯佳

    2012-01-01

    Objective To discuss the outcomes of using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants. Methods Small cuts and continuous negative pressure drainage were per-formeded in 20 cases of mammary abscess caused by HPG breast implants and the traditional incision and drainage was performed-ed in another 20 cases to evaluate the outcomes. Results Using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants has obvious advantages over the group of using incision and drainage in healing time, the frequency of changing dressings, the degree of pain and the bigrosmall of scar. Conclusion Using small cuts and continuous negative pressure drainage can obviously shorten the healing time, reduce the the frequency of changing dressings, reduce patients pain and reduce scar formation. It is the idealest way to treat mammary abscess caused by HPG breast implants.%目的 探讨小切口、持续负压引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的效果.方法 20例患者采用小切口、持续负压引流和20例患者采用传统切开油纱填塞引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿,观察治疗效果.结果 小切口、持续负压引流组在愈合时间、换药次数、疼痛程度、瘢痕大小等方面均明显优于传统切开引流组.结论 持续负压引流组可以明显缩短愈合时间,减少换药次数,减轻换药痛苦,减少瘢痕形成.是治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿最理想方法.

  16. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... your stomach on a narrow table with your breasts hanging down into cushioned openings. The table slides ...

  17. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  18. Stages of Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  19. Congenital Abnormalities of the Breast. A Case Report

    Directory of Open Access Journals (Sweden)

    Elvira María Martínez Barreto

    2015-12-01

    Full Text Available Normal breasts have a wide range of shapes and sizes varying according to cultural, racial, or other conditions, but it is clear that there are abnormalities related to the shape, size, number, location, and so on. Management of these defects requires prior clinical and imaging assessment in addition to plastic surgery. The case of a 14-year-old mestizo girl of rural origin treated at the Paquito González Cueto University Pediatric Hospital due to multiple breast abnormalities and significant asymmetry is presented. Reconstructive surgery of both breasts was performed, placing a breast implant in one of them. The asymmetry and the rest of the malformations were corrected to the patient and her family’s satisfaction. This is the first case of breast implants in the province, hence the interest in presenting it.

  20. Implant success!!!.....simplified

    Directory of Open Access Journals (Sweden)

    Luthra Kaushal

    2009-01-01

    Full Text Available The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of "restoration-driven implant placement" ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant treatment. By applying the harmony of artistic skill, scientific knowledge and clinical expertise, we can simply master the outstanding implant success in requisites of aesthetics, phonetics and function.

  1. Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2004-01-01

    Full Text Available Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.

  2. Conservative treatment for breast cancer. Complications requiring reconstructive surgery

    International Nuclear Information System (INIS)

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects

  3. Conservative treatment for breast cancer. Complications requiring reconstructive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bostwick, J. 3d.; Paletta, C.; Hartrampf, C.R.

    1986-05-01

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects.

  4. Urinary incontinence - injectable implant

    Science.gov (United States)

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  5. Implantable cardioverter defibrillator - discharge

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000108.htm Implantable cardioverter defibrillator - discharge To use the sharing features on this ... chest wall. A device called an implantable cardioverter-defibrillator (ICD) was inserted under your skin and muscle. ...

  6. Pacemakers and Implantable Defibrillators

    Science.gov (United States)

    ... need a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). They are devices that are implanted in ... can act as both a pacemaker and a defibrillator. Many ICDs also record the heart's electrical patterns ...

  7. Implantable cardioverter-defibrillator

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007370.htm Implantable cardioverter-defibrillator To use the sharing features on this page, please enable JavaScript. An implantable cardioverter-defibrillator (ICD) is a device that detects any life- ...

  8. Intracochlear misdirected implantation of a cochlear implant

    NARCIS (Netherlands)

    Tange, R A; Grolman, W; Maat, A

    2006-01-01

    This paper discusses a rare complication of an intracochlear misdirection of the electrode of a cochlear implant in a 55-year-old male. The patient received a cochlear implant using the mastoid-saving surgical approach. Intraoperative measurements showed impedance and NRT reactions suggesting a reas

  9. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t

  10. Risk Factors Associated With Complication Rates of Becker-Type Expander Implants in Relation to Implant Survival: Review of 314 Implants in 237 Patients.

    Science.gov (United States)

    Taboada-Suarez, Antonio; Brea-García, Beatriz; Magán-Muñoz, Fernando; Couto-González, Iván; González-Álvarez, Eduardo

    2015-12-01

    Although autologous tissue reconstruction is the best option for breast reconstruction, using implants is still a reliable and simple method, offering acceptable aesthetic results. Becker-type implants are permanent implants that offer a 1-stage reconstructive option. A retrospective study was carried out in our center reviewing the clinical reports of 237 patients, in whom a total of 314 Becker-type prostheses were implanted. Overall survival was calculated using a Kaplan-Meier estimate. Cox proportional hazard models were used to calculate adjusted hazard ratios. At the end of the study, 214 expanders (68.15%) presented no complications, 40 (12.47%) developed significant capsular contracture, in 27 (8.60%) infection occurred, 24 (7.64%) suffered minor complications, and 9 (2.87%) ruptured. The mean survival time of the expanders was 120.41 months (95% CI: 109.62, 131.19). Radiotherapy, chemotherapy, high Molecular Immunology Borstel, age, mastectomy performed previously to the implant, ductal carcinoma, advanced tumoral stage, experience of the surgeon, and Becker 35-type implants were significantly related to a high number of complications in relation to the survival of the implants. Cox regression analysis revealed that the main risk factors for the survival of expander implants included radiotherapy and surgeon experience. The complication hazard ratio or relative risk caused by these 2 factors was 1.976 and 1.680, respectively. One-stage reconstruction using Becker-type expanders is an appropriate, simple, and reliable option in delayed breast reconstruction in patients who have not received radiotherapy and as long as the procedure is carried out by surgeons skilled in the technique.

  11. Examining the efficacy, safety, and patient acceptability of the etonogestrel implantable contraceptive

    Directory of Open Access Journals (Sweden)

    Heather Hohmann

    2009-07-01

    Full Text Available Heather HohmannDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAAbstract: Contraceptive implants provide long-acting, highly effective reversible contraception. The etonogestrel implant (ENG implant is a single rod implant that offers three years of efficacy. The ENG implant was designed to provide contraceptive efficacy by inhibiting ovulation and Pearl Index scores reported for this method are similar to other long-acting reversible contraception as well as similar to sterilization. The implant has been shown to be safe during breast feeding and may improve symptoms of dysmenorrhea and endometriosis. Irregular bleeding patterns can be expected with the device’s use and should be addressed in order to decrease rates of discontinuation.Keywords: contraception, Implanon®, progestin-only, ENG-implant

  12. Genomic and phenotypic profiles of two Brazilian breast cancer cell lines derived from primary human tumors

    DEFF Research Database (Denmark)

    Corrêa, Natássia C R; Kuasne, Hellen; Faria, Jerusa A Q A;

    2013-01-01

    and MGSO-3, the only Brazilian breast cancer cell lines available for comparative studies. We evaluated the presence of hormone receptors, proliferation, differentiation and stem cell markers, using immunohistochemical staining of the primary tumor, cultured cells and xenografts implanted...

  13. Sterile Acellular Dermal Collagen as a Treatment for Rippling Deformity of Breast

    Directory of Open Access Journals (Sweden)

    Brittany Busse

    2014-01-01

    Full Text Available Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal matrix product, AlloMax. The patient presented with visible rippling of bilateral prosthetic breast implants as well as significant asymmetry of the breasts after multiple excisional biopsies for right breast ductal carcinoma in situ. A 6×10 cm piece of AlloMax was placed on the medial aspect of each breast between the implant and the skin flap. Follow-up was performed at 1 week, 3 months, and 1 year following the procedure. The patient recovered well from the surgery and there were no complications. At her first postoperative follow-up the patient was extremely satisfied with the result. At her 3-month and 1-year follow-up she had no recurrence of her previous deformity and no new deformity.

  14. Sterile acellular dermal collagen as a treatment for rippling deformity of breast.

    Science.gov (United States)

    Busse, Brittany; Orbay, Hakan; Sahar, David E

    2014-01-01

    Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal matrix product, AlloMax. The patient presented with visible rippling of bilateral prosthetic breast implants as well as significant asymmetry of the breasts after multiple excisional biopsies for right breast ductal carcinoma in situ. A 6 × 10 cm piece of AlloMax was placed on the medial aspect of each breast between the implant and the skin flap. Follow-up was performed at 1 week, 3 months, and 1 year following the procedure. The patient recovered well from the surgery and there were no complications. At her first postoperative follow-up the patient was extremely satisfied with the result. At her 3-month and 1-year follow-up she had no recurrence of her previous deformity and no new deformity. PMID:25610697

  15. 脱细胞真皮基质对扩张器/假体乳房再造并发症影响的Meta分析%The impact of acellular dermal matrix on complications of breast reconstruction using tissue expander/implant: a Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    董洁; 吴小蔚; 田方兴

    2013-01-01

    Objective To analyze the effect of acellular dermal matrix (ADM) on complications of breast reconstruction using tissue expander/implant,and to offer preliminary evidences for ADM clinical application.Methods Articles published from Jan.2010 to Oct.2012 were searched in Pubmed,EMbase,Science Direct and CNKI database.Literatures were filtrated according to inclusive criteria.Values were extracted from included literatures; factors regarding complications were collected.Metaanalysis was performed with Stata 12.0.Results 10 researches were included.Comparing to control group,the pooled odds ratio (OR) of overall complications,infections,hematomas/seromas,explantations are 1.51(P=0.038),1.91(P=0.032),1.80(P=0.005) and 2.37 (P=0.138) in ADM group respectively.Conclusions In breast reconstruction using tissue expander/implant,ADM increases the occurrence of hematomas/saromas as well as risks of infections and overall complications.%目的 对在扩张器/假体乳房再造术中应用脱细胞真皮基质(acellular dermal matrix,ADM)是否增加术后并发症进行探讨,以为临床应用提供初步依据.方法 计算机检索2010年1月至2012年10月Pubmed、EMbase、Science Direct、中国生物医学文献数据库和中国期刊网全文数据库中发表的文献,设定文献纳入条件,对符合条件的文献进行并发症相关数据导出,然后使用Stata 12.0进行Meta分析.结果 共有10篇文献被纳入分析.与对照组相比,ADM组总并发症、感染,血肿/血清肿及扩张器/假体取出发生率的比值比(OR)分别为1.51(P =0.038)、1.91(P=0.032)、1.80(P =0.005)和2.37(P =0.138).结论 在扩张器/假体的乳房再造术中,使用ADM对血肿/血清肿的发生有促进作用,并有增加感染率及总并发症发生率的趋势.

  16. COCHLEAR IMPLANTATION: MY EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-12-01

    Full Text Available Cochlear implant is a small, surgically implanted complex electronic device that can help to provide a sense of sound to a person with severe to profound sensorineural hearing loss. This type of hearing loss, typically involves damage to hair cells in the cochlea, as a result sound cannot reach the auditory nerve which usually receives information from hair cells. A cochlear implant skips the damaged hair cells and to stimulate the auditory nerve directly. An implant does not restore normal hearing, instead it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech. I am here presenting this article in relation to the indications, intraoperative and postoperative complications of cochlear implantation in our institute since January 2013. Children who receive implants at earlier age, outperform their peers who are implanted at a later age. This is reflected in all the areas of speech and language development.

  17. Characteristics of women with cosmetic breast augmentation surgery compared with breast reduction surgery patients and women in the general population of Sweden

    NARCIS (Netherlands)

    Fryzek, JP; Weiderpass, E; Signorello, LB; Hakelius, L; Lipworth, L; Blot, WJ; McLaughlin, JK; Nyren, O

    2000-01-01

    To determine whether women with cosmetic breast implants have distinct demographic, lifestyle, and reproductive characteristics that put them at increased risk for subsequent morbidity, the authors compared 1,369 such women to 2,211 women who had undergone breast reduction surgery, and to a random s

  18. Benefits and Risks of Cochlear Implants

    Science.gov (United States)

    ... and Medical Procedures Implants and Prosthetics Cochlear Implants Benefits and Risks of Cochlear Implants Share Tweet Linkedin ... the Use of Cochlear Implants What are the Benefits of Cochlear Implants? For people with implants: Hearing ...

  19. Radiological response of ceramic and polymeric devices for breast brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Batista Nogueira, Luciana, E-mail: lucibn19@yahoo.com.br [Departamento de Propedeutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil); Passos Ribeiro de Campos, Tarcisio, E-mail: campos@nuclear.ufmg.br [Departamento de Engenharia Nuclear, Programa de Pos Graduacao em Ciencias e Tecnicas Nucleares, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil)

    2012-04-15

    In the present study, the radiological visibility of ceramic and polymeric devices implanted in breast phantom was investigated for future applications in brachytherapy. The main goal was to determine the radiological viability of ceramic and polymeric devices in vitro by performing simple radiological diagnostic methods such as conventional X-ray analysis and mammography due to its easy access to the population. The radiological response of ceramic and polymeric devices implanted in breast phantom was determined using conventional X-ray, mammography and CT analysis. - Highlights: Black-Right-Pointing-Pointer Radiological visibility of ceramic and polymeric devices implanted in breast phantom. Black-Right-Pointing-Pointer The barium incorporation in the seed improves the radiological contrast. Black-Right-Pointing-Pointer Radiological monitoring shows the position, orientation and degradation of devices. Black-Right-Pointing-Pointer Simple radiological methods such as X-ray and mammography were used for radiological monitoring.

  20. Assessment of the breast volume by a new simple formula

    Directory of Open Access Journals (Sweden)

    El-Oteify Mahmoud

    2006-01-01

    Full Text Available Background: With the recent introduction of improved techniques for plastic surgery of the breast and increased public awareness toward these procedures, plastic surgeons are continuously trying to improve their methods and results to reach perfection. Assessment of the breast volume is an important issue prior to the use of breast implants in any aesthetic or reconstructive breast surgery. Previous methods to measure breast volume have included use of a simple bra and breast cup size, cumbersome fluid displacement, appliances and approximate visual estimation. Objectives: In this work we have tried to develop an easy method for assessment of the breast volume for both the patient and the the surgeon through a simple mathematical formula. Materials and Methods: Fifty two volunteers were included in this study. For every one, general parameters including age, weight and height were recorded. Local breast measurements and water volume displacement were also recorded. Results: The collected data were statistically correlated. Using the analyzed data, the breast volume was calculated through a simple and direct formula on the basis of the breast circumference. Conclusion: Our method has, as its principle, the use of an accurate and simple formula, which is based only on one measurement. This is easy for both the patient and the plastic surgeon. This equation is not only a significant technical advantage for the surgeon, but also provides a universal standardization of the breast volume.

  1. Implantes transcigomáticos Traszygomatic implants

    Directory of Open Access Journals (Sweden)

    B. Fernández Ateca

    2004-12-01

    Full Text Available Los implantes cigomáticos, originariamente diseñados por Branemark en 1989, son implantes de cabeza en 45 grados, de 4'5 milímetros de diámetro en su parte más ancha, y que pueden medir entre 30 y 50 milímetros de longitud. Se insertan desde la parte palatina del proceso alveolar, siguiendo la cresta cigomática-alveolar hasta anclarse en el cuerpo del malar, y en el caso de pacientes maxilectomizados, entrando directamente en el cuerpo del malar. Estos implantes ofrecen una alternativa más al cirujano en el momento de planificar un tratamiento protésico-rehabilitador implantosoportado. Sobretodo, en aquellos pacientes con un maxilar superior atrófico en el que no se pueden realizar injertos óseos o estos han fracasado. El objetivo de este artículo es proponer el protocolo quirúrgico de colocación de los implantes trascigomáticos y revisar la literatura actual sobre la evolución clínica de estos implantes.The zygomatic implants, originally designed by Branemark in 1989, are implants with a 45 degree inclined head, 4'5 millimetre diameter at their widest part and measuring between 30 and 50 millimetres in length. They are inserted from the palatine side of the alveolar process, following the zygomatic-alveolar edge and anchor in the body of the zygomatic bone. In the case of maxillectomized patients, they are inserted directly in the body of the malar bone. These implants offer an additional alternative to the surgeon when planning an implant supported rehabilitation treatment; specially in those patients with an atrophic maxilla in which osseous grafts cannot be realized or these grafts have failed. The objective of this article is to propose the surgical,protocol of placement of traszygomatic implants and to check the current literature on the clinical evolution of these implants.

  2. Filariasis of The Breast

    OpenAIRE

    Subhash Bhardwaj, Deepti Mahajan,MRAttri*

    2007-01-01

    Filariasis of the breast presenting as a breast lump and clinically simulating a breast cancer is an unusualpresentation. The present case is of a 42 year old female whose breast lump was excised and histopathologyrevealed filariasis.

  3. Premenstrual breast changes

    Science.gov (United States)

    Premenstrual tenderness and swelling of the breasts; Breast tenderness - premenstrual; Breast swelling - premenstrual ... Symptoms of premenstrual breast tenderness may range from mild to ... most severe just before each menstrual period Improve during ...

  4. Breast enlargement in males

    Science.gov (United States)

    Gynecomastia; Breast enlargement in a male ... The condition may occur in one or both breasts. It begins as a small lump beneath the nipple, which may be tender. One breast may be larger than the other. Enlarged breasts ...

  5. Fibrocystic breast disease

    Science.gov (United States)

    Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes ... made in the ovaries may make a woman's breasts feel swollen, lumpy, or painful before or during ...

  6. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... Breast Cancer > Breast Cancer - Treatment Options Request Permissions Breast Cancer - Treatment Options Approved by the Cancer.Net Editorial ... recommendations for ovarian ablation . Hormonal therapy for metastatic breast cancer Hormonal therapies are also commonly used to treat ...

  7. Surgery for Breast Cancer

    Science.gov (United States)

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  8. Learning about Breast Cancer

    Science.gov (United States)

    ... genetic terms used on this page Learning About Breast Cancer What do we know about heredity and breast ... Cancer What do we know about heredity and breast cancer? Breast cancer is a common disease. Each year, ...

  9. Breast Reconstruction

    Science.gov (United States)

    ... Autoconocimiento de los senos Preguntas Para el Médico Datos Para la Vida Komen El cuidado de sus ... and vary in the amount of projection and base width. The best implant shape and size will ...

  10. Breast Cancer

    Science.gov (United States)

    ... click the brackets in the lower right-hand corner of the video screen. To reduce the videos, ... with breast cancer are under way. With early detection, and prompt and appropriate treatment, the outlook for ...

  11. Breast cancer

    International Nuclear Information System (INIS)

    This article is about the diagnosis, treatment and monitoring of breast cancer. Positive diagnosis is based on clinical mammary exam, mammography, mammary ultrasonography, and histological study. Before the chemotherapy and radiotherapy treatment are evaluated the risks

  12. Breast ultrasound

    Science.gov (United States)

    Hacker NF, Friedland ML. Breast disease. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 30. Harvey ...

  13. Breast Density and Your Breast Mammogram Report

    Science.gov (United States)

    Breast Density and Your Mammogram Report Regular mammograms are the best way to find breast cancer early. But if ... But in some women, there’s little change. Breast density is very common, and is not abnormal. How ...

  14. External beam accelerated partial breast irradiation (EB-APBI yields favorable outcomes in patients with prior breast augmentation

    Directory of Open Access Journals (Sweden)

    Rachel Yi-Feng Lei

    2014-06-01

    Full Text Available Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI utilizing intensity modulated radiotherapy (IMRT or 3-dimensional conformal radiotherapy (3D-CRT, both with image-guided radiotherapy (IGRT.Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov. Patients received 38.5 Gy in 10 fractions over 5 consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.Results: The median follow-up from APBI completion was 18.0 months (range, 1.2-58.6. Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 93.8% (15/16, and by physicians as excellent/good in 100% (16/16. Eight patients (50.0% reported no breast/chest wall pain, and the remaining 8 patients (50.0% reported mild pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV, and implant volumes were 614 cc, 57 cc, and 333 cc. The median ratios of PTV/ipsilateral breast volume (implant excluded and PTV/total volume (implant included were 9% and 6%. Conclusions: These 16 breast cancer cases with prior bilateral breast augmentation treated with external beam APBI demonstrate favorable clinical outcomes. Further exploration of external beam APBI as a treatment option for this patient po

  15. Screening for Breast Problems

    Science.gov (United States)

    ... a clinical breast exam done? • What is breast self-awareness? • How is breast self-awareness different from the traditional breast self-exam? •Glossary ... problems includes mammography , clinical breast exams, and breast self-awareness. What is mammography? Mammography is an X-ray ...

  16. Dental Implant Systems

    OpenAIRE

    Yoshiki Oshida; Tuna, Elif B.; Oya Aktören; Koray Gençay

    2010-01-01

    Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with...

  17. Specific Volume of Female Subcutaneous Abdominal Tissue as a Reference in Autologous Breast Reconstruction

    NARCIS (Netherlands)

    W.J. van der Pot; M. Kreulen; P. Melis; J.J. Hage

    2010-01-01

    Use of the deep inferior epigastric perforator (DIEP) flap is gaining popularity as the method of choice for breast reconstruction and replacement of prosthetic breast implants. Ideally, the volume of the prosthesis is replaced by the same volume of autologous tissue to restore shape and symmetry. S

  18. Long-term Follow-up with AlloDerm in Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Richard A. Baxter, MD, FACS

    2013-05-01

    Full Text Available Summary: Little is known about the long-term fate of acellular dermal matrices in breast implant surgery. A 12-year follow-up case with tissue analysis of AlloDerm in revision breast reconstruction reveals retention of graft volume and integration with an organized collagen structure, minimal capsule formation, and little or no indication of inflammation.

  19. HA-Coated Implant

    DEFF Research Database (Denmark)

    Daugaard, Henrik; Søballe, Kjeld; Bechtold, Joan E

    2014-01-01

    The goal of osseointegration of orthopedic and dental implants is the rapid achievement of a mechanically stable and long lasting fixation between living bone and the implant surface. In total joint replacements of cementless designs, coatings of calcium phosphates were introduced as a means...... of improving the fixation of implants. Of these, hydroxyapatite (HA) is the most widely used and most extensively investigated. HA is highly osseoconductive, and the positive effect is well documented in both basic and long-term clinical research [1–6]. This chapter describes experimental and clinical studies...... evaluating bone-implant fixation with HA coatings....

  20. Temporary ectopic hand implantation

    Directory of Open Access Journals (Sweden)

    Xu Zhang

    2015-03-01

    Full Text Available Severe crushing injuries to the distal forearm can preclude immediate hand replantation, with temporary ectopic implantation as a practicable option under special circumstances. This report describes a case of temporary ectopic hand implantation for a crush injury extending from the wrist to the middle third of the forearm, using the left foot as the recipient site. The hand was replanted onto the left forearm 3 months after the ectopic implantation, with functional gains seen by 18 months. Satisfactory ambulation was retained, with no reported foot pain. Temporary ectopic implantation is a pragmatic alternative under select circumstances.

  1. Ion implantation technology

    CERN Document Server

    Downey, DF; Jones, KS; Ryding, G

    1993-01-01

    Ion implantation technology has made a major contribution to the dramatic advances in integrated circuit technology since the early 1970's. The ever-present need for accurate models in ion implanted species will become absolutely vital in the future due to shrinking feature sizes. Successful wide application of ion implantation, as well as exploitation of newly identified opportunities, will require the development of comprehensive implant models. The 141 papers (including 24 invited papers) in this volume address the most recent developments in this field. New structures and possible approach

  2. Breast Imaging in Evaluation of Breast Cancer: Radiologist’s Point of View

    Directory of Open Access Journals (Sweden)

    Nahid Sedighi

    2010-05-01

    Full Text Available In every breast imaging, the radiologist confronts these questions:"n1. Finding the lesion"n2. Is the lesion real?"n3. Where the pathology lies"n4. What the lesion is "n5. What should be done about it?"nThe major objective in breast imaging is the detection of breast cancers at a small size and early stage in an effort to reduce mortality."nSome conditions limit evaluation of breast cancer imaging."nWhen additional mammographic views or ultrasound are unable to triangulate the location of a lesion, computed tomography can be very helpful for locating lesions three dimensionally. MRI with and without contrast is the other modality for evaluation of problematic cases or ambiguous findings in other modalities."nImplants present a problem for breast imaging in that they may prevent optimal visualization of the tissues."nA focal asymmetric density may merely represent an island of breast tissue. DCIS, with or without calcification, and metastatic axillary lymph nodes in a normal mammogram are some of the problematic cases of breast cancer."nThis presentation is expected to include real cases of breast cancer with the above-mentioned problems or unusual manifestations, which are resolved by a combination of different imaging modalities.    

  3. 英国对PIP公司制造的乳房假体安全性展开调查%UK launches inquiry into safety of PIP breast implants

    Institute of Scientific and Technical Information of China (English)

    Adrian O'Dowd; 孙薇

    2012-01-01

    英国政府日前开展了对法国制造的某特定乳房假体安全性的紧急调查,以试图安抚英国4万名使用此类假体的女性.法国政府已发表声明,将为使用PIP( Poly Implant Prosthèse)公司制造假体的3万名女性接受预防性移除手术支付费用(详见BMJ2011;343:d8329, 29 Dec, doi:10.1136/bmj.d8329).

  4. Tracking the aesthetic outcomes of prosthetic breast reconstructions that have complications

    OpenAIRE

    Mioton, Lauren M; Seth, Akhil; Gaido, Jessica; Fine, Neil A; Kim, John YS

    2014-01-01

    Numerous studies have reported that successful breast reconstruction with satisfying aesthetic outcomes following mastectomy is vital to the quality of life of breast cancer patients. Although several patient factors have been shown to influence the aesthetic results of reconstructive surgery, it is unclear whether postoperative complications contribute to adverse cosmetic outcomes. Accordingly, this retrospective chart review examined a series of expander-implant breast reconstructions perfo...

  5. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial

    International Nuclear Information System (INIS)

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  6. Implantable CMOS Biomedical Devices

    Directory of Open Access Journals (Sweden)

    Toshihiko Noda

    2009-11-01

    Full Text Available The results of recent research on our implantable CMOS biomedical devices are reviewed. Topics include retinal prosthesis devices and deep-brain implantation devices for small animals. Fundamental device structures and characteristics as well as in vivo experiments are presented.

  7. MUSIC AND COCHLEAR IMPLANTS

    Institute of Scientific and Technical Information of China (English)

    Mao Yitao; Xu Li

    2013-01-01

    Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.

  8. Breast carcinoma en Cuirasse - Case report*

    OpenAIRE

    de Oliveira, Gabriela Mantovanelli; Zachetti, Daniele Bueno Carvalho; Barros, Hugo Rocha; Tiengo, Adriana; Romiti, Ney

    2013-01-01

    Cutaneous metastasis is a phenomenon that results from a tumor spreading via lymphatic or vascular embolization, direct implant during surgery or skin involvement by contiguity. The primary malignant tumor that most commonly metastasizes to the skin in women is breast cancer, which can be manifested through papulonodular lesions, erysipeloid or sclerodermiform infiltration, en cuirasse. We report the case of a female patient, 78 years old, with papular, scaly and confluent lesions in the righ...

  9. Surgical Approaches to Breast Augmentation: The Transaxillary Approach.

    Science.gov (United States)

    Strock, Louis L

    2015-10-01

    The transaxillary approach to breast augmentation has the advantage of allowing breast implants to be placed with no incisions on the breasts. There has been a general perception of a lack of technical control compared with the inframammary approach. This article presents the transaxillary approach from the perspective of the technical control gained with the aid of an endoscope, which allows precise creation of the tissue pocket with optimal visualization. The aspects of technique that allow optimal technical control are discussed, in addition to postoperative processes that aid in stabilizing the device position and allow consistent and predictable outcomes.

  10. Dental Implant Systems

    Directory of Open Access Journals (Sweden)

    Yoshiki Oshida

    2010-04-01

    Full Text Available Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities.

  11. Breast self-exam

    Science.gov (United States)

    Self-examination of the breast; BSE; Breast cancer - BSE; Breast cancer screening - self exam ... The best time to do a monthly self-breast exam is about 3 to 5 days after your period starts. Do it at the same time every month. Your breasts are ...

  12. Propionibacterium acnes: An Underestimated Pathogen in Implant-Associated Infections

    Directory of Open Access Journals (Sweden)

    María Eugenia Portillo

    2013-01-01

    Full Text Available The role of Propionibacterium acnes in acne and in a wide range of inflammatory diseases is well established. However, P. acnes is also responsible for infections involving implants. Prolonged aerobic and anaerobic agar cultures for 14 days and broth cultures increase the detection rate. In this paper, we review the pathogenic role of P. acnes in implant-associated infections such as prosthetic joints, cardiac devices, breast implants, intraocular lenses, neurosurgical devices, and spine implants. The management of severe infections caused by P. acnes involves a combination of antimicrobial and surgical treatment (often removal of the device. Intravenous penicillin G and ceftriaxone are the first choice for serious infections, with vancomycin and daptomycin as alternatives, and amoxicillin, rifampicin, clindamycin, tetracycline, and levofloxacin for oral treatment. Sonication of explanted prosthetic material improves the diagnosis of implant-associated infections. Molecular methods may further increase the sensitivity of P. acnes detection. Coating of implants with antimicrobial substances could avoid or limit colonization of the surface and thereby reduce the risk of biofilm formation during severe infections. Our understanding of the role of P. acnes in human diseases will likely continue to increase as new associations and pathogenic mechanisms are discovered.

  13. Lubricin in human breast tissue expander capsules.

    Science.gov (United States)

    Cheriyan, Thomas; Guo, Lifei; Orgill, Dennis P; Padera, Robert F; Schmid, Thomas M; Spector, Myron

    2012-10-01

    Capsular contraction is the most common complication of breast reconstruction surgery. While presence of the contractile protein alpha smooth muscle actin (α-SMA) is considered among the causes of capsular contraction, the exact etiology and pathophysiology is not fully understood. The objective of this study was to investigate the possible role of lubricin in capsular formation and contraction by determining the presence and distribution of the lubricating protein lubricin in human breast tissue expander capsules. Related aims were to evaluate select histopathologic features of the capsules, and the percentage of cells expressing α-SMA, which reflects the myofibroblast phenotype. Capsules from tissue expanders were obtained from eight patients. Lubricin, at the tissue-implant interface, in the extracellular matrix, and in cells, and α-SMA-containing cells were evaluated immunohistochemically. The notable finding was that lubricin was identified in all tissue expander capsules: as a discrete layer at the tissue-implant interface, extracellular, and intracellular. There was a greater amount of lubricin in the extracellular matrix in the intimal-subintimal zone when compared with the tissue away from the implant. Varying degrees of synovial metaplasia were seen at the tissue-implant interface. α-SMA-containing cells were also seen in all but one patient. The findings might help us better understand factors involved in capsule formation.

  14. Breast cancer

    CERN Multimedia

    2002-01-01

    "Cancer specialists will soon be able to compare mammograms with computerized images of breast cancer from across Europe, in a bid to improve diagnosis and treatment....The new project, known as MammoGrid, brings together computer and medical imaging experts, cancer specialists, radiologists and epidemiologists from Bristol, Oxford, Cambridge, France and Italy" (1 page).

  15. Progestin and breast cancer risk: a systematic review.

    Science.gov (United States)

    Samson, Marsha; Porter, Nancy; Orekoya, Olubunmi; Hebert, James R; Adams, Swann Arp; Bennett, Charles L; Steck, Susan E

    2016-01-01

    This systematic review summarizes research on the use of progestin and breast cancer risk. Although mainly used for contraception, progestin can help treat menstrual disorders, and benign breast, uterine, and ovarian diseases. Breast cancer is the leading site of new, non-skin, cancers in females in the United States, and possible factors that may modulate breast cancer risk need to be identified. ProQuest (Ann Arbor, MI) and PubMed-Medline (US National Library of Medicine, Bethesda MD, USA) databases were used to search for epidemiologic studies from 2000 to 2015 that examined the association between progestin and breast cancer. Search terms included epidemiologic studies + progesterone or progestin or progestogen or contraceptive or contraceptive agents + breast cancer or breast neoplasms. A total of six studies were included in the review. Five of the six studies reported no association between progestin-only formulations (including norethindrone oral contraceptives, depot medroxyprogesterone acetate, injectable, levonorgestrel system users, implantable and intrauterine devices) and breast cancer risk. Duration of use was examined in a few studies with heterogeneous results. Unlike studies of other oral contraceptives, studies indicate that progestin-only formulations do not increase the risk of breast cancer, although the literature is hampered by small sample sizes. Future research is needed to corroborate these findings, as further understanding of synthetic progesterone may initiate new prescription practices or guidelines for women's health.

  16. Progestin and breast cancer risk: a systematic review.

    Science.gov (United States)

    Samson, Marsha; Porter, Nancy; Orekoya, Olubunmi; Hebert, James R; Adams, Swann Arp; Bennett, Charles L; Steck, Susan E

    2016-01-01

    This systematic review summarizes research on the use of progestin and breast cancer risk. Although mainly used for contraception, progestin can help treat menstrual disorders, and benign breast, uterine, and ovarian diseases. Breast cancer is the leading site of new, non-skin, cancers in females in the United States, and possible factors that may modulate breast cancer risk need to be identified. ProQuest (Ann Arbor, MI) and PubMed-Medline (US National Library of Medicine, Bethesda MD, USA) databases were used to search for epidemiologic studies from 2000 to 2015 that examined the association between progestin and breast cancer. Search terms included epidemiologic studies + progesterone or progestin or progestogen or contraceptive or contraceptive agents + breast cancer or breast neoplasms. A total of six studies were included in the review. Five of the six studies reported no association between progestin-only formulations (including norethindrone oral contraceptives, depot medroxyprogesterone acetate, injectable, levonorgestrel system users, implantable and intrauterine devices) and breast cancer risk. Duration of use was examined in a few studies with heterogeneous results. Unlike studies of other oral contraceptives, studies indicate that progestin-only formulations do not increase the risk of breast cancer, although the literature is hampered by small sample sizes. Future research is needed to corroborate these findings, as further understanding of synthetic progesterone may initiate new prescription practices or guidelines for women's health. PMID:26700034

  17. Effects of therapeutic touch associated with musicotherapy and aromatherapy on perioperative stress reaction of patients undergoing breast implants surgery%音乐香薰疗法和触摸疗法相结合对假体隆乳术患者围手术期应激反应的影响

    Institute of Scientific and Technical Information of China (English)

    鲁妍

    2011-01-01

    目的:探讨触摸疗法和音乐香薰疗法相结合对假体隆乳术患者围手术期应激反应的影响.方法:选取90例静脉麻醉下行假体隆胸术的患者,按随机数字表分为3组,每组30例,于术前一天上午,下午及临睡前半小时分别给予三次不同的护理干预:对照组(A组),静卧于病床20 min;触摸疗法组(B组),触摸治疗20 min;触摸疗法+音乐香薰疗法组(C组),触摸治疗+音乐香薰疗法20 min.干预前(术前1h)和干预后(术后6h)分别测定患者状态焦虑值(SAI);入院时,术前1h、术中(切皮时),术后4h测定患者平均动脉血压(MAP)、心率(HR)和血糖(Glu);术后6h测定患者疼痛程度(VAS)的变化.结果:三组患者入院时SAI值均显著高于常模,组闻无差异(P>0.05);干预后A组略上升,B组和C组明显下降,低于常模,C组低于B组(P0.05);术中三组MAP、HR均升高,B.C组间差异明显(P0.05);术中略升高;术后4h下降,C组最低(P0.05).结论:术前触摸疗法和音乐香薰疗法相结合的护理措施可以有效减轻假体隆乳术患者的围手术期应激反应.%Objective To investigate the effects of therapeutic touch associated with musicotherapy and aromatherapy on perioperative stress reaction of patients undergoing breast implants surgery. Methods 90 women undergoing breast implants surgery with intravenous anesthesia were randomly into three groups (n=30):control group (group A),therapeutic touch group (group B) and therapeutic touch associated with musicotherapy and aromatherapy group (group C).Treatments were applied for 20 min in preoperative day three times, with (group A) lying in bed with eyes closed only; (group B) therapeutic touch; (group C) therapeutic touch associated with musicotherapy and aromatherapy.The values of SAI from patients were determined at 1h before operation and 6h after operation; MAP,HR and Glu were detected at admission to hospital,1h before operation, during operation and 4h after operation; the values

  18. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  19. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  20. Perioperative Management of Multiple Noncardiac Implantable Electronic Devices.

    Science.gov (United States)

    Ramos, Juan A; Brull, Sorin J

    2015-12-01

    The number of patients with noncardiac implantable electronic devices is increasing, and the absence of perioperative management standards, guidelines, practice parameters, or expert consensus statements presents clinical challenges. A 69-year-old woman presented for latissimus dorsi breast reconstruction. The patient had previously undergone implantation of a spinal cord stimulator, a gastric pacemaker, a sacral nerve stimulator, and an intrathecal morphine pump. After consultation with device manufacturers, the devices with patient programmability were switched off. Bipolar cautery was used intraoperatively. Postoperatively, all devices were interrogated to ensure appropriate functioning before home discharge. Perioperative goals include complete preoperative radiologic documentation of device component location, minimizing electromagnetic interference, and avoiding mechanical damage to implanted device components. PMID:26588030

  1. MEMS biomedical implants

    Institute of Scientific and Technical Information of China (English)

    Tai Yuchong

    2012-01-01

    The field of micro-electro-mechanical systems (MEMS) has advanced tremendously for the last 20 years. Most commercially noticeably, the field has successfully advanced from pressure sensors to micro physical sensors, such as accelerometers and gyros, for handheld electronics application. In parallel, MEMS has also advanced into micro total analysis system(TAS) and/or lab-on-a-chip applications. This article would discuss a relatively new but promising future direction towards MEMS biomedical implants. Specifically, Parylene C has been explored to be used as a good MEMS implant material and will be discussed in detail. Demonstrated implant devices, such as retinal and spinal cord implants, are presented in this article.

  2. Ion Implantation of Polymers

    DEFF Research Database (Denmark)

    Popok, Vladimir

    2012-01-01

    The current paper presents a state-of-the-art review in the field of ion implantation of polymers. Numerous published studies of polymers modified by ion beams are analysed. General aspects of ion stopping, latent track formation and changes of structure and composition of organic materials...... are discussed. Related to that, the effects of radiothermolysis, degassing and carbonisation are considered. Specificity of depth distributions of implanted into polymers impurities is analysed and the case of high-fluence implantation is emphasised. Within rather broad topic of ion bombardment, the focus...... is put on the low-energy implantation of metal ions causing the nucleation and growth of nanoparticles in the shallow polymer layers. Electrical, optical and magnetic properties of metal/polymer composites are under the discussion and the approaches towards practical applications are overviewed....

  3. Superelastic Orthopedic Implant Coatings

    Science.gov (United States)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  4. Breast lump removal

    Science.gov (United States)

    Lumpectomy; Wide local excision; Breast conservation surgery; Breast-sparing surgery; Partial mastectomy ... If the breast cancer can be seen on imaging tests but the doctor cannot feel it when examining you, a wire ...

  5. Breast Cancer Disparities

    Science.gov (United States)

    ... 2.65 MB] Read the MMWR Science Clips Breast Cancer Black Women Have Higher Death Rates from Breast ... of Page U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

  6. Breast cancer screenings

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000837.htm Breast cancer screenings To use the sharing features on this page, please enable JavaScript. Breast cancer screenings can help find breast cancer early, before ...

  7. Male Breast Cancer

    Science.gov (United States)

    Although breast cancer is much more common in women, men can get it too. It happens most often to men between ... 60 and 70. Breast lumps usually aren't cancer. However, most men with breast cancer have lumps. ...

  8. Cochlear Implant in Adults

    Directory of Open Access Journals (Sweden)

    Jaleh Samadi

    2003-09-01

    Full Text Available Cochlear implant is the result of a great combination and collaboration of engineering and medicine. It is mainly because it has the most conflict with the human nervous system among all prosthesis. Cochlear implant helps a child with profound hearing loss to understand and articulate speech and let an adult person with hearing loss communicate with people by phone. Although these wonderful results could not be seen in all patients, will let us know about the great scientific findings.

  9. [Biological implant in single-stage reconstruction of mammary gland for cancer].

    Science.gov (United States)

    Zikiriakhodzhaev, A D; Ermoshchenkova, M V

    2015-01-01

    Brief literature review about features of biological implants application for mammary gland reconstruction is presented in the article. Possible complications after such materials use, first experience of acellular dermal matrix administration for single-stage mammary gland reconstruction in 6 patients with breast cancer are also described. We offered surgical techniques, complications and methods of its treatment. We presented advantages of biological implant use which are consisted in decrease of surgical damage and duration of surgery, opportunity for enlargement of pocket for implant, decrease of pain syndrome. PMID:25909549

  10. Simple Implant Augmentation Rhinoplasty.

    Science.gov (United States)

    Nguyen, Anh H; Bartlett, Erica L; Kania, Katarzyna; Bae, Sang Mo

    2015-11-01

    Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placement. An implant prosthesis should be used on a case-by-case basis. Augmentation rhinoplasty requires the consideration of specific anatomical preoperative factors, including the external nose, nasal length, nasofrontal angle, humps, and facial proportions. It is equally important to consider several operative guidelines to appropriately shape implants to minimize the occurrence of adverse effects and postoperative complications. The most common postoperative complications include infection, nasal height change, movement of implant prosthesis, and silicone implant protrusion. In addition, the surgeon should consider the current standards of Asian beauty aesthetics to better understand the patient's desired outcome. PMID:26648804

  11. Contraceptive implants: current perspectives

    Directory of Open Access Journals (Sweden)

    Rowlands S

    2014-09-01

    Full Text Available Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost-effective form of long-acting reversible contraception. They are the most effective reversible contraceptives and are of a similar effectiveness to sterilization. Pregnancies are rare in women using this method of contraception, and those that do occur must be fully investigated, with an ultrasound scan of the arm and serum etonogestrel level if the implant cannot be located. There are very few contraindications to use of implants, and they have an excellent safety profile. Both acceptability and continuation with the method are high. Noncontraceptive benefits include improvements in dysmenorrhea, ovulatory pain, and endometriosis. Problematic bleeding is a relatively common adverse effect that must be covered in preinsertion information-giving and supported adequately if it occurs. Recognized training for both insertion and removal should be undertaken. Care needs to be taken at both insertion and removal to avoid neurovascular injury. Implants should always be palpable; if they are not, noninsertion should be assumed until disproven. Etonogestrel implants are now radiopaque, which aids localization. Anticipated difficult removals should be performed by specially trained experts. Keywords: contraceptive, subdermal implant, etonogestrel, levonorgestrel, progestin-only, long-acting reversible contraception

  12. Biomaterials in cochlear implants

    Directory of Open Access Journals (Sweden)

    Lenarz, Thomas

    2009-01-01

    Full Text Available The cochlear implant (CI represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development.

  13. Protective effect of topical antibiotics in breast augmentation

    DEFF Research Database (Denmark)

    Pfeiffer, Philip; Jørgensen, Signe; Kristiansen, Thomas B;

    2009-01-01

    BACKGROUND: Previous studies indicate that antibacterial lavage and/or use of topical antibiotics may reduce infection in breast implant surgery and perhaps also reduce occurrence of capsular contracture. A retrospective analysis was performed to evaluate this effect. METHODS: The study participa......BACKGROUND: Previous studies indicate that antibacterial lavage and/or use of topical antibiotics may reduce infection in breast implant surgery and perhaps also reduce occurrence of capsular contracture. A retrospective analysis was performed to evaluate this effect. METHODS: The study...... versus 5.9 percent; p = 0.393). CONCLUSION: The authors' data support the use of topical antibiotics in cosmetic breast surgery, because significant increases of both infections and seroma were seen in patients not treated with topical antibiotics compared with a cohort of similar patients where topical...... antibiotics were used....

  14. Does the Use of Intraoperative Breast Sizers Increase Complication Rates in Primary Breast Augmentation? A Retrospective Analysis of 416 Consecutive Cases in a Single Institution

    Directory of Open Access Journals (Sweden)

    Lee Seng Khoo

    2016-01-01

    Full Text Available Background. Is the use of intraoperative breast sizers beneficial for plastic surgeons or do they result in higher complication rates? Methods. This is a retrospective study of 416 consecutive cases of primary breast augmentation with silicone implants at the Plastic Surgery Service of Professor Ivo Pitanguy at the 38th Infirmary Santa Casa Misericórdia Hospital, Rio De Janeiro, from January 2011 to March 2014. 212 cases (51% were carried out with use of intraoperative breast sizers with 204 cases (49% without the use of implant sizers. This study compares the outcome of cases that employed the use of intraoperative implant sizers versus those that did not in terms of infection, hematoma/seroma formation, and capsular contracture. Results. Of 416 primary breast augmentation cases, there were 5 cases of infection (1.2%, 4 cases of seroma (1%, 3 cases of hematoma (0.7%, and 7 cases of capsular contracture (Baker’s Grade III/IV(1.7%. Total complication rate limited to infection, seroma, hematoma, and capsular contracture was 1.15% (95% CI 0.96–1.93%. There was a significant difference in the scores for breast sizers (M = 4.3, SD = 1.4 and no breast sizers (M = 2.3, SD = 0.87 conditions, t(8 = 2.79, p=0.018. The use of implant sizers was correlated with a higher complication rate. Conclusion. Good results could be obtained without the use of breast sizers in primary breast augmentation with use of a biodimensional tissue based planning system while eliminating risks of infection and reducing intraoperative time. Notwithstanding, in a residency program breast sizers can be an excellent training tool to shorten the learning curve in the novice surgeon.

  15. Iatrogenic Tumor Implantation

    Institute of Scientific and Technical Information of China (English)

    Ying Ma; Ping Bai

    2008-01-01

    Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy. It involves desquamation and dissemination of tumor cells that develop into a local recurrence or distant metastasis from the tumor under treatment. The main clinical feature of the condition is nodules at the operation's porous channel or incision, which is easily diagnosed in accordance with the case history. Final diagnosis can be made based on pathological examination. Tumor implantation may occur in various puncturing porous channels, including a laparoscopic port, abdominal wall incision, and perineal incision, etc. Besides a malignant tumor,implantation potential exists with diseases, such as a borderline tumor and endometriosis etc. Once a tumor implantation is diagnosed, or suspected, surgical resection is usually conducted.During the diagnosis and treatment of diseases, avoiding and reducing iatrogenic implantation and dissemination has been regarded as an important principle for surgical treatment of tumors. In a clinical practice setting, if possible, excisional biopsy should be employed, if a biopsy is needed. Repeated puncturing should be avoided during a paracentesis. In a laparoscopic procedure, the tissue is first put into a sample bag and then is taken out from the point of incision. After a laparoscopic procedure, the peritoneum, abdominal muscular fasciae, and skin should be carefully closed, and/or the punctured porous channel be excised. In addition, the sample/tissue should be rinsed with distilled water before surgical closure of the abdominal cavity,allowing the exfoliated tumor cells to swell and rupture in the hypo-osmolar solution. Then surgical closure can be conducted following a change of gloves and equipment. The extent of hysteromyomectomy should as far as possible be away from the uterine cavity. The purpose of this study is to make clinicians aware of the possibility of tumor implantation

  16. Partial breast irradiation with interstitial high dose-rate brachytherapy: acute and late toxicities and cosmetic results

    International Nuclear Information System (INIS)

    Accelerated partial breast irradiation aims at decreasing the overall treatment time and reducing toxicity. The study we report is for early stage breast cancer and is a multicentre clinical investigation of partial breast irradiation achieved by interstitial high dose-rate (HDR) brachytherapy with intraoperative placement of catheters. We have been able to conclude from the initial data that an interstitial perioperative brachytherapy implant is a feasible method of treatment with good tolerance and good cosmetic results. (author)

  17. Breast Milk Best from the Breast?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_159054.html Breast Milk Best From the Breast? Babies were more likely ... get ear infections if they were fed pumped milk, study found To use the sharing features on ...

  18. Propeller thoracodorsal artery perforator flap for breast reconstruction

    Science.gov (United States)

    Angrigiani, Claudio; Escudero, Ezequiel; Artero, Guillermo; Gercovich, Gustavo; Deza, Ernesto Gil

    2014-01-01

    Background The thoracodorsal artery perforator (TDAP) flap has been described for breast reconstruction. This flap requires intramuscular dissection of the pedicle. A modification of the conventional TDAP surgical technique for breast reconstruction is described, utilizing instead a propeller TDAP flap. The authors present their clinical experience with the propeller TDAP flap in breast reconstruction alone or in combination with expanders or permanent implants. Methods From January 2009 to February 2013, sixteen patients had breast reconstruction utilizing a propeller TDAP flap. Retrospective analysis of patient characteristics, clinical indications, procedure and outcomes were performed. The follow-up period ranged from 4 to 48 months. Results Sixteen patients had breast reconstruction using a TDAP flap with or without simultaneous insertion of an expander or implant. All flaps survived, while two cases required minimal resection due to distal flap necrosis, healing by second intention. There were not donor-site seromas, while minimal wound dehiscence was detected in two cases. Conclusions The propeller TDAP flap appears to be safe and effective for breast reconstruction, resulting in minimal donor site morbidity. The use of this propeller flap emerges as a true alternative to the traditional TDAP flap. PMID:25207210

  19. Bilateral desmoid tumor of the breast: case seriesand literature review

    Science.gov (United States)

    Wongmaneerung, Phanchaporn; Somwangprasert, Areewan; Watcharachan, Kirati; Ditsatham, Chagkrit

    2016-01-01

    Background Desmoid tumor of the breast is very rare and locally aggressive but has no distant metastasis. Bilateral lesions are extremely rare, found in only 4% of patients. Two cases of bilateral desmoid tumor of the breast are reported. The clinical presentation, diagnosis, imaging, treatment, and follow-up outcomes of recurrence as well as a brief literature review are provided. Case reports Case 1 is a 31-year-old woman who presented with nipple retraction. An ultrasound revealed BIRAD V in both breasts. She underwent a bilateral excisional biopsy under ultrasound mark with the pathology result of extra-abdominal desmoid tumor in both breasts. The patient had a bilateral mastectomy with silicone implantation due to the involved margins by excision. She remained tumor free after 7-year follow-up. Case 2 is a 28-year-old woman who presented with a lump on her right breast that she had discovered ~2 months earlier. An ultrasound showed a spiculated mass in the right breast and some circumscribed hypoechoic masses in both breasts. A bilateral breast excision was done. The pathology result was an extra-abdominal desmoid tumor. She had recurrence on both sides and underwent a mastectomy and silicone implantation. The tumor has not recurred after 1-year follow-up. Conclusion Imaging cannot distinguish between benign breast lesions and malignancy. Pathology results are helpful in making a definitive diagnosis. Given that the desmoid tumor is locally aggressive, a local excision with clear margins is recommended. Chemotherapy and hormonal treatment are controversial. PMID:27578999

  20. Patient-Reported Outcomes Following Breast Reconstruction Surgery and Therapeutic Mammoplasty: Prospective Evaluation 1 Year Post-Surgery with BREAST-Q Questionnaire.

    Science.gov (United States)

    Shekhawat, Laxmi; Busheri, Laleh; Dixit, Santosh; Patel, Chaula; Dhar, Upendra; Koppiker, Chaitanyanand

    2015-12-01

    Breast Cancer (BC) treatment leads to mutilation and destruction of breast shape with negative effects on body image and self-esteem.One of the main goals of reconstructive and oncoplastic breast surgery is to satisfy patients and improve their quality of life (QoL).Therefore, it is important to assess the patient experience post-surgery by means of patient-reported outcome measures (PROMs) that focus on the patient's perception of the surgery and surgical care, as well as psychosocial well-being and physical functioning. The objective of the current study was to identify predictors of patient satisfaction such as breast appearance including implant type in a selective sample of women who underwent breast reconstruction surgery using implants. Participants in this prospective study were women, (age 26-75 years) that were newly diagnosed with breast carcinoma. All consecutive patients who underwent breast reconstruction between January 2013 and October 2014 were asked to complete the BREAST-Q questionnaire 1 year after surgery. 120 patients underwent unilateral breast reconstruction using implant. While 38 patients underwent reconstruction with opposite breast reduction symmertization, 27 patients underwent therapeutic mammoplasty. The response rate for BREAST-Q questionnaire completion was 98 % with 147 out of 150 study participants completed the questionnaire. From the data collected from 147 patients, the responses could be distributed into 4 distinct groups based on the reconstruction outcomes namely "very much satisfied" (93 %) or "definitely and mostly satisfied" (94 %) or "satisfied" with the outcome (88 %) or "definitely agree on having reconstruction rather than the alternative of having no breast "(91 %).The results showed significant improvement in all four areas that were evaluated after surgery namely satisfaction with the appearance of the breasts, psychosocial, sexual and physical well-being. While the reconstruction surgery had an overall

  1. Imaging for cochlear implants.

    Science.gov (United States)

    Phelps, P D; Annis, J A; Robinson, P J

    1990-07-01

    Insertion of a sound amplification device into the round window niche (extracochlear implant) or into the coils of the cochlea (intracochlear implant) can give significant benefits to some carefully selected, severely deaf patients. Imaging has an essential role in selective and pre-operative assessment. Severe otosclerosis and post-meningitic labyrinthitis ossificans are common causes of deafness in these patients and can be demonstrated by computed tomography (CT). The most suitable side for operation can be assessed. We describe our experiences with 165 patients, 69 of whom were found suitable for implants. Thin (1 mm) section CT in axial and coronal planes is the best imaging investigation of the petrous temporal bones but the place of magnetic resonance scanning to confirm that the inner ear is fluid-filled and polytomography to show a multichannel implant in the cochlea is discussed. No implants were used for congenital deformities, but some observations are made of this type of structural deformity of the inner ear. PMID:2390686

  2. IMMEDIATE BREAST RECONSTRUCTION WITH LATISSIMUS DORSI MUSCULOCUTANEOUS FLAP: A SUITABLE OPTION FOR CHINESE WOMEN AFTER MASTECTOMY

    Institute of Scientific and Technical Information of China (English)

    DI Gen-hong; YU Ke-da; WU Jiong; QI Fa-zhi; LU Jin-song; SHEN Zhen-zhou; SHAO Zhi-min

    2006-01-01

    Objective: To discuss the suitable immediate breast reconstruction modalities for Chinese patients by comparing thepedicled transverse rectus abdominis myocytaneous flap (TRAM) reconstruction with latissimus dorsi myocytaneous flap (LTD) reconstruction plus implants or not after mastectomy due to breast cancer. Methods: From Jan. 2000 to Jul. 2005, 74staged 0-Ⅱ patients (mean age 39) were performed immediate breast reconstruction with autologous tissue either using LTD flaps or pedicled TRAM flaps with supplemental implants when necessary after mastectomy due to breast cancer and the charts were reviewed. Results: The age, marriage and menses status did not affect the selection of modalities and the need of implants. In 74 patients, 62 cases (83.8%) were performed LTD reconstruction with 13 implants and 12 cases received TRAM with 1 implant. The difference in need of implants or not between the two modalities had no statistical significance (P=0.442,Fisher' exact test). Aesthetic results judged as good or fair were in 88% patients and the cosmetic effects between LTD and TRAM groups or implant and non-implant groups had no differences. All reconstructions were successful, with 4.1%cumulative locoregional recurrence and 100% overall survival by following up to 66 months (median 9 months). The DFS and RFS between the two modalities had no significant differences by log rank test. Conclusion: Immediate autologous tissue reconstruction makes it possible to regain the natural and symmetric contour of breast without increased local recurrence. The LTD flap reconstruction is a suitable option for most Chinese women as well as the pedicled TRAM flap.

  3. Long-Term Clinical and Cosmetic Outcomes After Breast Conservation Treatment for Women With Early-Stage Breast Carcinoma According to the Type of Breast Boost

    International Nuclear Information System (INIS)

    Purpose: The present study was performed to compare outcomes after breast conservation treatment with iridium-192 implant boost vs. electron boost. Methods and Materials: From 1977 to 1983, 141 patients were treated with whole breast radiotherapy followed by iridium-192 boost after breast-conserving surgery. They were matched 1:1 to patients treated with electron boost. Outcome measures included survival, local recurrence, cosmesis, and complications. Results: Median follow-up was 16.7 and 12.6 years for the implant vs. electron groups (p < 0.001). Rates of local recurrence, freedom from distant metastases, and overall survival at 10/20 years did not differ between the groups, nor did patterns of first failure. Patients in the electron group were more likely to have excellent/good cosmesis than those in the implant group 1 year after radiotherapy (p = 0.014); this trend continued through 10 years but did not reach statistical significance at years 5/10. Complication rates were similar, although patients receiving electron boost seemed less likely to develop breast fibrosis than did those receiving implant boost (23/141 vs. 58/141, respectively, incidence rate ratio 0.7, p = 0.17). Conclusions: Twenty-year data demonstrate no difference in rates of local recurrence, freedom from distant metastases, overall survival, or patterns of failure between groups treated with these two well-described radiotherapy boost techniques. Better cosmesis was observed in the electron group 1 year after radiotherapy, with a trend continuing for 10 years. The incidence of complications was similar between the groups, with a trend toward increased fibrosis in patients receiving implant boost.

  4. Psychological intervention following implantation of an implantable defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Sears, Samuel F

    2007-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current...

  5. Dosimetry in x-ray-based breast imaging

    Science.gov (United States)

    Dance, David R.; Sechopoulos, Ioannis

    2016-10-01

    The estimation of the mean glandular dose to the breast (MGD) for x-ray based imaging modalities forms an essential part of quality control and is needed for risk estimation and for system design and optimisation. This review considers the development of methods for estimating the MGD for mammography, digital breast tomosynthesis (DBT) and dedicated breast CT (DBCT). Almost all of the methodology used employs Monte Carlo calculated conversion factors to relate the measurable quantity, generally the incident air kerma, to the MGD. After a review of the size and composition of the female breast, the various mathematical models used are discussed, with particular emphasis on models for mammography. These range from simple geometrical shapes, to the more recent complex models based on patient DBCT examinations. The possibility of patient-specific dose estimates is considered as well as special diagnostic views and the effect of breast implants. Calculations using the complex models show that the MGD for mammography is overestimated by about 30% when the simple models are used. The design and uses of breast-simulating test phantoms for measuring incident air kerma are outlined and comparisons made between patient and phantom-based dose estimates. The most widely used national and international dosimetry protocols for mammography are based on different simple geometrical models of the breast, and harmonisation of these protocols using more complex breast models is desirable.

  6. Lipoestructura y relleno del polo superior de la mama frente a implantes Structural fat graft and lipofilling of mammary upper pole versus mammary implants

    Directory of Open Access Journals (Sweden)

    J.M. Cervilla Lozano

    2012-09-01

    Full Text Available La lipoestructura mamaria ofrece nuevas alternativas de tratamiento en la cirugía estética de aumento mamario, cumpliendo en algunos casos las expectativas esperadas y en otros no. Analizamos este hecho en 4 tipos de aplicación de lipoestructura mamaria que hemos venido realizando en los últimos años, centrándonos en un aspecto importante de esta cirugía que es el relleno del polo superior de la mama. Los tipos de aplicación empleados son: aumento mamario simple mediante lipoestructura en comparación con implantes; pexia más lipoestructura frente a pexia más implantes mamarios; reconstrucción de mama tuberosa mediante lipoestructura o implantes y finalmente, relleno periprotésico mediante lipoestructura en mamas sometidas a cirugía de aumento mamario con implantes. En definitiva, podríamos resumir este trabajo en una frase diciendo que la lipoestructura mamaria, a nuestro juicio, no sirve si lo que prima es conseguir el relleno del polo superior de la mama, siendo en este caso de elección la colocación de implantes mamarios. No obstante, en alguno de los casos señalados no solo es una alternativa, sino que obtiene resultados superiores a los logrados sólamente con implantes.The mammary structural fat graft offers news treatment options in breast augmentation cosmetic surgery, but it sometimes meets expectations and sometimes doesn´t. We analyze 4 different types of lipostructure mammary applications that we have been using in the last years, focused in an important aspect of this surgery as it´s the filling of the upper mammary pole. These applications are: mammary augmentation by simple structural fat compared with the use of mammary implants; structural fat graft and mastopexy versus implants and mastopexy; tuberous breast reconstruction using structural fat graft or implants and finally, periprosthetic filling in breast augmentation with mammary implants using structural fat graft. In short, we could summarize this paper

  7. Breast Cancer Overview

    Science.gov (United States)

    ... Other less common types of breast cancer include: Medullary Mucinous Tubular Metaplastic Papillary breast cancer Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers. Paget’s disease is a type of cancer that begins in ...

  8. Breast Cancer -- Male

    Science.gov (United States)

    ... Home > Types of Cancer > Breast Cancer in Men Breast Cancer in Men This is Cancer.Net’s Guide to Breast Cancer in Men. Use the menu below to choose ... social workers, and patient advocates. Cancer.Net Guide Breast Cancer in Men Overview Statistics Risk Factors and Prevention ...

  9. Breast cancer in men

    Science.gov (United States)

    ... in situ-male; Intraductal carcinoma-male; Inflammatory breast cancer-male; Paget disease of the nipple-male; Breast cancer-male ... The cause of breast cancer is not clear. But there are risk ... breast cancer more likely in men: Exposure to radiation Higher ...

  10. Dental Implant Complications.

    Science.gov (United States)

    Liaw, Kevin; Delfini, Ronald H; Abrahams, James J

    2015-10-01

    Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging.

  11. Capsular synovial metaplasia mimicking silicone leak of a breast prosthesis: a case report

    Directory of Open Access Journals (Sweden)

    Krishnanandan Sarah

    2008-08-01

    Full Text Available Abstract Introduction Synovial metaplasia around a prosthesis and in particular around silicone breast implants has been noted by various investigators, but has unknown clinical significance. We report on a patient where a large amount of synovial fluid mimicked rupture of an implant. We believe this to be an unusual clinical presentation of this phenomenon. Review of the English language literature failed to identify a comparable case. Case presentation A 25-year-old woman had undergone bilateral breast augmentation for cosmetic reasons. One implant was subsequently subjected to two attempts at expansion to correct asymmetry. The patient was later found to have a large quantity of viscous fluid around the port of that same prosthesis. Histological assessment of the implant had consequently confirmed capsular synovial metaplasia. This had initially caused the suspicion of a silicone 'bleed' from the implant and had resulted in an unnecessary explantation. Conclusion Capsular synovial metaplasia should be ruled out before the removal of breast implants where a leak is suspected. Manipulation and expansion of an implant may be risk factors for the development of synovial metaplasia.

  12. Imaging male breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, S., E-mail: sdoyle2@nhs.net [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom); Steel, J.; Porter, G. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom)

    2011-11-15

    Male breast cancer is rare, with some pathological and radiological differences from female breast cancer. There is less familiarity with the imaging appearances of male breast cancer, due to its rarity and the more variable use of preoperative imaging. This review will illustrate the commonest imaging appearances of male breast cancer, with emphasis on differences from female breast cancer and potential pitfalls in diagnosis, based on a 10 year experience in our institution.

  13. Dental implants in growing children

    OpenAIRE

    S.K. Mishra; Chowdhary, N.; Chowdhary, R.

    2013-01-01

    The replacement of teeth by implants is usually restricted to patients with completed craniofacial growth. The aim of this literature review is to discuss the use of dental implants in normal growing patients and in patients with ectodermal dysplasia and the influence of maxillary and mandibular skeletal and dental growth on the stability of those implants. It is recommended that while deciding the optimal individual time point of implant insertion, the status of skeletal growth, the degree o...

  14. Implantable Impedance Plethysmography

    Directory of Open Access Journals (Sweden)

    Michael Theodor

    2014-08-01

    Full Text Available We demonstrate by theory, as well as by ex vivo and in vivo measurements that impedance plethysmography, applied extravascularly directly on large arteries, is a viable method for monitoring various cardiovascular parameters, such as blood pressure, with high accuracy. The sensor is designed as an implant to monitor cardiac events and arteriosclerotic progression over the long term.

  15. Remote actuated valve implant

    Science.gov (United States)

    McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

    2014-02-25

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  16. Corrosion of bio implants

    Indian Academy of Sciences (India)

    U Kamachi Mudali; T M Sridhar; Baldev Raj

    2003-06-01

    Chemical stability, mechanical behaviour and biocompatibility in body fluids and tissues are the basic requirements for successful application of implant materials in bone fractures and replacements. Corrosion is one of the major processes affecting the life and service of orthopaedic devices made of metals and alloys used as implants in the body. Among the metals and alloys known, stainless steels (SS), Co–Cr alloys and titanium and its alloys are the most widely used for the making of biodevices for extended life in human body. Incidences of failure of stainless steel implant devices reveal the occurrence of significant localised corroding viz., pitting and crevice corrosion. Titanium forms a stable TiO2 film which can release titanium particles under wear into the body environment. To reduce corrosion and achieve better biocompatibility, bulk alloying of stainless steels with titanium and nitrogen, surface alloying by ion implantation of stainless steels and titanium and its alloys, and surface modification of stainless steel with bioceramic coatings are considered potential methods for improving the performance of orthopaedic devices. This review discusses these issues in depth and examines emerging directions.

  17. Remote actuated valve implant

    Energy Technology Data Exchange (ETDEWEB)

    McKnight, Timothy E.; Johnson, Anthony; Moise, Kenneth J.; Ericson, Milton Nance; Baba, Justin S.; Wilgen, John B.; Evans, Boyd Mccutchen

    2016-05-10

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  18. Ion implantation in polymers

    Science.gov (United States)

    Wintersgill, M. C.

    1984-02-01

    An introductory overview will be given of the effects of ion implantation on polymers, and certain areas will be examined in more detail. Radiation effects in general and ion implantation in particular, in the field of polymers, present a number of contrasts with those in ionic crystals, the most obvious difference being that the chemical effects of both the implanted species and the energy transfer to the host may profoundly change the nature of the target material. Common effects include crosslinking and scission of polymer chains, gas evolution, double bond formation and the formation of additional free radicals. Research has spanned the chemical processes involved, including polymerization reactions achievable only with the use of radiation, to applied research dealing both with the effects of radiation on polymers already in commercial use and the tailoring of new materials to specific applications. Polymers are commonly divided into two groups, in describing their behavior under irradiation. Group I includes materials which form crosslinks between molecules, whereas Group II materials tend to degrade. In basic research, interest has centered on Group I materials and of these polyethylene has been studied most intensively. Applied materials research has investigated a variety of polymers, particularly those used in cable insulation, and those utilized in ion beam lithography of etch masks. Currently there is also great interest in enhancing the conducting properties of polymers, and these uses would tend to involve the doping capabilities of ion implantation, rather than the energy deposition.

  19. Early-stage bilateral breast cancer treated with breast-conserving surgery and definitive irradiation: the university of Pennsylvania experience

    International Nuclear Information System (INIS)

    Purpose: To determine whether patients with early-stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complications, and cosmesis. Methods and Materials: During the period 1977-1992, 55 women with Stage 0, I, or II concurrent (n = 12) or sequential (n = 43) bilateral breast cancer were treated with definitive irradiation following breast-conserving surgery. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, pathologic axillary lymph node status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Curves for survival, local control, and regional control were determined. Cosmetic outcome, complication rates, and matching technique were analyzed. The median total radiation dose delivered was 64 Gy (range 42-72) using tangential whole-breast irradiation followed by an electron or iridium implant boost. The tangential fields were matched with no overlap in 40 patients (73%); there was overlap on skin of up to 4 cm in 14 patients (25%); and the matching technique was unknown in 1 patient (2%). The median follow-up for the 12 women with concurrent bilateral breast cancer was 4.0 years. The median follow-up for the other 43 women with sequential cancer was 9.3 and 4.9 years, respectively, after the first and second cancers. Results: For the overall group of 55 patients, the 5- and 10-year overall survival rates were 96% and 94%, respectively, after treatment of the first cancer, and 96% and 92%, respectively, after treatment of the second cancer. The 5- and 10-year actuarial relapse-free survival rates were 90% and 75%, respectively, after treatment of the first cancer, and 83% and 72%, respectively, after treatment of the second cancer. For the 110 treated breast cancers, the 5- and 10-year actuarial local failure rates were 5% and 15%, respectively. Complication rates were: 28% breast edema, 8

  20. MRI of the breast: does the internet accurately report its beneficial uses and limitations?

    Science.gov (United States)

    Nekhlyudov, Larissa; Kiarsis, Keith; Elmore, Joann G

    2009-01-01

    As consumer use of the Internet for medical information grows, continuing evaluation of the medical content on the Internet is needed. We evaluated Internet sites describing breast magnetic resonance imaging (MRI), an emerging technology tool in breast cancer diagnosis and screening. We searched Google for sites describing breast MRI and abstracted the affiliation, content, media type, readability, and quality of 90 most popular unique sites. Over half (56%) of the sites were commercially sponsored. The content varied by site and included medical and procedural facts, information about clinical trials, grants and journal articles, as well as human interest stories. Most (82%) sites described potentially beneficial uses of breast MRI, such as further evaluation of newly diagnosed breast cancers (58%); screening women at high risk for breast cancer (54%); evaluation of abnormal breast findings (48%); screening women with dense breasts (48%) or implants (27%); and surveillance for breast cancer recurrences (24%). Approximately half (56%) of the sites described the limitations of breast MRI, most commonly false positive findings (44%) and costs (24%). Website quality, including the display of contact information, sponsorship, currency of information, authorship, and references varied. The reading level was close to high school graduate. Internet sites describing breast MRI were mostly commercially sponsored, more often described the potential beneficial uses of the procedure than its limitations, and were of variable quality and high reading level. With the lack of enforceable standards for display of medical information on the Internet, providers should encourage patients to direct their searches to the most credible sites.

  1. Breast-Conserving Treatment With Partial or Whole Breast Irradiation for Low-Risk Invasive Breast Carcinoma-5-Year Results of a Randomized Trial

    International Nuclear Information System (INIS)

    Purpose: To report the 5-year results of a randomized study comparing the survival and cosmetic results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 selected patients with T1 N0-1mi, Grade 1-2, nonlobular breast cancer without presence of extensive intraductal component and resected with negative margins were randomized after breast-conserving surgery to receive 50 Gy/25 fractions WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multicatheter brachytherapy (BT; n = 88) or 50 Gy/25 fractions electron beam (EB) irradiation (n = 40). Results: At a median follow-up of 66 months, the 5-year actuarial rate of local recurrence was 4.7% and 3.4% in the PBI and WBI arms, respectively (p = 0.50). There was no significant difference in the 5-year probability of overall survival (94.6% vs. 91.8%), cancer-specific survival (98.3% vs. 96.0%), and disease-free survival (88.3% vs. 90.3%). The rate of excellent to good cosmetic result was 77.6% in the PBI group (81.2% after HDR BT; 70.0% after EB) and 62.9% in the control group (52.2% after telecobalt; 65.6% after 6-9-MV photons; pWBI/PBI = 0.009). Conclusions: Partial breast irradiation using interstitial HDR implants or EB to deliver radiation to the tumor bed alone for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with carefully designed HDR multicatheter implants compared with the outcome after WBI

  2. Breast metastases from rectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Jia; FANG Yu; LI Ang; LI Fei

    2011-01-01

    Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

  3. 乳腺癌切除术后乳房再造%Breast reconstruction after mastectomy for breast cancer

    Institute of Scientific and Technical Information of China (English)

    钟少文; 刘鹏熙; 王一安; 许锐; 郝晓东; 郭莉; 赖熙雯

    2008-01-01

    目的 探讨乳腺癌切除术后乳房再造的方法及时间.方法 总结30例不符合保乳条件的乳腺癌病例,乳房切除术后假体置人乳房再造16例,下腹部横行腹直肌肌皮瓣(TRAM瓣)乳房再造10例,背阔肌肌皮瓣乳房再造4例.其中即刻乳房再造27例,延期乳房再造3例.结果 16例假体置入乳房再造术后外观评价均为良,未出现术后并发症.10例TRAM瓣乳房再造术后发生皮瓣部分坏死2例,腹壁疝1例,术后外观评价7例为良.2例为较好,1例为差.4例背阔肌肌皮瓣再造术后外观评价为良.结论 乳房再造术是乳腺癌综合治疗不可忽视一部分,对于有强烈的保乳愿望,而又不符合保乳条件的患者,乳房再造术是一种较好的选择.即刻乳房再造优于延迟乳房再造.乳房再造的方法选择要因人而异.局部晚期乳腺癌患者可以选择性进行即刻乳房再造术.%Objective To explore the technique of breast reconstruction after mastectomy. Methods 30 cases of patients with breast cancer who were not suitable for breast conservative surgery were sum-marized. Among them, immediate breast reconstruction with prosthetic implants after mastectomy was used in 16 patients, transverse rectus abdominis musculocutaneous flap (TRAM flap) in 10 patients, and latissimus dorsi musculocutaneous flap in 4 patients. There were 27 patients who underwent immediate breast reconstruction, while 3 patients underwent delayed breast construction. Results The appearance was good in 16 cases of breast reconstruction with prosthetic implants and no complications were found. Two out of the ten patients who had the transevarse rectus abdominis musculocutaneous flap (TRAM flap) breast reconstruction had partly necrosis of skin flap, and one lateral ventral syndrome. The appear-ance of the 7 cases after the TRAM flap breast reconstruction evaluated well, 2 cases moderate, and one case less satisfactory. The appearance of 4 patients who had breast

  4. Conservative treatment for breast cancer. Complications requiring reconstructive surgery.

    Science.gov (United States)

    Bostwick, J; Paletta, C; Hartrampf, C R

    1986-01-01

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects. Images FIGS. 1A and B. FIGS. 2A-C. FIGS. 2A-C. FIG. 3. FIGS. 4A and B. FIGS. 5A-C. FIGS. 5A-C. FIG. 7. PMID:3010888

  5. Accelerated partial breast irradiation

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Whole breast radiotherapy afier tumor lumpectomy is based on the premise that that the breast cancer recurrence rate is reduced through the elimination of residual cancer foci in the remaining tissue immediately adjacent to the lumpectomy site and occult multicentric areas of in situ or infiltrating cancer in remote areas of the breast. The relevance of remote foci to ipsilateral breast failure rates after breast conserving treatment is debatable, because 65%~100% of recurrences develop in the same quadrant as the initial tumor. This has led several investigators to question whether radiotherapy must be administered to the entire breast.

  6. Does giant breast tumour have an increased complication risk for subcutaneous mastectomy and reconstruction?

    Directory of Open Access Journals (Sweden)

    Coban Yusuf

    2006-01-01

    Full Text Available Prosthetic breast reconstruction after subcutaneous mastectomy has some complications such as skin necrosis, loss of areola-nipple, haematoma, seroma, infection, displacement of implants, areola nipple disposition and inadequate skin construction resulting in skin wrinkles. We discuss whether giant breast tumour has an increased complication risk after the surgery, in this paper which reports a patient with giant breast tumour i.e., a large recurrent fibroadenoma in the same breast. Subcutaneous mastectomy was performed without skin reduction through submammary incision. Total muscular coverage was provided for immediate reconstruction using 350 cc gel- filled breast implant. Though haematoma or seroma didn′t exist, superficial skin necrosis developed subsequently. Spontaneous epithelisation was observed all of the necrosis area to cover this area in a few weeks. Initially, skin coverage and areola nipple position on the breast was acceptable, but 8 months after the operation, skin reconstruction was not good enough to provide good skin envelope. Just as as skin lack or insufficiency is a severe problem in breast reconstruction, excess skin may be another trouble for providing an acceptable breast shape.

  7. MRI of the breast: state of the art

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, M. [Abteilung Radiologie/Nuklearmedizin, Krankenhaus am Urban, Dieffenbachstrasse 1, D-10 967 Berlin (Germany)

    1998-06-02

    Contrast-enhanced MRI of the breast is probably the most sensitive method to detect breast pathology. It is best used to improve the sensitivity of mammography and sonography in selected patient groups with high breast cancer prevalence, where conventional methods are known to be less sensitive. Despite the high sensitivity of MRI, 5-12 % of invasive carcinomas are not recognized during MRI, because of lack of the typical criteria of carcinoma. MRI is probably inferior to mammography in detecting ductal in-situ carcinoma or very small carcinomas (< 3 mm), because the neo-angiogenesis induced by these small carcinomas is too faint to be detected by contrast-enhanced MRI. These tumours cannot be excluded by a normal MRI examination. MRI is non-specific as the distinction of benign and malignant breast lesions is unreliable. Only in selected cases (fat- or blood-containing lesions) may it improve the specificity of mammography and sonography. Mostly image-guided core biopsy is by far the most specific and least expensive method to establish a definitive diagnosis. For lesions exclusively detected by contrast-enhanced MRI, simple and reliable localisation devices are urgently needed. Presently accepted indications for MRI of the breast are: patients with silicone implants after mastectomy or augmentation mammoplasty (detection of recurrence/prothesis rupture/silicon leakage); patients whose breasts are difficult to evaluate by combined mammography and sonography, who have had breast conservation therapy (local recurrence), or who have proven carcinoma in one breast (multifocality/-centricity or contralateral breast carcinoma) or proven axillary lymph node metastases from an unknown primary tumor, especially when these are hormone receptor positive; patients with extensive postoperative scarring. In the future, genetically defined high breast cancer risk may become an indication. (orig.) With 11 figs., 2 tabs., 151 refs.

  8. Aesthetic breast augmentation with hyaluronic acid: imaging findings and implications for radiological assessment

    Directory of Open Access Journals (Sweden)

    Divanei Aparecida Bottaro Criado

    2012-06-01

    Full Text Available New injectable fillers such as hyaluronic acid have recently been employed as a non-surgical alternative to implants such as silicone for aesthetic breast enhancement. Although their utilization is not yet widespread in Brazil, radiologists should be aware of the imaging findings in this context and of the implications of the presence of this filler for the radiological evaluation in the screening for breast cancer.

  9. Aesthetic breast augmentation with hyaluronic acid: imaging findings and implications for radiological assessment

    OpenAIRE

    Divanei Aparecida Bottaro Criado; Fernanda Del Campo Braojos; Ulysses dos Santos Torres; Marcos Pontes Muniz

    2012-01-01

    New injectable fillers such as hyaluronic acid have recently been employed as a non-surgical alternative to implants such as silicone for aesthetic breast enhancement. Although their utilization is not yet widespread in Brazil, radiologists should be aware of the imaging findings in this context and of the implications of the presence of this filler for the radiological evaluation in the screening for breast cancer.

  10. Inhibition of Human Breast Cancer Xenograft Growth by Cruciferous Vegetable Constituent Benzyl Isothiocyanate

    OpenAIRE

    Warin, Renaud; Xiao, Dong; Arlotti, Julie A.; Bommareddy, Ajay; Singh, Shivendra V

    2010-01-01

    Benzyl isothiocyanate (BITC), a constituent of cruciferous vegetables such as gardencress, inhibits growth of human breast cancer cell lines in culture. The present study was undertaken to determine in vivo efficacy of BITC against MDA-MB-231 human breast cancer xenografts. The BITC administration retarded growth of MDA-MB-231 cells subcutaneously implanted in female nude mice without causing weight loss or any other side effects. The BITC-mediated suppression of MDA-MB-231 xenograft growth c...

  11. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps.

    Science.gov (United States)

    Hansen, Keith S; Gutwein, Luke G; Hartman, Brett C; Sood, Rajiv; Socas, Juan

    2016-09-01

    Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments. PMID:27689054

  12. Modeling Breast Tumor Development with a Humanized Mouse Model.

    Science.gov (United States)

    Arendt, Lisa M

    2016-01-01

    The tumor microenvironment plays a critical role in breast cancer growth and progression to metastasis. Here, we describe a method to examine stromal-epithelial interactions during tumor formation and progression utilizing human-derived mammary epithelial cells and breast stromal cells. This method outlines the isolation of each cell type from reduction mammoplasty tissue, the culture and genetic modification of both epithelial and stromal cells using lentiviral technology, and the method of humanizing and implantation of transformed epithelial cells into the cleared mammary fat pads of immunocompromised mice. This model system may be a useful tool to dissect signaling interactions that contribute to invasive tumor behavior and therapeutic resistance. PMID:27581027

  13. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  14. Peri-implant hastalıklar

    OpenAIRE

    Dilsiz, Alparslan; Zihni, Meltem; Yavuz, M Selim

    2011-01-01

    The treatment of partially or totally edentulous subjects with oral implants is a common procedure. Biological complications are occur around implants which are peri-implant mucositis and periimplantitis. Peri-implant mucositis is pathological condition which is normally localized in the soft tissues surrounding an oral implant. Peri-implantitis surrounding oral implants is an inflammatory process affecting the soft and hard tissues resulting in rapid loss of supporting bone associated with b...

  15. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    2007-01-01

      Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  16. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  17. A False Positive {sup 18}F-FDG PET/CT Scan Caused by Breast Silicone Injection

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chao Jung; Lee, Bi Fang; Yao, Wei Jen; Wu, Pei Shan; Chen, Wen Chung; Peng, Shu Lin; Chiu, Nan Tsing [Cheng Kung University Medical College and Hospital, Tainan (Turkmenistan)

    2009-04-15

    We present here the case of a 40-year-old woman with a greater than 10 year prior history of bilateral breast silicone injection and saline bag implantation. Bilateral palpable breast nodules were observed, but the ultrasound scan was suboptimal and the magnetic resonance imaging showed no gadolinium enhanced tumor. The {sup 18}F-FDG PET/CT scan showed a hypermetabolic nodule in the left breast with a 30% increase of {sup 18}F-FDG uptake on the delayed imaging, and this mimicked breast cancer. She underwent a left partial mastectomy and the pathology demonstrated a siliconoma.

  18. Opaque intraocular lens implantation

    OpenAIRE

    Yusuf IH; Patel CK

    2013-01-01

    Imran H Yusuf, CK Patel The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, United KingdomWe read with great interest the recent article by Lee et al,1 who described their clinical experience with three patients who underwent primary implantation of Morcher (Stuttgart, Germany) occlusive intraocular lenses (IOLs) across a variety of neuro-ophthalmic indications. We hope to offer some further insight into these clinical observations in the context of o...

  19. Bone Substitutes for Peri-Implant Defects of Postextraction Implants

    Directory of Open Access Journals (Sweden)

    Pâmela Letícia Santos

    2013-01-01

    Full Text Available Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration.

  20. Silicone breast implants in the Netherlands : A market surveillance study

    NARCIS (Netherlands)

    Keizers P; van Drongelen A; de Jong W; van Oostrom C; Roszek B; Venhuis B; de Vries C; Geertsma R; Janssen R; PRS; V& Z

    2016-01-01

    Voor medische hulpmiddelen, zoals siliconen borstimplantaten, zijn fabrikanten verplicht om 'technische dossiers' aan te leggen op basis waarvan wordt bepaald of het product op de markt wordt toegelaten. Dossiers van 10 fabrikanten die in Nederland siliconen borstimplantaten op de markt br

  1. Presentation of Apocrine Breast Carcinoma in a Woman with Bilateral Silicone Prosthesis; Presentacion de un carcinoma apocrino de mama en una mujer con protesis bilateral de silicona

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, J. A.; Salvador, R.; Salvador, M.; Barranco, C.

    2003-07-01

    We present a case of apocrine breast carcinoma in a 45 year-old woman with bilateral silicone breast prosthesis whose clinical manifestations and mammography were that of a palpable nodule-high glandular density, rounded and with imprecise borders devoid of any visible microcalcifications. A bibliographical revision confirmed the infrequent association of this type of tumor with the presence of silicone breast implants, precisely in which we consider its radiological interest to lie. (Author) 11 refs.

  2. Breastfeeding and Breast Milk

    Science.gov (United States)

    ... Clinical Trials Resources and Publications Breastfeeding and Breast Milk: Condition Information Skip sharing on social media links Share this: Page Content Breastfeeding and Breast Milk: Condition Information​ ​​Breastfeeding, also called nursing, is the ...

  3. Types of Breast Cancers

    Science.gov (United States)

    ... about this condition, see Inflammatory Breast Cancer . Paget disease of the nipple This type of breast cancer ... carcinoma (this is a type of metaplastic carcinoma) Medullary carcinoma Mucinous (or colloid) carcinoma Papillary carcinoma Tubular ...

  4. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... reconstruction with or without radiotherapy. Current Opinion in Obstetrics and Gynecology 2011;23(1):44–50. [PubMed Abstract] Barry M, Kell MR. Radiotherapy and breast reconstruction: a meta-analysis. Breast ...

  5. Breast cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

  6. Breast Tissue Composition and Susceptibility to Breast Cancer

    OpenAIRE

    Boyd, Norman F.; Lisa J Martin; Bronskill, Michael; Martin J. Yaffe; Duric, Neb; Minkin, Salomon

    2010-01-01

    Breast density, as assessed by mammography, reflects breast tissue composition. Breast epithelium and stroma attenuate x-rays more than fat and thus appear light on mammograms while fat appears dark. In this review, we provide an overview of selected areas of current knowledge about the relationship between breast density and susceptibility to breast cancer. We review the evidence that breast density is a risk factor for breast cancer, the histological and other risk factors that are associat...

  7. Tissue modeling schemes in low energy breast brachytherapy.

    Science.gov (United States)

    Afsharpour, Hossein; Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-11-21

    Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this

  8. Breast sarcomas. Literature review

    Directory of Open Access Journals (Sweden)

    D. A. Ryabchikov

    2014-01-01

    Full Text Available The article presents an overview of the literature about breast sarcomas (nonepithelial malignances. Primary sarcomas are extremely rare, with less than 1 % of all malignant tumors of the breast. Breast carcinomas cause an increased interest of the scientists due to their unique clinical and pathological features and unpredictable prognosis.

  9. Oncoplastic breast conserving surgery

    OpenAIRE

    Mansfield, Lucy; Agrawal, Avi; Cutress, Ramsey I.

    2013-01-01

    Oncoplastic breast conserving surgery is a fundamental component of the repertoire for the management of breast cancer. It facilitates removal of large volumes of breast tissue, and can improve cosmetic outcomes and patient satisfaction whilst maintaining good oncological principles, reducing re-excision and mastectomy rates and assisting in adjuvant radiotherapy planning.

  10. Breast lift (mastopexy) - slideshow

    Science.gov (United States)

    ... for drooping breasts, which may occur after a woman has had children. Mammograms (breast X-rays) and a routine breast exam are required before surgery. Update Date 2/12/2013 Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. ...

  11. Breast Cancer (For Kids)

    Science.gov (United States)

    ... With Breast Cancer Breast Cancer Prevention en español Cáncer de mama You may have heard about special events, like walks or races, to raise money for breast cancer research. Or maybe you've seen people wear ...

  12. Optical breast imaging

    NARCIS (Netherlands)

    van de Ven, S.M.W.Y.

    2011-01-01

    Optical breast imaging uses near-infrared light to assess the optical properties of breast tissue. It can be performed relying on intrinsic breast tissue contrast alone or with the use of exogenous imaging agents that accumulate at the tumor site. Different tissue components have unique scattering a

  13. Effect of breast augmentation after breast-conserving surgery for breast cancer on radiation dose. Silicone prosthesis and changes in radiation dose

    International Nuclear Information System (INIS)

    The results of a study simulating postoperative radiation therapy of remaining breast tissue with a silicone bag prosthesis implanted to examine the effects of the prosthesis on radiation dosage and surrounding tissue are reported. The evaluation was conducted in two stages: a water phantom was used to evaluate scattering effects of a prosthesis installed inside the phantom using glass rod detector (GRD) set around the prosthesis. Measurements were conducted on both entrance and rear sides of the prosthesis. A Rand phantom was used to measure radiation doses around the prosthesis. The first evaluation resulted in a less than 5.4% reduction in dose at the rear side of the prosthesis whereas the second evaluation, for opposing portal irradiation used with breast-conserving surgical treatment, showed the effects of the prosthesis on radiation dosage being within ±2%, the permitted treatment range. In conclusion, for treating breast cancer, combining surgical treatment of the cancer with implanting of prosthesis for breast reconstruction followed by radiation treatment appears feasible as no effects on dosage were observed on treatment effectiveness. (author)

  14. [Prosthetic dilemmas. Connecting natural teeth and implants

    NARCIS (Netherlands)

    Cune, M.S.; Putter, C de; Verhoeven, J.W.; Meijer, G.J.

    2008-01-01

    In clinical practice, the prognosis seems, with some reservations, to be comparable for tooth-implant and implant-implant supported bridges in the middle-long term.This conclusion seems particularly valid for tooth-implant bridges in free-end situations, where a single implant is connected with a to

  15. The change of rotational freedom following different insertion torques in three implant systems with implant driver

    OpenAIRE

    Kwon, Joo-Hyun; Han, Chong-Hyun; Kim, Sun-Jai; Chang, Jae-Seung

    2009-01-01

    STATEMENT OF PROBLEM Implant drivers are getting popular in clinical dentistry. Unlike to implant systems with external hex connection, implant drivers directly engage the implant/abutment interface. The deformation of the implant/abutment interface can be introduced while placing an implant with its implant driver in clinical situations. PURPOSE This study evaluated the change of rotational freedom between an implant and its abutment after application of different insertion torques. MATERIAL...

  16. Current trends in dental implants

    OpenAIRE

    Gaviria, Laura; Salcido, John Paul; Guda, Teja; Ong, Joo L.

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evoluti...

  17. Dental Implants: Dual Stabilization Technology

    OpenAIRE

    Saini, Rajiv

    2015-01-01

    More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries; the presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. A dental implant is a titanium screw which is placed into bone to replace missing teeth. The implant mimics the root of a tooth in function. Dental Implants have changed the face of dentistry over the last three decades. Success of dental i...

  18. Short implants in oral rehabilitation

    OpenAIRE

    Emmanuel Panobianco Chizolini; Ana Cláudia Rossi; Alexandre Rodrigues Freire; Mario Roberto Perussi; Paulo Henrique Ferreira Caria; Felippe Bevilacqua Prado

    2011-01-01

    Introduction and objective: The placement of short dental implants is used as an alternative treatment modality to bone grafting procedures. The aim of this study was to discuss, through a literature review, the features, indications and biomechanical aspects of short implants, as well as to report the clinical factors that influence on their indication. Literature review and conclusion: It was found that short implants osseointegration can be compromised by risk factors that must be controll...

  19. Nanostructured Surfaces of Dental Implants

    OpenAIRE

    Stefano Sivolella; Barbara Zavan; Letizia Ferroni; Chiara Gardin; Vincenzo Vindigni; Edoardo Stellini; Marco Roman; Ilaria Tocco; Riccardo Guazzo; Luca Sbricoli; Eriberto Bressan

    2013-01-01

    The structural and functional fusion of the surface of the dental implant with the surrounding bone (osseointegration) is crucial for the short and long term outcome of the device. In recent years, the enhancement of bone formation at the bone-implant interface has been achieved through the modulation of osteoblasts adhesion and spreading, induced by structural modifications of the implant surface, particularly at the nanoscale level. In this context, traditional chemical and physical process...

  20. Cochlear implants in genetic deafness

    Institute of Scientific and Technical Information of China (English)

    Xuezhong Liu

    2014-01-01

    Genetic defects are one of the most important etiologies of severe to profound sensorineural hearing loss and play an important role in determining cochlear implantation outcomes. While the pathogenic mutation types of a number of deafness genes have been cloned, the pathogenesis mechanisms and their relationship to the outcomes of cochlear implantation remain a hot research area. The auditory performance is considered to be affected by the etiology of hearing loss and the number of surviving spiral ganglion cells, as well as others. Current research advances in cochlear implantation for hereditary deafness, especially the relationship among clinic-types, genotypes and outcomes of cochlear implantation, will be discussed in this review.

  1. Dental implants in growing children

    Directory of Open Access Journals (Sweden)

    S K Mishra

    2013-01-01

    Full Text Available The replacement of teeth by implants is usually restricted to patients with completed craniofacial growth. The aim of this literature review is to discuss the use of dental implants in normal growing patients and in patients with ectodermal dysplasia and the influence of maxillary and mandibular skeletal and dental growth on the stability of those implants. It is recommended that while deciding the optimal individual time point of implant insertion, the status of skeletal growth, the degree of hypodontia, and extension of related psychological stress should be taken into account, in addition to the status of existing dentition and dental compliance of a pediatric patient.

  2. Short implants: A systematic review

    OpenAIRE

    Karthikeyan, I.; Shrikar R. Desai; Singh, Rika

    2012-01-01

    Background: Short implants are manufactured for use in atrophic regions of the jaws. Although many studies report on short implants as ≤10 mm length with considerable success, the literature regarding survival rate of ≤7 mm is sparse. Purpose: The purpose of this study was to systematically evaluate the publications concerning short dental implants defined as an implant with a length of ≤7 mm placed in the maxilla or in the mandible. Materials and Methods: A Medline and manual search was cond...

  3. Breast cancer imaging: A perspective for the next decade

    Energy Technology Data Exchange (ETDEWEB)

    Karellas, Andrew; Vedantham, Srinivasan [Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655 (United States)

    2008-11-15

    Breast imaging is largely indicated for detection, diagnosis, and clinical management of breast cancer and for evaluation of the integrity of breast implants. In this work, a prospective view of techniques for breast cancer detection and diagnosis is provided based on an assessment of current trends. The potential role of emerging techniques that are under various stages of research and development is also addressed. It appears that the primary imaging tool for breast cancer screening in the next decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without depth information. MRI and ultrasonography will have an increasingly important adjunctive role for imaging high-risk patients and women with dense breasts. Pilot studies with dedicated breast CT have demonstrated high-resolution three-dimensional imaging capabilities, but several technological barriers must be overcome before clinical adoption. Radionuclide based imaging techniques and x-ray imaging with intravenously injected contrast offer substantial potential as a diagnostic tools and for evaluation of suspicious lesions. Developing optical and electromagnetic imaging techniques hold significant potential for physiologic information and they are likely to be of most value when integrated with or adjunctively used with techniques that provide anatomic information. Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can provide edge enhancement and contrast improvement but more research is needed to evaluate their potential role in clinical breast imaging. From the technological perspective, in addition to improvements within each modality, there is likely to be a trend towards multi-modality systems that combine anatomic with physiologic information. We are also likely to transition from a standardized screening, where all women undergo the same imaging exam (mammography), to selection of a screening modality or modalities based an

  4. Inheritance of proliferative breast disease in breast cancer kindreds

    International Nuclear Information System (INIS)

    Previous studies have emphasized that genetic susceptibility to breast cancer is rare and is expressed primarily as premenopausal breast cancer, bilateral breast cancer, or both. Proliferative breast disease (PBD) is a significant risk factor for the development of breast cancer and appears to be a precursor lesion. PBD and breast cancer were studied in 103 women from 20 kindreds that were selected for the presence of two first degree relatives with breast cancer and in 31 control women. Physical examination, screening mammography, and four-quadrant fine-needle breast aspirates were performed. Cytologic analysis of breast aspirates revealed PBD in 35% of clinically normal female first degree relatives of breast cancer cases and in 13% of controls. Genetic analysis suggests that genetic susceptibility causes both PBD and breast cancer in these kindreds. This study supports the hypothesis that this susceptibility is responsible for a considerable portion of breast cancer, including unilateral and postmenopausal breast cancer

  5. Long-term outcome with interstitial brachytherapy in the management of patients with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Purpose: We reviewed our institution's experience with interstitial implant boosts to determine their long-term impact on local control and cosmetic results. Methods and Materials: Between January 1, 1980 and December 31, 1987, 390 women with 400 cases of Stage I and II breast cancer were managed with breast-conserving therapy (BCT) at William Beaumont Hospital. All patients were treated with an excisional biopsy and 253 (63%) underwent reexcision. Radiation consisted of 45-50 Gy external beam irradiation to the whole breast followed by a boost to the tumor bed to at least 60 Gy using either electrons [108], photons [15], or an interstitial implant [277] with either 192Ir [190] or 125I [87]. Long-term local control and cosmetic outcome were assessed and contrasted between patients boosted with either interstitial implants, electrons, or photons. Results: With a median follow-up of 81 months, 25 patients have recurred in the treated breast for a 5- and 8-year actuarial rate of local recurrence of 4 and 8%, respectively. There were no statistically significant differences in the 5- or 8-year actuarial rates of local recurrence using either electrons, photons, or an interstitial implant. Greater than 90% of patients obtained a good or excellent cosmetic result, and no statistically significant differences in cosmetic outcome were seen whether electrons, photons, or implants were used. Conclusions: We conclude that patients with Stage I and II breast cancer undergoing BCT and judged to be candidates for boosts can be effectively managed with LDR interstitial brachytherapy. Long-term local control and cosmetic outcome are excellent and similar to patients boosted with either electrons or photons

  6. Galactorrea grave tras aumento mamario con implantes Severe galactorrhea after mammary augmentation with implants

    Directory of Open Access Journals (Sweden)

    F.T. Fidalgo Rodríguez

    2012-06-01

    Full Text Available La galactorrea es una complicación poco frecuente después de la cirugía plástica mamaria. Su causa aun es desconocida, aunque lo más probable es que su aparición tenga un origen multifactorial. En el caso que presentamos la paciente desarrolló incremento simétrico del volumen de ambas mamas después de un cirugía de aumento mamario. No se detectaron cambios en los valores de prolactina. El proceso no respondió al tratamiento con bromocriptina. La galactorrea postquirúrgica con frecuencia sigue un curso benigno y autolimitado, culminando con resolución espontánea. Dependiendo de la severidad de los síntomas, su tratamiento puede ser médico y/o quirúrgico, con drenaje o incluso retirada de los implantes mamarios.Galactorrhea is a complication rarely observed after mammary plastic surgery. The cause remains unknown although it's likely to be multifactorial. In the reported case, the patient described symmetric massive engorgement of both breasts after augmentation mammoplasty. No significant change was detected in the postoperative prolactin values. The condition was unresponsive to treatment with bromocriptine. Postsurgical galactorrhea often follows a benign course culminating in spontaneous resolution Depending on symptom severity, treatment may be medical with the prescription of dopaminergic agonists, and/or surgical with drainage or even removal of the mammary implants.

  7. Fat injection to correct contour deformities of the reconstructed breast: a single surgeon experience

    Directory of Open Access Journals (Sweden)

    Youssef Tahiri

    2015-06-01

    Full Text Available Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in breast reconstruction. The purpose of this study was to share our clinical experience using autologous fat injection to correct contour deformities during breast reconstruction. Methods: A single surgeon, prospectively maintained database of patients who underwent autologous fat injection during breast reconstruction from January 2008 to November 2013 at McGill University Health Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume of fat injected, and complications were analyzed. Results: One hundred and twenty-four patients benefited from autologous fat injection from January 2008 to November 2013, for a total of 187 treated breasts. The patients were on average 49.3 years old (΁ 8.9 years. Fat was harvested from the medial thighs (20.5%, flanks (39.1%, medial thighs and flanks (2.9%, trochanters (13.3%, medial knees (2.7%, and abdomen (21.9%. An average of 49.25 mL of fat was injected into each reconstructed breast. A total of 187 breasts in 124 patients were lipo-infiltrated during the second stage of breast reconstruction. Thirteen breasts (in 12 separate patients were injected several years after having undergone lumpectomy and radiotherapy. Of the 187 treated breasts, 118 were reconstructed with expanders to implants, 45 with deep inferior epigastric perforator flaps, 9 with latissimus dorsi flaps with implants, 4 with transverse rectus abdominis myocutaneous flaps, and 13 had previously undergone lumpectomy and radiotherapy. Six complications were noted in the entire series, for a rate of 3.2%. All were in previously radiated breasts. Average follow-up time was 12 months (range: 2-36 months. Conclusion: Fat injection continues to grow in popularity as an adjunct to breast reconstruction. Our experience demonstrates a low complication rate as compared to most surgical interventions of the breast

  8. Breast ptosis managed by mastopexy using the triple flaps procedure.

    Science.gov (United States)

    Gheita, Alaa; Moftah, Ali

    2011-02-01

    Breast ptosis is a highly unattractive appearance of the breast. In the mind, it is associated with aging, multiple pregnancies, lactation, and senile changes. Its correction by mastopexy presents one of the greatest challenges to the breast surgeon aiming at a pleasant full conical shape and stability of the results. The authors present their mastopexy procedure using a triple-flap method based on the principle of a superior pedicle flap mammaplasty. The technique, presented in detail, basically consists of a superior pedicle dermaglandular flap that carries the nipple-areola complex between outer and inner flaps. The outer flap is rotated inward and upward behind the main superior pedicle to give fullness to the breast and fixed to the chest wall. The inner flap is double-breasted on top or superficial to outer flap, and both are sutured to each other resembling a hammock or a cradle that carries the main superior pedicle middle flap. The results are presented and advantages discussed. This method, besides its simplicity, gives good projection with a pleasant and attractive conical shape to the breast and upper fullness, frequently negating the need for an implant. In addition, the results were stable in the long term, with no need for a mesh or any other foreign material. PMID:20652567

  9. Management of dislocated intraocular implants.

    Science.gov (United States)

    Chan, C K; Agarwal, A; Agarwal, S; Agarwal, A

    2001-12-01

    Implant dislocation may occur in the absence of appropriate capsular or zonular support (PCIOL) (11,35,53) or following traumatic injury to anterior ocular tissues (ACIOL). (11,19,20) Other factors (e.g., advanced patient age, high myopia, previous vitrectomy, pseudoexfoliation syndrome, and certain connective tissue disorders) also may predispose implant dislocation. (9,52) Although reported for all types of IOLs, implant dislocation is becoming more manageable because of the advancement of surgical techniques. A dislocated ACIOL or PCIOL may be explanted, exchanged, or repositioned. (11,48,71) Repositioning the dislocated PCIOL in the ciliary sulcus with modern vitreoretinal techniques provides an optimal environment for visual recovery. (11,71) Implant repositioning techniques generally may be categorized into the external or the internal approaches. (8,11) The former involves external suturing methods for a primary or secondary implant in the absence of adequate capsular or zonular support (15,16,31,42,56,60,61,64,66,73,76) and the latter is achieved through modern pars plana techniques. 8,11,62,69) Recently, several implant repositioning methods gaining increasing acceptance include the scleral loop fixation, (45) the snare approach, (43) the use of the 25-gauge implant forceps, (13) temporary haptic externalization, (8,11,36,71) and the use of perfluorocarbon liquids. (1,28,40,41,44) The temporary haptic externalization method combines the best features of the external and the internal approaches, avoids complex intraocular maneuvers, and allows precise scleral fixation of the dislocated IOL on a consistent basis. (8,11,71) Endoscopy provides the surgeon with optimal viewing of the anterior retropupillary anatomy that is often difficult to appreciate (e.g., capsular-zonular complex, ciliary sulcus, anterior retina, and vitreous base). (6,11) As a result, precise haptic placement is possible during the repositioning process. (6,11) However, a three

  10. Implant periapical lesion: Diagnosis and treatment

    OpenAIRE

    Peñarrocha Diago, María; Maestre Ferrín, Laura; Cervera Ballester, Juan; Peñarrocha Oltra, David

    2012-01-01

    The implant periapical lesion is the infectious-inflammatory process of the tissues surrounding the implant apex. It may be caused by different factors: contamination of the implant surface, overheating of bone during drilling, preparation of a longer implant bed than the implant itself, and pre-existing bone disease. Diagnosis is achieved by studying the presence of symptoms and signs such us pain, swelling, suppuration or fistula; in the radiograph an implant periapical radiolucency may app...

  11. Breast abscesses after breast conserving therapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Kazuhisa [National Kyoto Hospital (Japan)

    2001-09-01

    Breast abscess after breast conserving therapy is a rare complication and the study of this cause has not been reported. A retrospective review of 190 patients undergoing breast conserving therapy in our institution revealed 4 patients with breast abscess (mean age, 50.6 years; range, 47-57 years and median follow up 4 months; 1-11 months). Risk factors which were common to all patients were: fine needle aspiration (FNA), surgical treatment; wide excision, adjuvant therapy; oral administration of tamoxifen (TAM), radiation therapy (RT) to ipsilateral whole breast; total dose of 50 Gy and skin desquamation by RT; level I or II. Other important risk factors in 3 patients were repeated aspirations of seroma post operatively and 2 patients received chemotherapy; CAF. Cultures from one abscess grew staphylococcus aureus, one grew staphylococcus epidermidis, and two were sterile. Breast abscess may be caused by a variety of factors and it is often difficult to specify the cause. This suggests that careful observation will be necessary to determine the cause. (author)

  12. Piezosurgery in implant dentistry

    Directory of Open Access Journals (Sweden)

    Stübinger S

    2015-11-01

    Full Text Available Stefan Stübinger,1 Andres Stricker,2 Britt-Isabelle Berg3,4 1Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland; 2Private Practice, Konstanz, Germany; 3Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland; 4Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA Abstract: Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. Keywords: implantology, piezoelectric device, piezosurgery, maxillary sinus elevation, bone grafting, osteotomy, edentulous ridge splitting

  13. Gamma-ray detector guidance of breast cancer therapy

    Science.gov (United States)

    Ravi, Ananth

    2009-12-01

    Breast cancer is the most common form of cancer in women. Over 75% of breast cancer patients are eligible for breast conserving therapy. Breast conserving therapy involves a lumpectomy to excise the gross tumour, followed by adjuvant radiation therapy to eradicate residual microscopic disease. Recent advances in the understanding of breast cancer biology and recurrence have presented the opportunity to improve breast conserving therapy techniques. This thesis has explored the potential of gamma-ray detecting technology to improve guidance of both surgical and adjuvant radiation therapy aspects of breast conserving therapy. The task of accurately excising the gross tumour during breast conserving surgery (BCS) is challenging, due to the limited guidance currently available to surgeons. Radioimmuno guided surgery (RIGS) has been investigated to determine its potential to delineate the gross tumour intraoperatively. The effects of varying a set of user controllable parameters on the ability of RIGS to detect and delineate model breast tumours was determined. The parameters studied were: Radioisotope, blood activity concentration, collimator height and energy threshold. The most sensitive combination of parameters was determined to be an 111Indium labelled radiopharmaceutical with a gamma-ray detecting probe collimated to a height of 5 mm and an energy threshold at the Compton backscatter peak. Using these parameters it was found that, for the breast tumour model used, the minimum tumour-to-background ratio required to delineate the tumour edge accurately was 5.2+/-0.4 at a blood activity concentration of 5 kBq/ml. Permanent breast seed implantation (PBSI) is a form of accelerated partial breast irradiation that dramatically reduces the treatment burden of adjuvant radiation therapy on patients. Unfortunately, it is currently difficult to localize the implanted brachytherapy seeds, making it difficult to perform a correction in the event that seeds have been misplaced

  14. Endometrium implantation and ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIU; Yixun

    2004-01-01

    Embryo in uterine implantation is a complex and multifactor-related process and is a downstream and ideal point for woman fertility control.Understanding the cellular and molecular mechanism of implantation is a prerequisite for development of anti-implantation contraceptives.In spite of considerable accumulation of information from the laboratory animals that has been achieved,it is difficult to generate such information in human due to ethical restriction and experimental limitation,and the present knowledge for understanding the definitive mechanisms which control these events remains elusive.Embryo implantation can also occur outside uterus.Some women with abdominal pregnancies could successfully complete the processes of gestation and bear normal babies,implying that implantation itself may be not an endometrium-specific process.Reproductive biologists should cooperate with gynecologists to further comparatively study the molecular and cellular mechanisms of implantation normally occurring in endometrium and abnormally appearing outside uterine cavity.Such collaborative studies may generate new important information for developing anti-implantation contraceptive and for techniques of accurate diagnosis of ectopic pregnancy.A specially designed GnRH-2 analog and a combination use of Iow dose RU486 and gossypol as anti-implantation contraceptives have been suggested.

  15. NEGATIVE IMPLANT - A RETROSPECTIVE STUDY

    NARCIS (Netherlands)

    LANDESZ, M; WORST, JGF; SIERTSEMA, JV; VANRIJ, G

    1993-01-01

    Implantation of a negative power intraocular lens is one of the options for surgical correction of high myopia. We studied 36 eyes with a Fechner Worst Claw Lens, implanted in Groningen between March 1987 and November 1991. The preoperative myopia ranged from -7.00 to -30.00 diopters. Twentyone eyes

  16. Implantable Antennas for Biomedical Applications

    OpenAIRE

    Merli, Francesco

    2011-01-01

    Since the introduction of implantable pacemakers in the early 1960s, implantable medical devices have become more and more interesting for healthcare services. Nowadays, the devices designed to monitor physiological data from inside the human body have great promises to provide major contributions to disease prevention, diagnosis and therapy. Furthermore, minimally invasive devices allow reducing hospitalization terms, thus improving the patients' qua...

  17. Diagnostic value of mammography flowing plastic and reconstructive breast surgery

    International Nuclear Information System (INIS)

    Breast cancer is the most frequent malignant neoplasm in women. Due to the growing knowledge and self- consciousness about the disease itself as well as regarding treatment options among breast cancer patients. Main indications for reconstruction after mastectomy include fear of both physical and psychological damage and, in a broader sense, the lack of contraindications for the procedure. Altogether, these factors are in fact directly responsible for the increase in the number of reconstructive procedures, which have become one of the important elements in breast cancer treatment. Year by year, the number of plastic surgery procedures has been growing. Assessment of the breast aimed at discerning the presence diminishing procedures. In women with prostheses implanted for cosmetic reasons, mamsaography provides an opportunity to correctly diagnose and confirm implant damage. Women who have undergonew such procedures should be screened mammographically in the same way as the rest of the female population is. The aim of this paper is to summarize the value of diagnostic mammagraphy after plastic and reconstructive surgery. (authors)

  18. Periprosthetic breast abscess caused by Streptococcus pyogenes after scarlet fever.

    Science.gov (United States)

    Persichetti, Paolo; Langella, Marika; Marangi, Giovanni Francesco; Vulcano, Ettore; Gherardi, Giovanni; Dicuonzo, Giordano

    2008-01-01

    We present a case of a 32-year-old white women, affected by breast cancer and treated with mastectomy, who underwent immediate breast reconstruction with a tissue expander. She presented a periprosthetic infection from Streptococcus pyogenes (group A streptococcus, GAS) after scarlet fever. S. pyogenes may be responsible for suppurative complications of the respiratory system and a variety of metastatic foci of infection such as suppurative arthritic, endocarditis, meningitis, or brain abscess. Even though, in the literature, several cases and types of infection associated with breast implantation have been described, to our knowledge this is the first case report of periprosthetic infection after scarlet fever. Signs, symptoms, diagnosis, and treatment of GAS infection that occurred 2 months after the surgery are discussed.

  19. MODIFIED DISSECTION OF SUBPECTORAL SPACE FOR BETTER AESTHETICAL AUGMENTED BREAST

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To reconstruct an augmented breast that resembles a virginal one that is difficult to be achieved by the traditional technique. Methods We modified the dissection of the subpectoral space by extending it over the sternum edge 1cm medially and beyond the breast crease 2cm inferiorly, yet keeping strictly the upper border of the space on the third rib and the lateral border on the anterior axillary line. Results All 50 patients were satisfied with their augmented breasts which nearly resembled the virginal ones. Conclusion Our modified dissection enabled the mammary implant to stay in the position where it originally was and not be pushed upward and laterally by the pectoral muscle contraction as usually seen by the traditional technique.

  20. Short implants in oral rehabilitation

    Directory of Open Access Journals (Sweden)

    Emmanuel Panobianco Chizolini

    2011-07-01

    Full Text Available Introduction and objective: The placement of short dental implants is used as an alternative treatment modality to bone grafting procedures. The aim of this study was to discuss, through a literature review, the features, indications and biomechanical aspects of short implants, as well as to report the clinical factors that influence on their indication. Literature review and conclusion: It was found that short implants osseointegration can be compromised by risk factors that must be controlled to achieve treatment success. In conclusion, the main indication of short implants is to avoid an invasive surgery at atrophic areas of maxilla and mandible. Furthermore, implant design associated with surface treatment are factors that compensate its short length.

  1. [Dental implants in tooth grinders].

    Science.gov (United States)

    Lobbezoo, F; Brouwers, J E; Cune, M S; Naeije, M

    2004-03-01

    Bruxism (tooth grinding and clenching) is generally considered a contraindication for dental implants, although the evidence is usually based on clinical experience only. So far, studies to the possible cause-and-effect relationship between bruxism and implant failure do not yield consistent and specific outcomes. This is partly due to the large variation in the technical and the biological aspects of the investigations. Although there is still no proof that bruxism causes overload of dental implants and their suprastructures, a careful approach is recommended. Practical advices as to minimize the chance of implant failure are given. Besides the recommendation to reduce or eliminate bruxism itself, these advices concern the number and dimensions of the implants, the design of the occlusion and articulation patterns, and the use of a hard nightguard. PMID:15058243

  2. Breast Cancer Risk in American Women

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Risk in American Women On This Page What ... risk of developing the disease. Personal history of breast cancer : Women who have had breast cancer are more ...

  3. Contralateral breast cancer risk

    International Nuclear Information System (INIS)

    The use of breast-conserving treatment approaches for breast cancer has now become a standard option for early stage disease. Numerous randomized studies have shown medical equivalence when mastectomy is compared to lumpectomy followed by radiotherapy for the local management of this common problem. With an increased emphasis on patient involvement in the therapeutic decision making process, it is important to identify and quantify any unforeseen risks of the conservation approach. One concern that has been raised is the question of radiation- related contralateral breast cancer after breast radiotherapy. Although most studies do not show statistically significant evidence that patients treated with breast radiotherapy are at increased risk of developing contralateral breast cancer when compared to control groups treated with mastectomy alone, there are clear data showing the amount of scattered radiation absorbed by the contralateral breast during a routine course of breast radiotherapy is considerable (several Gy) and is therefore within the range where one might be concerned about radiogenic contralateral tumors. While radiation related risks of contralateral breast cancer appear to be small enough to be statistically insignificant for the majority of patients, there may exist a smaller subset which, for genetic or environmental reasons, is at special risk for scatter related second tumors. If such a group could be predicted, it would seem appropriate to offer either special counselling or special prevention procedures aimed at mitigating this second tumor risk. The use of genetic testing, detailed analysis of breast cancer family history, and the identification of patients who acquired their first breast cancer at a very early age may all be candidate screening procedures useful in identifying such at- risk groups. Since some risk mitigation strategies are convenient and easy to utilize, it makes sense to follow the classic 'ALARA' (as low as reasonably

  4. 6 Common Cancers - Breast Cancer

    Science.gov (United States)

    ... Home Current Issue Past Issues 6 Common Cancers - Breast Cancer Past Issues / Spring 2007 Table of Contents For ... slow her down. Photo: AP Photo/Brett Flashnick Breast Cancer Breast cancer is a malignant (cancerous) growth that ...

  5. Breast Cancer Rates by State

    Science.gov (United States)

    ... Associated Lung Ovarian Prostate Skin Uterine Cancer Home Breast Cancer Rates by State Language: English Español (Spanish) Recommend ... from breast cancer each year. Rates of Getting Breast Cancer by State The number of people who get ...

  6. CDC Vital Signs: Breast Cancer

    Science.gov (United States)

    ... 2.65 MB] Read the MMWR Science Clips Breast Cancer Black Women Have Higher Death Rates from Breast ... of Page U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

  7. Ceramic and polymeric devices for breast brachytherapy - Mammographic and CT response

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Luciana B.; Campos, Tarcisio P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares], e-mail: campos@nuclear.ufmg.br

    2009-07-01

    The present research investigates the radiological visibility of ceramic and polymeric devices implanted in breast phantom (in vitro) for future applications in brachytherapy treatments. The main research goal is to investigate the viability of monitoring ceramic and polymeric devices, in vitro based on simple methods of radiological diagnostic, maintaining the easiest access to the population, represented by the conventional X-ray and mammography. The methodology involves the processing of ceramic devices constituted by bioglasses of Sm, SmBa, Ho, HoBa and the production of polymeric devices, such as polymeric membranes incorporating Ho e HoBa. Contrast agent of Barium was introduced in the syntheses of those devices to improve the radiological visibility in breast equivalent-tissue (TE) phantom. The breast phantom is constituted of glandular, adipose and skin TE, reproducing a 5 cm compressed real breast. In the compressed breast phantom, all types of ceramic and polymeric devices were implanted side by side. Radiological images were generated through X-ray equipment, mammography and computerized tomography (TC), for the samples implanted in the compressed breast phantom. The results show that SmBa and HoBa seeds on breast phantom presented suitable radiological visibility, on all the radiological diagnostic methods. However, the X-rays radiological visibility of Sm seeds without contrast was discreet. On mammography and TC images, it was not possible to identify those seeds, because the same ones were degraded after two months immersed in the glandular TE, after placed on the phantom. The Ho seeds were identified on all radiological diagnostic images, although non contrast agent in its constitution was added. However, the holmium polymeric membranes in direct contact with TE did not show Xray radiological visibility. However, the polymeric membranes of HoBa in the same conditions presented efficient X-rays radiological response. For mammography and TC methods

  8. Classification of breast tissue for protocols development in mammography exam;Classificacao dos tecidos mamarios para elaboracao de protocolos em exames de mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, M. Ines; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Chohfi, Adriana C.S.; Figueiredo, Zenaide A. [Universidade Nove de Julho (UNINOVE), Sao Paulo, SP (Brazil). Dept. da Saude. Radiologia Medica

    2009-07-01

    For accomplishment of a mammogram should be considered several factors such as equipment used and the classification of breast cancer patients. The density of the breast is different of patient to patient, thus making it difficult many precocious diagnostic of breast cancer. There is a significant variation in the breast to be radiographed, depending on several factors presented in the breast tissue of breast prosthesis with or without breasts or with implants. This work had as objective main to make a survey of the factors that influence in the classification of mammary fabrics. With this survey and classification it can be better adjusted the protocols which will be more efficient in the mammography exam, preventing excess of radiation dose, stress for the patient, economy of raw material, control of the quality and rapidity in the process of image attainment. (author)

  9. Breast motion asymmetry during running

    OpenAIRE

    Mills, Chris; Risius, Debbie; Scurr, Joanna

    2015-01-01

    Breast asymmetry is common in females, despite a similar driving force; dynamic activity may result in asymmetrical breast motion. This preliminary study investigated how breast categorisation (left/right or dominant/non-dominant) may affect breast support recommendations and its relationship with breast pain. Ten females ran on a treadmill at 10 kph in three breast supports (no bra, everyday bra, sports bra). Five reflective markers on the thorax and nipples were tracked using infrared camer...

  10. Implantable, multifunctional, bioresorbable optics.

    Science.gov (United States)

    Tao, Hu; Kainerstorfer, Jana M; Siebert, Sean M; Pritchard, Eleanor M; Sassaroli, Angelo; Panilaitis, Bruce J B; Brenckle, Mark A; Amsden, Jason J; Levitt, Jonathan; Fantini, Sergio; Kaplan, David L; Omenetto, Fiorenzo G

    2012-11-27

    Advances in personalized medicine are symbiotic with the development of novel technologies for biomedical devices. We present an approach that combines enhanced imaging of malignancies, therapeutics, and feedback about therapeutics in a single implantable, biocompatible, and resorbable device. This confluence of form and function is accomplished by capitalizing on the unique properties of silk proteins as a mechanically robust, biocompatible, optically clear biomaterial matrix that can house, stabilize, and retain the function of therapeutic components. By developing a form of high-quality microstructured optical elements, improved imaging of malignancies and of treatment monitoring can be achieved. The results demonstrate a unique family of devices for in vitro and in vivo use that provide functional biomaterials with built-in optical signal and contrast enhancement, demonstrated here with simultaneous drug delivery and feedback about drug delivery with no adverse biological effects, all while slowly degrading to regenerate native tissue. PMID:23150544

  11. Implant materials modified by colloids

    Directory of Open Access Journals (Sweden)

    Zboromirska-Wnukiewicz Beata

    2016-03-01

    Full Text Available Recent advances in general medicine led to the development of biomaterials. Implant material should be characterized by a high biocompatibility to the tissue and appropriate functionality, i.e. to have high mechanical and electrical strength and be stable in an electrolyte environment – these are the most important properties of bioceramic materials. Considerations of biomaterials design embrace also electrical properties occurring on the implant-body fluid interface and consequently the electrokinetic potential, which can be altered by modifying the surface of the implant. In this work, the surface of the implants was modified to decrease the risk of infection by using metal colloids. Nanocolloids were obtained using different chemical and electrical methods. It was found that the colloids obtained by physical and electrical methods are more stable than colloids obtained by chemical route. In this work the surface of modified corundum implants was investigated. The implant modified by nanosilver, obtained by electrical method was selected. The in vivo research on animals was carried out. Clinical observations showed that the implants with modified surface could be applied to wounds caused by atherosclerotic skeleton, for curing the chronic and bacterial inflammations as well as for skeletal reconstruction surgery.

  12. Familial breast cancer.

    OpenAIRE

    Phipps, R. F.; Perry, P M

    1988-01-01

    Familial breast cancer is important because of all the known risk factors associated with developing the disease. The one with the most predictability is a positive family history. It is also important because a family history causes anxiety in the families concerned, and young women will often ask their chance of developing the disease. This form of breast cancer accounts for 10% of causes and has factors that distinguish it from the sporadic variety. Relatives of familial breast cancer pati...

  13. COCHLEAR IMPLANTATION PREVALENCE IN ELDERLY

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    A. V. Starokha

    2014-01-01

    Full Text Available Current paper describes an experience of cochlear implantation in elderly. Cochlear implantation has become a widely accepted intervention in the treatment of individuals with severe-to-profound sensorineural hearing loss. Cochlear implants are now accepted as a standard of care to optimize hearing and subsequent speech development in children and adults with deafness. But cochlear implantation affects not only hearing abilities, speech perception and speech production; it also has an outstanding impact on the social life, activities and self-esteem of each patient. The aim of this study was to evaluate the cochlear implantation efficacy in elderly with severe to profound sensorineural hearing loss. There were 5 patients under our observation. Surgery was performed according to traditional posterior tympanotomy and cochleostomy for cochlear implant electrode insertion for all observed patients. The study was conducted in two stages: before speech processor’s activation and 3 months later. Pure tone free field audiometry was performed to each patient to assess the efficiency of cochlear implantation in dynamics. The aim of the study was also to evaluate quality of life in elderly with severe to profound sensorineural hearing loss after unilateral cochlear implantation. Each patient underwent questioning with 36 Item Short Form Health Survey (SF-36. SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The eight sections are: physical functioning; physical role functioning; emotional role functioning; vitality; emotional well-being; social role functioning; bodily pain; general health perceptions. Our results demonstrate that cochlear implantation in elderly consistently improved quality of life

  14. Microsystems Technology for Retinal Implants

    Science.gov (United States)

    Weiland, James

    2005-03-01

    The retinal prosthesis is targeted to treat age-related macular degeneration, retinitis pigmentosa, and other outer retinal degenerations. Simulations of artificial vision have predicted that 600-1000 individual pixels will be needed if a retinal prosthesis is to restore function such as reading large print and face recognition. An implantable device with this many electrode contacts will require microsystems technology as part of its design. An implantable retinal prosthesis will consist of several subsystems including an electrode array and hermetic packaging. Microsystems and microtechnology approaches are being investigated as possible solutions for these design problems. Flexible polydimethylsiloxane (PDMS) substrate electrode arrays and silicon micromachined electrode arrays are under development. Inactive PDMS electrodes have been implanted in 3 dogs to assess mechanical biocompatibility. 3 dogs were followed for 6 months. The implanted was securely fastened to the retina with a single retinal tack. No post-operative complications were evident. The array remained within 100 microns of the retinal surface. Histological evaluation showed a well preserved retina underneath the electrode array. A silicon device with electrodes suspended on micromachined springs has been implanted in 4 dogs (2 acute implants, 2 chronic implants). The device, though large, could be inserted into the eye and positioned on the retina. Histological analysis of the retina from the spring electrode implants showed that spring mounted posts penetrated the retina, thus the device will be redesigned to reduce the strength of the springs. These initial implants will provide information for the designers to make the next generation silicon device. We conclude that microsystems technology has the potential to make possible a retinal prosthesis with 1000 individual contacts in close proximity to the retina.

  15. Basic research on maxillofacial implants

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-11-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  16. Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR for early breast cancer: Eight years single institution experience

    Directory of Open Access Journals (Sweden)

    Bobin Jean

    2008-04-01

    Full Text Available Abstract Background Skin Sparing Mastectomy (SSM and immediate breast reconstruction has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the clinical outcome of skin sparing mastectomy in early breast cancer at a single population-based institution. Methods Records of ninety-five consecutive patients with operable breast cancer who had skin-sparing mastectomy and immediate breast reconstructions between 1995 and 2003 were reviewed. Patient and tumor characteristic, type of reconstruction, postoperative complications, aesthetic results and incidence of recurrence were analyzed. Results Mean age of the patients was 51.6(range 33–72 years. The AJCC pathologic stages were 0 (n = 51, 53.7%, I (n = 20, 21.1%, and II (n = 2, 2.1%. Twenty of the patients had recurrent disease (21.1%. The immediate breast reconstructions were performed with autologus tissue including latissimus dorsi musculocutaneous flap in 63 (66.3% patients and transverse rectus abdominis myocutaneous (TRAM flap in 4 (4.2% patients. Implants were used in 28 (29.4% patients. The average hospital stay was 7.7 days. Flap complication occurred in seven (10.4% patients resulting in four (6% re-operations and there were no delay in accomplishing postoperative adjuvant therapy. At a median follow-up of 69 months (range 48 to 144, local recurrence was seen in one patient (1.1% and systemic recurrence was seen in two patients (2.1%. Conclusion Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.

  17. Alleviation of capsular formations on silicone implants in rats using biomembrane-mimicking coatings.

    Science.gov (United States)

    Park, Ji Ung; Ham, Jiyeon; Kim, Sukwha; Seo, Ji-Hun; Kim, Sang-Hyon; Lee, Seonju; Min, Hye Jeong; Choi, Sunghyun; Choi, Ra Mi; Kim, Heejin; Oh, Sohee; Hur, Ji An; Choi, Tae Hyun; Lee, Yan

    2014-10-01

    Despite their popular use in breast augmentation and reconstruction surgeries, the limited biocompatibility of silicone implants can induce severe side effects, including capsular contracture - an excessive foreign body reaction that forms a tight and hard fibrous capsule around the implant. This study examines the effects of using biomembrane-mimicking surface coatings to prevent capsular formations on silicone implants. The covalently attached biomembrane-mimicking polymer, poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), prevented nonspecific protein adsorption and fibroblast adhesion on the silicone surface. More importantly, in vivo capsule formations around PMPC-grafted silicone implants in rats were significantly thinner and exhibited lower collagen densities and more regular collagen alignments than bare silicone implants. The observed decrease in α-smooth muscle actin also supported the alleviation of capsular formations by the biomembrane-mimicking coating. Decreases in inflammation-related cells, myeloperoxidase and transforming growth factor-β resulted in reduced inflammation in the capsular tissue. The biomembrane-mimicking coatings used on these silicone implants demonstrate great potential for preventing capsular contracture and developing biocompatible materials for various biomedical applications.

  18. Pediatric cochlear implantation: an update.

    Science.gov (United States)

    Vincenti, Vincenzo; Bacciu, Andrea; Guida, Maurizio; Marra, Francesca; Bertoldi, Barbara; Bacciu, Salvatore; Pasanisi, Enrico

    2014-01-01

    Deafness in pediatric age can adversely impact language acquisition as well as educational and social-emotional development. Once diagnosed, hearing loss should be rehabilitated early; the goal is to provide the child with maximum access to the acoustic features of speech within a listening range that is safe and comfortable. In presence of severe to profound deafness, benefit from auditory amplification cannot be enough to allow a proper language development. Cochlear implants are partially implantable electronic devices designed to provide profoundly deafened patients with hearing sensitivity within the speech range. Since their introduction more than 30 years ago, cochlear implants have improved their performance to the extent that are now considered to be standard of care in the treatment of children with severe to profound deafness. Over the years patient candidacy has been expanded and the criteria for implantation continue to evolve within the paediatric population. The minimum age for implantation has progressively reduced; it has been recognized that implantation at a very early age (12-18 months) provides children with the best outcomes, taking advantage of sensitive periods of auditory development. Bilateral implantation offers a better sound localization, as well as a superior ability to understand speech in noisy environments than unilateral cochlear implant. Deafened children with special clinical situations, including inner ear malformation, cochlear nerve deficiency, cochlear ossification, and additional disabilities can be successfully treated, even thogh they require an individualized candidacy evaluation and a complex post-implantation rehabilitation. Benefits from cochlear implantation include not only better abilities to hear and to develop speech and language skills, but also improved academic attainment, improved quality of life, and better employment status. Cochlear implants permit deaf people to hear, but they have a long way to go before

  19. Intrapulmonal dislocation of a totally implantable venous access device

    Directory of Open Access Journals (Sweden)

    Sido Bernd

    2005-04-01

    Full Text Available Abstract Background Totally implantable venous access devices are widely used for infusion of chemotherapy or parenteral nutrition. Device associated complications include technical operative problems, infections, paravasal infusions and catheter or punction chamber dislocation. Case presentation We present the case of a 49-year-old patient with the rare complication of a intrapulmonal catheter dislocation of a totally implantable venous access system. Treosulfane for chemotherapy of metastatic breast cancer was infused via the catheter causing instant coughing and dyspnoea which lead to the diagnosis of catheter dislocation. The intrapulmonal part of the catheter was removed under thoracoscopic control without further complications. Conclusion Intrapulmonal catheter dislocation is a rare complication of a totally implantable venous access device which can not be avoided by any prophylactic measures. Therefore, the infusion system should be tested before each use and each new symptom, even when not obviously related to the catheter should be carefully documented and evaluated by expert physicians to avoid severe catheter-associated complications.

  20. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial; Teilbrustbestrahlung beim Mammakarzinom mit guenstigen prognostischen Faktoren: 3-Jahres-Ergebnisse der deutschoesterreichischen Phase II-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Strahlenklinik, Universitaetsklinikum Erlangen (Germany); Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, AKH Wien (Austria); Hildebrandt, G. [Strahlenklinik, Universitaetsklinikum Leipzig (Germany); Hammer, J. [Abt. fuer Strahlentherapie, KH Barmherzige Schwestern Linz (Austria); Beckmann, M.W. [Frauenklinik, Universitaetsklinikum Erlangen (Germany)

    2005-07-01

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)