WorldWideScience

Sample records for breast seed implant

  1. Seed Placement in Permanent Breast Seed Implant Brachytherapy: Are Concerns Over Accuracy Valid?

    Energy Technology Data Exchange (ETDEWEB)

    Morton, Daniel, E-mail: dmorton@bccancer.bc.ca [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Hilts, Michelle [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Batchelar, Deidre [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Crook, Juanita [Department of Radiation Oncology, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada)

    2016-07-01

    Purpose: To evaluate seed placement accuracy in permanent breast seed implant brachytherapy (PBSI), to identify any systematic errors and evaluate their effect on dosimetry. Methods and Materials: Treatment plans and postimplant computed tomography scans for 20 PBSI patients were spatially registered and used to evaluate differences between planned and implanted seed positions, termed seed displacements. For each patient, the mean total and directional seed displacements were determined in both standard room coordinates and in needle coordinates relative to needle insertion angle. Seeds were labeled according to their proximity to the anatomy within the breast, to evaluate the influence of anatomic regions on seed placement. Dosimetry within an evaluative target volume (seroma + 5 mm), skin, breast, and ribs was evaluated to determine the impact of seed placement on the treatment. Results: The overall mean (±SD) difference between implanted and planned positions was 9 ± 5 mm for the aggregate seed population. No significant systematic directional displacements were observed for this whole population. However, for individual patients, systematic displacements were observed, implying that intrapatient offsets occur during the procedure. Mean displacements for seeds in the different anatomic areas were not found to be significantly different from the mean for the entire seed population. However, small directional trends were observed within the anatomy, potentially indicating some bias in the delivery. Despite observed differences between the planned and implanted seed positions, the median (range) V{sub 90} for the 20 patients was 97% (66%-100%), and acceptable dosimetry was achieved for critical structures. Conclusions: No significant trends or systematic errors were observed in the placement of seeds in PBSI, including seeds implanted directly into the seroma. Recorded seed displacements may be related to intrapatient setup adjustments. Despite observed seed

  2. Dosimetric intercomparison of permanent Ho-166 seed's implants and HDR Ir-192 brachytherapy in breast cancer.

    Science.gov (United States)

    de Campos, Tarcisio Passos Ribeiro; Nogueira, Luciana Batista; Trindade, Bruno; Cuperschmid, Ethel Mizrahy

    2016-01-01

    To provide a comparative dosimetric analysis of permanent implants of Ho(166)-seeds and temporary HDR Ir(192)-brachytherapy through computational simulation. Brachytherapy with Ir(192)-HDR or LDR based on temporary wires or permanent radioactive seed implants can be used as dose reinforcement for breast radiation therapy. Permanent breast implants have not been a practical clinical routine; although, I(125) and Pd(103)-seeds have already been reported. Biodegradable Ho(166)-ceramic-seeds have been addressed recently. Simulations of implants of nine Ho(166)-seeds and equivalent with HDR Ir(192)-brachytherapy were elaborated in MCNP5, shaped in a computational multivoxel simulator which reproduced a female thorax phantom. Spatial dose rate distributions and dose-volume histograms were generated. Protocol's analysis involving exposure time, seed's activities and dose were performed. Permanent Ho(166)-seed implants presented a maximum dose rate per unit of contained activity (MDR) of 1.1601 μGy h(-1) Bq(-1); and, a normalized MDR in standard points (8 mm, equidistant to 03-seeds - SP1, 10 mm - SP2) of 1.0% (SP1) and 0.5% (SP2), respectively. Ir(192)-brachytherapy presented MDR of 4.3945 × 10(-3) μGy h(-1) Bq(-1); and, 30% (SP1), and 20% (SP2). Therefore, seed's implant activities of 333 MBq (Ho(166)) and 259 GBq (Ir(192)) produced prescribed doses of 58 Gy (SP1; 5d) and 56 Gy (SP1, 5 fractions, 6 min), respectively. Breast Ho(166)-implants of 37-111 MBq are attractive due to the high dose rate near 6-10 mm from seeds, equivalent to Ir(192)-brachytherapy of 259 GBq (3 fractions, 6 min) providing similar dose in standard points at a week; however, with spatial dose distribution better confined. The seed positioning can be adjusted for controlling the breast tumor, in stages I and II, in flat and deep tumors, without any breast volumetric limitation.

  3. 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.

  4. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... harder to find a tumor if your breast cancer comes back. Getting breast implants does not take as long as breast reconstruction ...

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

    Science.gov (United States)

    Furstoss, C; Reniers, B; Bertrand, M J; Poon, E; Carrier, J-F; Keller, B M; Pignol, J P; Beaulieu, L; Verhaegen, F

    2009-05-01

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of 125I 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 125I 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 V85, V100, and V200 for this kind of treatment in the target. D90 and D50 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 Gafchromic film and within 7% for TLD-100

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

    International Nuclear Information System (INIS)

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

    2010-01-01

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast 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 90 reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D 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.

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

    International Nuclear Information System (INIS)

    Pignol, Jean-Philippe; Keller, Brian; Rakovitch, Eileen; Sankreacha, Raxa; Easton, Harry; Que, William

    2006-01-01

    Purpose: A new technique of adjuvant partial breast irradiation using 103 Pd 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

  8. Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers

    International Nuclear Information System (INIS)

    Pignol, Jean-Philippe; Caudrelier, Jean-Michel; Crook, Juanita; McCann, Claire; Truong, Pauline; Verkooijen, Helena A.

    2015-01-01

    Purpose: Permanent breast seed implant is an accelerated partial breast irradiation technique realizing the insertion of "1"0"3Pd seeds in the seroma after lumpectomy. We report the 5-year efficacy and tolerance for a cohort, pooling patients from 3 clinical trials. Methods and Materials: The trials accrued postmenopausal patients with infiltrating ductal carcinoma or ductal carcinoma in situ ≤3 cm and clear surgical margins, who were node negative, and had a planning target volume <120 cm"3. The outcomes included overall and disease-free survival and local and contralateral recurrence at 5 years. The true local recurrence rate was compared using 2-tailed paired t tests for estimates calculated using the Tufts University ipsilateral breast tumor recurrence and Memorial Sloan Kettering ductal carcinoma in situ nomograms. Results: The cohort included 134 patients, and the observed local recurrence rate at a median follow-up period of 63 months was 1.2% ± 1.2%, similar to the estimate for whole breast irradiation (P=.23), significantly better than for surgery alone (relative risk 0.27; P<.001), and significantly lower than contralateral recurrence (relative risk 0.33; P<.001). The 5-year overall survival rate was 97.4% ± 1.9%, and the disease-free survival rate was 96.4% ± 2.1%. At 2 months, 42% of the patients had erythema, 20% induration, and 16% moist desquamation. The rate of mainly grade 1 telangiectasia was 22.4% at 2 years and 24% at 5 years. The rate of asymptomatic induration was 23% at 2 years and 40% at 5 years. Conclusions: The 5-year data suggest that permanent breast seed implantation is a safe accelerated partial breast irradiation option after lumpectomy for early-stage breast cancer with a tolerance profile similar to that of whole breast irradiation.

  9. Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl [Radiation Oncology Department, University of Toronto at Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Caudrelier, Jean-Michel [Department of Radiation Medicine, The Ottawa Hospital Cancer Centre, Ottawa, Ontario (Canada); Crook, Juanita [Department of Radiation Oncology, BC Cancer Agency Center for the Southern Interior, Kelowna, British Columbia (Canada); McCann, Claire [Radiation Oncology Department, University of Toronto at Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Truong, Pauline [Radiation Oncology Department, BC Cancer Agency Vancouver Island Centre, Victoria, British Columbia (Canada); Verkooijen, Helena A. [Imaging Division, University Medical Centre Utrecht, Utrecht (Netherlands)

    2015-11-01

    Purpose: Permanent breast seed implant is an accelerated partial breast irradiation technique realizing the insertion of {sup 103}Pd seeds in the seroma after lumpectomy. We report the 5-year efficacy and tolerance for a cohort, pooling patients from 3 clinical trials. Methods and Materials: The trials accrued postmenopausal patients with infiltrating ductal carcinoma or ductal carcinoma in situ ≤3 cm and clear surgical margins, who were node negative, and had a planning target volume <120 cm{sup 3}. The outcomes included overall and disease-free survival and local and contralateral recurrence at 5 years. The true local recurrence rate was compared using 2-tailed paired t tests for estimates calculated using the Tufts University ipsilateral breast tumor recurrence and Memorial Sloan Kettering ductal carcinoma in situ nomograms. Results: The cohort included 134 patients, and the observed local recurrence rate at a median follow-up period of 63 months was 1.2% ± 1.2%, similar to the estimate for whole breast irradiation (P=.23), significantly better than for surgery alone (relative risk 0.27; P<.001), and significantly lower than contralateral recurrence (relative risk 0.33; P<.001). The 5-year overall survival rate was 97.4% ± 1.9%, and the disease-free survival rate was 96.4% ± 2.1%. At 2 months, 42% of the patients had erythema, 20% induration, and 16% moist desquamation. The rate of mainly grade 1 telangiectasia was 22.4% at 2 years and 24% at 5 years. The rate of asymptomatic induration was 23% at 2 years and 40% at 5 years. Conclusions: The 5-year data suggest that permanent breast seed implantation is a safe accelerated partial breast irradiation option after lumpectomy for early-stage breast cancer with a tolerance profile similar to that of whole breast irradiation.

  10. Clinical Significance of Accounting for Tissue Heterogeneity in Permanent Breast Seed Implant Brachytherapy Planning

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, Shahram [Medical Biophysics Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Fleury, Emmanuelle [Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Lai, Priscilla [Medical Biophysics Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Merino, Tomas [Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Radiotherapy Unit, School of Medicine, Departamento de Hemato-oncologia, Pontificia Universidad Católica de Chile, Santiago (Chile); Lechtman, Eli [Medical Biophysics Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Kiss, Alex [Sunnybrook Research Institute, Toronto, Ontario (Canada); McCann, Claire [Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl [Medical Biophysics Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Radiation Oncology Department, Erasmus Medical Center, Cancer Institute, Rotterdam (Netherlands)

    2016-03-15

    Purpose: The inhomogeneity correction factor (ICF) method provides heterogeneity correction for the fast calculation TG43 formalism in seed brachytherapy. This study compared ICF-corrected plans to their standard TG43 counterparts, looking at their capacity to assess inadequate coverage and/or risk of any skin toxicities for patients who received permanent breast seed implant (PBSI). Methods and Materials: Two-month postimplant computed tomography scans and plans of 140 PBSI patients were used to calculate dose distributions by using the TG43 and the ICF methods. Multiple dose-volume histogram (DVH) parameters of clinical target volume (CTV) and skin were extracted and compared for both ICF and TG43 dose distributions. Short-term (desquamation and erythema) and long-term (telangiectasia) skin toxicity data were available on 125 and 110 of the patients, respectively, at the time of the study. The predictive value of each DVH parameter of skin was evaluated using the area under the receiver operating characteristic (ROC) curve for each toxicity endpoint. Results: Dose-volume histogram parameters of CTV, calculated using the ICF method, showed an overall decrease compared to TG43, whereas those of skin showed an increase, confirming previously reported findings of the impact of heterogeneity with low-energy sources. The ICF methodology enabled us to distinguish patients for whom the CTV V{sub 100} and V{sub 90} are up to 19% lower compared to TG43, which could present a risk of recurrence not detected when heterogeneity are not accounted for. The ICF method also led to an increase in the prediction of desquamation, erythema, and telangiectasia for 91% of skin DVH parameters studied. Conclusions: The ICF methodology has the advantage of distinguishing any inadequate dose coverage of CTV due to breast heterogeneity, which can be missed by TG43. Use of ICF correction also led to an increase in prediction accuracy of skin toxicities in most cases.

  11. Experimental evaluation of an online gamma-camera imaging of permanent seed implantation (OGIPSI) prototype for partial breast irradiation

    International Nuclear Information System (INIS)

    Ravi, Ananth; Caldwell, Curtis B.; Pignol, Jean-Philippe

    2008-01-01

    Previously, our team used Monte Carlo simulation to demonstrate that a gamma camera could potentially be used as an online image guidance device to visualize seeds during permanent breast seed implant procedures. This could allow for intraoperative correction if seeds have been misplaced. The objective of this study is to describe an experimental evaluation of an online gamma-camera imaging of permanent seed implantation (OGIPSI) prototype. The OGIPSI device is intended to be able to detect a seed misplacement of 5 mm or more within an imaging time of 2 min or less. The device was constructed by fitting a custom built brass collimator (16 mm height, 0.65 mm hole pitch, 0.15 mm septal thickness) on a 64 pixel linear array CZT detector (eValuator-2000, eV Products, Saxonburg, PA). Two-dimensional projection images of seed distributions were acquired by the use of a digitally controlled translation stage. Spatial resolution and noise characteristics of the detector were measured. The ability and time needed for the OGIPSI device to image the seeds and to detect cold spots was tested using an anthropomorphic breast phantom. Mimicking a real treatment plan, a total of 52 103 Pd seeds of 65.8 MBq each were placed on three different layers at appropriate depths within the phantom. The seeds were reliably detected within 30 s with a median error in localization of 1 mm. In conclusion, an OGIPSI device can potentially be used for image guidance of permanent brachytherapy applications in the breast and, possibly, other sites

  12. A Radiation Badge Survey for Family Members Living With Patients Treated With a 103Pd Permanent Breast Seed Implant

    International Nuclear Information System (INIS)

    Keller, Brian M.; Pignol, Jean-Philippe; Rakovitch, Eileen; Sankreacha, Raxa; O'Brien, Peter

    2008-01-01

    Purpose: Sixty-seven patients with early-stage breast cancer were treated in a Phase I/II clinical trial using a 103 Pd permanent breast seed implant as adjuvant radiotherapy after breast-conserving surgery. We report the dose received by family members living with these patients and compare measured doses with theoretical worst-case scenario estimates. Methods and Materials: Exposure-rate measurements were taken at 1 m from the patient by using a calibrated low-energy survey meter. Landauer (Landauer Inc., Glenwood, IL) Luxel badges, with sensitivity of 0.01 mSv, were given to family members to wear after the implantation. Badge readings for 33 spouses and 28 other family members were used to estimate effective doses, and these were compared with theory. Results: Average preimplantation planning target volume from computed tomography was 50.3 ml (range, 18.0-96.7 ml), and average preimplantation distance between the skin and the most anterior planning target volume margin was 0.57 cm. The average maximum exposure rate was measured to be 2.4 ± 1.1 mR/h, and average measured dose to a spouse was 0.99 ± 1.0 mSv. The calculated exposure rates and spousal doses using preimplantation computed tomography scan data overestimated those measured. Average measured family member dose (excluding spouses) was 0.20 ± 0.58 mSv. Conclusions: Based on measured and calculated spousal doses, a permanent breast seed implant using 103 Pd is safe for the public. However, it is recommended that extra precautions in the way of a breast patch be used when patients with an implant will be in the vicinity of toddlers or pregnant women

  13. Tolerance and Acceptance Results of a Palladium-103 Permanent Breast Seed Implant Phase I/II Study

    International Nuclear Information System (INIS)

    Pignol, Jean-Philippe; Rakovitch, Eileen; Keller, Brian M.; Sankreacha, Raxa; Chartier, Carole

    2009-01-01

    Purpose: To test, in a prospective Phase I/II trial, a partial breast irradiation technique using a 103 Pd permanent breast seed implant (PBSI) realized in a single 1-h procedure under sedation and local freezing. Methods and Materials: Eligible patients had infiltrating ductal carcinoma ≤3 cm in diameter, surgical margin ≥2 mm, no extensive intraductal component, no lymphovascular invasion, and negative lymph nodes. Patients received a permanent seed implant, and a minimal peripheral dose of 90 Gy was prescribed to the clinical target volume, with a margin of 1.5 cm. Results: From May 2004 to April 2007, 67 patients received the PBSI treatment. The procedure was well tolerated, with 17% of patients having significant pain after the procedure. Only 1 patient (1.5%) had an acute skin reaction (Grade 3 according to the National Cancer Institute Common Toxicity Criteria). The rates of acute moist desquamation, erythema, and indurations were 10.4%, 42%, and 27%, respectively. At 1 year the rate of Grade 1 telangiectasia was 14%. The rate of skin reaction decreased from 65% to 28% when skin received less than the 85% isodose. According to a Radiation Therapy Oncology Group questionnaire, 80-90% of patients were very satisfied with their treatment, and the remainder were satisfied. One patient (1.5%) developed an abscess, which resolved after the use of antibiotics. There was no recurrence after a median follow-up of 32 months (range, 11-49 months). Conclusions: The feasibility, safety, and tolerability of PBSI compares favorably with that of external beam and other partial breast irradiation techniques.

  14. Risks of Breast Implants

    Science.gov (United States)

    ... have a risk of developing a type of cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in the breast tissue surrounding the implant. BIA-ALCL is not breast cancer. Women diagnosed with BIA-ALCL may need to ...

  15. Evaluation of implanted gold seeds for breast radiotherapy planning and on treatment verification: A feasibility study on behalf of the IMPORT trialists

    International Nuclear Information System (INIS)

    Coles, Charlotte E.; Harris, Emma J.; Donovan, Ellen M.; Bliss, Peter; Evans, Philip M.; Fairfoul, Jamie; Mackenzie, Christine; Rawlings, Christine; Syndikus, Isabel; Twyman, Nicola; Vasconcelos, Joana; Vowler, Sarah L.; Wilkinson, Jenny S.; Wilks, Robin; Wishart, Gordon C.; Yarnold, John

    2011-01-01

    Background and purpose: We describe a feasibility study testing the use of gold seeds for the identification of post-operative tumour bed after breast conservation surgery (BCS). Materials and Methods: Fifty-three patients undergoing BCS for invasive cancer were recruited. Successful use was defined as all six seeds correctly positioned around the tumour bed during BCS, unique identification of all implanted seeds on CT planning scan and ≥3 seeds uniquely identified at verification to give couch displacement co-ordinates in 10/15 fractions. Planning target volume (PTV) margin size for four correction strategies were calculated from these data. Variability in tumour bed contouring was investigated with five radiation oncologists outlining five CT datasets. Results: Success in inserting gold seeds, identifying them at CT planning and using them for on-treatment verification was recorded in 45/51 (88%), 37/38 (97%) and 42/43 (98%) of patients, respectively. The clinicians unfamiliar with CT breast planning consistently contoured larger volumes than those already trained. Margin size ranged from 10.1 to 1.4 mm depending on correction strategy. Conclusion: It is feasible to implant tumour bed gold seeds during BCS. Whilst taking longer to insert than surgical clips, they have the advantage of visibility for outlining and verification regardless of the ionising radiation beam quality. Appropriate correction strategies enable margins of the order of 5 mm as required by the IMPORT trials however, tackling clinician variability in contouring is important.

  16. Sci-Thur PM – Brachytherapy 02: Positional accuracy in Pd-103 permanent breast seed implant (PBSI) brachytherapy at the Tom Baker Cancer Centre (TBCC)

    Energy Technology Data Exchange (ETDEWEB)

    Frederick, Amy; Watt, Elizabeth; Peacock, Michael; Husain, Siraj; Meyer, Tyler; Roumeliotis, Michael [University of Calgary, Tom Baker Cancer Centre (Canada)

    2016-08-15

    Purpose: This retrospective study aims to quantify the positional accuracy of seed delivery in permanent breast seed implant (PBSI) brachytherapy at the Tom Baker Cancer Centre (TBCC). Methods: Treatment planning and post-implant CT scans for 5 patients were rigidly registered using the MIM Symphony™ software (MIM Software, Cleveland, OH) and used to evaluate differences between planned and implanted seed positions. Total and directional seed displacements were calculated for each patient in a clinically relevant ‘needle coordinate system’, defined relative to the angle of fiducial needle insertion. Results: The overall average total seed displacement was 10±8 mm. Systematic seed displacements were observed in individual patients and the magnitude and direction of these offsets varied among patients. One patient showed a significant directional seed displacement in the shallow-deep direction compared with the other four patients. With the exception of this one patient outlier, no significant systematic directional displacements in the needle coordinate system were observed for this cohort; the average directional displacements were −1±5 mm, 2±3 mm, and −2±4 mm in the shallow-deep, up-down, and right-left directions respectively. Conclusion: With the exception of one patient outlier, the magnitude of seed displacements were relatively consistent among patients. The results indicate that the shallow-deep direction possesses the largest uncertainty for the seed delivery method used at the TBCC. The relatively large uncertainty in seed placement in this direction is expected, as this is the direction of needle insertion. Further work will involve evaluating deflections of delivered needle tracks from their planned positions.

  17. 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

  18. 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...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  19. 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 untre...

  20. The breast implant controversy.

    Science.gov (United States)

    Cook, R R; Harrison, M C; LeVier, R R

    1994-02-01

    The breast implant issue is a "bad news/good news" story. For many women with implants, the controversy has caused a fair degree of anxiety which may or may not be resolved as further information becomes available. It has also taken its toll on Dow Corning. Whole lines of medical products have been eliminated or are being phase out. The development of new medical applications has been terminated. As a consequence, employees have lost their jobs. What the effect will be on the biomedical industry as a whole remains to be seen (11). While silicones have been an important component in various medical devices, it is likely that other materials can be used as replacements. However, suppliers of non-silicone materials are also reevaluating their role in this market. For example, Du Pont, the nation's largest chemical company, has determined that the unpredictable and excessive costs of doing business with manufacturers of implantable medical devices no longer justifies the unrestricted sale of standard raw materials into this industry. Other companies are quietly following suit. On the up side, it is possible that the research being driven by this controversy will result in a greater understanding of the immunologic implications of xenobiotics, of the importance of nonbiased observations, of the need for ready access to valid data sets, and of the opportunity for valid scientific information to guide legal decisions. Only time will tell.

  1. Immediate Direct-To-Implant Breast Reconstruction Using Anatomical Implants

    Directory of Open Access Journals (Sweden)

    Sung-Eun Kim

    2014-09-01

    Full Text Available BackgroundIn 2012, a new anatomic breast implant of form-stable silicone gel was introduced onto the Korean market. The intended use of this implant is in the area of aesthetic breast surgery, and many reports are promising. Thus far, however, there have been no reports on the use of this implant for breast reconstruction in Korea. We used this breast implant in breast reconstruction surgery and report our early experience.MethodsFrom November 2012 to April 2013, the Natrelle Style 410 form-stable anatomically shaped cohesive silicone gel-filled breast implant was used in 31 breasts of 30 patients for implant breast reconstruction with an acellular dermal matrix. Patients were treated with skin-sparing mastectomies followed by immediate breast reconstruction.ResultsThe mean breast resection volume was 240 mL (range, 83-540 mL. The mean size of the breast implants was 217 mL (range, 125-395 mL. Breast shape outcomes were considered acceptable. Infection and skin thinning occurred in one patient each, and hematoma and seroma did not occur. Three cases of wound dehiscence occurred, one requiring surgical intervention, while the others healed with conservative treatment in one month. Rippling did not occur. So far, complications such as capsular contracture and malrotation of breast implant have not yet arisen.ConclusionsBy using anatomic breast implants in breast reconstruction, we achieved satisfactory results with aesthetics better than those obtained with round breast implants. Therefore, we concluded that the anatomical implant is suitable for breast reconstruction.

  2. Breast Reconstruction with Implants

    Science.gov (United States)

    ... your surgical options and discuss the advantages and disadvantages of implant-based reconstruction, and may show you ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  3. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

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

    2011-01-01

    the period 1999 to 2006; 239 one-stage procedures and 353 two-stage procedures. The postoperative course through November 2009 was evaluated by cumulative incidence adjusting for competing risks for the selected outcomes; hematoma, infection, seroma, implant rupture, severe capsular contracture (modified...

  4. [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.

  5. MR imaging of breast implants.

    Science.gov (United States)

    Gorczyca, D P

    1994-11-01

    MR imaging has proved to be an excellent imaging modality in locating free silicone and evaluating an implant for rupture, with a sensitivity of approximately 94% and specificity of 97%. Silicone has a unique MR resonance frequency and long T1 and T2 relaxation times, which allows several MR sequences to provide excellent diagnostic images. The most commonly used sequences include T2-weighted, STIR, and chemical shift imaging (Figs. 3, 13, and 14). The T2-weighted and STIR sequences are often used in conjunction with chemical water suppression. The most reliable findings on MR images for detection of implant rupture include identification of the collapsed implant shell (linguine sign) and free silicone within the breast parenchyma.

  6. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  7. 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.

  8. PIP breast implants: rupture rate and correlation with breast cancer.

    Science.gov (United States)

    Moschetta, M; Telegrafo, M; Cornacchia, I; Vincenti, L; Ranieri, V; Cirili, A; Rella, L; Stabile Ianora, A A; Angelelli, G

    2014-01-01

    To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years' experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated.

  9. 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.

  10. 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...

  11. MR images of rupture and leakage of breast implants

    International Nuclear Information System (INIS)

    Fang Ling; Liu Pengcheng; Huang Rong; Hu Huaxin; Chen Zaizhong; Du Duanming; Liu Hanqiao; Feng Fei

    2002-01-01

    Objective: To investigate the diagnostic value of magnetic resonance imaging in detecting rupture and leakage of breast implants. Methods: Seventeen cases with breast implants were imaged by MR scanner. 1 normal silicone breast implant outside the body was scanned by MR as an consultative standard. MR images of silicone implants and polypropylene acyl amine implants were classified and analyzed. Results: In 7 cases, 12 single lumen silicone implants were intact, among them 8 were silicone gel-filled implants, 4 were physiological saline-filled implants. 2 physiological saline-filled implants ruptured, among them 1 belonged to intracapsular silicone implant rupture with subsided silicone gel capsule which presented as long T 1 signal and short T 2 signal on MR images; The other belonged to extracapsular silicone implant rapture with physiological saline granule outside breast on MR images. 20 breast implants in 10 cases were injected by polypropylene acyl amine, among them 2 breast implants were intact, 16 breast implants ruptured completely with pieces and nodes of long T 1 signal and long T 2 signal on MR images, 14 of 16 also presented polypropylene acyl amine granule outside breast; 2 breast implants splited inside with linguine sign. Conclusion: The magnetic resonance imaging can make clear the type and the seat of breast implants, the type of rupture of breast implants, and the distribution of leakage material. Therefore magnetic resonance imaging can be an effective guidance for clinical operation and can be an consultative standard for follow-up

  12. Physical Properties of Silicone Gel Breast Implants.

    Science.gov (United States)

    Jewell, Mark L; Bengtson, Bradley P; Smither, Kate; Nuti, Gina; Perry, TracyAnn

    2018-04-28

    Surgical applications using breast implants are individualized operations to fill and shape the breast. Physical properties beyond shape, size, and surface texture are important considerations during implant selection. Compare form stability, gel material properties, and shell thickness of textured shaped, textured round, and smooth round breast implants from 4 manufacturers: Allergan, Mentor, Sientra, and Establishment Labs through bench testing. Using a mandrel height gauge, form stability was measured by retention of dimensions on device movement from a horizontal to vertical supported orientation. Dynamic response of gel material (gel cohesivity, resistance to gel deformation, energy absorption) was measured using a synchronized target laser following application of graded negative pressure. Shell thickness was measured using digital thickness gauge calipers. Form stability, gel material properties, and shell thickness differed across breast implants. Of textured shaped devices, Allergan Natrelle 410 exhibited greater form stability than Mentor MemoryShape and Sientra Shaped implants. Allergan Inspira round implants containing TruForm 3 gel had greater form stability, higher gel cohesivity, greater resistance to gel deformation, and lower energy absorption than those containing TruForm 2 gel and in turn, implants containing TruForm 1 gel. Shell thickness was greater for textured versus smooth devices, and differed across styles. Gel cohesivity, resistance to gel deformation, and energy absorption are directly related to form stability, which in turn determines shape retention. These characteristics provide information to aid surgeons choosing an implant based on surgical application, patient tissue characteristics, and desired outcome.

  13. Analysis of 30 breast implant rupture cases.

    Science.gov (United States)

    Tark, Kwan Chul; Jeong, Hii Sun; Roh, Tae Suk; Choi, Jong Woo

    2005-01-01

    Breast implants used for augmentation mammoplasty or breast reconstruction could rupture from various causes such as trauma or spontaneous failure. The objectives of this study were to investigate the relationships between the causes of implant rupture and the degree of capsular contracture, and then to evaluate the relative efficacies of specific signs on magnetic resonance imaging (MRI) known to be beneficial for diagnosing the rupture. A retrospective review identified patients with prosthetic implant rupture or impending rupture treated by the senior author. The 30 cases of implant rupture available for review were classified into two groups: intracapsular and extracapsular ruptures. The 30 cases of breast implant ruptures were analyzed with respect to the clinical symptoms and signs, the causes of rupture, the degree of capsular contracture, and therapeutic plans. Among the 30 cases, 14 patients who had undergone MRI during the diagnostic period were analyzed with respect to the relationships between MRI readings and operative findings. Spontaneous rupture of membranes was most common (80%), followed by failure because of trauma (7%) and valve or implant base (4%). The symptoms during implant rupture were contour deformity, palpated mass-like lesions, pain, and focal inflammation. According to the analysis of specific MRI signs, the sensitivity and specificity of the linguine sign were 87% and 100%, respectively, for intracapsular rupture. For extracapsular rupture, the sensitivity and specificity of the linguine sign were, respectively, 67% and 75%. The sensitivity and specificity of the rat-tail sign and tear drop sign were 14% and 50%, respectively. Breast implant rupture was correlated with the degree of capsular contracture in our study. Among the various specific MRI signs used in diagnosing the rupture, the linguine sign was reliable and had a high sensitivity and specificity, especially in cases of intracapsular rupture. On the other hand, the rat

  14. 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.

  15. 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.

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

    DEFF Research Database (Denmark)

    Holmich, L.R.; During, M.; Henriksen, T.F.

    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...

  17. 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...

  18. Sensation Following Immediate Breast Reconstruction with Implants.

    Science.gov (United States)

    Lagergren, Jakob; Wickman, Marie; Hansson, Per

    2010-01-01

    Sensation is a neglected aspect of the outcome of breast reconstructions with implants. The aim of this prospective study was to evaluate the cutaneous somatosensory status in breasts following mastectomy and immediate reconstruction with permanent adjustable prostheses and to analyze the patients' subjective experience of the sensation. Twenty-four consecutive patients diagnosed with invasive or in situ breast carcinoma were examined preoperatively and 2 years after mastectomy and reconstruction, for assessment of perception thresholds for touch, cold, warmth, and heat pain above and below the areola. Von Frey filaments and a Peltier element-based thermode were used. The patients completed a questionnaire concerning their experienced sensation in the reconstructed breast. Using quantitative somato-sensory testing, the sensation to all the examined modalities was significantly impaired compared to preoperatively. Most affected was the area above the areola. Patients given postoperative radiotherapy (n = 9) did not differ from those without radiotherapy (n = 15) regarding any of the modalities. All patients reported reduced sensation in the reconstructed breast compared to that preoperatively. Twenty-three patients stated that the reconstructed breast felt different from the other breast; nevertheless 16 reported that the reconstructed breast felt like a real breast. The study revealed sensation impairment following mastectomy and immediate reconstruction with implants. Patients should be informed about this effect preoperatively to allow adequate expectations regarding the sensation outcome. However, two-thirds of the study patients considered that the reconstructed breast felt like a real breast, which must be one of the main purposes of a breast reconstruction.

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

    OpenAIRE

    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 i...

  20. Automated treatment planning engine for prostate seed implant brachytherapy

    International Nuclear Information System (INIS)

    Yu Yan; Zhang, J.B.Y.; Brasacchio, Ralph A.; Okunieff, Paul G.; Rubens, Deborah J.; Strang, John G.; Soni, Arvind; Messing, Edward M.

    1999-01-01

    Purpose: To develop a computer-intelligent planning engine for automated treatment planning and optimization of ultrasound- and template-guided prostate seed implants. Methods and Materials: The genetic algorithm was modified to reflect the 2D nature of the implantation template. A multi-objective decision scheme was used to rank competing solutions, taking into account dose uniformity and conformity to the planning target volume (PTV), dose-sparing of the urethra and the rectum, and the sensitivity of the resulting dosimetry to seed misplacement. Optimized treatment plans were evaluated using selected dosimetric quantifiers, dose-volume histogram (DVH), and sensitivity analysis based on simulated seed placement errors. These dosimetric planning components were integrated into the Prostate Implant Planning Engine for Radiotherapy (PIPER). Results: PIPER has been used to produce a variety of plans for prostate seed implants. In general, maximization of the minimum peripheral dose (mPD) for given implanted total source strength tended to produce peripherally weighted seed patterns. Minimization of the urethral dose further reduced the loading in the central region of the PTV. Isodose conformity to the PTV was achieved when the set of objectives did not reflect seed positioning uncertainties; the corresponding optimal plan generally required fewer seeds and higher source strength per seed compared to the manual planning experience. When seed placement uncertainties were introduced into the set of treatment planning objectives, the optimal plan tended to reach a compromise between the preplanned outcome and the likelihood of retaining the preferred outcome after implantation. The reduction in the volatility of such seed configurations optimized under uncertainty was verified by sensitivity studies. Conclusion: An automated treatment planning engine incorporating real-time sensitivity analysis was found to be a useful tool in dosimetric planning for prostate

  1. Prepectoral Implant-Based Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Lyndsey Highton, BMBCh, MA, FRCS(Plast

    2017-09-01

    Conclusion:. Prepectoral implant placement with ADM cover is emerging as an alternative approach for IBR. This method facilitates breast reconstruction with a good cosmetic outcome for patients who want a quick recovery without potential compromise of pectoral muscle function and associated problems.

  2. 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.

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

    International Nuclear Information System (INIS)

    Watt, E; Long, K; Husain, S; Meyer, T

    2014-01-01

    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

  4. Dosimetric comparison of seed strength for I-125 prostate implants

    International Nuclear Information System (INIS)

    Elliott, S.; Droege, J.; Beaufort, C.

    2004-01-01

    Full text: The strength of 1-125 seeds for prostate brachytherapy has been a topic of increasing popularity in the literature over the last few years. Recent reports, which include planning and clinical studies, compare dosimetry between plans and implants using higher (0.5 - 0.8 U, where IU = I μGym 2 h -1 ) or lower (0.3 - 0.4 U) seed strength. The majority of these studies support higher seed strengths for obtaining optimal dosimetry. At the WBRC, a seed air kerma strength of just under 0.4 U is currently used for seed implants. The purpose of this work is to investigate the use of higher strength seeds for our prostate implants. Twenty-four patients were selected according to prostate size, and re-planned using a seed strength of 0.5 U or 0.6 U. Planning was performed following our standard preplanning guidelines as closely as possible; that is, manual planning using a modified Seattle approach and dosimetry limits for the target volume of D 100 : > 95 Gy, v 100 > 98 %, V 150 : 52 - 62 % and V 200 : 11 - 16 %. Dosimetry from the original preplans was then compared to the dosimetry from the re-planned cases. Satisfactory dosimetry was obtained using 0.5 U or 0.6 U strength seeds. Seed placement was typically around the periphery of the target on all slices, to avoid overdosing the urethra. The mean D 100 (Gy) is marginally improved with the higher seed strength. As expected, the V200 (%) is also higher. The mean number of seeds required per implant decreased by 16 % and 28 % for 0.5 U and 0.6 U seeds respectively. The mean number of needles decreased by 7 needles for 0.6 U seeds, however only by 3 needles for 0.5 U seeds. Rectal doses, when using the higher strength seeds, were easily constrained to less than the original preplan doses. Although there was no apparent trend in dosimetry statistics with volume size, as a function of seed strength, it was noted that the reduction in needle and seed number was most significant for medium and large target volumes. A

  5. Factors influencing upon the incidence of seed migration in I-125 seed transperineal prostate implantation

    International Nuclear Information System (INIS)

    Itami, Jun; Onishi, Kayoko; Kanemura, Mikio

    2005-01-01

    Transperineal I-125 seed brachytherapy for prostate cancer is rapidly expanding in Japan. Seed migrations to lung and abdomen are well known complication in the seed brachytherapy. The rate of incidence and the predisposing factors were studied. From April 2004 through January 2005, 36 patients underwent transperineal I-125 seed brachytherapy for prostate cancer. In all patients loose I-125 seeds were inserted with Mick applicator according to modified peripheral loading pattern. One day, 1 week, and 1 month after the procedure, posteroanterior and lateral chest X-rays and abdominal X-ray were performed. Abdominal and chest seed migrations were seen in 11 (30.6%) and 14 (38.9%) patients, respectively. In total, 20 patients (55.6%) showed seed migrations. Forty-two I-125 seeds migrated out of 2,508 implanted seeds. Most of the migrations were seen until 1 month after the procedure. The preplanned number of the extraprostatic seeds had a statistically significant influence upon the incidence of seed migration. Seed migration is not a rare phenomenon in transperineal I-125 seed brachytherapy for prostate cancer. To confirm seed migration, X-ray examinations 1 month after the procedure are suited. At the preplanning, the number of extraprostatic seeds should be limited to minimal to decrease the incidence of seed migration. In future, the introduction of linked I-125 seeds is preferred. (author)

  6. Image fusion techniques in permanent seed implantation

    Directory of Open Access Journals (Sweden)

    Alfredo Polo

    2010-10-01

    image fusion for permanent seed implantation.

  7. Poly Implants Prosthèse Breast Implants: A Case Series and Review of the Literature.

    Science.gov (United States)

    Klein, Doron; Hadad, Eran; Wiser, Itay; Wolf, Omer; Itzhaki Shapira, Ortal; Fucks, Shir; Heller, Lior

    2018-01-01

    Silicone breast implants from the French manufacturer Poly Implants Prosthèse (PIP) were recalled from the European market after the French regulator has revealed the implants contain non-medical-grade silicone filler. In December 2011, following a large increase in reported rupture rate and a possible cancer risk, the French Ministry of Health recommended consideration of the PIP explantation, regardless of their condition. In 2012, the Israel Ministry of Health recommended to replace the implants only upon suspected implant rupture. The aims of this study were to characterize breast-augmented Israeli patients with PIP implants, compare their outcomes with those of breast-augmented patients with different implant types, and review the current PIP literature. Breast-augmented patients who underwent an elective breast implant exchange in Israel between January 2011 and January 2017 were included in the study. Data were collected from electronic and physical medical files. There were 73 breast-augmented female patients with 146 PIP breast implants included in this study. Average implant age was 6.7 ± 2.79 years. Mean implant size was 342.8 ± 52.9 mL. Fourteen women (19 implants [16%]) had a high-grade capsular contracture (Baker grade 3-4). During exchange, 28 implants were found to be ruptured (19.2%). Less than 10 years following breast augmentation, PIP implants demonstrated higher rupture rate compared with other implants. Our data are comparable to overall available rupture rate. Among patients with definitive rupture diagnosis, an elective implant removal should be recommended. In cases of undamaged implants, plastic surgeons should also seriously consider PIP implant explantation. When the patient does not desire to remove the implant, an annual physical examination and breast ultrasound are recommended, beginning a year after augmentation.

  8. Study of breast implant rupture: MRI versus surgical findings.

    Science.gov (United States)

    Vestito, A; Mangieri, F F; Ancona, A; Minervini, C; Perchinunno, V; Rinaldi, S

    2012-09-01

    This study evaluated the role of breast magnetic resonance (MR) imaging in the selective study breast implant integrity. We retrospectively analysed the signs of breast implant rupture observed at breast MR examinations of 157 implants and determined the sensitivity and specificity of the technique in diagnosing implant rupture by comparing MR data with findings at surgical explantation. The linguine and the salad-oil signs were statistically the most significant signs for diagnosing intracapsular rupture; the presence of siliconomas/seromas outside the capsule and/or in the axillary lymph nodes calls for immediate explantation. In agreement with previous reports, we found a close correlation between imaging signs and findings at explantation. Breast MR imaging can be considered the gold standard in the study of breast implants.

  9. Enhancing surface properties of breast implants by using electrospun silk fibroin.

    Science.gov (United States)

    Valencia-Lazcano, A A; Román-Doval, R; De La Cruz-Burelo, E; Millán-Casarrubias, E J; Rodríguez-Ortega, A

    2017-08-24

    In the present study, a new electrospun silk fibroin coating of silicone breast implants with improved biocompatibility and mechanical properties was obtained. Fibrous scaffolds were produced by electrospinning a solution containing silk fibroin, derived from Bombyx mori cocoons, and polyethylene oxide (PEO) to be used as a coating of breast implants. A randomly oriented structure of fibroin/PEO was electrospun on implants as assessed by SEM analysis, roughness measurements and ATR-FTIR spectroscopy. The scaffold showed 0.25 µm diameter fibres, 0.76 µm size superficial pores, arithmetic roughness of 0.632 ± 0.12 µm and texture aspect ratio of 0.893 ± 0.04. ATR-FTIR spectroscopy demonstrates the presence of PEO and fibroin in the coating. The mechanical characterisation of the implants before and after being coated with fibroin/PEO demonstrated that the fibroin/PEO scaffold contributes to the increase in the elastic modulus from 0.392 ± 0.02 to 0.560 ± 0.03 MPa and to a more elastic behaviour of the breast implants. Using the fibroin/PEO coating, human fibroblasts seeded on this matrix increased viability up to 30% compared to conventional breast implants. Electrospun silk fibroin could represent a clinically compatible, viable form to coat breast implants. Low cytotoxicity by the fibroin coating and its physico-chemical and mechanical properties may find application in improving breast implants biocompatibility. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  10. 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...

  11. 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.

  12. The Austrian breast implant register: recent trends in implant-based breast surgery.

    Science.gov (United States)

    Wurzer, Paul; Rappl, Thomas; Friedl, Herwig; Kamolz, Lars-Peter; Spendel, Stephan; Hoflehner, Helmut; Parvizi, Daryousch

    2014-12-01

    Due to the fact that the number of breast implant surgeries for cosmetic and medical purposes is rising yearly, a discussion about the quality of service for both patients and physicians is more important than ever. To this end, we reviewed the Austrian Breast Implant Register with one specific question in mind: What are the trends? In the statistical analysis of the Austrian Breast Implant Register, we were able to identify 13,112 registered breast implants between 2004 and 2012. The whole dataset was then divided into medical and cosmetic groups. We focused on device size, surface characteristics, filling material, device placement and incision site. All factors were considered for all examined years. In summary, the most used device had a textured surface (97 %) and silicone gel as the filling material (93 %). The mean size of implants for the cosmetic group was 240 cc, placement was submuscular (58 %) and the incision site was inframammary (67 %). In the medical group, the mean size was 250 cc. Yearly registrations had their peak in 2008 (1,898 registered devices); from this year on, registrations decreased annually. A slight trend away from subglandular placement in the cosmetic group was noted. Also, the usage of implants with polyurethane surface characteristics has increased since 2008. The smooth surface implants had a peak usage in 2006 and their usage decreased steadily from then on whereas the textured surface was steady over the years. Keeping the problems related to the quality of breast implants in mind, we could recommend an obligatory national register. Organisations of surgeons and governments should develop and establish these registers. Furthermore, an all-encompassing international register should be established by the European Union and the American FDA (Food and Drug Administration); this might be useful in comparing the individual country registers and also would help in delivering "evidence based" medicine in cosmetic and medical procedures

  13. In vitro deflation of prefilled saline breast implants.

    Science.gov (United States)

    Stevens, W Grant; Hirsch, Elliot M; Stoker, David A; Cohen, Robert

    2006-08-01

    The purpose of this study was to determine whether or not prefilled breast implants retain their volume in packaging. This study examined 32 Poly Implant Prosthesis prefilled textured saline breast implants. All of these implants were within the manufacturer's expiration date at the time of weighing. No holes were visible on any of the implants. All were weighed on an electronic scale. The measured weight was compared with the expected weight (based on the implant size as specified by the manufacturer) and the percentage deflation was calculated. The manufacturer declined to provide specific information about the manufacture dates of the implants; thus, relative age (rather than absolute age) was examined with respect to percentage deflation. Of the 32 implants examined, all showed some degree of deflation (range, 8.84 to 57.14 percent; 95 percent confidence interval of the mean, 22.01 +/- 4.17 percent). There was a moderate correlation (r = 0.41) between relative age of the implant and percentage deflation. From these results, it is clear that this type of prefilled saline breast implant does not maintain its volume in vitro. If these implants are used, the underfilling could contribute to a higher deflation rate and cosmetic deformity. This risk should be taken into account by plastic surgeons who use this type of implant in breast augmentation procedures.

  14. First symposium seed implant 125I and high rate of prostate

    International Nuclear Information System (INIS)

    2012-01-01

    The First symposium seed implant 125 I and high rate of prostate, was organized by the Marie Curie Foundation, between the 12 to april 2012, in the Cordoba city of Argentina. In this event were presented several documents in different topics: patients selection for impacts of 125 I seeds; high doses radiation in radiotherapy; brachytherapy for prostate cancer; prostate implant technique with 125 I seeds; implant dosimetric aspects; radioprotection of 125 I seeds.

  15. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies

    NARCIS (Netherlands)

    Noels, Eline C.; Lapid, Oren; Lindeman, Jan H. N.; Bastiaannet, Esther

    2015-01-01

    The popularity of cosmetic breast augmentation and the incidence of breast cancer have been increasing worldwide. It has been hypothesized that the risk of breast cancer may be greater among patients who have undergone cosmetic breast implantation. The authors performed a meta-analysis of the

  16. Suggestions on technical guide of implantation of radioactive seeds

    International Nuclear Information System (INIS)

    Wang Zhongmin; Huang Gang; Lv Zhongwei; Liu Jianjun; Chen Kemin; Chen Yongde

    2009-01-01

    Implantation of radioactive seeds is an effective therapeutic option for the treatment of malignant tumors. With the development of imaging technique and the use of treatment planning system (TPS) it has been more and more employed in clinical settings. The technique has been widely practiced in various malignant tumors, such as prostate cancer, lung caner, pancreatic cancer, hepatocarcinoma, etc. In order to standardize the clinical application of this technology, the authors propose some suggestions concerning the management of radioactive seeds, the indications and contraindications as well as the method of operation as a technical guidance. (authors)

  17. Suggestions on technical guide of implantation of radioactive seeds

    Energy Technology Data Exchange (ETDEWEB)

    Zhongmin, Wang; Gang, Huang; Zhongwei, Lv; Jianjun, Liu [Department of Radiology, Luwan Branch of Ruijin Hospital, School of Medicine, Shanghai Jiaotong Univ., Shanghai (China); Kemin, Chen; Yongde, Chen

    2009-09-15

    Implantation of radioactive seeds is an effective therapeutic option for the treatment of malignant tumors. With the development of imaging technique and the use of treatment planning system (TPS) it has been more and more employed in clinical settings. The technique has been widely practiced in various malignant tumors, such as prostate cancer, lung caner, pancreatic cancer, hepatocarcinoma, etc. In order to standardize the clinical application of this technology, the authors propose some suggestions concerning the management of radioactive seeds, the indications and contraindications as well as the method of operation as a technical guidance. (authors)

  18. Cancer risk among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

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

    2006-01-01

    The available epidemiologic evidence does not support a carcinogenic effect of silicone breast implants on breast or other cancers. Data on cancer risk other than breast cancer are limited and few studies have assessed cancer risk beyond 10-15 years after breast implantation. We extended follow...... proportional hazards models, adjusting for age, calendar period and reproductive history. We observed 163 cancers among women with breast implants compared to 136.7 expected based on general population rates (SIR = 1.2; 95% confidence interval [CI] = 1.0-1.4), during a mean follow-up period of 14.4 years...... (range = 0-30 years). Women with breast implants experienced a reduced risk of breast cancer (SIR = 0.7; 95% CI = 0.5-1.0), and an increased risk of non-melanoma skin cancer (SIR = 2.1; 95% CI = 1.5-2.7). Stratification by age at implantation, calendar year at implantation and time since implantation...

  19. Recall management of patients with Rofil Medical breast implants.

    Science.gov (United States)

    Schott, Sarah; Bruckner, Thomas; Golatta, Michael; Wallwiener, Markus; Küffner, Livia; Mayer, Christine; Paringer, Carmen; Domschke, Christoph; Blumenstein, Maria; Schütz, Florian; Sohn, Christof; Heil, Joerg

    2014-07-01

    Some Rofil Medical breast implants are relabelled Poly Implant Prothèse (PIP) implants, and it is recommended that Rofil implants be managed in the same way as PIP implants. We report the results of a systematic recall of patients who had received Rofil implants. All patients who received Rofil implants at our centre were identified and invited for specialist consultation. In patients who opted for explantation, preoperative and intraoperative work-up was performed in accordance with national guidelines and analysed. In cases suspicious for rupture, an MRI scan was performed. Two-hundred and twenty-five patients (average age 56; range 28-80) received a total of 321 Rofil implants an average of 5.8 (range 1-11) years previously, 225/321 (70%) implants were used for reconstruction after breast cancer. A total of 43 implants were removed prior to 2011, mainly due to capsular contracture (CC). A total of 188 patients were still affected at the time of recall. Of the 188 patients, 115 (61%) attended for specialist consultation, of which 50 (44%) requested immediate implant removal. To date, 72 of 115 (63%) women attending consultation (38% of all affected) have chosen explantation, 66 of 72 (92%) opting for new implants. Of the 108 explanted implants, 25 (23%) had capsular rupture and 57 (53%) had implant bleeding. Preoperative clinical assessment was unreliable for predicting CC or rupture. The majority of patients attended for consultation and requested explantation. The quality of the explanted Rofil implants was comparable to PIP implants, with a higher rupture prevalence compared with other, non-affected implants. Nevertheless, the acceptance of breast implants for reimplantation remained high. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. 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)

  1. 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...... implantation. Most of the women were satisfied with the implantation, but only 40% considered the preoperative information on possible risks related to implantation as sufficient. With respect to the occurrence of local complications following cosmetic breast implantation, the findings of this study...... cosmetic silicone breast implants between 1968 and 2002. Patient records were abstracted, and additional information was gathered using a structured questionnaire that was mailed to 470 of the women in the cohort. Overall, 36% of the women had 1 or more diagnoses of postoperative complications...

  2. Study of the radiation effect in breast implants

    International Nuclear Information System (INIS)

    Moreno T, L. R.; Ramirez R, A.

    2013-01-01

    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)

  3. Mental models of women with breast implants : local complications

    NARCIS (Netherlands)

    Byram, S.; Fischhoff, B.; Embrey, M.; Bruine de Bruin, W.J.A.; Thorne, S.

    2001-01-01

    Twenty-five women with breast implants participated in semistructured interviews designed to reveal their "mental models" of the processes potentially causing local (ie, nonsystemic) problems. The authors analyzed their responses in terms of an "expert model," circumscribing scientifically relevant

  4. PIP breast implant removal: a study of 828 cases.

    Science.gov (United States)

    Oulharj, S; Pauchot, J; Tropet, Y

    2014-03-01

    In March, 2010, the French Health Products Safety Agency suspended the sale of prefilled silicone breast implants manufactured by Poly Implants Prosthèse Prothese (PIP) because of a high failure rate and the use of an inappropriate silicone gel that did not comply with CE marking. These findings led to an international medical crisis. In France, 30,000 female patients had PIP implants. In our Department, 1150 PIP breast implants had been implanted in 630 patients since 2001. A retrospective study was conducted to define the rupture rate of these implants and the complications that arise. The women included in the study underwent implant removal from May 2010 to September 2012 for preventive or curative reasons. Data were collected from medical records that included: results of clinical examination, breast ultrasound before removal, rates of implant rupture, results of biopsy of periprosthetic capsule and pericapsule tissue and postoperative complications. A total of 828 PIP breast implants were removed in 455 patients. The rate of ruptured implants was 7.73% (64/828), corresponding to 11.6% of patients. A periprosthetic effusion was associated with rupture in 44% of cases. Breast ultrasound indicated a rupture for 87 implants; 32% were true positives and 3% were false negatives. Periprosthetic capsule biopsy demonstrated the presence of a foreign body, which seemed to be silicone, in 26% of cases and the presence of inflammation in 13% of cases. No siliconoma-type lesion was identified in the pericapsular tissue at biopsy. A total of 14 implants presented perspiration at removal. A statistically significant difference was found between the rates of rupture for texturised implants as compared to the smooth-surfaced implants. There were eight post-revisional-surgery complications (1%) and three cases of breast adenocarcinoma. The preventive explantation of PIP breast implants is justified given the high failure rate (7.73%) and given patients' exposure to silicone

  5. 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.

  6. The Clinical Implications of Poly Implant Prothèse Breast Implants: An Overview

    Directory of Open Access Journals (Sweden)

    Umar Wazir

    2015-01-01

    Full Text Available 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.

  7. Anaplastic large cell lymphoma associated with breast implants

    Directory of Open Access Journals (Sweden)

    Vid Bajuk

    2017-02-01

    Full Text Available An increasing number of women worldwide decide for esthetic correction of breasts with silicone implants and post-cancer breast reconstruction with tissue expanders and silicone breast implants. It is estimated that more than 10 million women around the globe have them. Tere are approximately 200 known cases of patients with anaplastic large cell lymphoma (ALCL linked with silicone breast implants reported in medical literature. ALCL is a rare disease with an annual incidence of 0.1–0.3/100 000 women with breast silicone implants. In the presence of clinical signs, physician should also consider this rare form of ALCL in differential diagnosis. Patients are on average 50 years old. Long afer implantation surgery, the patient may experience breast swelling, pain and/or asymmetry. In diagnostics, ultrasound and cytological examination are required. During ultrasound examination fluid formation (seroma or solid tumor mass can be detected. Treatment is individualized. Due to tumor nature, implant resection and total capsulectomy are usually indicated; also, chemo- and radiotherapy might rarely be required. Five-year survival rate depends on tumor form and correlates well with clinical fndings of seroma or solid mass. In the more frequent form, seroma, fve-year survival rate is 100 %, while in the case of solid tumor mass fve-year survival rate is 75 %. The rarity of this disease makes it difficult to diagnose, but nevertheless, early detection and treatment are important for better recovery.

  8. A comparison in cosmetic outcome between per-operative interstitial breast implants and delayed interstitial breast implants after external beam radiotherapy

    NARCIS (Netherlands)

    Pieters, Bradley R.; Hart, Augustinus A. M.; Russell, Nicola S.; Jansen, Edwin P. M.; Peterse, Johannes L.; Borger, Jacques; Rutgers, Emiel J. Th

    2003-01-01

    Background and purpose: Interstitial implants for brachytherapy boost in the breast conserving therapy of breast cancer can be performed in two ways; implants during the tumor excision (per-operative implants) or after the external beam therapy (delayed interstitial implants). Differences in

  9. Radiobiologically based treatment plan evaluation for prostate seed implants

    Directory of Open Access Journals (Sweden)

    Sotirios Stathakis

    2011-07-01

    Full Text Available Purpose: Accurate prostate low dose-rate brachytherapy treatment plan evaluation is important for future care decisions. Presently, an evaluation is based on dosimetric quantifiers for the tumor and organs at risk. However, these do not account for effects of varying dose-rate, tumor repopulation and other biological effects. In this work, incorporation of the biological response is used to obtain more clinically relevant treatment plan evaluation.Material and methods: Eleven patients were evaluated. Each patient received a 145 Gy implant. Iodine-125 seeds were used and the treatment plans were created on the Prowess system. Based on CT images the post-implant plan was created. In the post-plan, the tumor, urethra, bladder and rectum were contoured. The biologically effective dose was used to determine the tumor control probability and the normal tissue complication probabilities for the urethra, bladder, rectum and surrounding tissue. Results: The average tumor control probability and complication probabilities for the urethra, bladder, rectum and surrounding tissue were 99%, 29%, 0%, 12% and 6%, respectively. These measures provide a simpler means for evaluation and since they include radiobiological factors, they provide more reliable estimation of the treatment outcome. Conclusions: The goal of this work was to create more clinically relevant prostate seed-implant evaluation by incorporating radiobiological measures. This resulted in a simpler descriptor of treatment plan quality and was consistent with patient outcomes.

  10. A novel curvilinear approach for prostate seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun K.; Dicker, Adam P.; Hutapea, Parsaoran; Darvish, Kurosh; Yu Yan [Department of Radiation Oncology, Leo Jenkins Cancer Center, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27834 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Department of Mechanical Engineering, Temple University, Philadelphia, Pennsylvania 19122 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States)

    2012-04-15

    Purpose: A new technique called ''curvilinear approach'' for prostate seed implantation has been proposed. The purpose of this study is to evaluate the dosimetric benefit of curvilinear distribution of seeds for low-dose-rate (LDR) prostate brachytherapy. Methods: Twenty LDR prostate brachytherapy cases planned intraoperatively with VariSeed planning system and I-125 seeds were randomly selected as reference rectilinear cases. All the cases were replanned by using curved-needle approach keeping the same individual source strength and the volume receiving 100% of prescribed dose 145 Gy (V{sub 100}). Parameters such as number of needles, seeds, and the dose coverage of the prostate (D{sub 90}, V{sub 150}, V{sub 200}), urethra (D{sub 30}, D{sub 10}) and rectum (D{sub 5}, V{sub 100}) were compared for the rectilinear and the curvilinear methods. Statistical significance was assessed using two-tailed student's t-test. Results: Reduction of the required number of needles and seeds in curvilinear method were 30.5% (p < 0.001) and 11.8% (p < 0.49), respectively. Dose to the urethra was reduced significantly; D{sub 30} reduced by 10.1% (p < 0.01) and D{sub 10} reduced by 9.9% (p < 0.02). Reduction in rectum dose D{sub 5} was 18.5% (p < 0.03) and V{sub 100} was also reduced from 0.93 cc in rectilinear to 0.21 cc in curvilinear (p < 0.001). Also the V{sub 150} and V{sub 200} coverage of prostate reduced by 18.8% (p < 0.01) and 33.9% (p < 0.001), respectively. Conclusions: Significant improvement in the relevant dosimetric parameters was observed in curvilinear needle approach. Prostate dose homogeneity (V{sub 150}, V{sub 200}) improved while urethral dose was reduced, which might potentially result in better treatment outcome. Reduction in rectal dose could potentially reduce rectal toxicity and complications. Reduction in number of needles would minimize edema and thereby could improve postimplant urinary incontinence. This study indicates that the

  11. Dosimetry consequences of the accuracy at the position of the seeds in a seeds implant of I-125 in prostate

    International Nuclear Information System (INIS)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-01-01

    The quality control of equipment used to carry out implants of seeds of low rate in prostate, van destined to watch, the activity of seeds and the calculation of planning both positioning them on the inside of the patient. The objective of this work is, using the Nucletron Spot Pro and SeedSelectron, rating dosimetry possible consequences related to the position of the seeds. (Author)

  12. Pulmonary embolization of permanently implanted radioactive palladium-103 seeds for carcinoma of the prostate

    International Nuclear Information System (INIS)

    Nag, Subir; Vivekanandam, Singhavajhala; Martinez-Monge, Rafael

    1997-01-01

    Purpose: It has been reported that permanently implanted iodine-125 seeds can embolize to the lungs. There is little data on the embolization of palladium-103 seeds. The purpose of this study is to collect and evaluate data on the embolization of Pd-103 seeds. Methods and Materials: The records of 112 patients implanted with Pd-103 for carcinoma of the prostate were reviewed to systemically study the incidence and dynamics of pulmonary embolism of Pd-103 seeds. Five patients had no postoperative chest radiograph and were thus excluded, leaving 107 patients for review. Results: Chest radiographs of 19 of the 107 patients showed embolized seeds in the lungs (18%). Two patients had three seeds each, nine patients had two seeds each; and in the remaining eight patients, a single seed migrated to the lungs. The seeds migrated mainly (84%) to the lower lobes. None of the eight patients who had their first postoperative chest radiograph on the day of the implant showed any embolized seeds. The embolized seed appeared only on subsequent chest radiographs taken 27 to 40 days later. Ten of the other 11 patients who had their first radiograph 1 to 97 days after brachytherapy had embolized seeds on their first chest radiograph. In the other patient, the embolized seed appeared only on a subsequent chest radiograph taken after 127 days. There were no clinical pulmonary or cardiac effects evident on routine follow-up of these patients with pulmonary embolized seeds. Conclusion: Embolization of Pd-103 seeds to the lungs after implantation for carcinoma of the prostate is an unusual event. In this study only 0.3% of the seeds implanted migrated to the lungs. Although it was previously thought that pulmonary seed migration mainly occurred on the day of brachytherapy, our experience shows that seeds usually migrated to the lungs after the day of the implant. There were no clinical pulmonary or cardiac effects attributable to embolized seeds in the lungs on routine follow-up

  13. Cancer risk among Danish women with cosmetic breast implants.

    Science.gov (United States)

    Friis, Søren; Hölmich, Lisbet R; McLaughlin, Joseph K; Kjøller, Kim; Fryzek, Jon P; Henriksen, Trine F; Olsen, Jørgen H

    2006-02-15

    The available epidemiologic evidence does not support a carcinogenic effect of silicone breast implants on breast or other cancers. Data on cancer risk other than breast cancer are limited and few studies have assessed cancer risk beyond 10-15 years after breast implantation. We extended follow-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 proportional hazards models, adjusting for age, calendar period and reproductive history. We observed 163 cancers among women with breast implants compared to 136.7 expected based on general population rates (SIR = 1.2; 95% confidence interval [CI] = 1.0-1.4), during a mean follow-up period of 14.4 years (range = 0-30 years). Women with breast implants experienced a reduced risk of breast cancer (SIR = 0.7; 95% CI = 0.5-1.0), and an increased risk of non-melanoma skin cancer (SIR = 2.1; 95% CI = 1.5-2.7). Stratification by age at implantation, calendar year at implantation and time since implantation showed no clear trends, however, the statistical precision was limited in these analyses. When excluding non-melanoma skin cancer, the SIR for cancer overall was 1.0 (95% CI = 0.8-1.2). With respect to other site-specific cancers, no significantly increased or decreased SIR were observed. Similar results 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

  14. Preoperative Saline Implant Deflation in Revisional Aesthetic Breast Surgery.

    Science.gov (United States)

    Wu, Cindy; Grotting, James C

    2015-09-01

    Preoperative saline deflation is a clinically useful intervention in revisional breast surgery. It allows suspensory ligament recovery, reveals true glandular volume, and simplifies mastopexy markings. Presently unknown are the volumetric changes that occur after deflation. The authors report the three-dimensional (3D) changes that occur with preoperative deflation prior to revisional breast surgery. We reviewed available charts of revisional breast surgery patients who underwent preliminary saline implant deflation. Our protocol is deflation 4 weeks prior to revision. Three weeks following deflation, the patient is evaluated to finalize the operative plan, including the need for implants, mastopexy, and adjunctive procedures. A subset underwent 3D imaging to quantify the volumetric changes over the 3-week deflation period. Between 2002 and 2014, 55 patients underwent saline implant deflation prior to 57 revisional surgeries. Seventeen were revised without implants and 40 with implants. The 3D subset of 10 patients showed a mean 15.2% volume increase and 0.18 cm notch-to-nipple distance decrease over the 3 weeks following deflation and prior to definitive surgical correction. Breast volume increases and the notch-to-nipple distance decreases during the 3-week interval prior to reoperation. This "elastic breast recoil" occurs after the mass effect of the implant is removed, resulting in recovery of stretched suspensory ligaments and gland reexpansion. We believe 4 weeks is optimal for gland normalization. Ideal candidates include patients requiring secondary mastopexy without implants, implant downsizing in the same pocket, and secondary augmentation mastopexy. Preoperative saline deflation and 3D analyses are useful for preoperative planning in reoperative breast surgery. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  15. Comparative silicone breast implant evaluation using mammography, sonography, and magnetic resonance imaging: experience with 59 implants.

    Science.gov (United States)

    Ahn, C Y; DeBruhl, N D; Gorczyca, D P; Shaw, W W; Bassett, L W

    1994-10-01

    With the current controversy regarding the safety of silicone implants, the detection and evaluation of implant rupture are causing concern for both plastic surgeons and patients. Our study obtained comparative value analysis of mammography, sonography, and magnetic resonance imaging (MRI) in the detection of silicone implant rupture. Twenty-nine symptomatic patients (total of 59 silicone implants) were entered into the study. Intraoperative findings revealed 21 ruptured implants (36 percent). During physical examination, a positive "squeeze test" was highly suggestive of implant rupture. Mammograms were obtained of 51 implants (sensitivity 11 percent, specificity 89 percent). Sonography was performed on 57 implants (sensitivity 70 percent, specificity 92 percent). MRI was performed on 55 implants (sensitivity 81 percent, specificity 92 percent). Sonographically, implant rupture is demonstrated by the "stepladder sign." Double-lumen implants may appear as false-positive results for rupture on sonography. On MRI, the "linguine sign" represents disrupted fragments of a ruptured implant. The most reliable imaging modality for implant rupture detection is MRI, followed by sonogram. Mammogram is the least reliable. Our study supports the clinical indication and diagnostic value of sonogram and MRI in the evaluation of symptomatic breast implant patients.

  16. Dosimetry study of three-dimensional print template-guided precision 125I seed implantation

    Directory of Open Access Journals (Sweden)

    Zhang Hongtao

    2016-01-01

    Conclusions: The postplan and preplan dose parameters of 3D print template-guided seed implantation were nearly consistent. The dose parameters of template group superior to the traditional group. The seeds can be implanted accurately with 3D print template.

  17. Localized morphea after breast implant for breast cancer: A case report.

    Science.gov (United States)

    Moretti, A; Bianchi, F; Abbate, I V; Gherardi, G; Bonavita, M; Passoni, E; Nazzaro, G; Bramati, A; Dazzani, M C; Piva, S; Paternò, E; Frungillo, N; Farina, G; La Verde, N

    2018-03-01

    Early breast cancer follow-up guidelines for patients who underwent surgery suggest a regular and accurate clinical examination of the breast area, for an early identification of cutaneous or subcutaneous breast cancer relapse. Nonetheless, breast skin lesions arising in patients treated with mastectomy for breast cancer can be caused by several diseases. A series of diagnostic hypotheses should be considered, not only focusing on cutaneous metastasis, but also on dermatologic and systemic diseases. In February 2015, a 37-year-old patient underwent a right subcutaneous mastectomy for stage IIA breast cancer. Five months after beginning adjuvant chemotherapy, she noted hyperpigmentation and thickening of the skin on the right breast. Differential diagnosis included local relapse, skin infection, lymphoma, or primary cutaneous disease, and a skin biopsy was performed. The histopathologic specimen showed full-thickness sclerosis, with features of localized morphea. Therapy with clobetasol was prescribed, with progressive resolution of the thickness. The collaboration between many professionals in a multidisciplinary team (oncologist, dermatologist, plastic surgeon, and pathologist) was crucial to achieving the diagnosis. In the literature, some articles describe correlation between connective tissue diseases and silicone breast implants, but the pathogenetic mechanisms are unknown. We report a rare case of breast morphea after positioning a silicone implant in a patient who had undergone mastectomy. This clinical report represents an interesting model of multidisciplinary management of a patient with breast cancer who developed an uncommon dermatologic disease. Further studies are needed to clarify the association between silicone implants and breast morphea.

  18. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Breast implants and breast cancer: a review of incidence, detection, mortality, and survival.

    Science.gov (United States)

    Deapen, Dennis

    2007-12-01

    Soon after breast implants were commercially introduced over 30 years ago, questions about potential carcinogenicity were raised. Animal experiments dating back to the mid-twentieth century demonstrated that foreign body implantation of many materials, including silicone, can induce sarcomas. Indeed, female breast cancer incidence rates in the United States have increased substantially over that period. Of the several published studies from various countries that have formally investigated the risk of breast cancer among augmentation mammaplasty patients, none show any evidence of increased risk. In fact, most find lower than expected risk, some with statistically significant reductions. Similarly, breast cancer mortality among these patients is generally found to be below that expected of other similar women. Delayed detection of breast cancer is a concern for these patients because implants can interfere with mammography. However, using indicators such as stage at diagnosis and tumor size, current research shows that augmentation patients do not experience delayed detection. Furthermore, several comparisons of post-breast cancer survival of augmented versus nonaugmented patients have found no significant differences. In summary, breast implants are not associated with an increased risk of breast cancer incidence or death, and these patients do not experience delayed detection or poorer post-breast cancer survival.

  20. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  1. Loss of I-125 seeds after perineal implantation of the prostate

    International Nuclear Information System (INIS)

    Wopereis, A.J.M.; Moerland, M.A.; Koning, J.H.A.G. de; Battermann, J.J.

    1996-01-01

    Introduction: One of the treatment modalities of early stage prostate cancer is the permanent implantation of I-125 seeds. The aim of this study was to obtain insight in the loss of seeds after implantation. Methods and Materials: During the past 6 years, 100 patients were treated and examined. Radiographs of the prostate area were taken at discharge (after 2 or 3 days) and combined with a follow-up appointment, successively after 1, 3, 6, 12 and 24 months. 10 patients were excluded from this study because of a later performed prostatectomy or TURP. During the hospitalisation period the patient's excrements were examined for lost seeds. Furthermore patients were instructed to urinate through a tea-strainer in the first month following implantation in order to prevent seeds from entering the sewage system. Results: We observed an overall loss of 5% during the entire follow-up period of 2 years. Further analysis of the obtained data showed that most of the seeds (3% of the implanted seeds) were lost in the first 2 days after implantation. Due to special attention paid to safety measures, 94% of the lost seeds were retrieved during the admission period. Because of adequate instructions given to the patients, 70% of the seeds lost during the first month after discharge (0.5% of the total number of remaining implanted seeds) were also retrieved. Losing seeds during the first month after implantation did not increase the chance of further loss later on. A total of 13 seeds (in all patients) was lost after 1 month (of which 6 were lost after more then one year and are for radiation safety reasons not of importance). Conclusions: Most seeds are lost during the first days after implantation. Therefore, radiographs are indicated at discharge, after 1 month (for evaluation of safety precautions) and after 1 year as a conclusion to the treatment

  2. Intraoperative HDR implant boost for breast cancer (preliminary results)

    International Nuclear Information System (INIS)

    Rodriguez, I.; Torre, M. de la; Gonzalez, E.; Bourel, V.

    1996-01-01

    Introduction: In spite of the fact that it is been discussed whether or not a boost is necessary for all conservative treated breast cancer patients, it is a generalized radiotherapy practice. Since september 1993 we developed a breast conservative protocol for early stage breast cancer (T1-T2) with intraoperative HDR implant boost. Side effects, cosmetic results and recurrence rates are reviewed. Method and Material: From September 1993 we treated 55 patients with intraoperative HDR implant boost to the lumpectomy site for clinical T1 or T2 invasive breast cancer, followed by external megavoltage radiotherapy to the entire breast. We used the Nucletron microselectron HDR remote afterloading system with flexible implant tubes. The geometric distribution of the tubes was performed according to the 'Paris' configuration. Each implant was evaluated by calculating the dose-volume natural histograms. The HDR fractionation schedule consists of three fractions of 4.5Gy each given at least 48 hs apart, and starting between 48-72hs from surgical procedure. The external radiotherapy to the entire breast started one week after the completion of brachytherapy, using conventional fractionation of 5 fractions per week, 1,8Gy per fraction up to 45-50Gy. Results: So far there is not any local recurrence, but medium follow up is only 18 months. We did not observe any acute damage and the cosmetic outcome was 60% excellent, 30% good and 10% acceptable. Two patients developed localized fibrosis, in both the implant involved the submamary fold. Conclusion: The intraoperative implant is the most accurate way to localize the lumpectomy site, to define the target volume, decrease the total treatment time and avoid a second anesthetic procedure without delaying the inpatient time or the initial wound healing process

  3. SU-F-T-39: Comparing Nomograms for Ordering of Palladium-103 Seeds for Dynamic Intraoperative Prostate Seed Implantation

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, P; Wang, L; Riegel, A [Northwell Health, Lake Success, NY (United States)

    2016-06-15

    Purpose: Several nomograms exist for the purpose of ordering palladium- 103 seeds for permanent prostate seed implants. Excess seeds pose additional radiation safety risks and increase the cost of care. This study compared three seed ordering nomograms with seed counts from dynamic intra-operative PSI to determine (1) the cause of excess seeds and (2) the optimal nomogram for our institution. Methods: Pre-operative and intra-operative clinical data were collected for 100 Gy (n=151) and 125 Gy (n=224) prostate seed implants. The number of implanted seeds which would have given D90=100% was normalized to that criteria and seed strength of 2U. This was plotted against intra-operative prostate volume and compared to two previously published nomograms and an in-house nomogram. A linear fit was produced and confidence intervals were calculated. The causes of excess seeds were assessed by comparing pre- and intra-operative prostate volumes, variability of D90 around 100%, and variance of seed strength from 2U. Results: Of the 375 total cases, 97.6% had excess seeds. On average, 27.17±12.91% of ordered seeds were wasted. Of this percentage, 6.98±5.47% of excess seeds were due to overestimation of pre-operative prostate volume, 1.10±0.88% were due to D90<100%, 1.17±0.67% were due to seed strength over 2U, and 17.36±7.79% could not be directly attributed to a specific reason. The latter percentage may be due to overestimation of the in-house nomogram. Two of three nomograms substantially overestimated the number of seeds required. The third nomogram underestimated the required seed number for smaller prostate treatment volume. A linear fit to the clinical data was derived and 99.9% confidence intervals were calculated. Conclusion: Over 85% of clinical cases wasted over 15% of ordered seeds. Two of three nomograms overestimated the required number of seeds. The upper 99.9% C.I. of the clinical data may provide a more reasonable nomogram for Pd-103 seed ordering.

  4. SU-F-T-39: Comparing Nomograms for Ordering of Palladium-103 Seeds for Dynamic Intraoperative Prostate Seed Implantation

    International Nuclear Information System (INIS)

    Taylor, P; Wang, L; Riegel, A

    2016-01-01

    Purpose: Several nomograms exist for the purpose of ordering palladium- 103 seeds for permanent prostate seed implants. Excess seeds pose additional radiation safety risks and increase the cost of care. This study compared three seed ordering nomograms with seed counts from dynamic intra-operative PSI to determine (1) the cause of excess seeds and (2) the optimal nomogram for our institution. Methods: Pre-operative and intra-operative clinical data were collected for 100 Gy (n=151) and 125 Gy (n=224) prostate seed implants. The number of implanted seeds which would have given D90=100% was normalized to that criteria and seed strength of 2U. This was plotted against intra-operative prostate volume and compared to two previously published nomograms and an in-house nomogram. A linear fit was produced and confidence intervals were calculated. The causes of excess seeds were assessed by comparing pre- and intra-operative prostate volumes, variability of D90 around 100%, and variance of seed strength from 2U. Results: Of the 375 total cases, 97.6% had excess seeds. On average, 27.17±12.91% of ordered seeds were wasted. Of this percentage, 6.98±5.47% of excess seeds were due to overestimation of pre-operative prostate volume, 1.10±0.88% were due to D90<100%, 1.17±0.67% were due to seed strength over 2U, and 17.36±7.79% could not be directly attributed to a specific reason. The latter percentage may be due to overestimation of the in-house nomogram. Two of three nomograms substantially overestimated the number of seeds required. The third nomogram underestimated the required seed number for smaller prostate treatment volume. A linear fit to the clinical data was derived and 99.9% confidence intervals were calculated. Conclusion: Over 85% of clinical cases wasted over 15% of ordered seeds. Two of three nomograms overestimated the required number of seeds. The upper 99.9% C.I. of the clinical data may provide a more reasonable nomogram for Pd-103 seed ordering.

  5. Silicone implant incompatibility syndrome (SIIS) in a 57-year-old woman with unilateral silicone breast implant

    DEFF Research Database (Denmark)

    Schierbeck, Juliane; Davidsen, Jesper Rømhild; Grindsted Nielsen, Sanne

    2017-01-01

    implants can lead to different interstitial lung manifestations predominantly with granuloma evolvement, leading to the so-called silicone implant incompatibility syndrome (SIIS). This case describes a 57-year-old woman with multiple lung infiltrations and a left-sided breast implant. The implant had been...

  6. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies.

    Science.gov (United States)

    Noels, Eline C; Lapid, Oren; Lindeman, Jan H N; Bastiaannet, Esther

    2015-01-01

    The popularity of cosmetic breast augmentation and the incidence of breast cancer have been increasing worldwide. It has been hypothesized that the risk of breast cancer may be greater among patients who have undergone cosmetic breast implantation. The authors performed a meta-analysis of the available literature on the risk of breast cancer among women with cosmetic breast implants. The study was designed as a meta-analysis of observational studies. A systematic search of the English literature (published by August 28, 2013) was conducted in PubMed and EMBASE. Eligible reports were those that included relative risk (RR; the increased or decreased risk of breast cancer associated with breast implants) or the standardized incidence ratio (SIR) of the observed number of cases of breast cancer to the expected number of cases among patients that previously underwent cosmetic breast augmentation. Seventeen studies representing 7 cohorts were selected. Some of these were follow-up reports of previously published studies; in such cases, only the most recent reports were included in the meta-analysis. Summary SIR and RR rates and the corresponding 95% confidence intervals (CIs) were calculated with a random-effects (SIR) or fixed-effects (RR) model. The overall SIR estimate was 0.69 (95% CI, 0.56-0.85), and the overall RR, based on 4 studies, was 0.63 (95% CI, 0.56-0.71). Finding of this meta-analysis suggest that women who have undergone cosmetic breast implantation do not have an increased risk of breast cancer. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  7. Occupational exposure in prostate permanent implants with I-125 seeds

    Energy Technology Data Exchange (ETDEWEB)

    Fdez Garcia, J.; Luna, V.; Sancho, J. M. g.; Martinez, J.; Galiano, P. S.; Jimenez, I.; Prada, P.; Juan, G.; Vivanco, J.

    2002-07-01

    Prostate brachytherapy is one of the techniques increasing faster in the environment of the radiotherapy and will probably go on increasing in the future. There are two forms in their use; by means of remote afterloading high dose rate (HDR) with Ir-192 radioactive sources or by means of permanent implant by manual/automatic afterloading of low dose rate (LDR) with seeds of I-125 or Pd-103. Iodine-125 has a half life of 59.4 days and it decays by electron capture with emissions of characteristic photons and electrons. The electrons are absorbed by the titanium wall of the I-125 seed. The principal photon emissions are 27.4 and 31.4 keV X-rays and a 35.5 keV gamma ray. Besides 22.1 and 25.2 keV fluorescent X-rays are also emitted resulting from interactions of the iodine-125 photons with the silver rod. The resulting average photon energy is approximately 27.4 keV. (Author)

  8. Different types of implants for reconstructive breast surgery.

    Science.gov (United States)

    Rocco, Nicola; Rispoli, Corrado; Moja, Lorenzo; Amato, Bruno; Iannone, Loredana; Testa, Serena; Spano, Andrea; Catanuto, Giuseppe; Accurso, Antonello; Nava, Maurizio B

    2016-05-16

    Breast cancer is the most common cancer in women worldwide, and is a leading cause of cancer death among women. Prophylactic or curative mastectomy is often followed by breast reconstruction for which there are several surgical approaches that use breast implants with which surgeons can restore the natural feel, size and shape of the breast. To assess the effects of different types of breast implants on capsular contracture, surgical short- and long-term complications, postoperative satisfaction level and quality of life in women who have undergone reconstructive breast surgery after mastectomy. We searched the Cochrane Breast Cancer Group's Specialised Register on 20 July 2015, MEDLINE (1985 to 20 July 2015), EMBASE (1985 to 20 July 2015) and the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 8, 2015). We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 16 July 2015. We included randomised controlled trials (RCTs) and quasi-RCTs that compared different types of breast implants for reconstructive surgery. We considered the following types of intervention: implant envelope surfaces - texturised versus smooth; implant filler material - silicone versus saline, PVP-Hydrogel versus saline; implant shape - anatomical versus round; implant volume - variable versus fixed; brands - different implant manufacturing companies and implant generation (fifth versus previous generations). Two review authors independently assessed methodological quality and extracted data. We used standard Cochrane methodological procedures. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Five RCTs with 202 participants met the inclusion criteria. The women participants were typically in their 50s, and the majority of them (about 82%) received reconstructive surgery following breast cancer, while the others had

  9. Cancer risk among Los Angeles women with cosmetic breast implants.

    Science.gov (United States)

    Deapen, Dennis M; Hirsch, Elliot M; Brody, Garry S

    2007-06-01

    As the first generation of women who received cosmetic breast implants ages, questions remain about cancer risk. This study is an update of the Los Angeles Augmentation Mammaplasty Study and examines cancer risk among women with long-term exposure to breast implants. The authors conducted a record linkage cohort study of patients with cosmetic breast implants by abstracting from records of the private practices of 35 board-certified plastic surgeons in Los Angeles County, California. They included 3139 Caucasian women who received cosmetic breast implants between 1953 and 1980. Spanish-surnamed women, nonresidents of Los Angeles County, and patients with prior subcutaneous mastectomy or breast cancer were excluded. Cancer outcomes through 1994 were ascertained through record linkage with the Los Angeles County Cancer Surveillance Program. With a mean follow-up period of 15.5 years, 43 cases of breast cancer were observed, compared with 62.6 expected, based on Los Angeles County population-based incidence rates (standardized incidence ratio, 0.69; 95% CI, 0.50 to 0.93). Significant increases were observed for cancer of the lung and bronchus (standardized incidence ratio, 2.14; 95% CI, 1.42 to 3.09) and vulvar cancer (standardized incidence ratio, 3.47; 95% CI, 1.39 to 7.16). The breast cancer results of this study are consistent with the previous reports of the Los Angeles study as well as with several other long-term cohort studies. Lung cancer has previously been found to be increased in this cohort and also in some, but not most, other studies. The increased risk of vulva cancer has previously been observed in this cohort and just one other.

  10. Recurrent invasive lobular carcinoma presenting as a ruptured breast implant

    International Nuclear Information System (INIS)

    Botros, Maikel; Chang, Kenneth; Miller, Robert; Krishnan, Sunil; Iott, Matthew

    2011-01-01

    For years, the treatment for invasive lobular carcinoma (ILC) has been mastectomy secondary to the lack of studies investigating the efficacy of breast conservation therapy on patients afflicted with ILC and due to the lack of long-term follow up investigating locoregional recurrence in this patient population. In this article we report the clinical course of a patient diagnosed with ILC. We describe the case of a 50-year-old woman with stage IIB (T2N1M0) ER/PR positive right breast ILC who underwent a right modified radical mastectomy, postoperative chemotherapy, a prophylactic left simple mastectomy with bilateral breast reconstruction and tamoxifen. Approximately 12 years later, she presented with a deflated breast implant and recurrent breast cancer with metastatic spread. She received palliative radiotherapy then palliative chemotherapy. Unfortunately, she succumbed to the cancer less than a year after being diagnosed with metastatic disease. This may be the first case report of a ruptured breast implant presenting at the same time as the diagnosis of recurrent breast cancer

  11. Use of antibiotic beads to salvage infected breast implants.

    Science.gov (United States)

    Sherif, Rami D; Ingargiola, Michael; Sanati-Mehrizy, Paymon; Torina, Philip J; Harmaty, Marco A

    2017-10-01

    When an implant becomes infected, implant salvage is often performed where the implant is removed, capsulectomy is performed, and a new implant is inserted. The patient is discharged with a PICC line and 6-8 weeks of intravenous (IV) antibiotics. This method has variable success and subjects the patient to long-term systemic antibiotics. In the 1960s, the use of antibiotic-impregnated beads for the treatment of chronic osteomyelitis was described. These beads deliver antibiotic directly to the site of the infection, thereby eliminating the complications of systemic IV antibiotics. This study aimed to present a case series illustrating the use of STIMULAN calcium sulfate beads loaded with vancomycin and tobramycin to increase the rate of salvage of the infected implant and forgo IV antibiotics. A retrospective analysis was performed of patients who were treated at Mount Sinai Hospital for implant infection with salvage and antibiotic beads. Twelve patients were identified, 10 of whom had breast cancer. Comorbidities included hypertension, smoking, and immunocompromised status. Infections were noted anywhere from 5 days to 8 years postoperatively. Salvage was successful in 9 out of the 12 infected implants using antibiotic bead therapy without home IV antibiotics. The use of antibiotic beads is promising for salvaging infected breast implants without IV antibiotics. Seventy-five percent of the implants were successfully salvaged. Of the three patients who had unsalvageable implants, one was infected with antibiotic-resistant Rhodococcus that was refractory to bead therapy and one was noncompliant with postoperative instructions. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

    Science.gov (United States)

    Cifuentes, Ignacio; Dagnino, Bruno; Rada, Gabriel

    2017-08-31

    The use of breast implants for aesthetic and reconstructive purposes has become one of the most common procedures performed by plastic surgeons. Several breast implants models exist. They differ in their size, filling, shape and characteristic of the shell, which can be smooth or textured. Capsular contracture is one of the main complications of breast implants. It has been suggested that the use of textured implants could reduce the incidence of capsular contracture. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified 15 studies overall, of which 13 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded the use of textured breast implants probably decreases the risk of capsular contracture, however, they might be associated to an increased risk of anaplastic large cell lymphoma.

  13. Efficacies of 125I seed implantation in advanced stage central lung cancer via fibrobronchoscope

    International Nuclear Information System (INIS)

    Liu Jianguo; An Liqing; Cheng Jinguang; Zhang Yufen; Guo Xiaokui

    2009-01-01

    Objective: To explore the temporal curative effect of 125 I seed implantation in advanced stage central type lung cancer. Methods: 125 I seed was implanted in 56 patients confirmed advanced stage central type lung cancer via fibrobronchoscope and all cases were fellow up in certain duration to explore their efficacies and the adverse reaction. Results: Total efficient rate was 76.78% in 56 patients. Lung reexpanded rate was 90.90%. Conclusion: The therapy of 125 I seed implantation in advanced stage central type lung cancer is safe and available. (authors)

  14. 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.

  15. Do breast implants after a mastectomy affect subsequent prognosis and survival?

    OpenAIRE

    Brinton, Louise A

    2005-01-01

    In a large study, published in this issue of Breast Cancer Research, Le and colleagues report that women receiving implants after mastectomies for early-stage breast cancer experience lower breast cancer mortality than women not receiving implants. Assessment of survival patterns among women receiving reconstructive implants is complex given unique patient characteristics, disease attributes, and treatment patterns. The interpretation of reduced mortality from breast cancer must be assessed i...

  16. Distant Migration of Multiple Siliconomas in Lower Extremities following Breast Implant Rupture: Case Report

    OpenAIRE

    Oh, Joo Hyun; Song, Seung Yong; Lew, Dae Hyun; Lee, Dong Won

    2016-01-01

    Summary: Siliconoma from ruptured breast implants has been reported in multiple body sites, including but not limited to the breast parenchyma, axillary lymph nodes, upper arm, and even lower leg. In this regard, we report a rare case of distant silicone migration to the lower extremities after traumatic breast implant rupture. A 55-year-old Asian woman who received bilateral augmentation mammoplasty 20 years ago presented with ruptured breast implants from a car accident 2 years earlier. Mag...

  17. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

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

    2005-01-01

    participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... were in fact ruptured at surgery. Thirty-four of the 43 intact implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89...

  18. Immediate breast reconstruction using autologous skin graft associated with breast implant.

    Science.gov (United States)

    Dutra, A K; Andrade, W P; Carvalho, S M T; Makdissi, F B A; Yoshimatsu, E K; Domingues, M C; Maciel, M S

    2012-02-01

    Immediate breast reconstruction with skin graft is still little mentioned in the literature. Follow-up studies regarding the technique aspects are particularly scarce. The objective was to detail immediate breast reconstruction using autologous skin graft. Patients (n = 49) who underwent mastectomies and autologous immediate breast reconstruction with skin graft associated with a breast implant at A. C. Camargo Hospital (São Paulo, Brazil) between January 2007 and July 2010 were included. Information on clinical data, technique details and clinical outcome were prospectively collected. Following mastectomy, the autologous full-thickness skin graft was obtained through an inframammary fold incision along the contralateral breast in most patients. The skin graft was placed on the surface of the pectoralis major muscle after adjustments to conform to the mastectomy defect. A minimum of 10-month follow-up period was established. Patients' age ranged from 35 to 55 years and all received a silicone gel textured surface implant to obtain the necessary breast mound. The mean surgical time was 45 min, and the mean amount of skin resection was 4.5 cm in the largest diameter. Follow-up ranged from 10 to 35 months (median 23). All patients had silicone-gel textured surface implants to perform the breast mound reconstruction. No complications were observed in 87.8% of reconstructions. Forty-six patients (94%) had no complaints about the donor-site aesthetics. The result was a breast mound with a central ellipse of healed skin graft. Three (6%) poor results were observed. Thirty-six patients (67%) reported the results as good or very good. Our results lead us to conclude that autologous skin graft provided a reliable option in immediate breast reconstruction to skin-sparing mastectomy defects. The technique accomplished a single-stage implant breast reconstruction when there is inadequate skin coverage. Copyright © 2011 British Association of Plastic, Reconstructive and

  19. 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.......7-5.2). Women who underwent breast reduction exhibited low SMRs for death overall (0.7; 95% CI, 0.7-0.8) and several specific causes, including breast cancer (0.4; 95% CI, 0.2-0.6), whereas death from suicide was moderately above expectation (SMR, 1.6; 95% CI, 1.0-2.5). The prevalence of psychiatric admission...... prior to cosmetic surgery was higher among women who underwent cosmetic breast implant surgery (8.0%; 95% CI, 7.0%-9.0%) than among women who underwent breast reduction (4.7%; 95% CI, 4.2%-5.2%) or other cosmetic procedures (5.5%; 95% CI, 4.5%-6.7%). When compared with all control groups, women...

  20. Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort.

    Science.gov (United States)

    Lavigne, Eric; Holowaty, Eric J; Pan, Sai Yi; Xie, Lin; Villeneuve, Paul J; Morrison, Howard; Brisson, Jacques

    2012-10-01

    Cosmetic breast implants may impair the ability to detect breast cancers. The aims of this study were to examine whether implants and implant characteristics are associated with more advanced breast tumors at diagnosis and poorer survival. Study population includes all invasive breast cancer cases diagnosed during follow-up of the large Canadian Breast Implant Cohort. A total of 409 women with cosmetic breast implants and 444 women with other cosmetic surgery were diagnosed with breast cancer. These women were compared for stage at diagnosis using multinomial logistic regression models. Cox proportional hazards regression models were used for breast cancer-specific mortality analyses. Comparisons were also conducted according to implant characteristics. Compared with women with other cosmetic surgery, those with cosmetic breast implants had at later stage breast cancer diagnosis (OR of having stage III/IV vs. stage I at diagnosis: 3.04, 95% confidence interval (CI): 1.81-5.10; P breast cancer-specific mortality rate for women with breast implants relative to surgical controls was observed (HR = 1.32, 95% CI: 0.94-1.83, P = 0.11). No statistically significant differences in stage and breast cancer mortality were observed according to implant characteristics. At diagnosis, breast cancers tended to be at more advanced stages among women with cosmetic breast implants. Breast cancer-specific survival was lower in these women although the reduction did not reach statistical significance. Further investigations of the effect of breast implants on breast cancer prognosis are warranted. 2012 AACR

  1. Early dissemination seeds metastasis in breast cancer

    Science.gov (United States)

    Hosseini, Hedayatollah; Obradović, Milan M.S.; Hoffmann, Martin; Harper, Kathryn; Sosa, Maria Soledad; Werner-Klein, Melanie; Nanduri, Lahiri Kanth; Werno, Christian; Ehrl, Carolin; Maneck, Matthias; Patwary, Nina; Haunschild, Gundula; Gužvić, Miodrag; Reimelt, Christian; Grauvogl, Michael; Eichner, Norbert; Weber, Florian; Hartkopf, Andreas; Taran, Florin-Andrei; Brucker, Sara Y.; Fehm, Tanja; Rack, Brigitte; Buchholz, Stefan; Spang, Rainer; Meister, Gunter; Aguirre-Ghiso, Julio A.; Klein, Christoph A.

    2016-01-01

    Accumulating data suggest that metastatic dissemination often occurs early during tumour formation but the mechanisms of early metastatic spread have not yet been addressed. Here, we studied metastasis in a HER2-driven mouse breast cancer model and found that progesterone-induced signalling triggered migration of cancer cells from early lesions shortly after HER2 activation, but promoted proliferation in advanced primary tumour cells. The switch from migration to proliferation was regulated by elevated HER2 expression and increased tumour cell density involving miRNA-mediated progesterone receptor (PGR) down-regulation and was reversible. Cells from early, low-density lesions displayed more stemness features than cells from dense, advanced tumours, migrated more and founded more metastases. Strikingly, we found that at least 80% of metastases were derived from early disseminated cancer cells (DCC). Karyotypic and phenotypic analysis of human disseminated cancer cells and primary tumours corroborated the relevance of these findings for human metastatic dissemination. PMID:27974799

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

    International Nuclear Information System (INIS)

    Le, Gem M; O'Malley, Cynthia D; Glaser, Sally L; Lynch, Charles F; Stanford, Janet L; Keegan, Theresa HM; West, Dee W

    2005-01-01

    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

  3. A comparison of 500 prefilled textured saline breast implants versus 500 standard textured saline breast implants: is there a difference in deflation rates?

    Science.gov (United States)

    Stevens, W Grant; Hirsch, Elliot M; Stoker, David A; Cohen, Robert

    2006-06-01

    This study provides the first large-volume (1000 implant) comparison of the deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants versus a control group of Mentor Siltex textured saline implants. A consecutive series of 500 Poly Implant Prosthesis prefilled textured saline breast implants was compared with a consecutive series of 500 Mentor Siltex breast implants. Each breast implant was evaluated for a 4-year period, and the annual deflation rate (number of deflations during a given year divided by the total number of implants) and cumulative deflation rate (cumulative total of deflations through a given year divided by the total number of implants) were recorded. Statistical significance was calculated using the Fisher's exact test at year 1 and the chi-square analysis at years 2 through 4. The cumulative deflation rates of the Poly Implant Prosthesis implants was as follows: year 1, 1.2 percent; year 2, 5.6 percent; year 3, 11.4 percent; and year 4, 15.4 percent. The cumulative deflation rates of the Mentor implants was: year 1, 0.2 percent; year 2, 0.6 percent; year 3, 1.6 percent; and year 4, 4.4 percent. At year 1, the difference between deflation rates was not statistically significant (Fisher's exact test, p > 0.05). However, at year 2 (chi-square, 13.29; p deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants and Mentor Siltex breast implants at year 2, year 3, and year 4. After 4 years, the 15.56 percent cumulative deflation rate of Poly Implant Prosthesis implants was over 3.5 times higher than the 4.31 percent deflation rate of the Mentor Siltex implants. There may be several factors contributing to the higher deflation rate seen in Poly Implant Prosthesis implants, including possible in vitro deflation before implantation and silicone shell curing technique. Nevertheless, this statistically significant deflation difference must be taken into account when balancing the risks and benefits of

  4. Definitive diagnosis of breast implant rupture using magnetic resonance imaging.

    Science.gov (United States)

    Ahn, C Y; Shaw, W W; Narayanan, K; Gorczyca, D P; Sinha, S; Debruhl, N D; Bassett, L W

    1993-09-01

    Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lack specificity. In the current study, we have established magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible technique to diagnose both intracapsular and extracapsular ruptures. The study was conducted in 100 symptomatic patients. Our imaging parameters were able to identify ruptures in implants with silicone shells. All the ruptures showed the presence of wavy lines, free-floating silicone shell within the gel ("free-floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence of false-positive and false-negative results. The sensitivity for detection of silicone implant rupture was 76 percent, with a specificity of 97 percent. In addition, we also were able to identify the artifacts that may interfere with the definitive diagnosis of implant rupture.

  5. Safely re-integrating silicone breast implants into the plastic surgery practice.

    Science.gov (United States)

    Gladfelter, Joanne

    2006-01-01

    In the early 1990s, it was reported that silicone breast implants were possibly responsible for serious damage to women's health. In January 1992, the Food and Drug Administration issued a voluntary breast implant moratorium and, in April, issued a ban on the use of silicone gel-filled implants for cosmetic breast augmentation. Since that time, silicone gel-filled breast implants have been available to women only for select cases: women seeking breast reconstruction or revision of an existing breast implant, women who have had breast cancer surgery, a severe injury to the breast, a birth defect that affects the breast, or a medical condition causing a severe breast deformity. Since the ban on the use of silicone gel-filled breast implants for cosmetic breast augmentation, numerous scientific studies have been conducted. To ensure patient safety, the American Board of Plastic Surgery believes that these scientific studies and the Food and Drug Administration's scrutiny of silicone gel-filled breast implants have been appropriate and necessary.

  6. The Clinical and Diagnostic Consequences of Poly Implant Prothese Silicone Breast Implants, Recalled from the European Market in 2010

    NARCIS (Netherlands)

    Maijers, M.C.; Niessen, F.B.

    2013-01-01

    BACKGROUND:: Recently, Poly Implant Prothèse silicone breast implants were recalled from the European market. The authors studied 112 women and previously published data on rupture prevalence. Women are presenting with symptoms they feel may be a result of ruptured implants. The authors' aim was to

  7. Dynamic observation on changes of serum tumor markers levels after implantation of 125I radioactive seeds as treatment for several malignancies

    International Nuclear Information System (INIS)

    Sun Qihe; Yang Jiali; Gao Mingzhong

    2005-01-01

    Objective: To study the dynamic changes of serum levels of several tumor markers after implantation of 125 I seeds as treatment for breast, prostate and lung malignancies. Methods: Serum CA15-3 (in 48 cases of breast cancer), PSA (in 59 cases of prostate cancer) and CYFRA21-1 (in 59 cases of lung cancer) levels were measured with RIA both before and after implantation of 125 I seeds as treatment. Furthermore, dynamic observation on the serum markers levels was carried out every 3 months in ten patients in each category. Results: After treatment, levels of these markers dropped significantly. Dynamic observation revealed that in the 10 cases of breast cancer, the levels of CA15-3 dropped continually. However, in the 10 cases of prostatic cancer, the disease got worse and the PSA levels kept increasing. In the lung cancer group, the CYFRA21-1 levels rose markedly and all patients expired before 9 months. Conclusion: Dynamic observation on changes of serum tumor markers (CA15-3, PSA, CYFRA21-1) levels after 125 I seed implantation treatment was of definite prognostic value. (authors)

  8. 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...

  9. Effects of silicone expanders and implants on echocardiographic image quality after breast reconstruction.

    Science.gov (United States)

    Pignatti, Marco; Mantovani, Francesca; Bertelli, Luca; Barbieri, Andrea; Pacchioni, Lucrezia; Loschi, Pietro; De Santis, Giorgio

    2013-08-01

    Use of silicone expanders and implants is the most common breast reconstruction technique after mastectomy. Postmastectomy patients often need echocardiographic monitoring of potential cardiotoxicity induced by cancer chemotherapy. The impairment of the echocardiographic acoustic window caused by silicone implants for breast augmentation has been reported. This study investigates whether the echocardiographic image quality was impaired in women reconstructed with silicone expanders and implants. The records of 44 consecutive women who underwent echocardiographic follow-up after breast reconstruction with expanders and implants at the authors' institution from January of 2000 to August of 2012 were reviewed. The population was divided into a study group (left or bilateral breast expanders/implants, n=30) and a control group (right breast expanders/implants, n=14). The impact of breast expanders/implants on echocardiographic image quality was tested (analysis of covariance model). Patients with a breast expander/implant (left or bilateral and right breast expanders/implants) were included. The mean volume of the breast devices was 353.2±125.5 cc. The quality of the echocardiographic images was good or sufficient in the control group; in the study group, it was judged as adequate in only 50 percent of cases (15 patients) and inadequate in the remaining 15 patients (pimplants in postmastectomy left breast reconstruction considerably reduce the image quality of echocardiography. This may have important clinical implications, given the need for periodic echocardiographic surveillance before and during chemotherapy. Therapeutic, III.

  10. Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Lavigne, Eric; Holowaty, Eric J; Pan, Sai Yi; Villeneuve, Paul J; Johnson, Kenneth C; Fergusson, Dean A; Morrison, Howard; Brisson, Jacques

    2013-04-29

    To evaluate whether the stage distribution among women diagnosed as having breast cancer differs between those who have received breast implants for cosmetic purposes and those with no implants and to evaluate whether cosmetic breast augmentation before the detection of breast cancer is a predictor of post-diagnosis survival. Systematic review of observational studies with two meta-analyses. Systematic search of the literature published before September 2012 conducted in Medline, Embase, Global health, CINAHL, IPAB, and PsycINFO. Eligible publications were those that included women diagnosed as having breast cancer and who had had augmentation mammaplasty for cosmetic purposes. The overall odds ratio of the first meta-analysis based on 12 studies was 1.26 (95% confidence interval 0.99 to 1.60; P=0.058; I(2)=35.6%) for a non-localized stage of breast cancer at diagnosis comparing women with implants who had breast cancer and women without implants who had breast cancer. The second meta-analysis, based on five studies, evaluated the relation between cosmetic breast implantation and survival. This meta-analysis showed reduced survival after breast cancer among women who had implants compared with those who did not (overall hazard ratio for breast cancer specific mortality 1.38, 95% confidence interval 1.08 to 1.75). The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer. These findings should be interpreted with caution, as some studies included in the meta-analysis on survival did not adjust for potential confounders. Further investigations are warranted regarding diagnosis and prognosis of breast cancer among women with breast implants.

  11. Comparison of Reconstructive Outcomes in Breast Cancer Patients With Preexisting Subpectoral Implants: Implant-Sparing Mastectomy With Delayed Implant Exchange Versus Immediate Tissue Expander Reconstruction.

    Science.gov (United States)

    Parabkaharan, Sangeetha; Melody, Megan; Trotta, Rose; Lleshi, Amina; Sun, Weihong; Smith, Paul D; Khakpour, Nazanin; Dayicioglu, Deniz

    2016-06-01

    Women who have undergone prior augmentation mammoplasty represent a unique subset of breast cancer patients with several options available for breast reconstruction. We performed a single institution review of surgical outcomes of breast reconstruction performed in patients with breast cancer with prior history of subpectoral breast augmentation. Institutional review board-approved retrospective review was conducted among patients with previously mentioned criteria treated at our institution between 2000 and 2014. Reconstructions were grouped into 2 categories as follows: (1) removal of preexisting subpectoral implant during mastectomy with immediate tissue expander placement and (2) implant-sparing mastectomy followed by delayed exchange to a larger implant. We reviewed demographics, tumor features, and reconstruction outcomes of these groups. Fifty-three patients had preexisting subpectoral implants. Of the 63 breast reconstructions performed, 18 (28.6%) had immediate tissue expander placed and 45 (71.4%) had implant-sparing mastectomy followed by delayed implant exchange. The groups were comparable based on age, body mass index, cancer type, tumor grade, TNM stage at presentation, and hormonal receptor status. No significant difference was noted between tumor margins or subsequent recurrence, mastectomy specimen weight, removed implant volume, volume of implant placed during reconstruction, or time from mastectomy to final implant placement. Rates of complications were significantly higher in the tissue expander group compared to the implant-sparing mastectomy group 7 (38.9%) versus 4 (8.9%) (P = 0.005). Implant-sparing mastectomy with delayed implant exchange in patients with preexisting subpectoral implants is safe and has fewer complications compared to tissue expander placement. There was no difference noted in the final volume of implant placed, time interval for final implant placement, or tumor margins.

  12. Clinical application of permanent implantation of iodine 125 seeds for osseous metastases

    International Nuclear Information System (INIS)

    Li Jinxin; Zhang Qizhou; Li Guoliang

    2010-01-01

    Objective: To evaluate the clinical efficacy of permanent implantation of iodine 125 seeds in the treatment of osseous metastases. Methods: Radioactive iodine 125 seeds were implanted permanently in 32 lesions of 25 patients with osseous metastases of different origins. The ostalgia-relieving degree and the imaging alterations of the osseous metastasis lesions were observed. Results: The effective pain-relieving rate was 92% caused by permanent implantation of iodine 125 seeds. Of al 1 the patients, 15 patients achieved complete response, 8 patients obtained partial response (PR), and 2 patients had no change. The pain grade was decreased significantly after the treatment (P 125 I seeds has a definite effect on tumor metastasis and caused minimal damage and few complications. It is worthy of popularization in clinic. (authors)

  13. Ten cases of metastatic cervical cancer with the treatment of permanent 125I seeds interstitial implants

    International Nuclear Information System (INIS)

    Zhang Hongwei; Li Naibin; Li Qingxin; Liu Huiping; Meng Hui; Chao Dong

    2011-01-01

    Objective: To investigate the clinical effect of permanent 125 I seeds interstitial implants for metastatic cervical cancer. Methods: Under the guidance of the B-sonography, 125 I seeds were implanted into the eleven cervical lymph nodes of ten patients who had been given tumor resection. The pain relief and tumor size were observed in regular follow-up after one-month treatment. Results: All the patients were followed up for 6-14 months,and the postoperative recovery was good with no complication. One month after the implantation, the pain symptom was alleviated entirely in two nodes and partly in nine nodes. The tumor size shrank in ten nodes while there was no change in one node after one month. Conclusion: Permanent 125 I seeds interstitial implants for metastatic cervical cancer is a safe, minimally invasive and effective treatment. (authors)

  14. What's really behind the attack on silicone breast implants.

    Science.gov (United States)

    Angell, M

    1996-09-09

    Millions of dollars are being awarded by injuries and a major company has been forced into bankruptcy because of litigation over silicone breast implants. Yet scientific research hasn't established a link between the implants and disease, notes Marcia Angell, executive editor of the New England Journal of Medicine. When she began studying the issue, this self-described feminist and liberal Democrat expected to uncover iniquities of big business and the implant manufacturers. Instead, she's written an indictment of the tort system, junk science, and the gullibility of the news media. Attorneys have twisted facts and played on the emotions of juries, with the consent of judges and often to the cheers of the press. Angell worries that it's now become politically correct to bash the scientific method in the name of diversity, multiculturalism, and feminism.

  15. 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.

  16. Iodine-125 seed implantation for unresectable pancreatic carcinoma guided by intraoperative ultrasound

    International Nuclear Information System (INIS)

    Wang Junjie; Xiu Dianrong; Ran Weiqiang; Bai Jing; Zhu Lihong; Liu Jiangping

    2005-01-01

    Objective: To investigate the surgical technique, efficacy and side effects of 125 I seed interstitial implantation for pancreatic carcinoma. Methods: A total of 22 patients with biopsy proven unresectable adenocarcinoma of pancreas were treated with 125 I implants during laparotomy. Of them 11 patients were treated previously by a combination of bypass surgery. The stent was implanted in 2 cases 2 weeks before and 4 weeks after seed implantation. Seed needles were implanted parallelly to each other, with 1-1.5 cm apart. Mick applicator was being connected to each needle to implant seed. The radioactive activity ranged 0.40-0.70 mCi, the matched peripheral doses were 65-145 Gy. The mean number of 125 I seed was 11-78. Five cases received external beam irradiation with 3D-CRT, the doses were 39-70 Gy and 5 patients received 2 cycle of gemcitabine chemotherapy at 1000 mg/m 2 on dl and d8. Results: Pain was completely relieved in 12 cases, partially relieved in 2 cases, and no response was noted in one case, so the response rate was 93.33%. The median time was 2-3 d. Altogethe 27.27% of the cases died from local recurrence of pancreatic carcinoma and 50% from metastasis. The median survival time in these patients was 6 months, with a 2-year survival rate of 9.09%. The seed immigrated to liver in 3 cases. There were no serious side effects such as infection, pancreatitis, pancreatic fistula, etc. Conclusion: Radioactive seed implantation was safe, high local control, minidamage, satisfactory palliation of pain and without significant complications. (authors)

  17. Investigation on curative efficacy for malignant tumor by implantation '125I permanent brachytherapy seeds

    International Nuclear Information System (INIS)

    Hu Shu; Gao Zhou; Jia Shaowei; Cheng Xianyi; Chen Junhui; Yin Weihua; Sun Desheng

    2011-01-01

    Twenty inpatients suffered from malignant tumors with twenty-four lesions were treated with 125 I permanent brachytherapy seed in Peking University Shenzhen Hospital, and the feasibility, curative effect and adverse effect of the treatment were observed. Before 125 I seeds implantation, the three-dimensional treatment planning was preconcerted. There were two methods to implant 125 I seeds. One was to insert the seeds in the location of residual focus and metastatic lesions of the tumors directly in ordinary operations or through laparoscopy under general anesthesia. The other w as to implant the seeds into the tumors through percutaneous needles by the guidance of CT scanning or color doppler ultrasonography under local anesthesia. The implantations for all of the 20 patients (24 lesions) were performed successfully. During and one week after the implantation, the distributions of the planted seeds were approximately the same as the scheduled three-dimensional treatment planning, and no seed migration was found. Adverse reactions during and after the operation were slight and recovered after correlative treatments. Clinical symptoms were palliated and ser um tumor marker decreased to a different extent among most patients. The complete remission (CR) rate is 20.00% (4/20 patients ), the partial emission (PR) rate is 35.00% (7/20 patients), the stable disease (SD) rate is 30.00% (6/20 patients), the progressive disease (PD) rate is 15.00% (3/20 patients), and the overall response rate (CR + PR) is 53.33% (8 patients). 125 I seeds implantation for targeted therapy is convenient, safe and effective on malignant tumor, and is well worth advanced application. (authors)

  18. Preparation and administration of I-125 labeled seeds for localization of nonpalpable breast lesions

    DEFF Research Database (Denmark)

    Langhans, Linnea; Klausen, Thomas Levin; Tvedskov, Tove Holst Filtenborg

    2016-01-01

    Radioactive seed localization (RSL) is a new technique for surgical identification of nonpalpable breast lesions. We describe the preparation of the needle with I-125 seeds for ultrasound-guided deposition in breast lesions. In a feasibility study we investigated the minimum activity amount needed...... for reliable gamma probe identification of the seeds and the levels of exposure to the staff. METHODS: 11 patients received a seed, which was manually placed in an 18 gauge needle with bone wax occluding the tip, and the radiologist introduced it into the breast tissue guided by ultrasound. The seed...... identified. The surgeon removed the seeds together with the breast lesions, and they were identified by the pathologist. There were no unexpected adverse drug reactions. Water bath studies suggest that 1-3 MBq I-125 was sufficient for precise identification, regardless of the presence of conventional Tc-99m...

  19. Consideration of safety of implant-based breast reconstruction with postreconstruction radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Aomatsu, Naoki; Tei, Seika; Haraoka, Goichi

    2016-01-01

    There is controversy as to whether immediate autologous breast reconstruction followed by postoperative radiotherapy has acceptable complications and aesthetic outcomes. To evaluate the interval between surgery and adjuvant chemotherapy and radiation in patients treated with mastectomy and immediate expander-implant reconstruction, and to evaluate locoregional and distant control and cosmesis in these patients. Between 2011 and 2015, 9 patients with breast cancer were treated at our institution with definitive mastectomy and axillary lymph node dissection followed by immediate tissue expander placement and postreconstruction radiotherapy. We reviewed the complications of implant-based breast reconstruction followed by postreconstruction radiotherapy. The timing of irradiation was after implant insertion for 8 patients and after tissue expander insertion for 1 patient. The mean follow-up was 601 days. There were no unacceptable complications or local recurrences. For the majority of patients, overall symmetry, aesthetic results, and patient satisfaction were high. Breast reconstruction using tissue expansion and implants is an acceptable option for the subset of patients who may undergo postreconstruction radiotherapy. (author)

  20. The temperature effect of low-energy ion beam implantation on seed

    International Nuclear Information System (INIS)

    Chang Shenghe; Su Mingjie; Qin Guangyong; Wu Yuping; Zhao Haizhen

    2005-01-01

    The temperature effects of low-energy ion beam implantation on the seed germination were studied. Maize dry seeds were covered with copy paper, aluminum foil and without cover, respectively. Results showed that the germination rate of the seeds covered with paper which was the bad heat transmitter was the highest among three treatments, while that covered with aluminum foil which can transmit heat energy well was the least. The germination rate of the seeds covered with nothing was the second. Temperature affected seeds germination markedly. Generally the temperature of the target room inhibited the seeds' germination. After minus the effects of the temperature in the target room, the germination rates of the seeds were modified in this paper. The modified germination rate curve was also provided. (authors)

  1. Monte carlo simulation of penetration range distribution of ion beam with low energy implanted in plant seeds

    International Nuclear Information System (INIS)

    Huang Xuchu; Hou Juan; Liu Xiaoyong

    2009-01-01

    The depth and density distribution of V + ion beam implanted into peanut seed is simulated by the Monte Carlo method. The action of ions implanted in plant seeds is studied by the classical collision theory of two objects, the electronic energy loss is calculated by Lindhard-Scharff formulation. The result indicates that the depth of 200keV V + implanted into peanut seed is 5.57μm, which agrees with experimental results, and the model is appropriate to describe this interaction. This paper provides a computational method for the depth and density distribution of ions with low energy implanted in plant seeds. (authors)

  2. Canadian breast implant cohort: extended follow-up of cancer incidence.

    Science.gov (United States)

    Pan, Sai Yi; Lavigne, Eric; Holowaty, Eric J; Villeneuve, Paul J; Xie, Lin; Morrison, Howard; Brisson, Jacques

    2012-10-01

    Cosmetic breast implants are not associated with increased breast cancer incidence, but variations of risk according to implant characteristics are still poorly understood. As well, the assessment of cancer risk for sites other than breast needs to be clarified. The purpose of this study was to fill these research gaps. This study presents an extended analysis of 10 more years of follow-up of a large Canadian cohort of women who received either cosmetic breast implants (n = 24,558) or other cosmetic surgery (15,893). Over 70% of the implant cohort was followed for over 20 years. Cancer incidence among implant women was compared to those of controls using multivariate Poisson models and the general female population using the standardized incidence ratios (SIRs). Women with breast implants had reduced rates of breast and endometrial cancers compared to other surgery women. Subglandular implants were associated to a reduced rate of breast cancer compared to submuscular implants [incidence rate ratio (IRR) = 0.78, 95% confidence interval (CI) = 0.63-0.96] and this reduction persisted over time. We observed a sevenfold increased rate (IRR = 7.36, 95% CI = 1.86-29.12) of breast cancer in the first 5 years after the date of surgery for polyurethane-coated subglandular implant women but this IRR decreased progressively over time (p value for trend = 0.02). We also observed no increased risk of rarer forms of cancer among augmented women. A reduction in breast cancer incidence was observed for women with subglandular implants relative to women with submuscular implants. Possible increase of breast cancer incidence shortly after breast augmentation with polyurethane implants needs to be verified. Copyright © 2012 UICC.

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

    OpenAIRE

    Le, Gem M; O'Malley, Cynthia D; Glaser, Sally L; Lynch, Charles F; Stanford, Janet L; Keegan, Theresa HM; West, Dee W

    2004-01-01

    Background 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. Methods 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 diagnos...

  4. Evaluation of breast implants with breast magnetic resonance: Practical utility in comparison with other methods

    International Nuclear Information System (INIS)

    Melendez, Florencia; Blejman, Oscar; Lamattina Mariano; Villamea, Victoria; Sarquis, Flavio; Torrillo, Fabiana

    2010-01-01

    The purpose of this study was to demonstrate the utility of Breast Magnetic Resonance (BMR) in the evaluation of breast implants comparing Mammography and Breast ultrasound in an ambulatory private institute setting. Method: Between May 2008 and April 2010, 729 BRM were performed in patients between 22 and 77 years of age, 474 were evaluated for implant integrity. The studies were performed in a high field equipment (1.5T) with T1, T2, fat Sat, Silicone only and silicone suppression sequences. Results: Of the 474 patients that were evaluated for implant integrity: 291 patients (61.39%) presented with intact implants, 252 (86.6%) showed concordant findings with mammography and or ultrasound and 39 (13.4%) showed discordant findings. Then, 116 patients (24.47%) presented signs of intracapsular rupture, 82 (70.7%) were concordant with ultrasound findings and 34 (29.3%) had normal ultrasound evaluation. 44 patients (9.28%) presented extracapsular rupture, 40 (90.9%) were concordant with mammography and ultrasound and 4 (9.10%) were discordant. Finally, 23 patients (4.85%) presented residual silicone granulomas, with history of previous implant rupture and explanted surgery, 13 (56.52%) concordant with mammography and ultrasound and 10 (43.48%) were discordant. Conclusion: Non contrast BMR, using multiples planes and sequences is very useful in the evaluation of the internal structure of the implants and extracapsular silicone. It's the most sensible study to demonstrate intra and extracapsular rupture. BMR exceeds mammography and ultrasound in the detection of implant rupture and residual granulomas following explanted surgery.

  5. Urinary morbidity following ultrasound-guided transperineal prostate seed implantation

    International Nuclear Information System (INIS)

    Gelblum, Daphna Y.; Potters, Louis; Ashley, Richard; Waldbaum, Robert; Wang Xiaohong; Leibel, Steven

    1999-01-01

    Purpose: To assess the urinary morbidity experienced by patients undergoing ultrasound-guided, permanent transperineal seed implantation for adenocarcinoma of the prostate. Methods and Materials: Between September 1992 and September 1997, 693 consecutive patients presented with a diagnosis of clinically localized adenocarcinoma of the prostate, and were treated with ultrasound-guided transperineal interstitial permanent brachytherapy (TPIPB). Ninety-three patients are excluded from this review, having received neoadjuvant antiandrogen therapy. TPIPB was performed with 125 I in 165 patients and with 103 Pd in 435 patients. Patients treated with implant alone received 160 Gy with 125 I (pre TG43) or 120 Gy with 103 Pd. One hundred two patients received preimplant, pelvic external beam radiation (XRT) to a dose of either 41.4 or 45 Gy because of high-risk features including PSA ≥ 10 and/or Gleason score ≥ 7. Combined modality patients received 120 Gy and 90 Gy, respectively for 125 I or 103 Pd. All patients underwent postimplant cystoscopy and placement of an indwelling Foley catheter for 24-48 h. Follow-up was at 5 weeks after implant, every 3 months for the first 2 years, and then every 6 months for subsequent years. Patients completed AUA urinary symptom scoring questionnaires at initial consultation and at each follow-up visit. Urinary toxicity was classified by the RTOG toxicity scale with the following adaptations; grade 1 urinary toxicity was symptomatic nocturia or frequency requiring none or minimal medical intervention such as phenazopyridine; grade 2 urinary toxicity was early obstructive symptomatology requiring alpha-blocker therapy; and grade 3 toxicity was considered that requiring indwelling catheters or posttreatment transurethral resection of the prostate for symptom relief. Log-rank analysis and Chi-square testing was performed to assess AUA score, prostate size, isotope selection, and the addition of XRT as possible prognosticators of

  6. Effects of seed migration on post-implant dosimetry of prostate brachytherapy

    International Nuclear Information System (INIS)

    Gao, M.; Wang, J. Z.; Nag, S.; Gupta, N.

    2007-01-01

    Brachytherapy using permanent seed implants has been an effective treatment for prostate cancer. However, seeds will migrate after implant, thus making the evaluation of post-implant dosimetry difficult. In this study, we developed a computer program to simulate seed migration and analyzed dosimetric changes due to seed migration at various migration amounts. The study was based on 14 patients treated with Pd-103 at the James Cancer Hospital. Modeling of seed migration, including direction, distance as well as day of migration, was based on clinical observations. Changes of commonly used dosimetric parameters as a function of migration amount (2, 4, 6 mm respectively), prostate size (from 20 to 90 cc), and prostate region (central vs peripheral) were studied. Change of biological outcome (tumor control probability) due to migration was also estimated. Migration reduced prostate D90 to 99±2% of original value in 2 mm migration, and the reduction increased to 94±6% in 6 mm migration. The reduction of prostate dose led to a 14% (40%) drop in the tumor control probability for 2 mm (6 mm) migration, assuming radiosensitive tumors. However, migration has less effect on a prostate implanted with a larger number of seeds. Prostate V100 was less sensitive to migration than D90 since its mean value was still 99% of original value even in 6 mm migration. Migration also showed a different effect in the peripheral region vs the central region of the prostate, where the peripheral mean dose tended to drop more significantly. Therefore, extra activity implanted in the peripheral region during pre-plan can be considered. The detrimental effects of migration were more severe in terms of increasing the dose to normal structures, as rectum V50 may be 70% higher and urethra V100 may be 50% higher in the case of 6 mm migration. Quantitative knowledge of these effects is helpful in treatment planning and post-implant evaluation

  7. 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...

  8. 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.

  9. 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.

  10. 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

    Long-term safety data are important in the evaluation of possible adverse health outcomes related to silicone breast implants. The authors evaluated long-term symptoms and conditions and medication use among 190 Danish women with cosmetic silicone breast implants compared with 186 women who had u...

  11. Presence of Biofilms on Polyurethane-Coated Breast Implants: Preliminary Results.

    Science.gov (United States)

    Rieger, Ulrich M; Djedovic, Gabriel; Pattiss, Alexander; Raschke, Gregor F; Frei, Reno; Pierer, Gerhard; Trampuz, Andrej

    2016-01-01

    Polyurethane-coated breast implants seem to be associated with lower medium- and long-term capsular contracture rates in comparison to textured or smooth implant surfaces. Although the etiology of capsular contracture is uncertain, bacterial biofilms have been suggested to trigger chronic peri-implant inflammation, eventually leading to capsular contracture. It is unknown whether polyurethane-coated implants are less prone to biofilm colonization than other implant surfaces. We extracted data from patient records included in a prospective cohort between 2008 and 2011. All patients who underwent removal of polyurethane-coated implants were included in this current study and screened for presence of biofilms by sonication. In addition, implant- and patient-related data were analyzed. Of the ten included polyurethane-coated breast implants, six had been inserted for reconstructive purposes and four for aesthetic reasons. The median implant indwelling time was 28.3 mo. Overall, sonication cultures were positive in 50% of implants. Propionibacterium acnes and coagulase-negative staphylococci were the predominant pathogens isolated from biofilm cultures. Like other implant surfaces, polyurethane-coated implants are prone to biofilm colonization. Further investigations are needed to determine why capsular contracture rates seem to be lower in polyurethane implants than in other implant surfaces. Notably, in this study, 40% of the implants were explanted from breasts with severe capsular contracture.

  12. A magazine for the implantation of I-125 seeds in interstitial therapy of cerebral tumors

    International Nuclear Information System (INIS)

    Bockermann, V.; Dieckmann, G.; Lott, H.

    1988-01-01

    A compact magazine has been developed allowing a quick and easy implantation of I-125 seeds in interstitial therapy of intracranial tumors. The magazine is made of steel and has the shape of a right parallelepiped. One seed can be put each time into a movable insert. The magazine is connected to a normal application canula. It is easy to handle and contributes much to radioprotection. (orig.) [de

  13. Clinical efficacy of CT-guided 125I seed implantation therapy for advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Wang Zhongmin; Lu Jian; Gong Ju; Zheng Yunfeng; Zhang Liyun; Huang Gang; Chen Kemin

    2009-01-01

    Objective: To discuss the clinical efficacy of CT-guided radioactive 125 I seed implantation treatment for unresectable pancreatic cancer. Methods: Forty patients with inoperable pancreatic cancer were enrolled in this study, including 25 males and 15 females with an median age of 69 years (38-89 years). Treatment planning system (TPS) was used to reconstruct 3-dimensional images of pancreatic tumor and to define the quantity and distribution of 125 I seeds. The radioactivity of 125 I seeds was 0.5 - 0.8 mCi / seed. The seeds were implanted into pancreatic tumor under CT guidance at intervals of 1 cm and were kept away from vessels, pancreatic duct and other adjacent important organs. The tumor matched peripheral dose (MPD) was 60-140 Gy. The median amount of implanted 125 I seeds was 36 (18-68) in number. CT scan was performed immediately after the procedure to check the quality of the seeds. In addition, 10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluororacil (5-Fu) for 3 to 4 therapeutic courses. Results: The median diameter of the tumors was 4.9 cm. The follow-up period was 2 to 28 months. After the treatment the refractory pain was significantly relieved (P 125 I seed implantation is a safe, effective and minimally-invasive brachytherapy for unresectable pancreatic cancer with reliable short-term efficacy. It has an excellent anti-pain effect. The curative results can be further improved when chemotherapy is employed together. However, its long-term efficacy needs to be observed. (authors)

  14. The surgical viability and radiological monitoring of brain implants of bioactive micro-seeds in an animal model

    International Nuclear Information System (INIS)

    Silva, Giane X.O.; Campos, Tarcisio Passos Ribeiro de; Siqueira, Savio Lana; Maciel, Marcelo B.

    2005-01-01

    The interstitial implant is a therapeutic modality in brachytherapy of the head and neck. Presently, the seeds implanted in tumors in the central nervous system are metallic I-125. After the full emission of the radionuclide, the seed remains inert in the implanted area. Bioactive ceramic seeds have been prepared for this research group incorporating Sm-152 to be active in Sm-153. The main goal of the present study is the development of a the surgical technique for implanting the biodegradable radioactive micro-seeds in the brains of rabbits, as well as the observation of the clinical reactions of the animal after implantation of two sets of three seeds. The surgical procedure consisted of performing two separate perforations 10 mm from each other in the skull, permitting the implantation of two groups of three seeds, totaling six seeds. The results of the pilot study showed the effectiveness of the surgical procedure and of the biocompatibility of the seeds and the lack of presence of adverse reactions, functional sequels, or inflammation in a follow up 50 days post-surgery. Such seeds of reduced volume, 0.2 x 1.6 mm, could be monitored by computerized tomography 30 days after implanting. (author)

  15. Breast Implant-Associated Anaplastic Large Cell Lymphoma: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Eva Berlin

    2018-01-01

    Full Text Available We are reporting the case of a 58-year-old woman with history of bilateral silicone breast implants for cosmetic augmentation. At 2-year interval from receiving the breast implants, she presented with swelling of the right breast with associated chest wall mass, effusion around the implant, and axillary lymphadenopathy. Pathology confirmed breast implant-associated anaplastic large cell lymphoma (stage III, T4N2M0, using BIA-ALCL TNM staging and stage IIAE, using Ann-Arbor staging. The patient underwent bilateral capsulectomy and right partial mastectomy with excision of the right breast mass and received adjuvant CHOP chemotherapy and radiation to the right breast and regional nodes. Since completion of multimodality therapy, the patient has sustained remission on both clinical exam and PET/CT scan. We report this case and review of the literature on this rare form of lymphoma.

  16. Breast Implant-Associated Anaplastic Large Cell Lymphoma: Case Report and Review of the Literature.

    Science.gov (United States)

    Berlin, Eva; Singh, Kunwar; Mills, Christopher; Shapira, Ilan; Bakst, Richard L; Chadha, Manjeet

    2018-01-01

    We are reporting the case of a 58-year-old woman with history of bilateral silicone breast implants for cosmetic augmentation. At 2-year interval from receiving the breast implants, she presented with swelling of the right breast with associated chest wall mass, effusion around the implant, and axillary lymphadenopathy. Pathology confirmed breast implant-associated anaplastic large cell lymphoma (stage III, T4N2M0, using BIA-ALCL TNM staging and stage IIAE, using Ann-Arbor staging). The patient underwent bilateral capsulectomy and right partial mastectomy with excision of the right breast mass and received adjuvant CHOP chemotherapy and radiation to the right breast and regional nodes. Since completion of multimodality therapy, the patient has sustained remission on both clinical exam and PET/CT scan. We report this case and review of the literature on this rare form of lymphoma.

  17. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma.

    Science.gov (United States)

    Hu, Honghua; Johani, Khalid; Almatroudi, Ahmad; Vickery, Karen; Van Natta, Bruce; Kadin, Marshall E; Brody, Garry; Clemens, Mark; Cheah, Chan Yoon; Lade, Stephen; Joshi, Preeti Avinash; Prince, H Miles; Deva, Anand K

    2016-06-01

    A recent association between breast implants and the development of anaplastic large-cell lymphoma (ALCL) has been observed. The purpose of this study was to identify whether bacterial biofilm is present in breast implant-associated ALCL and, if so, to compare the bacterial microbiome to nontumor capsule samples from breast implants with contracture. Twenty-six breast implant-associated ALCL samples were analyzed for the presence of biofilm by real-time quantitative polymerase chain reaction, next-generation sequencing, fluorescent in situ hybridization, and scanning electron microscopy, and compared to 62 nontumor capsule specimens. Both the breast implant-associated ALCL and nontumor capsule samples yielded high mean numbers of bacteria (breast implant-associated ALCL, 4.7 × 10 cells/mg of tissue; capsule, 4.9 × 10 cells/mg of tissue). Analysis of the microbiome in breast implant-associated ALCL specimens showed significant differences with species identified in nontumor capsule specimens. There was a significantly greater proportion of Ralstonia spp. present in ALCL specimens compared with nontumor capsule specimens (p capsule specimens compared with breast implant-associated ALCL specimens (p < 0.001). Bacterial biofilm was visualized both on scanning electron microscopy and fluorescent in situ hybridization. This novel finding of bacterial biofilm and a distinct microbiome in breast implant-associated ALCL samples points to a possible infectious contributing cause. Breast implants are widely used in both reconstructive and aesthetic surgery, and strategies to reduce their contamination should be more widely studied and practiced. Risk, V.

  18. Breast cancer in a patient with silicone breast implants after 13 years.

    Science.gov (United States)

    Bingham, H G; Copeland, E M; Hackett, R; Caffee, H H

    1988-03-01

    The patient described in this article is a 45-year-old woman who developed an infiltrating ductal carcinoma in her left breast next to a Silastic mammary implant that had been used for augmentation some 13 years previously. She underwent a modified radical mastectomy and removal of the silicone prosthesis with an axillary lymph node dissection. Twenty-six axillary lymph nodes were negative for metastatic disease. The 165-gram silicone gel prosthesis was surrounded by a thin fibrous capsule with an attached 1-cm carcinoma that did not invade the fibrous capsule. It appeared that the capsule presented a barrier to the invading ductal carcinoma. The fibrous capsule surrounding the Silastic implant may have altered the spread of the breast cancer without being related to its genesis.

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

    Science.gov (United States)

    Lindenblatt, Nicole; El-Rabadi, Karem; Helbich, Thomas H; Czembirek, Heinrich; Deutinger, Maria; Benditte-Klepetko, Heike

    2014-01-01

    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. 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. 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. Our results show that rupture of only the inner layers of the implant shell with integrity of the outer shell leads to a misdiagnosis on MRI. Correlation with clinical symptoms and the specific wishes of the patient should guide the indication for implant removal.

  20. Intraoperative ultrasound quided iodine-125 seed implantation for unresectable pancreatic carcinoma

    International Nuclear Information System (INIS)

    Wang Junjie; Liu Jiangping; Jiang Yuliang; Jiang Weijuan; Li Jinna; Xiu Dianrong; Ran Weiqiang

    2007-01-01

    Objective: To investigate the surgical technique, efficacy and side effects of intraoperative ultrasound quided 125 I seed interstitial implantation for pancreatic carcinoma. Methods: Twenty-seven patients with biopsy proven unresectable adenocarcinoma of pancreas were treated with 125 I implants during laparotomy. Eleven patients were treated by a combination of bypass surgery. Seed needles were implanted parallel to each other, at 1.0-1.5 cm apart and guided by ultrasound. Mick applicator was applied to each needle to implant seed at 1.0-1.5 cm apart. The radioactive activity ranged 0.40-0.70 mCi; the D 90 were 110-160 Gy. The mean number of 125 I seed were 11-78. Six patients also received external beam radiation at doses of 39-50 Gy. Five patients received 2-4 cycle DDP + gemCitabine chemotherapy also. Results: The incidence of perioperative mortality was 0%. Pain was complete relieved in 15 patients, partial relieved in two, but in the rest three patients there was no response. The response rate was 85%. The starting time of pain relief was 1-30 d, with a median of 5 days. The overall local control rate was 74%. Four patients have died of recurrence, 20 patients died of metastasis, 3 patients died of recurrence and metastasis. The median survival of II + III[ stage patients was 8 months, with a 1- and 2-year survival of 25% and 15%, respectively. The median survival time of IV stage patients was 5 months, with 1-year survival of 8%. The seeds immigrated into the liver in 3 patients. There are no serious side effects such as infection or pancreatic fistula. Conclusions: Intraoperative ultrasound quided 125 I seed implantation is safe, giving high local control, but minimal damage. It is a satisfactorily palliative for pain and causing little noticeable complications. (authors)

  1. The relationship of silicone breast implants and cancer at other sites.

    Science.gov (United States)

    Brinton, Louise A

    2007-12-01

    Although most attention regarding the effects of silicone breast implants on cancer risk has focused on breast cancer, there have also been concerns regarding effects on other cancers. This includes malignancies that could occur as a result of foreign-body carcinogenesis (sarcomas) or immune alterations (hematopoietic malignancies), or cancers suggested as possibly elevated on the basis of previous epidemiologic studies (cancers of the cervix, vulva, lung, and brain). Searches of the English language literature on the topic of silicone breast implants and cancer risk were conducted and reviewed to determine relationships that might have etiologic relevance. Epidemiologic studies provide no support for an increased risk of either sarcoma or multiple myeloma among breast implant recipients, disputing clinical and laboratory findings suggesting such a link. Although a number of epidemiologic studies have demonstrated elevated risks of cervical, vulvar, and lung cancers among breast implant patients, it is likely that these excesses relate more to lifestyle characteristics (e.g., cigarette smoking, sexual behavior) than to the effects of the implants. Brain cancer excesses, suggested in one study, have not been confirmed in either an update of the mortality experience in this study or on the basis of other investigations. At present, there is no convincing evidence that breast implants alter the risk of nonbreast malignancies. Breast implant patients should continue to be monitored for longer term risks and to assess whether cancer risk is influenced by various patient and implant characteristics.

  2. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    International Nuclear Information System (INIS)

    Xu Gang; Wang Xiaoteng; Gan Cailing; Fang Yanqiong; Zhang Meng

    2012-01-01

    Highlights: ► We analyzed biological effects of N + implantation on dry Jatropha curcas seed. ► N + implantation greatly decreased seedling survival rate. ► At doses beyond 15 × 10 16 ion cm −2 , biological repair took place. ► CAT was essential for H 2 O 2 removal. POD mainly functioned as seed was severely hurt. ► HAsA–GSH cycle mainly contributed to the regeneration of HAsA. - Abstract: To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N + with energy of 25 keV was applied to treat the dry seed at six different doses. N + beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 × 10 16 to 15 × 10 16 ions cm −2 severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 × 10 16 ion cm −2 , biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 × 10 16 ions cm −2 may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA–GSH cycle appeared to be for regeneration of HAsA.

  3. Effect of permanent 103Pd radioactive seed implantation on brachytherapy of malignant tumor

    International Nuclear Information System (INIS)

    Chen Ping; Wei Xianzhong; Liu Yanmin; Wu Kaijun; Liang Jianxin; Chen Hanzhang

    2003-01-01

    Objective: To investigate and assess the brachytherapeutic effectiveness of 103 Pd radioactive seeds in malignant tumor therapy. Methods: 196.1-2127.5 MBq 103 Pd seeds were implanted in 21 confirmed malignant tumor patients. The seeds were evenly scattered in 15/21 patients' tumors and peripherally in the remaining 6 cases' tumors. The size and shape, local recurrence and remote metastasis of the tumors were observed. Results: The brachytherapy of 103 Pd seeds in tumor patients resulted in obvious efficacy. No local recurrence and remote metastasis were observed. 19/21 (90.5%) patients scored 0 and 2/21 (9.5%) of them scored 1 in skin acute radiation morbidity scoring criteria within the observation period. Conclusion: The 103 Pd seeds can be safely used in brachytherapy of malignant tumors with lower or medium sensitivity to radiation therapy

  4. Breast implant capsule-associated squamous cell carcinoma: a report of 2 cases.

    Science.gov (United States)

    Olsen, Daniel L; Keeney, Gary L; Chen, Beiyun; Visscher, Daniel W; Carter, Jodi M

    2017-09-01

    The use of prosthetic implants for breast augmentation has become commonplace. Although implants do not increase the risk of conventional mammary carcinoma, they are rarely associated with anaplastic large cell lymphoma. We report 2 cases of breast implant capsule-associated squamous cell carcinoma with poor clinical outcomes. Both patients (56-year-old woman and 81-year-old woman) had long-standing implants (>25 years) and presented with acute unilateral breast enlargement. In both cases, squamous cell carcinoma arose in (focally dysplastic) squamous epithelium-lined breast implant capsules and widely invaded surrounding breast parenchyma or chest wall. Neither patient had evidence of a primary mammary carcinoma or squamous cell carcinoma at any other anatomic site. Within 1 year, one patient developed extensive, treatment-refractory, locoregional soft tissue metastasis, and the second patient developed hepatic and soft tissue metastases and died of disease. There are 2 prior reported cases of implant-associated squamous cell carcinoma in the plastic surgery literature; one provides no pathologic staging or outcome information, and the second case was a capsule-confined squamous cell carcinoma. Together, all 4 cases share notable commonalities: the patients had long-standing breast implants and presented with acute unilateral breast pain and enlargement secondary to tumors arising on the posterior aspect of squamous epithelialized implant capsules. Because of both its rarity and its unusual clinical presentation, implant capsule-associated squamous cell carcinoma may be underrecognized. The aggressive behavior of the tumors in this series underscores the importance of excluding malignancy in patients with long-standing breast implants who present with acute unilateral breast pain and enlargement. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The effect of silicone implants on the diagnosis, prognosis, and treatment of breast cancer.

    Science.gov (United States)

    Handel, Neal

    2007-12-01

    Because of the prevalence of breast cancer, many augmented women eventually will develop the disease. This article reviews what is known about the effect of implants on the detection, prognosis, and treatment of carcinoma of the breast. Observations were made on 4082 breast cancer patients (3953 nonaugmented and 129 augmented) treated over a 23-year time span. Findings in the two groups were compared and differences analyzed statistically. Mammograms of all women with palpable lesions were reviewed to assess mammographic sensitivity in patients with and without implants. Cosmetic outcomes in augmented patients treated with breast conservation therapy were reviewed. Augmented patients presented more frequently with palpable lesions, invasive tumors, axillary nodal metastases, and false-negative mammograms. However, there was no significant difference in stage of disease, tumor size, recurrence rates, or survival between the two groups. Augmented patients treated with breast conservation therapy often experienced poor cosmetic results and frequently required reoperation. Despite the diminished sensitivity of mammography in women with implants, augmented and nonaugmented patients are diagnosed at a similar stage of disease and have a comparable prognosis. Implants may impair mammography but appear to facilitate tumor detection on physical examination. Magnetic resonance imaging and breast ultrasound may be useful adjuncts, but conventional mammography remains the most reliable tool for diagnosing early breast cancer in augmented patients. Breast implants do not interfere with mastectomy or breast reconstruction but may compromise the outcome of breast conservation therapy.

  6. Quality control of system of imaging for rectal ultrasound for implants seed prostate low rate

    International Nuclear Information System (INIS)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-01-01

    In this work, the objective is the evaluation of the image system used in implants of prostate of low rate held at our hospital, for maximum control on the placement of the seeds in the patient and therefore carried out dosimetry. (Author)

  7. Is Salvage of Recently Infected Breast Implant After Breast Augmentation or Reconstruction Possible? An Experimental Study.

    Science.gov (United States)

    Castus, P; Heymans, O; Melin, P; Renwart, L; Henrist, C; Hayton, E; Mordon, S; Leclère, F M

    2018-04-01

    The reinsertion of an infected implant when peri-prosthetic infection occurs early after breast augmentation or breast reconstruction remains controversial. In this experimental study, the authors tried to remove bacteria, and their biofilm, from the colonized surface of breast prostheses, without damaging their integrity. A total of 112 shell samples of silicone breast prostheses, smooth (SPSS) and textured (TPSS), were colonized by S. epidermidis (SE) or S. aureus (SA) strains, all able to produce biofilms. After 15 days, all the samples were removed from the contaminated culture broth and constituted 4 groups of 20 contaminated samples: SPSS/SE (group I), SPSS/SA (group II), TPSS/SE (group III), TPSS/SE (group IV). In another group-group SEM-, 16 colonized samples were used for documentation with scanning electron microscopy (SEM). The remaining 16 samples were used to test the limits of detection of the sterility test. All samples of groups I-IV and 8 samples of group SEM were « washed » with a smooth brush in a povidone-iodine bath and rinsed with saline solution. A subset of the washed samples was sent for SEM and the others were immersed in sterile broth and were incubated at 35 °C for 3 weeks (groups I-IV). Fifteen days after contamination, all the samples in groups I-IV were colonized. In the SEM group, SEM images attested to the presence of bacteria in biofilm attached to the shells. After cleaning, SEM did not reveal any bacteria and there was no visible alteration in the outer structure of the shell. Sterility tests performed after decontamination in groups I-IV remained negative for all the samples. Breast prostheses recently contaminated with Staphylococci, frequently involved in peri-prosthetic breast implant infection and capable of producing biofilms, can be efficiently decontaminated by the procedure used in this study. Our decontamination procedure did not alter the surface structure of the prostheses. This decontamination procedure

  8. CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Yu L; Meng, Na; Wang, Jun J; Jiang, Ping [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China); Yuan, Hui SH; Liu, Chen [Department of Radiology, Peking University Third Hospital, Beijing, 100191 (China); Qu, Ang; Yang, Rui J [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China)

    2010-07-30

    To investigate the feasibility, and safety of {sup 125}I seed permanent implantation for recurrent head and neck carcinoma under CT-guidance. A retrospective study on 14 patients with recurrent head and neck cancers undergone {sup 125}I seed implantation with different seed activities. The post-plan showed that the actuarial D90 of {sup 125}I seeds ranged from 90 to 218 Gy (median, 157.5 Gy). The follow-up was 3 to 60 months (median, 13 months). The median local control was 18 months (95% CI, 6.1-29.9 months), and the 1-, 2-, 3-, and 5- year local controls were 52%, 39%, 39%, and 39%, respectively. The 1-, 2-, 3-, and 5- survival rates were 65%, 39%, 39% and 39%, respectively, with a median survival time of 20 months (95% CI, 8.7-31.3 months). Of all patients, 28.6% (4/14) died of local recurrence, 7.1% (1/14) died of metastases, one patient died of hepatocirrhosis, and 8 patients are still alive to the date of data analysis. CT-guided {sup 125}I seed implantation is feasible and safe as a salvage or palliative treatment for patients with recurrent head and neck cancers.

  9. Biologically effective dose (BED) for interstitial seed implants containing a mixture of radionuclides with different half-lives

    International Nuclear Information System (INIS)

    Chen Zhe; Nath, Ravinder

    2003-01-01

    Purpose: To develop a tool for evaluating interstitial seed implants that contain a mixture of radionuclides with different half-lives and to demonstrate its utility by examining the clinical implications of prescribing to an isodose surface for such an implant. Methods and Materials: A linear-quadratic model for continuous low dose rate irradiation was developed for permanent implants containing a mixture of radionuclides. Using a generalized equation for the biologically effective dose (BED), the effects of cell proliferation and sublethal damage repair were examined systematically for implants containing a mixture of radionuclides. A head-and-neck permanent seed implant that contained a mixture of 125 I and 103 Pd seeds was used to demonstrate the utility of the generalized BED. Results: An equation of BED for implants containing a mixture of radionuclides with different half-lives was obtained. In such an implant, the effective cell kill was shown to depend strongly on the relative dose contributions from each radionuclide type; dose delivered by radionuclides with shorter half-life always resulted in more cell kill for any given sublethal damage repair and cell proliferation rates. Application of the BED formula to an implant containing a mixture of 125 I and 103 Pd seeds demonstrates that the conventional dose prescription to an isodose surface is not unique for such an implant. When the prescription dose was based on existing clinical experience of using 125 I seeds alone, mixing 103 Pd seeds with 125 I seeds would increase the cell kill. On the other hand, if the prescription dose were based on existing clinical experience of using 103 Pd seeds alone, mixing 125 I seeds with 103 Pd seeds in the same implant would create radiobiologically 'cold' spots (i.e., an increase in cell survival) at locations where a major portion of the prescription dose is contributed by the 125 I seeds. For fast-growing tumors, these 'cold' spots can become significant

  10. Permanent interstitial implantation of 125Iodine seed for thoracic malignant tumors

    International Nuclear Information System (INIS)

    Xu Zhongheng; Qian Yongyue; Wu Jinchang; Liu Zengli

    2002-01-01

    Objective: To observe effect of 125 Iodine sed on interstitial brachytherapy of patient with thoracic malignant tumor. Methods: 125 Iodine seed were inserted into the target tissue and permanent left there for brachytherapy in 6 cases of thoracic malignant tumors, which including lung cancer, Pancoast's tumour, mediastinal malignant schwannoma. Results: All cases were rehabilitated shortly after operation. The implanted lesions remained controlled now and in dead patients. No radiation-related and 125 Iodine seed-related complications occurred. Conclusion: Brachytherapy by implantation of 125 Iodine seeds of remained tumor tissue in patients with thoracic malignant tumor after operation has a satisfactory outcome. This therapy can control local recurrent of thoracic malignant tumor. But the results in long term should be studied further

  11. Intra-prosthetic breast MR virtual navigation: a preliminary study for a new evaluation of silicone breast implants.

    Science.gov (United States)

    Moschetta, Marco; Telegrafo, Michele; Capuano, Giulia; Rella, Leonarda; Scardapane, Arnaldo; Angelelli, Giuseppe; Stabile Ianora, Amato Antonio

    2013-10-01

    To assess the contribute of intra-prosthetic MRI virtual navigation for evaluating breast implants and detecting implant ruptures. Forty-five breast implants were evaluated by MR examination. Only patients with a clinical indication were assessed. A 1.5-T device equipped with a 4-channel breast coil was used by performing axial TSE-T2, axial silicone-only, axial silicone suppression and sagittal STIR images. The obtained dicom files were also analyzed by using virtual navigation software. Two blinded radiologists evaluated all MR and virtual images. Eight patients for a total of 13 implants underwent surgical replacement. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for both imaging strategies. Intra-capsular rupture was diagnosed in 13 out of 45 (29%) implants by using MRI. Basing on virtual navigation, 9 (20%) cases of intra-capsular rupture were diagnosed. Sensitivity, specificity, accuracy, PPV and NPV values of 100%, 86%, 89%, 62% and 100%, respectively, were found for MRI. Virtual navigation increased the previous values up to 100%, 97%, 98%, 89% and 100%. Intra-prosthetic breast MR virtual navigation can represent an additional promising tool for the evaluation of breast implants being able to reduce false positives and to provide a more accurate detection of intra-capsular implant rupture signs. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. A greedy heuristic using adjoint functions for the optimization of seed and needle configurations in prostate seed implant

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Sua [Department of Radiation Oncology, Duke University Medical Center, Box 3295, Durham, NC 27710 (United States); Kowalok, Michael E [Department of Radiation Oncology, Virginia Commonwealth University Health System, 401 College St., PO Box 980058, Richmond, VA 23298-0058 (United States); Thomadsen, Bruce R [Department of Medical Physics, University of Wisconsin-Madison, 1530 MSC, 1300 University Ave., Madison, WI 53706 (United States); Henderson, Douglass L [Department of Engineering Physics, University of Wisconsin-Madison, 153 Engineering Research Bldg., 1500 Engineering Dr., Madison, WI 53706 (United States)

    2007-02-07

    We continue our work on the development of an efficient treatment-planning algorithm for prostate seed implants by incorporation of an automated seed and needle configuration routine. The treatment-planning algorithm is based on region of interest (ROI) adjoint functions and a greedy heuristic. As defined in this work, the adjoint function of an ROI is the sensitivity of the average dose in the ROI to a unit-strength brachytherapy source at any seed position. The greedy heuristic uses a ratio of target and critical structure adjoint functions to rank seed positions according to their ability to irradiate the target ROI while sparing critical structure ROIs. Because seed positions are ranked in advance and because the greedy heuristic does not modify previously selected seed positions, the greedy heuristic constructs a complete seed configuration quickly. Isodose surface constraints determine the search space and the needle constraint limits the number of needles. This study additionally includes a methodology that scans possible combinations of these constraint values automatically. This automated selection scheme saves the user the effort of manually searching constraint values. With this method, clinically acceptable treatment plans are obtained in less than 2 min. For comparison, the branch-and-bound method used to solve a mixed integer-programming model took close to 2.5 h to arrive at a feasible solution. Both methods achieved good treatment plans, but the speedup provided by the greedy heuristic was a factor of approximately 100. This attribute makes this algorithm suitable for intra-operative real-time treatment planning.

  13. A greedy heuristic using adjoint functions for the optimization of seed and needle configurations in prostate seed implant

    International Nuclear Information System (INIS)

    Yoo, Sua; Kowalok, Michael E; Thomadsen, Bruce R; Henderson, Douglass L

    2007-01-01

    We continue our work on the development of an efficient treatment-planning algorithm for prostate seed implants by incorporation of an automated seed and needle configuration routine. The treatment-planning algorithm is based on region of interest (ROI) adjoint functions and a greedy heuristic. As defined in this work, the adjoint function of an ROI is the sensitivity of the average dose in the ROI to a unit-strength brachytherapy source at any seed position. The greedy heuristic uses a ratio of target and critical structure adjoint functions to rank seed positions according to their ability to irradiate the target ROI while sparing critical structure ROIs. Because seed positions are ranked in advance and because the greedy heuristic does not modify previously selected seed positions, the greedy heuristic constructs a complete seed configuration quickly. Isodose surface constraints determine the search space and the needle constraint limits the number of needles. This study additionally includes a methodology that scans possible combinations of these constraint values automatically. This automated selection scheme saves the user the effort of manually searching constraint values. With this method, clinically acceptable treatment plans are obtained in less than 2 min. For comparison, the branch-and-bound method used to solve a mixed integer-programming model took close to 2.5 h to arrive at a feasible solution. Both methods achieved good treatment plans, but the speedup provided by the greedy heuristic was a factor of approximately 100. This attribute makes this algorithm suitable for intra-operative real-time treatment planning

  14. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results

    International Nuclear Information System (INIS)

    Genebes, Caroline; Filleron, Thomas; Graff, Pierre; Jonca, Frédéric; Huyghe, Eric; Thoulouzan, Matthieu; Soulie, Michel; Malavaud, Bernard; Aziza, Richard; Brun, Thomas; Delannes, Martine; Bachaud, Jean-Marc

    2013-01-01

    Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3 urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes

  15. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Genebes, Caroline, E-mail: genebes.caroline@claudiusregaud.fr [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Filleron, Thomas; Graff, Pierre [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Jonca, Frédéric [Department of Urology, Clinique Ambroise Paré, Toulouse (France); Huyghe, Eric; Thoulouzan, Matthieu; Soulie, Michel; Malavaud, Bernard [Department of Urology and Andrology, CHU Rangueil, Toulouse (France); Aziza, Richard; Brun, Thomas; Delannes, Martine; Bachaud, Jean-Marc [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France)

    2013-11-15

    Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3 urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes.

  16. Prostate brachytherapy postimplant dosimetry: Seed orientation and the impact of dosimetric anisotropy in stranded implants

    International Nuclear Information System (INIS)

    Chng, Nicholas; Spadinger, Ingrid; Rasoda, Rosey; Morris, W. James; Salcudean, Septimiu

    2012-01-01

    Purpose: In postimplant dosimetry for prostate brachytherapy, dose is commonly calculated using the TG-43 1D formalism, because seed orientations are difficult to determine from CT images, the current standard for the procedure. However, the orientation of stranded seeds soon after implantation is predictable, as these seeds tend to maintain their relative spacing, and orient themselves along the implant trajectory. The aim of this study was to develop a method for determining seed orientations from reconstructed strand trajectories, and to use this information to investigate the dosimetric impact of applying the TG-43 2D formalism to clinical postimplant analysis. Methods: Using in-house software, the preplan to postimplant seed correspondence was determined for a cohort of 30 patients during routine day-0 CT-based postimplant dosimetry. All patients were implanted with stranded-seed trains. Spline curves were fit to each set of seeds composing a strand, with the requirement that the distance along the spline between seeds be equal to the seed spacing within the strand. The orientations of the seeds were estimated by the tangents to the spline at each seed centroid. Dose distributions were then determined using the 1D and 2D TG-43 formalisms. These were compared using the TG-137 recommended dose metrics for the prostate, prostatic urethra, and rectum. Results: Seven hundred and sixty one strands were analyzed in total. Defining the z-axis to be cranial-positive and the x-axis to be left-lateral positive in the CT coordinate system, the average seed had an inclination of 21 deg. ± 10 deg. and an azimuth of -81 deg. ± 57 deg. These values correspond to the average strand rising anteriorly from apex to base, approximately parallel to the midsagittal plane. Clinically minor but statistically significant differences in dose metrics were noted. Compared to the 2D calculation, the 1D calculation underestimated prostate V100 by 1.1% and D90 by 2.3 Gy, while

  17. Dosimetric effects of edema in permanent prostate seed implants: a rigorous solution

    International Nuclear Information System (INIS)

    Chen Zhe; Yue Ning; Wang Xiaohong; Roberts, Kenneth B.; Peschel, Richard; Nath, Ravinder

    2000-01-01

    Purpose: To derive a rigorous analytic solution to the dosimetric effects of prostate edema so that its impact on the conventional pre-implant and post-implant dosimetry can be studied for any given radioactive isotope and edema characteristics. Methods and Materials: The edema characteristics observed by Waterman et al (Int. J. Rad. Onc. Biol. Phys, 41:1069-1077; 1998) was used to model the time evolution of the prostate and the seed locations. The total dose to any part of prostate tissue from a seed implant was calculated analytically by parameterizing the dose fall-off from a radioactive seed as a single inverse power function of distance, with proper account of the edema-induced time evolution. The dosimetric impact of prostate edema was determined by comparing the dose calculated with full consideration of prostate edema to that calculated with the conventional dosimetry approach where the seed locations and the target volume are assumed to be stationary. Results: A rigorous analytic solution on the relative dosimetric effects of prostate edema was obtained. This solution proved explicitly that the relative dosimetric effects of edema, as found in the previous numerical studies by Yue et. al. (Int. J. Radiat. Oncol. Biol. Phys. 43, 447-454, 1999), are independent of the size and the shape of the implant target volume and are independent of the number and the locations of the seeds implanted. It also showed that the magnitude of relative dosimetric effects is independent of the location of dose evaluation point within the edematous target volume. It implies that the relative dosimetric effects of prostate edema are universal with respect to a given isotope and edema characteristic. A set of master tables for the relative dosimetric effects of edema were obtained for a wide range of edema characteristics for both 125 I and 103 Pd prostate seed implants. Conclusions: A rigorous analytic solution of the relative dosimetric effects of prostate edema has been

  18. Single- and double- lumen silicone breast implant integrity: prospective evaluation of MR and US criteria.

    Science.gov (United States)

    Berg, W A; Caskey, C I; Hamper, U M; Kuhlman, J E; Anderson, N D; Chang, B W; Sheth, S; Zerhouni, E A

    1995-10-01

    To evaluate the accuracy of magnetic resonance (MR) and ultrasound (US) criteria for breast implant integrity. One hundred twenty-two single-lumen silicone breast implants and 22 bilumen implants were evaluated with surface coil MR imaging and US and surgically removed. MR criteria for implant failure were a collapsed implant shell ("linguine sign"), foci of silicone outside the shell ("noose sign"), and extracapsular gel, US criteria were collapsed shell, low-level echoes within the gel, and "snowstorm" echoes of extracapsular silicone. Among single-lumen implants, MR imaging depicted 39 of 40 ruptures, 14 of 28 with minimal leakage; 49 of 54 intact implants were correctly interpreted. US depicted 26 of 40 ruptured implants, four of 28 with minimal leakage, and 30 of 54 intact implants. Among bilumen implants, MR imaging depicted four of five implants with rupture of both lumina and nine of 10 as intact; US depicted one rupture and helped identify two of 10 as intact. Mammography accurately depicted the status of 29 of 30 bilumen implants with MR imaging correlation. MR imaging depicts implant integrity more accurately than US; neither method reliably depicts minimal leakage with shell collapse. Mammography is useful in screening bilumen implant integrity.

  19. Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature.

    Science.gov (United States)

    Gardani, Marco; Bertozzi, Nicolò; Grieco, Michele Pio; Pesce, Marianna; Simonacci, Francesco; Santi, PierLuigi; Raposio, Edoardo

    2017-09-01

    One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of "the ideal breast size", although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article.

  20. ALK-1-negative anaplastic large cell lymphoma associated with breast implants: a new clinical entity.

    Science.gov (United States)

    Lazzeri, Davide; Agostini, Tommaso; Bocci, Guido; Giannotti, Giordano; Fanelli, Giovanni; Naccarato, Antonio Giuseppe; Danesi, Romano; Tuccori, Marco; Pantaloni, Marcello; D'Aniello, Carlo

    2011-10-01

    Concerns have been raised recently regarding the increasing number of reports of non-Hodgkin lymphoma (NHL) that developed in close proximity to silicone or saline breast implants. In particular, an increased risk of anaplastic large cell lymphoma (ALCL) in patients with breast prostheses has been proposed. We reviewed clinical and pathologic findings in 40 women who received a diagnosis of breast NHL arising in association with breast implants and of 27 patients who had a diagnosis of ALCL with breast involvement reported in the published literature. Among the 40 reported cases of prosthesis-associated breast lymphomas, 28 were anaplastic lymphoma kinase-1-negative (ALK-1(-)) ALCLs, whereas of 27 ALCLs in patients without implants found in the literature, only 10 were ALK-1(-). The finding of 28 cases of breast ALK-1(-) ALCL occurring in patients with implants compared with 10 cases in women without implants is in favor of an association between silicone breast prostheses and ALK-1(-) ALCL. Although the incidence of this type of lymphoma remains remarkably low given that breast prostheses have been widely used for decades, clinical and pathologic evidence for a causative role is becoming dramatically strong. The histologic, phenomenologic, and clinical similarities of the majority of implant-related ALK-1(-) ALCLs suggest a common mechanism, especially when compared with the counterpart of patients without implants in which very few and highly dishomogeneous cases of the same malignancy were detected. There is convincing evidence that primary implant-related ALK-1(-) ALCL represents a distinct clinicopathologic entity that has been inappropriately fitted into the category of systemic ALK-1(-) ALCL. Thus it should be recognized as a separate category and classified on its own. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Patient satisfaction with postmastectomy breast reconstruction: a comparison of saline and silicone implants.

    Science.gov (United States)

    McCarthy, Colleen M; Klassen, Anne F; Cano, Stefan J; Scott, Amie; Vanlaeken, Nancy; Lennox, Peter A; Alderman, Amy K; Mehrara, Babak J; Disa, Joseph J; Cordeiro, Peter G; Pusic, Andrea L

    2010-12-15

    At a time when the safety and effectiveness of breast implants remains under close scrutiny, it is important to provide reliable and valid evidence regarding patient outcomes. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life may be the most significant outcome variables when evaluating surgical success. The objective of the current study was to identify predictors of patient satisfaction with breast appearance, including implant type, in a large sample of women who underwent breast reconstruction surgery using implants. A multicenter, cross-sectional study design was used. A total of 672 women who had completed postmastectomy, implant-based reconstruction at 1 of 3 centers in North America were asked to complete the BREAST-Q (Reconstruction Module). Multivariate linear regression modeling was performed. Completed questionnaire data were available for 482 of the 672 patients. In 176 women, silicone implants were placed and in 306, saline implants were used. The multivariate model confirmed that patients' satisfaction with their breasts was significantly higher in patients with silicone implants (P = .016). The receipt of postmastectomy radiotherapy was found to have a significant, negative effect on breast satisfaction (Pimplant recipients. In addition, for women who received either silicone or saline implants, satisfaction diminished over time (P = .017). In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher satisfaction with the results of reconstruction than those who received saline implants. This information can be used to optimize shared medical decision-making by providing patients with realistic postoperative expectations. Copyright © 2010 American Cancer Society.

  2. A comparison in cosmetic outcome between per-operative interstitial breast implants and delayed interstitial breast implants after external beam radiotherapy

    International Nuclear Information System (INIS)

    Pieters, Bradley R.; Hart, Augustinus A.M.; Russell, Nicola S.; Jansen, Edwin P.M.; Peterse, Johannes L.; Borger, Jacques; Rutgers, Emiel J.Th.

    2003-01-01

    Background and purpose: Interstitial implants for brachytherapy boost in the breast conserving therapy of breast cancer can be performed in two ways; implants during the tumor excision (per-operative implants) or after the external beam therapy (delayed interstitial implants). Differences in cosmetic outcome were investigated. Patients and methods: Cosmetic results in 47 patients having a per-operative implant were compared to 123 patients having a delayed interstitial implant in a matched case-control study. Cosmesis was scored on a four-point-scale varying from 0 (excellent) to 3 (poor). Results: After mean follow-up of 63 months, three observers found no difference in cosmetic outcome between the two groups after adjustment for variables found to be related with cosmesis (difference in mean score 0.50, P=0.26). Implant volume at 100% isodose was not found to differ (P=0.084) between the per-operative group (mean 102 cm 3 , S.D. 34 cm 3 ) and the delayed group (mean 93 cm 3 , S.D. 29 cm 3 ). Conclusions: Performing per-operative implants has not led to smaller implants. The method of performing brachytherapy does not result in marked differences in cosmetic outcome

  3. SU-E-T-123: Anomalous Altitude Effect in Permanent Implant Brachytherapy Seeds

    International Nuclear Information System (INIS)

    Watt, E; Spencer, DP; Meyer, T

    2015-01-01

    Purpose: Permanent seed implant brachytherapy procedures require the measurement of the air kerma strength of seeds prior to implant. This is typically accomplished using a well-type ionization chamber. Previous measurements (Griffin et al., 2005; Bohm et al., 2005) of several low-energy seeds using the air-communicating HDR 1000 Plus chamber have demonstrated that the standard temperature-pressure correction factor, P TP , may overcompensate for air density changes induced by altitude variations by up to 18%. The purpose of this work is to present empirical correction factors for two clinically-used seeds (IsoAid ADVANTAGE™ 103 Pd and Nucletron selectSeed 125 I) for which empirical altitude correction factors do not yet exist in the literature when measured with the HDR 1000 Plus chamber. Methods: An in-house constructed pressure vessel containing the HDR 1000 Plus well chamber and a digital barometer/thermometer was pumped or evacuated, as appropriate, to a variety of pressures from 725 to 1075 mbar. Current measurements, corrected with P TP , were acquired for each seed at these pressures and normalized to the reading at ‘standard’ pressure (1013.25 mbar). Results: Measurements in this study have shown that utilization of P TP can overcompensate in the corrected current reading by up to 20% and 17% for the IsoAid Pd-103 and the Nucletron I-125 seed respectively. Compared to literature correction factors for other seed models, the correction factors in this study diverge by up to 2.6% and 3.0% for iodine (with silver) and palladium respectively, indicating the need for seed-specific factors. Conclusion: The use of seed specific altitude correction factors can reduce uncertainty in the determination of air kerma strength. The empirical correction factors determined in this work can be applied in clinical quality assurance measurements of air kerma strength for two previously unpublished seed designs (IsoAid ADVANTAGE™ 103 Pd and Nucletron selectSeed 125 I

  4. SU-E-T-123: Anomalous Altitude Effect in Permanent Implant Brachytherapy Seeds

    Energy Technology Data Exchange (ETDEWEB)

    Watt, E; Spencer, DP; Meyer, T [University of Calgary and Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: Permanent seed implant brachytherapy procedures require the measurement of the air kerma strength of seeds prior to implant. This is typically accomplished using a well-type ionization chamber. Previous measurements (Griffin et al., 2005; Bohm et al., 2005) of several low-energy seeds using the air-communicating HDR 1000 Plus chamber have demonstrated that the standard temperature-pressure correction factor, P{sub TP}, may overcompensate for air density changes induced by altitude variations by up to 18%. The purpose of this work is to present empirical correction factors for two clinically-used seeds (IsoAid ADVANTAGE™ {sup 103}Pd and Nucletron selectSeed {sup 125}I) for which empirical altitude correction factors do not yet exist in the literature when measured with the HDR 1000 Plus chamber. Methods: An in-house constructed pressure vessel containing the HDR 1000 Plus well chamber and a digital barometer/thermometer was pumped or evacuated, as appropriate, to a variety of pressures from 725 to 1075 mbar. Current measurements, corrected with P{sub TP}, were acquired for each seed at these pressures and normalized to the reading at ‘standard’ pressure (1013.25 mbar). Results: Measurements in this study have shown that utilization of P{sub TP} can overcompensate in the corrected current reading by up to 20% and 17% for the IsoAid Pd-103 and the Nucletron I-125 seed respectively. Compared to literature correction factors for other seed models, the correction factors in this study diverge by up to 2.6% and 3.0% for iodine (with silver) and palladium respectively, indicating the need for seed-specific factors. Conclusion: The use of seed specific altitude correction factors can reduce uncertainty in the determination of air kerma strength. The empirical correction factors determined in this work can be applied in clinical quality assurance measurements of air kerma strength for two previously unpublished seed designs (IsoAid ADVANTAGE™ {sup 103}Pd and

  5. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    Science.gov (United States)

    Xu, Gang; Wang, Xiao-teng; Gan, Cai-ling; Fang, Yan-qiong; Zhang, Meng

    2012-09-01

    To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N+ with energy of 25 keV was applied to treat the dry seed at six different doses. N+ beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 × 1016 to 15 × 1016 ions cm-2 severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 × 1016 ion cm-2, biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 × 1016 ions cm-2 may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA-GSH cycle appeared to be for regeneration of HAsA.

  6. Seed loss through the urinary tract after prostate brachytherapy: examining the role of cystoscopy and urine straining post implant

    International Nuclear Information System (INIS)

    Stutz, Michael; Petrikas, James; Raslowsky, Michael; Lee, Plato; Gurel, Michelle; Moran, Brian

    2003-01-01

    This study describes one institution's experience with seed retrieval through the urinary tract and makes recommendations for cystoscopy and urine straining post prostate brachytherapy (PB). 1794 patients from two separate cohorts covering different time periods (early versus late) were analyzed. All patients were preplanned with a modified peripheral loading technique and implanted with preloaded needles ( 125 I or 103 Pd) under ultrasound guidance. A catheter was used to delineate the urethra during the volume study but was not used during the implant. All patients underwent post implant cystoscopy. All patients were instructed to strain their urine for seven days post implant and return any seeds to our center. In our experience, seed loss through the urinary tract is a common event after PB, occurring in 29.7% of patients and was more common in patients from the early cohort, those implanted with 125 I seeds or those patients with prior transurethral resection of the prostate. Average seed loss per case, however, represents only 0.58% of total activity. We continue to recommend routine post implant cystoscopy for seed retrieval and periprocedural management. We no longer recommend that patients strain their urine at home after documenting a low rate of seed loss after discharge

  7. Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture.

    Science.gov (United States)

    Seiler, Stephen J; Sharma, Pooja B; Hayes, Jody C; Ganti, Ramapriya; Mootz, Ann R; Eads, Emily D; Teotia, Sumeet S; Evans, W Phil

    2017-01-01

    Breast implants are frequently encountered on breast imaging studies, and it is essential for any radiologist interpreting these studies to be able to correctly assess implant integrity. Ruptures of silicone gel-filled implants often occur without becoming clinically obvious and are incidentally detected at imaging. Early diagnosis of implant rupture is important because surgical removal of extracapsular silicone in the breast parenchyma and lymphatics is difficult. Conversely, misdiagnosis of rupture may prompt a patient to undergo unnecessary additional surgery to remove the implant. Mammography is the most common breast imaging examination performed and can readily depict extracapsular free silicone, although it is insensitive for detection of intracapsular implant rupture. Ultrasonography (US) can be used to assess the internal structure of the implant and may provide an economical method for initial implant assessment. Common US signs of intracapsular rupture include the "keyhole" or "noose" sign, subcapsular line sign, and "stepladder" sign; extracapsular silicone has a distinctive "snowstorm" or echogenic noise appearance. Magnetic resonance (MR) imaging is the most accurate and reliable means for assessment of implant rupture and is highly sensitive for detection of both intracapsular and extracapsular rupture. MR imaging findings of intracapsular rupture include the keyhole or noose sign, subcapsular line sign, and "linguine" sign, and silicone-selective MR imaging sequences are highly sensitive to small amounts of extracapsular silicone. © RSNA, 2017.

  8. SU-E-T-378: Evaluation of An Analytical Model for the Inter-Seed Attenuation Effect in 103-Pd Multi-Seed Implant Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Safigholi, H; Soliman, A; Song, W [Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, U of T, Toronto, Ontario (Canada); Meigooni, A Soleimani [Comprehensive Cancer Center of Nevada, Las Vegas, Nevada (United States); Han, D [Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, U of T, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: Brachytherapy treatment planning systems based on TG-43 protocol calculate the dose in water and neglects the heterogeneity effect of seeds in multi-seed implant brachytherapy. In this research, the accuracy of a novel analytical model that we propose for the inter-seed attenuation effect (ISA) for 103-Pd seed model is evaluated. Methods: In the analytical model, dose perturbation due to the ISA effect for each seed in an LDR multi-seed implant for 103-Pd is calculated by assuming that the seed of interest is active and the other surrounding seeds are inactive. The cumulative dosimetric effect of all seeds is then summed using the superposition principle. The model is based on pre Monte Carlo (MC) simulated 3D kernels of the dose perturbations caused by the ISA effect. The cumulative ISA effect due to multiple surrounding seeds is obtained by a simple multiplication of the individual ISA effect by each seed, the effect of which is determined by the distance from the seed of interest. This novel algorithm is then compared with full MC water-based simulations (FMCW). Results: The results show that the dose perturbation model we propose is in excellent agreement with the FMCW values for a case with three seeds separated by 1 cm. The average difference of the model and the FMCW simulations was less than 8%±2%. Conclusion: Using the proposed novel analytical ISA effect model, one could expedite the corrections due to the ISA dose perturbation effects during permanent seed 103-Pd brachytherapy planning with minimal increase in time since the model is based on multiplications and superposition. This model can be applied, in principle, to any other brachytherapy seeds. Further work is necessary to validate this model on a more complicated geometry as well.

  9. 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...

  10. The effect of the radial function on I-125 seeds used for permanent prostate implantation

    International Nuclear Information System (INIS)

    Pickett, Barby; Pouliot, Jean

    2004-01-01

    The purpose of this study was to evaluate the integrity of eight commercially-available low-activity Iodine-125 ( 125 I) seeds for their radial function g(r) and its effect on the dose delivered to the adjacent critical structures when used in permanent prostate implants (PPI). Ten previously treated patients were retrospectively used in this comparison. The Amersham Health Oncura seed was used to peripherally design an isodose distribution with urethral and anterior rectal wall sparing. Plan criteria included minimum coverage of 144 Gy to the planning target volume (PTV), ≤ 70% dose to 150% of the PTV volume (V150-PTV), and the quantity of needles ≤ 70% of the size of the PTV, in cc. Upon completion of the Oncura plan, the seed type was changed and the activity was adjusted until the V100-PTV for each of the other 7 seed types matched the V100-PTV defined by the Oncura seed. Computed tomography (CT)-based postimplant dosimetry was used to determine the dose to 40% (D40) of the bulb of the penis (in Gy). Dose-volume histograms (DVH) were used to evaluate the differences to V100 (in %) and D40 (in Gy) of the anterior rectal wall and bulb of the penis, and V100 (in %) of the urethra. The data was tabulated. Radioactive 125 I sources included in this study were 125 I Source 2301 (Best); I-Plant (MedTech), IoGold (Mentor), Oncura (Amersham Health), ProstaSeed (UroCor), SelectSeed (Nucletron), SourceTech (Bard), and Symmetra (UroMed). The sizes of the PTV for the 10 patients ranged from 18.82 cc to 48.99 cc. The Oncura seed was used as the reference seed and all other seed types were normalized to it for data comparison. It was determined that the dose rate constant (xwedge) and anisotropy factor (phi) contribute to the activity needed to achieve comparable V100-PTV doses, but a strong dependence on the radial function g(r) was found to effect the doses to the critical structures studied. Values of g(r) at 4 cm were calculated and the IoGold and SourceTech seeds

  11. Breast implants and anaplastic large-cell lymphoma: a danish population-based cohort study.

    Science.gov (United States)

    Vase, Maja Ølholm; Friis, Søren; Bautz, Andrea; Bendix, Knud; Sørensen, Henrik Toft; d'Amore, Francesco

    2013-11-01

    A potential link between breast implants and anaplastic large-cell lymphoma (ALCL) has been suggested. We examined lymphoma occurrence in a nationwide cohort of 19,885 Danish women who underwent breast implant surgery during 1973-2010. Standardized incidence ratios (SIR), with 95% confidence intervals (CI), for ALCL and lymphoma overall associated with breast implantation were calculated. During 179,246 person-years of follow-up, we observed 31 cases of lymphoma among cohort members. No cases of ALCL were identified. SIRs for ALCL and lymphoma overall were zero (95% CI, 0-10.3) and 1.20 (95% CI, 0.82-1.70), respectively. In our nationwide cohort study, we did not find an increased risk of lymphoma in general, or ALCL in particular, among Danish women who underwent breast implantation. However, our evaluation of ALCL risk was limited by the rarity of the disease. Our results do not support an association between breast implants and ALCL and are consistent with other studies on cancer risk and breast implants. ©2013 AACR.

  12. Do Breast Implants Influence Breastfeeding? A Meta-Analysis of Comparative Studies.

    Science.gov (United States)

    Cheng, Fengrui; Dai, Shuiping; Wang, Chiyi; Zeng, Shaoxue; Chen, Junjie; Cen, Ying

    2018-06-01

    Aesthetic breast implant augmentation surgery is the most popular plastic surgery worldwide. Many women choose to receive breast implants during their reproductive ages, although the long-term effects are still controversial. Research aim: We conducted a meta-analysis to assess the influence of aesthetic breast augmentation on breastfeeding. We also compared the exclusive breastfeeding rates of periareolar versus inframammary incision. A systematic search for comparative studies about breast implants and breastfeeding was performed in PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science through May 2018. Meta-analysis was conducted with a random-effects model (or fixed effects, if heterogeneity was absent). Four cohorts and one cross-sectional study were included. There was a significant reduction in the exclusive breastfeeding rate for women with breast implants compared with women without implants, pooled relative risk = 0.63, 95% confidence interval [0.46, 0.86], as well as the breastfeeding rate, pooled relative risk = 0.88, 95% confidence interval [0.81, 0.95]. There was no evidence that periareolar incision was associated with a reduction in the exclusive breastfeeding rate, pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58]. Participants with breast implants are less likely to establish breastfeeding, especially exclusive breastfeeding. Periareolar incision does not appear to reduce the exclusive breastfeeding rate.

  13. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    Energy Technology Data Exchange (ETDEWEB)

    Xu Gang, E-mail: xg335300@yahoo.com.cn [Center for Research and Development of Fine Chemicals, Guizhou University, Guiyang 550025 (China); Institute of Entomology, Guizhou University, Guiyang 550025 (China); Wang Xiaoteng [Department of Agricultural Resources and Environment, College of Agricultural, Guizhou University, Guiyang 550025 (China); Gan Cailing; Fang Yanqiong; Zhang Meng [College of Life Sciences, Guizhou University, Guiyang 550025 (China)

    2012-09-15

    Highlights: Black-Right-Pointing-Pointer We analyzed biological effects of N{sup +} implantation on dry Jatropha curcas seed. Black-Right-Pointing-Pointer N{sup +} implantation greatly decreased seedling survival rate. Black-Right-Pointing-Pointer At doses beyond 15 Multiplication-Sign 10{sup 16} ion cm{sup -2}, biological repair took place. Black-Right-Pointing-Pointer CAT was essential for H{sub 2}O{sub 2} removal. POD mainly functioned as seed was severely hurt. Black-Right-Pointing-Pointer HAsA-GSH cycle mainly contributed to the regeneration of HAsA. - Abstract: To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N{sup +} with energy of 25 keV was applied to treat the dry seed at six different doses. N{sup +} beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 Multiplication-Sign 10{sup 16} to 15 Multiplication-Sign 10{sup 16} ions cm{sup -2} severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 Multiplication-Sign 10{sup 16} ion cm{sup -2}, biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 Multiplication-Sign 10{sup 16} ions cm{sup -2} may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA-GSH cycle appeared to be for regeneration of HAsA.

  14. Evaluation of anatomical and round breast implant aesthetics and preferences in Dutch young lay and plastic surgeon cohort.

    Science.gov (United States)

    Bletsis, Patrick P; Bouwer, Lesley R; Ultee, Klaas H; Cromheecke, Michel; van der Lei, Berend

    2018-04-16

    Literature remains inconclusive on the attractiveness and natural aspect of anatomical breast implants, and thus far, studies have failed to demonstrate the visible difference in implants that are in practice compared to those that are round. This study was undertaken to evaluate (1) whether lay and professional participants can distinguish between breasts augmented with either round or anatomical breast implants and (2) their opinion with regard to naturalness and attractiveness of these augmented breasts. Twenty breast augmentations (10 anatomical and 10 round implants), each depicted by two postoperative pictures, were scored by 100 lay participants and 15 plastic surgeons. Implant volume ranged from 275 to 400 g. Ptotic or malformed breasts were excluded. Finally, they had to score the most natural, unnatural, attractive, and unattractive breast shapes on a schematic depiction of breast types with varying upper poles. The rate of correct implant identifications was 74.0% (1480/2000 observations, p lay and 67.3% (202/300 observations, p lay participants and surgeons. Participants preferred breasts with a neutral or slightly negative upper pole contour. Participants were able to distinguish between the results achieved with either anatomical or round textured Allergan breast implants and found augmented breasts with the anatomical implants more natural and attractive. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. 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

    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...

  16. Mammary prostheses may hide breast cancer. Silicon implants and cancer diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Heywang, S H

    1987-10-30

    Mammoplasty with silicon implants is risky: In women wearing protheses of this type, carcinomas of the breast may be diagnosed in a more advanced stage than in women without silicon implants. This is the result of a study by US oncologists and was proved by observation in Grosshadern hospital, Munich. (orig.)

  17. 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...

  18. Prepectoral Implant-Based Breast Reconstruction and Postmastectomy Radiotherapy: Short-Term Outcomes

    Directory of Open Access Journals (Sweden)

    Steven Sigalove, MD

    2017-12-01

    Conclusions:. Immediate implant-based prepectoral breast reconstruction followed by PMRT appears to be well tolerated, with no excess risk of adverse outcomes, at least in the short term. Longer follow-up is needed to better understand the risk of PMRT in prepectorally reconstructed breasts.

  19. [Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy].

    Science.gov (United States)

    Chai, Lijun; Zhang, Xuehui

    2017-09-01

    To investigate effectiveness of the combination of serratus anterior muscle flap and breast implants for breast reconstruction after modified radical mastectomy. Between January 2015 and December 2015, 25 female patients with breast cancer were enrolled, aged 24-62 years (mean, 40.6 years). The tumor located at left side in 9 cases and right side in 16 cases; 14 cases were in the left upper quadrant, 4 cases were in the left lower quadrant, 7 cases were on the top of the breast. All cases were invasive ductal carcinoma. According to TNM staging, 14 cases were at stageⅠand 11 cases were at stageⅡA. The diameter of lumps were all less than 3 cm. All those lumps were solitary and without distant metastasis. The sentinel nodes were all negative. After modified radical mastectomy, the breasts were reconstructed by serratus anterior muscle flap and breast implants. The nipples were spared in 22 cases. The operation time was 113-148 minutes (mean, 136 minutes). All breasts survived and incisions healed at stageⅠ. There was no complication such as hematoma, infection, etc . All patients were followed up 6-18 months (mean, 15 months). Except 1 case, the others were evaluated according to the criteria of the reconstructed breast at 12 months after operation. Among them, 23 cases were evaluated as good and 1 case as fair. There was no tumor recurrence during the follow-up period. The combination of serratus anterior muscle flap and breast implants after the modified radical mastectomy is a handy approach of breast reconstruction which is less harmful with few postoperative complications. It also gains a high degree of satisfaction from patients for good breast shape.

  20. 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

  1. SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

    Science.gov (United States)

    Matena, Julia; Petersen, Svea; Gieseke, Matthias; Kampmann, Andreas; Teske, Michael; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

    2015-01-01

    To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM) enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL) coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF), high mobility group box 1 (HMGB1) and chemokine (C-X-C motif) ligand 12 (CXCL12). As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI). Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release. PMID:25849656

  2. SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

    Directory of Open Access Journals (Sweden)

    Julia Matena

    2015-04-01

    Full Text Available To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF, high mobility group box 1 (HMGB1 and chemokine (C-X-C motif ligand 12 (CXCL12. As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI. Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release.

  3. Distant Migration of Multiple Siliconomas in Lower Extremities following Breast Implant Rupture: Case Report.

    Science.gov (United States)

    Oh, Joo Hyun; Song, Seung Yong; Lew, Dae Hyun; Lee, Dong Won

    2016-10-01

    Siliconoma from ruptured breast implants has been reported in multiple body sites, including but not limited to the breast parenchyma, axillary lymph nodes, upper arm, and even lower leg. In this regard, we report a rare case of distant silicone migration to the lower extremities after traumatic breast implant rupture. A 55-year-old Asian woman who received bilateral augmentation mammoplasty 20 years ago presented with ruptured breast implants from a car accident 2 years earlier. Magnetic resonance imaging confirmed intracapsular and extracapsular rupture of the right breast implant, showing "linguine sign." We removed the bilateral breast implants and performed capsulectomy and bilateral reduction mammoplasty using inverted-T incisions. The implant was confirmed as a smooth, silicone gel-filled mammary implant of 125 cm 3 by a Japanese manufacturer, Koken. During her regular follow-up outpatient visits, physical examination revealed 2.5- × 1.5-cm ill-defined, tender, subcutaneous nodules on both knees and 8.5- × 3.0-cm inflammatory changes in the inguinal area with persistent pain. Computed tomography showed no definite mass, but rather infiltrative, nonenhancing soft-tissue densities in the subcutaneous layers of the bilateral inguinal and knee areas. Surgical excision was performed, and pathologic findings confirmed variable vacuoles with foreign body reaction and fibrosis, consistent with siliconoma. It is important to acknowledge that siliconomas can be encountered in patients with ruptured breast implants, especially those manufactured decades ago. Our patient with masses as remote as the inguinal and knee areas is a prime example of how far siliconomas can migrate.

  4. Distribution of implanted ions in seeds and roots of mung bean

    International Nuclear Information System (INIS)

    Liu Donghua; Wang Wei; Jiang Wusheng; Zhang Zhixiang; Hou Wenqiang; Guo Ximing; Li Yi

    1998-01-01

    Doses of 1 x 10 16 , and 2 x 10 16 cm -2 and 1 x 10 16 , 2 x 10 16 , 3 x 10 16 and 3.6 x 10 16 cm -2 for iron and copper ions are implanted in dry seeds of mung bean, respectively. The results show that the accumulated-copper and -iron ion amounts in the seeds and roots vary with different doses of ion beam, and the fresh and dry weights of the roots decrease progressively with increasing iron and copper doses, except the treatment of 1 x 10 16 Cu + ions/cm 2 , and the accumulated-copper and -iron ion amounts in the seeds of the different test groups can be correlated with the ion distribution in the roots

  5. Biological effects of ion implantation on processing tomato and eggplant seed

    International Nuclear Information System (INIS)

    Mao Peihong; Zeng Xianxian; Jin Xiang

    2004-01-01

    The seed of processing tomato '87-5' (Lycopersicon esculentum Mill) were implanted by the low energy nitrogen ion (N + ) with 6 different doses. The rate of emergence was little reduced in M1 generation, but the fruiting number per plant was increased and it's maturing earlier 20 days than the control. The precocity, disease resistance and stronger growth vigor were shown in M2 generation. Experimental results of two years showed that, according to synthetic analysis in factors such as precocity, disease resistance, high yield and quality, the N + dose of 6 x 10 16 cm -2 (60 times of pulse) for tomato seed '87-5' had been proved to have notable biological effects on M1 and M2 generation. The seed of eggplant 'Wuyeqie' (Solanum melongena L.) was also implanted by the low energy nitrogen ion (N + ) with 2 different doses. Multi-vertical channel fruits were obtained in variable M1 generation, which liked the pomelo without peel. The seed of these variable eggplants was taken and planted in the next year. The meaningful variable fruits, the characters of disease-resistance, purple-peel, small-navel, lantern-form, large-scale, etc. were obtained in beneficial M2 generation. The biggest single-fruit weight reached 1.53 kg, providing valuable germplasm resource for breeding. (authors)

  6. The natural history of Becker expandable breast implants: a single-center 10-year experience.

    Science.gov (United States)

    Sindali, Katia; Davis, Marcus; Mughal, Maleeha; Orkar, Kusu S

    2013-09-01

    Use of Becker expandable breast implants in single-stage breast surgery is a well-established technique; however, replacement with fixed-volume implants is common. The authors sought to analyze the long-term natural history of these implants over a wide range of surgical indications. A retrospective review of 330 consecutive patients who underwent 384 Becker expander breast reconstructions over a 10-year period in a dedicated plastic surgery unit was undertaken. Implant indication, Becker type, volume and site, complications, expander lifespan, and explant reasons were assessed. Two hundred twenty-eight patients (267 implants) and 102 patients (117 implants) underwent implantation for congenital deformities and breast cancer reconstruction, respectively. One hundred eighty-seven (48 percent) were explanted at a median period of 13.0 months (range, 9.0 to 26.0 months), 149 (39 percent) for aesthetic reasons and 38 (10 percent) for complications. Complication rates were higher in breast cancer reconstruction compared with congenital patients (19.6 percent versus 7.9 percent; p = 0.002), driven by an increased rate of wound complications (13.7 percent versus 4.4 percent; p = 0.003). Cancer-related surgery and advancing age were the only predictors of complication risk. The overall Becker expander retention rate was 24.9 percent and 46.8 percent at 150 months in the cancer reconstruction and congenital groups, respectively. Forty-seven percent of Becker implants were retained long term after congenital corrective surgery; only 25 percent were retained after postmastectomy reconstruction. Poor aesthetics was driving the exchange for fixed-volume implants, indicating that after breast cancer reconstruction, Becker expanders were being used as part of a two-stage reconstructive strategy.

  7. Techniques used by United Kingdom consultant plastic surgeons to select implant size for primary breast augmentation.

    Science.gov (United States)

    Holmes, W J M; Timmons, M J; Kauser, S

    2015-10-01

    Techniques used to estimate implant size for primary breast augmentation have evolved since the 1970s. Currently no consensus exists on the optimal method to select implant size for primary breast augmentation. In 2013 we asked United Kingdom consultant plastic surgeons who were full members of BAPRAS or BAAPS what was their technique for implant size selection for primary aesthetic breast augmentation. We also asked what was the range of implant sizes they commonly used. The answers to question one were grouped into four categories: experience, measurements, pre-operative external sizers and intra-operative sizers. The response rate was 46% (164/358). Overall, 95% (153/159) of all respondents performed some form of pre-operative assessment, the others relied on "experience" only. The most common technique for pre-operative assessment was by external sizers (74%). Measurements were used by 57% of respondents and 3% used intra-operative sizers only. A combination of measurements and sizers was used by 34% of respondents. The most common measurements were breast base (68%), breast tissue compliance (19%), breast height (15%), and chest diameter (9%). The median implant size commonly used in primary breast augmentation was 300cc. Pre-operative external sizers are the most common technique used by UK consultant plastic surgeons to select implant size for primary breast augmentation. We discuss the above findings in relation to the evolution of pre-operative planning techniques for breast augmentation. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. A Prospective Analysis of Dynamic Loss of Breast Projection in Tissue Expander-Implant Reconstruction

    Directory of Open Access Journals (Sweden)

    Lauren M Mioton

    2015-05-01

    Full Text Available BackgroundBreast projection is a critical element of breast reconstruction aesthetics, but little has been published regarding breast projection as the firm expander is changed to a softer implant. Quantitative data representing this loss in projection may enhance patient education and improve our management of patient expectations.MethodsFemale patients who were undergoing immediate tissue-expander breast reconstruction with the senior author were enrolled in this prospective study. Three-dimensional camera software was used for all patient photographs and data analysis. Projection was calculated as the distance between the chest wall and the point of maximal projection of the breast form. Values were calculated for final tissue expander expansion and at varying intervals 3, 6, and 12 months after implant placement.ResultsFourteen breasts from 12 patients were included in the final analysis. Twelve of the 14 breasts had a loss of projection at three months following the implant placement or beyond. The percentage of projection lost in these 12 breasts ranged from 6.30% to 43.4%, with an average loss of projection of 21.05%.ConclusionsThis study is the first prospective quantitative analysis of temporal changes in breast projection after expander-implant reconstruction. By prospectively capturing projection data with three-dimensional photographic software, we reveal a loss of projection in this population by three months post-implant exchange. These findings will not only aid in managing patient expectations, but our methodology provides a foundation for future objective studies of the breast form.

  9. Contrast-enhanced MR imaging of the breast in patients with breast implants after cancer surgery

    International Nuclear Information System (INIS)

    Bone, B.; Aspelin, P.; Isberg, B.; Perbeck, L.; Veress, B.

    1995-01-01

    The purpose of the study was to determine the value of contrast-enhanced MR imaging in the assessment of local recurrence in breast cancer patients who underwent mastectomy and breast reconstruction with an implant. Eighty-three patients have been evaluated by semidynamic contrast-enhanced MR imaging. The T1-weighted FLASH 3-D sequence was repeated twice postcontrast for evaluation of the entire breast bilaterally. The findings were compared to physical examination, mammography and histopathology. Recurrence verified by histopathology occurred in 14 of 83 patients (17%). Contrast-enhanced MR imaging was superior to palpation and mammography in revealing recurrences, especially when these were located close to the chest wall. MR was also more sensitive in detecting multiple foci of cancers. Our study revealed that MR imaging was influenced by size, type and composition of the tumor, as illustrated by the false-negative results. Therefore, the use of all 3 investigation methods is necessary for detecting recurrence at an early stage during the postoperative follow-up. (orig.)

  10. Electron beam irradiation after reconstruction with silicone gel implant in breast cancer

    International Nuclear Information System (INIS)

    Krishnan, L.; Krishnan, E.C.

    1986-01-01

    Irradiation for breast cancer in the presence of a silicone gel breast prosthesis is sometimes necessary. There is a concern among radiation and other oncologists as to whether the presence of the prosthetic implant would interfere with delivery of the needed irradiation doses. Electron beams, with their finite penetration and rapid fall-off, offer a mode of adequately treating the recurrence and minimizing the radiation to the underlying normal structures, such as the lung and the heart. The dose distribution using 9-20 MeV electrons in the presence of a breast prosthesis is compared to the dose distribution without the implant in a tissue equivalent water phantom. The results reveal no significant difference in the dose delivered due to the presence of the prosthesis. Clinical verification of the dosimetry in the presence of the prosthesis confirmed that the presence of the silicone gel implant does not compromise treatment by irradiation in the management of breast cancer

  11. Anaplastic large cell lymphoma of the breast arising around mammary implant capsule: an Italian report.

    Science.gov (United States)

    Farace, Francesco; Bulla, Antonio; Marongiu, Francesco; Campus, Gian Vittorio; Tanda, Francesco; Lissia, Amelia; Cossu, Antonio; Fozza, Claudio; Rubino, Corrado

    2013-06-01

    Anaplastic large cell lymphoma (ALCL) of the breast is a very rare nonepithelial neoplasm. In the literature, this tumor has sometimes been described in proximity of breast implants (60 implant-related ALCL reported). In 2010, a patient who had undergone a right mastectomy and tissue expander/implant reconstruction for a "ductal" carcinoma 10 years before was referred to our unit for evaluation. On examination, an enlarged reconstructed right breast was found. The reconstructed breast did not show tenderness or signs of infection, ulceration, or breakdown. Mammograms and ultrasound scan did not suggest the presence of recurrent cancer, infection, deflation of the implant, or severe capsule contracture. The patient underwent mammary implant replacement. About 3 weeks after surgery, the patient came back to our unit for a new mild enlargement of the operated breast and the implant was removed. Three months later, the patient returned with a skin lesion in the right parasternal region. A radical excisional biopsy was performed under local anesthesia and the diagnosis of ALK-1-negative ALCL was finally made. The clinical and histological diagnosis of this disease is difficult as it can often be mistaken for a simple seroma (breast enlargement), an infection, or an unspecific reaction to silicone (redness and/or tension of the skin, itching, and fever). We strongly suggest considering ALCL in any patient with a spontaneous breast seroma lasting more than 6 months after mammary prosthesis implantation. The suspicion of ALCL must be suggested to the pathologist immediately. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. SU-F-19A-11: Retrospective Evaluation of Thermal Coverage by Thermobrachytherapy Seed Arrangements of Clinical LDR Prostate Implants

    Energy Technology Data Exchange (ETDEWEB)

    Warrell, G; Shvydka, D; Chen, C; Parsai, E [University of Toledo Medical Center, Toledo, OH (United States)

    2014-06-15

    Purpose: The superiority of a properly-administered combination of radiation therapy and hyperthermia over radiation alone in treatment of human cancers has been demonstrated in multiple studies examining radiobiology, local control, and survival. Unfortunately, hyperthermia is not yet a common modality in oncology practice, due in part to the technical difficulty of heating a deep-seated target volume to sufficient temperature. To address this problem, our group has invented a thermobrachytherapy (TB) seed based on a commonly-used low dose-rate permanent brachytherapy seed for implant in solid tumors. Instead of the tungsten radiographic marker of the standard seed, the TB seed contains one of a self-regulating ferromagnetic alloy. Placement of a patient implanted with such seeds in an oscillating magnetic field generates heat via induction of eddy currents. We present the results of studies of the capability of clinically-realistic TB seed arrangements to adequately heat defined target volumes. Methods: Seed distributions for several past LDR prostate permanent implant brachytherapy patients were reproduced in the finite element analysis software package COMSOL Multiphysics 4.4, with the difference that TB seeds were modelled, rather than the radiation-only seeds actually used for their treatments. The implant geometries were mainly of the modified peripheral loading type; a range of prostatic volumes and blood perfusion rates likely to be seen in a clinical setting were examined. Results: According to the simulations, when distributed to optimize radiation dose, TB seeds also produce sufficient heat to provide thermal coverage of the target given proper selection of the magnetic field strength. However, the thermal distributions may be improved by additional use of hyperthermia-only seeds. Conclusion: A dual-modality seed intended as an alternative to and using the same implantation apparatus and technique as the standard LDR permanent implant seed has been

  13. The Story of : Pathologic Risk Factors in Breast Implant Surgery

    Directory of Open Access Journals (Sweden)

    Caroline A Yao

    2014-07-01

    Full Text Available Serratia marcescens (S. marcescens emerged as an opportunist in the setting of immunodeficiency in the 1970s, when serious infections occurred in San Francisco hospitals after USA. Navy experiments had aerosolized the bacteria to study biologic warfare. We investigate the risks of S. marcescens in San Franciscans who undergo mastectomy with implant reconstruction. From 2007 to 2011, the senior author took breast capsule cultures for all patients at the time of tissue expander exchange/explant. Of the 142 women who had reconstruction, 23 had positive cultures. Only the two patients who were positive for S. marcescens developed clinical infections that required explantation. Both had postoperative chemotherapy with transient neutropenia, and both had close ties to San Francisco. Clinical signs of infection emerged for both patients months after initial surgery, despite having previously well healed incisions. Other patients were culture positive for Pseudomonas, Proteus, Enterococcus and MRSA and did not develop require explant. While the link between San Francisco and S. marcescens is controversial, a patient's geography is a simple screening tool when considering postoperative risks, especially in the immunocompromised. Closer monitoring for neutropenia during chemotherapy, and a lower threshold to administer S. marcescens targeted antibiotics may be warranted in these patients.

  14. The clinical application of TACE together with RFA and 125I seed implantation in treating hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Xie Xiaoxi; Lu Yinxiang; Zhang Hongxin; Zhang Shengchu; Zhou Jianwei; Zhang Guodong; Wang Xiaowei; Yang Liping

    2011-01-01

    Objective: to assess the clinical value of the combined treatment of transcatheter arterial chemoembolization (TACE), CT-guided radiofrequency ablation (RFA) and radioactive 125 I seed implantation for hepatocellular carcinoma (HCC). Methods: During the period from March 2008 to Dec. 2010, 15 patients with HCC were admitted to the hospital. A total of 25 hepatic lesions were detected with the size of 1-8 cm. TACE was carried out first, which was followed by CT-guided RFA and radioactive 125 I seed implantation. With the help of treat plan system (TPS), the radioactive 125 I seed implantation was conducted to make additional management for the same lesion when RFA was finished, or the radioactive 125 I seeds were directly implanted into the areas where RFA could not reach. The radioactive dose was 60-100 Gy. All the patients were followed up and were kept under observation for the signs of related complications. The therapeutic results were evaluated. Results: The combined treatment was successfully accomplished in all patients. All patients were followed up for 3-28 months (mean of 10.6 months). The complete necrosis rate of the tumor was 96%. No serious complications occurred except the immigration of 125 I seeds in 1 case. Conclusion: The combined treatment of TACE and CT-guided RFA together with 125 I seed implantation is a safe, reliable and effective therapy for HCC with excellent short-term result. (authors)

  15. ASPS clinical practice guideline summary on breast reconstruction with expanders and implants.

    Science.gov (United States)

    Alderman, Amy; Gutowski, Karol; Ahuja, Amy; Gray, Diedra

    2014-10-01

    After reading this article, participants should be able to: 1. Understand the evidence regarding the timing of expander/implant breast reconstruction in the setting of radiation therapy. 2. Discuss the implications of a patient's risk factors for possible outcomes and complications of expander/implant breast reconstruction. 3. Implement proper prophylactic antibiotic protocols. 4. Use the guidelines to improve their own clinical outcomes and reduce complications. In March of 2013, the Executive Committee of the American Society of Plastic Surgeons approved an evidence-based guideline on breast reconstruction with expanders and implants, as developed by a guideline-specific work group commissioned by the society's Health Policy Committee. The guideline addresses ten clinical questions: patient education, immediate versus delayed reconstruction, risk factors, radiation therapy, chemotherapy, hormonal therapy, antibiotic prophylaxis, acellular dermal matrix, monitoring for cancer recurrence, and oncologic outcomes associated with implant-based reconstruction. The evidence indicates that patients undergoing mastectomy should be offered a preoperative referral to a plastic surgeon. Evidence varies regarding the association between postoperative complications and timing of postmastectomy expander/implant breast reconstruction. Evidence is limited regarding the optimal timing of expand/implant reconstruction in the setting of radiation therapy but suggests that irradiation to the expander or implant is associated with an increased risk of postoperative complications. Evidence also varies regarding the association between acellular dermal matrix and surgical complications in the setting of postmastectomy expander/implant reconstruction. Data support the use of an appropriate preoperative antibiotic, but antibiotics should be discontinued within 24 hours of the procedure, unless a surgical drain is present. Furthermore, postmastectomy expander/implant breast reconstruction

  16. Gamma spectrometry and chemical characterization of bioactive glass seeds with Holmium-166 for oncological implants

    International Nuclear Information System (INIS)

    Valente, Eduardo S.

    2009-01-01

    Bioactive glass seeds synthesized by the sol-gel technique with Si:Ho:Ca composition with natural holmium incorporated were irradiated in the TRIGA type nuclear reactor IPR-R1 at 100kW, in the central thimble where the thermal neutron flux is 2.8x10 12 n/cm 2 .s and the epithermal neutron flux is 2.6 X 10 11 n/cm 2 .s . After an 8 hour irradiation time, with an induced activity close to 110MBq/seed, a set of seeds was submitted to Gamma Spectrometry Analysis in a counting system with an HPGe detector, ORTEC electronic instrumentation and a Camberra Multichannel Analyser, to determine all radionuclides present on the sample as well as its individual activities. Special attention was paid on the discrimination of Si, 40 Ca, 44 Ca, C and Ho as the other expected elements like 48 Ca, 2 H and 18 O were present in traces or have very short half-lives. The second sample was submitted to Plasma spectrometry to determine the 166 Ho concentration in weight. The third sample was submitted to an X-ray spectrometry in a JEOL-JXA-8900RL equipment to determine its qualitative chemical composition, in order to evaluate impurities and nominal composition. It was determined that most of the activity, after decaying of short half-life elements, was due to 166 Ho present on the sample, with a well characterized β and gamma spectra. The homogeneity of the seeds was tested on the X-ray spectrometry, and verified that there is no discrepancy in composition from distinct seeds or in a same seed. The results are relevant on the investigation of the viability of producing 166 Ho radioactive seeds for oncological implants. (author)

  17. Seed Implant Retention Score Predicts the Risk of Prolonged Urinary Retention After Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Lee, Hoon K.; Adams, Marc T.; Shi, Qiuhu; Basillote, Jay; LaMonica, Joanne; Miranda, Luis; Motta, Joseph

    2010-01-01

    Purpose: To risk-stratify patients for urinary retention after prostate brachytherapy according to a novel seed implant retention score (SIRS). Patients and Methods: A total of 835 patients underwent transperineal prostate seed implant from March 1993 to January 2007; 197 patients had 125 I and 638 patients had 103 Pd brachytherapy. Four hundred ninety-four patients had supplemental external-beam radiation. The final downsized prostate volume was used for the 424 patients who had neoadjuvant hormone therapy. Retention was defined as reinsertion of a Foley catheter after the implant. Results: Retention developed in 7.4% of patients, with an average duration of 6.7 weeks. On univariate analysis, implant without supplemental external-beam radiation (10% vs. 5.6%; p = 0.02), neoadjuvant hormone therapy (9.4% vs. 5.4%; p = 0.02), baseline α-blocker use (12.5% vs. 6.3%; p = 0.008), and increased prostate volume (13.4% vs. 6.9% vs. 2.9%, >45 cm 3 , 25-45 cm 3 , 3 ; p = 0.0008) were significantly correlated with increased rates of retention. On multivariate analysis, implant without supplemental external-beam radiation, neoadjuvant hormone therapy, baseline α-blocker use, and increased prostate volume were correlated with retention. A novel SIRS was modeled as the combined score of these factors, ranging from 0 to 5. There was a significant correlation between the SIRS and retention (p < 0.0001). The rates of retention were 0, 4%, 5.6%, 9%, 20.9%, and 36.4% for SIRS of 0 to 5, respectively. Conclusions: The SIRS may identify patients who are at high risk for prolonged retention after prostate brachytherapy. A prospective validation study of the SIRS is planned.

  18. SU-F-T-653: Radiation Exposure from Cs-131 Permanent Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Giaddui, T; Hardin, M; To, D; Kremmel, E; Peng, C; Hann, P; Richardson, S; Yu, Y; Harrison, A; Doyle, L [Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2016-06-15

    Purpose: Permanent seed implants have traditionally been used to treat prostate, lung and head or neck cancers using I-125 and Pd-103. Cs-131, which has higher dose rate is being used to treat brain, head and/or neck cancers in our clinic, therefore, we chose to monitor the dose received by surgeons during the extensive procedure. The aims of this work are to assess the level of radiation exposure to surgeons and the instantaneous exposure at bedside and 1 m from patients. Methods: Ten patients received Cs-131 implants for recurrent brain,head and/or neck cancer; the median implanted activity, number of implanted seeds and prescription dose at 0.5 cm from the perpendicular plane of the implant were: 54.3 mCi (14.52 – 77); 19 (4 – 24) and 60 Gy (range 42 – 60) respectively. Radiation exposure was recorded at bedside and 1 m from the patient using Victoreen ion chamber (Fluke Biomedical, Cleveland, OH). Exposure to surgeons was measured using TLD (Mirion Technologies (GDS), Inc., USA). Results: The median equivalent dose rate at 1 m and bedside immediately following implantation were 1.49×10-2 mSv/h (8.77×10-3–2.63×10-2) and 7.76×10-2 mSv/h (3.1×10-2– 1.53×10-1) respectively. Median equivalent dose to surgeons’ hands was 0.60 mSv (0.33 – 1.48) and no doses were detected for whole-body. Surgical reconstruction for one patient was performed 71 days post-implant and resulted in zero exposure to surgeons. Conclusion: The recorded exposure rates were low when compared with the literature. Post procedure surveys at bed site and 1 m indicated that all patients were within safe limits for discharge (< 0.05 mSv/h at 1 m). However, as a precautionary measure, patients were advised to avoid direct contact with children and pregnant women within four weeks of the implant and stay at least at 3 ft from other people. Surgeons doses were well within occupational dose limits.

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

    Science.gov (United States)

    Rella, L; Telegrafo, M; Nardone, A; Milella, A; Stabile Ianora, A A; Lioce, M; Angelelli, G; Moschetta, M

    2015-09-01

    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. 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. 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). 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. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Seeding of silicon by copper ion implantation for selective electroless copper plating

    Energy Technology Data Exchange (ETDEWEB)

    Bhansali, S; Sood, D K; Zmood, R B [Microelectronic and Materials Technology Centre, Royal Melbourne Institute of Technolgy, Melbourne, VIC (Australia)

    1994-12-31

    We report on the successful use of copper(self) ion implantation into silicon to seed the electroless plating of copper on silicon (100) surfaces. Copper ions have been implanted to doses of 5E14-6.4E16 ions/cm{sup 2} using a MEEVA ion implanter at extraction voltage of 40kV. Dose was varied in fine steps to determine the threshold dose of 2E15 Cu ions/cm{sup 2} for `seed` formation of copper films on silicon using a commercial electroless plating solution. Plated films were studied with Rutherford backscattering spectrometry, scanning electron microscopy, EDX and profilometry . The adhesion of films was measured by `scotch tape test`. The adhesion was found to improve with increasing dose. However thicker films exhibited rather poor adhesion and high internal stress. SEM results show that the films grow first as isolated islands which become larger and eventually impinge into a continuous film as the plating time is increased. (authors). 5 refs., 1 tab., 3 figs.

  1. Seeding of silicon by copper ion implantation for selective electroless copper plating

    Energy Technology Data Exchange (ETDEWEB)

    Bhansali, S.; Sood, D.K.; Zmood, R.B. [Microelectronic and Materials Technology Centre, Royal Melbourne Institute of Technolgy, Melbourne, VIC (Australia)

    1993-12-31

    We report on the successful use of copper(self) ion implantation into silicon to seed the electroless plating of copper on silicon (100) surfaces. Copper ions have been implanted to doses of 5E14-6.4E16 ions/cm{sup 2} using a MEEVA ion implanter at extraction voltage of 40kV. Dose was varied in fine steps to determine the threshold dose of 2E15 Cu ions/cm{sup 2} for `seed` formation of copper films on silicon using a commercial electroless plating solution. Plated films were studied with Rutherford backscattering spectrometry, scanning electron microscopy, EDX and profilometry . The adhesion of films was measured by `scotch tape test`. The adhesion was found to improve with increasing dose. However thicker films exhibited rather poor adhesion and high internal stress. SEM results show that the films grow first as isolated islands which become larger and eventually impinge into a continuous film as the plating time is increased. (authors). 5 refs., 1 tab., 3 figs.

  2. Seeding of silicon by copper ion implantation for selective electroless copper plating

    International Nuclear Information System (INIS)

    Bhansali, S.; Sood, D.K.; Zmood, R.B.

    1993-01-01

    We report on the successful use of copper(self) ion implantation into silicon to seed the electroless plating of copper on silicon (100) surfaces. Copper ions have been implanted to doses of 5E14-6.4E16 ions/cm 2 using a MEEVA ion implanter at extraction voltage of 40kV. Dose was varied in fine steps to determine the threshold dose of 2E15 Cu ions/cm 2 for 'seed' formation of copper films on silicon using a commercial electroless plating solution. Plated films were studied with Rutherford backscattering spectrometry, scanning electron microscopy, EDX and profilometry . The adhesion of films was measured by 'scotch tape test'. The adhesion was found to improve with increasing dose. However thicker films exhibited rather poor adhesion and high internal stress. SEM results show that the films grow first as isolated islands which become larger and eventually impinge into a continuous film as the plating time is increased. (authors). 5 refs., 1 tab., 3 figs

  3. Side effects of permanent I125 prostate seed implants in 667 patients treated in Leeds

    International Nuclear Information System (INIS)

    Bottomley, David; Ash, Dan; Al-Qaisieh, Bashar; Carey, Brendan; Joseph, Joji; St Clair, Shaun; Gould, Kathy

    2007-01-01

    Purpose: To report the side effects and complications after I-125 seeds prostate implant after 8.5 years experience. Methods and materials: Six hundred and sixty seven (667) patients were treated between March 1995 and December 2001. The median follow up is 31 months with a maximum of 98.2 months. Morbidity data were collected from a review of patient case-notes. Patients also provided prospective data on urinary symptoms using the International Prostate Symptom Score (IPSS) scoring chart before treatment and at regular follow up. Patients were also sent a questionnaire detailing symptoms and side effects following their brachytherapy. This enabled them to record urinary, bowel and sexual function side effects independently. Logistic regression analysis was carried out to identify the risk of catheterisation in relation to the pre-implant prostate volume and potential implant factors such as the number of seeds and needles and implant dose. Result: The urinary symptom score rises in the first few months after implantation and returns to within one or two points of the pre-treatment score within one year. Nine patients reported incontinence prior to treatment and 15, 12 and 10 patients reported incontinence 6, 12 and 24 months after treatment, respectively. Catheterisation was reported in 97 (14.5%) patients. At six months 84.9% of patients reported no change in bowel function and 78.9% at 12 months. 6.4% of patients complained of some increased bowel frequency at 6 months and 5.7% at 12 months. 402 (77.2%) patients reported being fully potent before treatment and that this fell to 32.4% after treatment. Logistic regression showed that the most significant factors which correlate with the probability of catheterisation are the pre-treatment prostate volume and the number of seeds and needles implanted. Conclusion: The side effects and complications after prostate brachytherapy as reported here and elsewhere confirm that the treatment is not only convenient but also

  4. Dosimetric response of radioactive bio glass seeds implants on rabbit brain; Resposta radiodosimetrica de implantes de sementes de biovidros radioativos no cerebro de coelhos

    Energy Technology Data Exchange (ETDEWEB)

    Costa, I.T.; Campos, T.P.R., E-mail: itemponi@yahoo.com.br, E-mail: campos@nuclear.ufmg.br [Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares - Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil)

    2007-07-01

    Interstitial implants of radioactive seeds are used as an efficient way of treating brain tumors. Bio glasses is an interesting alternative to the metallic implanted materials, because they can be absorbed by the organism, reducing the possibilities of side effects. The present paper investigates the dosimetry by the implants performed on rabbit's brain on the NRI/UFMG research group. The spatial distribution of the specific ionizing energy deposited per unit of mass generated by Sm-153 seeds were evaluated. A computational model of the brain's region was built using the software SISCODES produced by the research group. The sections of the computer tomography of a rabbit, which was included on the experiment, were digitalized. Those were converted in a three dimensional voxel model, including the tissues, its chemical composition and density. A simulation of the particles transport is performed by the stochastic code MCNP5. The implants consist of 15 ceramic Ca-Si-Sm seeds enriched with Sm-153, with 1.1.6 mm of length and 0.3 mm diameter, implanted on the rabbit's brain. It was predicted on the model three ribbons of 5 seeds each, spaced by 1.1.2 mm, since the ribbons were in a triangular topology whose vertices were spaced by 8 mm. The activities were 120 MBq/seed. The results show isodose regions superposed over the rabbits' model, reproducing the spatial energy deposition on the brain region. The absorbed dose predicted was 3.2 Gy per 15 seed; however it was not enough to tumor control. The authors suggest to increase the number of seeds and activity, reduction of the space to 5-6 mm among ribbons, improving dose with the beta emitting. (author)

  5. Cost-effectiveness analysis of implants versus autologous perforator flaps using the BREAST-Q.

    Science.gov (United States)

    Matros, Evan; Albornoz, Claudia R; Razdan, Shantanu N; Mehrara, Babak J; Macadam, Sheina A; Ro, Teresa; McCarthy, Colleen M; Disa, Joseph J; Cordeiro, Peter G; Pusic, Andrea L

    2015-04-01

    Reimbursement has been recognized as a physician barrier to autologous reconstruction. Autologous reconstructions are more expensive than prosthetic reconstructions, but provide greater health-related quality of life. The authors' hypothesis is that autologous tissue reconstructions are cost-effective compared with prosthetic techniques when considering health-related quality of life and patient satisfaction. A cost-effectiveness analysis from the payer perspective, including patient input, was performed for unilateral and bilateral reconstructions with deep inferior epigastric perforator (DIEP) flaps and implants. The effectiveness measure was derived using the BREAST-Q and interpreted as the cost for obtaining 1 year of perfect breast health-related quality-adjusted life-year. Costs were obtained from the 2010 Nationwide Inpatient Sample. The incremental cost-effectiveness ratio was generated. A sensitivity analysis for age and stage at diagnosis was performed. BREAST-Q scores from 309 patients with implants and 217 DIEP flap reconstructions were included. The additional cost for obtaining 1 year of perfect breast-related health for a unilateral DIEP flap compared with implant reconstruction was $11,941. For bilateral DIEP flaps compared with implant reconstructions, the cost for an additional breast health-related quality-adjusted life-year was $28,017. The sensitivity analysis demonstrated that the cost for an additional breast health-related quality-adjusted life-year for DIEP flaps compared with implants was less for younger patients and earlier stage breast cancer. DIEP flaps are cost-effective compared with implants, especially for unilateral reconstructions. Cost-effectiveness of autologous techniques is maximized in women with longer life expectancy. Patient-reported outcomes findings can be incorporated into cost-effectiveness analyses to demonstrate the relative value of reconstructive procedures.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ben-David, Merav, E-mail: Merav.ben-david@sheba.health.gov.il [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Granot, Hila [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Gelernter, Ilana [Statistical Laboratory, School of Mathematics, Tel Aviv University, Tel Aviv (Israel); Scheflan, Michael [Department of Surgery, Assuta and Herzliya Medical Centers, Ramat Gan (Israel)

    2016-07-01

    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 50 Gy. For plans excluding IMN coverage, mean D{sub mean} for right and left reconstructed breasts was 49.09 Gy (98.2% of the prescribed dose) and 48.51 Gy (97.0%), respectively. For plans including IMNs, mean D{sub mean} was 49.15 Gy (98.3%) for right and 48.46 Gy (96.9%) for left reconstructed breasts; the mean IMN D{sub mean} was 47.27 Gy (right) and 47.89 Gy (left). Heart D{sub mean} was below 1.56 Gy for all plans. Mean total lung volume receiving a dose of ≥ 20 Gy 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.

  7. Long-Term Health Outcomes in Women With Silicone Gel Breast Implants: A Systematic Review.

    Science.gov (United States)

    Balk, Ethan M; Earley, Amy; Avendano, Esther A; Raman, Gowri

    2016-02-02

    Silicone gel breast implants were removed from the U.S. market for cosmetic use in 1992 owing to safety concerns. They were reintroduced in 2006, with a call for improved surveillance of clinical outcomes. To systematically review the literature regarding specific long-term health outcomes in women with silicone gel breast implants, including cancer; connective tissue, rheumatologic, and autoimmune diseases; neurologic diseases; reproductive issues, including lactation; offspring issues; and mental health issues (depression and suicide). MEDLINE, EMBASE, and Ovid Healthstar (inception through 30 June 2015), and the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the first quarter of 2015). 4 researchers double-screened articles for longitudinal studies that compared women with and without breast implants and reported long-term health outcomes of interest. 4 researchers extracted data on participant and implant characteristics, analytic methods, and results. 32 studies (in 58 publications) met eligibility criteria. Random-effects model meta-analyses of effect sizes were conducted when feasible. For most outcomes, there was at most only a single adequately adjusted study, which usually found no significant associations. There were possible associations with decreased risk for primary breast and endometrial cancers and increased risks for lung cancer, rheumatoid arthritis, Sjögren syndrome, and Raynaud syndrome. Evidence on breast implants and other outcomes either was limited or did not exist. The evidence was most frequently not specific to silicone gel implants, and studies were rarely adequately adjusted for potential confounders. The evidence remains inconclusive about any association between silicone gel implants and long-term health outcomes. Better evidence is needed from existing large studies, which can be reanalyzed to clarify the strength of associations between silicone gel implants and health outcomes

  8. 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

  9. The surgical viability and radiological monitoring of brain implants of bioactive micro-seeds in an animal model

    Directory of Open Access Journals (Sweden)

    Giane X. O. Silva

    2005-10-01

    Full Text Available The interstitial implant is a therapeutic modality in brachytherapy of the head and neck. Presently, the seeds implanted in tumors in the central nervous system are metallic I-125. After the full emission of the radionuclide, the seed remains inert in the implanted area. Bioactive ceramic seeds have been prepared for this research group incorporating Sm-152 to be active in Sm-153. The main goal of the present study is the development of a the surgical technique for implanting the biodegradable radioactive micro-seeds in the brains of rabbits, as well as the observation of the clinical reactions of the animal after implantation of two sets of three seeds. The surgical procedure consisted of performing two separate perforations 10 mm from each other in the skull, permitting the implantation of two groups of three seeds, totaling six seeds. The results of the pilot study showed the effectiveness of the surgical procedure and of the biocompatibility of the seeds and the lack of presence of adverse reactions, functional sequels, or inflammation in a follow up 50 days post-surgery. Such seeds of reduced volume, 0.2 x 1.6 mm, could be monitored by computerized tomography 30 days after implanting.Os implantes intersticiais podem ser utilizados em braquiterapia de cabeça e pescoço. Atualmente as sementes implantadas no CNS são de I-125 metálicas. Após o decaimento do radioisótopo, a semente fica inerte na região implantada. Sementes cerâmicas bioativas tem sido preparadas pelo grupo de pesquisa incorporando Sm-152. O presente estudo tem o objetivo de viabilizar a técnica cirúrgica de implantes de microsementes biodegradáveis não radioativas no cérebro de coelhos, bem como verificar as reações clínicas e funcionais do animal ao corpo estranho implantado. O procedimento cirúrgico compreendeu em proceder duas perfurações separadas em 10mm na calota craniana onde foi possível a implantação de dois conjuntos de três sementes

  10. The response of breast cancer cells to mesenchymal stem cells: a possible role of inflammation by breast implants.

    Science.gov (United States)

    Orciani, Monia; Lazzarini, Raffaella; Scartozzi, Mario; Bolletta, Elisa; Mattioli-Belmonte, Monica; Scalise, Alessandro; Di Benedetto, Giovanni; Di Primio, Roberto

    2013-12-01

    Breast implants are widely used and at times might cause inflammation as a foreign body, followed by fibrous capsule formation around the implant. In cancer, the inflamed stroma is essential for preservation of the tumor. Mesenchymal stem cells can be recruited to sites of inflammation, and their role in cancer development is debated. The authors assessed the effects of inflammation caused by breast implants' effects on tumor. Mesenchymal stem cells were isolated from the fibrous capsules of women who underwent a second operation after 1 year (presenting inflammation) or after 20 years (not presenting inflammation) since initial surgery. After characterization, cells were co-cultured with MCF7, a breast cancer cell line. The expression of genes involved in oncogenesis, proliferation, and epithelial-to-mesenchymal transition was investigated, followed by Western blot analyses. After co-culture with mesenchymal stem cells from the inflamed capsule, MCF7 induced a dose- and time-dependent increase in proliferation. Polymerase chain reaction analyses revealed a dysregulation of genes involved in oncogenesis, proliferation, and epithelial-to-mesenchymal transition. The subsequent evaluation by Western blot did not confirm these results, showing only a modest decrease in the expression of E-cadherin after co-culture with mesenchymal stem cells (both derived from inflamed or control capsules). These data indicate that inflammation caused by breast implants partially affects proliferation of MCF7 but does not influence key mechanisms of tumor development.

  11. CT-guided interstitial 125I seed implantation for intractable pelvic recurrence of rectal carcinomas

    International Nuclear Information System (INIS)

    Lin Zhenwen; Chu Hong; Kong Jian; Dou Yongchong

    2011-01-01

    Objective: To evaluate the therapeutic effect and safety of CT-guided interstitial 125 I seed implantation in treating intractable pelvic recurrence of rectal carcinomas. Methods: During the period from April 2010 to September 2010 CT-guided interstitial 125 I seed implantation was carried out in 11 patients with pelvic recurrence of rectal carcinoma which developed after the patients had received comprehensive treatments such as surgical resection, chemotherapy and/or radiotherapy. The clinical data were retrospectively analyzed. The clinical symptoms, the tumor size and the quality of life (QOL) before the treatment and at two and six months after the treatment were recorded, and the complications were observed. The results were compared. All the patients were followed up for six months. Results: At two and six months after the treatment, the improvement rate of the clinical symptoms was 100.0% (11/11) and 90.9% (10/11) respectively, while the effective reduction of the tumor size was 90.9% (10/11) and 81.8% (9/11) respectively. At two and six months after the treatment the QOL score was (56.0±3.66) and (54.4±5.41) respectively, both of which were higher than the QOL score determined before the treatment (42.5±6.93), the difference between them was statistically significant (P 125 I seed implantation has satisfactory short-term effect. This treatment is also quite safe and effective for patients who are unbearable to external radiation therapy due to the tissue dose restriction. (authors)

  12. Dosimetry verification of radioactive seed implantation for malignant tumors assisted by 3D printing individual templates and CT guidance

    International Nuclear Information System (INIS)

    Ji, Zhe; Jiang, Yuliang; Guo, Fuxin; Sun, Haitao; Fan, Jinghong; Zhang, Lujing; Wang, Junjie

    2017-01-01

    Objective: We compared the dose distributions of postoperative plans with preoperative plans for 3D printing template-assisted radioactive seed implantations. Methods: A total of 14 patients with malignant tumors enrolled in the study. The dose parameters included D90, minimum peripheral dose, V100, V150, and V200. The statistical method was the paired t-test. Results: There was no significant difference in P values between the two groups for all parameters except for V100. Conclusions: The 3D printing guide template can provide good accuracy for radioactive seed implantation. - Highlights: • It is the first study we as for as we know to compare the preoperative and postoperative dosimetry results of 3D printing templates-assisted radioactive seeds implantation for malignant tumor. • 3D printing guide template can provide good accuracy for radioactive seeds implantation. • The actual dose distributions in postoperative validations were closed to the expectations of preoperative plans. • 3D printing template providing us an effective tool for the standardization and normalization of seed implantation, and having a good application prospect and worthy of further development and popularization.

  13. 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. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Metastatic Breast Cancer in Medication-Related Osteonecrosis Around Mandibular Implants.

    Science.gov (United States)

    Favia, Gianfranco; Tempesta, Angela; Limongelli, Luisa; Crincoli, Vito; Piattelli, Adriano; Maiorano, Eugenio

    2015-09-15

    Many authors have considered dental implants to be unrelated to increased risk of medication-related osteonecrosis of the jaw (MRONJ). Nevertheless, more recently, more cases of peri-implant MRONJ (PI-MRONJ) have been described, thus becoming a challenging health problem. Also, metastatic cancer deposits are not infrequently found at peri-implant sites and this may represent an additional complication for such treatments. We present the case of a breast cancer patient with PI-MRONJ, presenting a clinically and radiologically undetected metastasis within the necrotic bone, and highlight the necessity of an accurate histopathological analysis. A 66-year-old female patient, who had received intravenous bisphosphonates for bone breast cancer metastases, came to our attention for a non-implant surgery-triggered PI-MRONJ. After surgical resection of the necrotic bone, conventional and immunohistochemical examinations were performed, which showed breast cancer deposits within the necrotic bone. Cancer patients with metastatic disease, who are undergoing bisphosphonate treatment, may develop unusual complications, including MRONJ, which is a site at risk for hosting additional metastatic deposits that may be clinically and radiologically overlooked. Such risk is increased by previous or concomitant implant procedures. Consequently, clinicians should be prudent when performing implant surgery in cancer patients with advanced-stage disease and consider the possible occurrence of peri-implant metastases while planning adequate treatments in such patients.

  15. Aspects of an automatic system of implants of radioactive seeds and anatomic object simulator for tests in prostate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Leonardo S.M.; Braga, Viviane V.B.; Campos, Tarcísio P. R. de, E-mail: leonardosantiago.lsms@gmail.com, E-mail: vitoriabraga06@gmail.com, E-mail: tprcampos@yahoo.com.br [Universidade Federal de Minas Gerais (PCTN/UFMG), Belo Horizonte (Brazil). Pós-Graduação em Ciências e Técnicas Nucleares. Departamento de Engenharia Nuclear

    2017-07-01

    This work presents the state of the art of the research and development of an automatic radioactive seed implantation system (PSIS). PSIS may assist in the procedure of testing permanent implants in the prostate. These tests will be important in measurements of absorbed doses in the pelvic structures, involving the organs and tissues at risk to improve planning, seed positioning and dosimetry. The automated Prostate Seed Implant System (PSIS) has been designed to meet operational needs, which offers the freedom of positioning of the brachytherapy needle within the treatment area and ensures repeatability and fidelity to the planned treatment. Both the ultrasound probe and the seed implant needle are driven by step motors, Atmega microcontroller, bearings, aluminum shafts and a GUI (Graphical User Interface). Movement of both the probe and the needle holder was performed by fixed spindle on a threaded rod rushing to the step motors by a coupling. The step motors used to move the system consist of step motors used in CNC (Computer Numeric Control) machine. The choice of these engines occurred due to the precision in the movements that can be obtained with these types of motors. The ultrasound probe serves to help, through the images acquired during the longitudinal movement, to monitor the application of the seeds. The parts that make up the system infrastructure were made of aluminum and translucent acrylic and cylindrical aluminum bars of different diameters. All these pieces were fixed and adjusted trough screws, washers, nuts and adhesive to metal, composing the final prototype of the PSIS. The project was developed and the PSIS prototype was assembled. The prototype presented acceptable operating characteristics for prostate implants. The advantage of this system is the automation of the application that provides an accurate positioning and movement of both probe and seed application. In addition to this study, seeds implantation tests will be performed, and

  16. Aspects of an automatic system of implants of radioactive seeds and anatomic object simulator for tests in prostate brachytherapy

    International Nuclear Information System (INIS)

    Silva, Leonardo S.M.; Braga, Viviane V.B.; Campos, Tarcísio P. R. de

    2017-01-01

    This work presents the state of the art of the research and development of an automatic radioactive seed implantation system (PSIS). PSIS may assist in the procedure of testing permanent implants in the prostate. These tests will be important in measurements of absorbed doses in the pelvic structures, involving the organs and tissues at risk to improve planning, seed positioning and dosimetry. The automated Prostate Seed Implant System (PSIS) has been designed to meet operational needs, which offers the freedom of positioning of the brachytherapy needle within the treatment area and ensures repeatability and fidelity to the planned treatment. Both the ultrasound probe and the seed implant needle are driven by step motors, Atmega microcontroller, bearings, aluminum shafts and a GUI (Graphical User Interface). Movement of both the probe and the needle holder was performed by fixed spindle on a threaded rod rushing to the step motors by a coupling. The step motors used to move the system consist of step motors used in CNC (Computer Numeric Control) machine. The choice of these engines occurred due to the precision in the movements that can be obtained with these types of motors. The ultrasound probe serves to help, through the images acquired during the longitudinal movement, to monitor the application of the seeds. The parts that make up the system infrastructure were made of aluminum and translucent acrylic and cylindrical aluminum bars of different diameters. All these pieces were fixed and adjusted trough screws, washers, nuts and adhesive to metal, composing the final prototype of the PSIS. The project was developed and the PSIS prototype was assembled. The prototype presented acceptable operating characteristics for prostate implants. The advantage of this system is the automation of the application that provides an accurate positioning and movement of both probe and seed application. In addition to this study, seeds implantation tests will be performed, and

  17. Risk of lymphoma in women with breast implants: analysis of clinical studies.

    Science.gov (United States)

    Largent, Joan; Oefelein, Michael; Kaplan, Hilton M; Okerson, Ted; Boyle, Peter

    2012-05-01

    Large studies suggest that the overall rate of lymphoma in women with breast implants is no greater than in the general population; clinical reports suggest an association between breast implants and the rare non-Hodgkin lymphoma, anaplastic large cell lymphoma (ALCL). Observed cases of lymphoma reported in Allergan-sponsored breast implant clinical studies were compared with expected cases on the basis of the incidence of lymphoma among women in the National Cancer Institute's Surveillance Epidemiology and End Results program, using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). In clinical studies, there were 28 observed cases of lymphoma among 89 382 patients and 204 682 person-years of follow-up compared with 43 expected cases [SIR: 28/43=0.65 (95% CI: 0.43-0.94), P=0.02]. SIRs were calculated stratifying by baseline cancer history: women without prior cancer [SIR: 17/24=0.70 (95% CI: 0.41-1.13), P=0.17] and women with prior cancer [SIR: 11/14=0.79 (95% CI: 0.39-1.41), P=0.52]. SIRs were calculated by implant shell type: textured shell implants [SIR: 16/23=0.70 (95% CI: 0.40-1.13), P=0.16] and smooth shell implants [SIR: 12/19=0.63 (95% CI: 0.33-1.10), P=0.12]. Surveillance Epidemiology and End Results reported 12 cases of primary breast ALCL in women between 1996 and 2007 without a history of cancer, for an average annual incidence of 4.28 (95% CI: 3.51-5.05)/100 million women in the US - these women may or may not have breast implants. In clinical studies, three ALCL cases were reported in women with breast implants and a history of breast cancer, yielding a crude incidence rate of 1.46 (95% CI: 0.30-4.3)/100 000 person-years. Large clinical studies, based on over 200 000 person-years of follow-up, suggest no evidence of an increased risk of lymphoma among women who have received breast implants.

  18. Cell Seeding Densities in Autologous Chondrocyte Implantation Techniques for Cartilage Repair.

    Science.gov (United States)

    Foldager, Casper Bindzus; Gomoll, Andreas H; Lind, Martin; Spector, Myron

    2012-04-01

    Cartilage repair techniques have been among the most intensively investigated treatments in orthopedics for the past decade, and several different treatment modalities are currently available. Despite the extensive research effort within this field, the generation of hyaline cartilage remains a considerable challenge. There are many parameters attendant to each of the cartilage repair techniques that can affect the amount and types of reparative tissue generated in the cartilage defect, and some of the most fundamental of these parameters have yet to be fully investigated. For procedures in which in vitro-cultured autologous chondrocytes are implanted under a periosteal or synthetic membrane cover, or seeded onto a porous membrane or scaffold, little is known about how the number of cells affects the clinical outcome. Few published clinical studies address the cell seeding density that was employed. The principal objective of this review is to provide an overview of the cell seeding densities used in cell-based treatments currently available in the clinic for cartilage repair. Select preclinical studies that have informed the use of specific cell seeding densities in the clinic are also discussed.

  19. Ultrasonically guided 125iodine seed implantation with external radiation in management of localized prostatic carcinoma

    DEFF Research Database (Denmark)

    Iversen, P; Bak, M; Juul, N

    1989-01-01

    Thirty-three patients with localized prostatic carcinoma (16 poorly differentiated) were treated with transperineal 125Iodine seed implantation (160 Gy) guided by transrectal ultrasonography and subsequent external beam irradiation (47.4 Gy). The observation time was six to sixty-eight months...... with a median follow-up of thirty-five months. Median change in prostatic volume was a reduction of 35 percent. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after one to two years, revealing still malignant histology in 12 (48%). Development of distant metastases occurred...

  20. Patterns of failure after iodine-125 seed implantation for prostate cancer

    International Nuclear Information System (INIS)

    Lamb, David S.; Greig, Lynne; Russell, Grant L.; Nacey, John N.; Broome, Kim; Studd, Rod; Delahunt, Brett; Iupati, Douglas; Jain, Mohua; Rooney, Colin; Murray, Judy; Lamb, Peter J.; Bethwaite, Peter B.

    2014-01-01

    Purpose: To determine the site of relapse when biochemical failure (BF) occurs after iodine-125 seed implantation for prostate cancer. Materials and methods: From 2001–2009, 500 men underwent implantation in Wellington, New Zealand. Men who sustained BF were placed on relapse guidelines that delayed restaging and intervention until the prostate-specific antigen (PSA) was ⩾20 ng/mL. Results: Most implants (86%) had a prostate D90 of ⩾90%, and multivariate analysis showed that this parameter was not a variable that affected the risk of BF. Of 21 BFs that occurred, the site of failure was discovered to be local in one case and distant in nine cases. Restaging failed to identify the site of relapse in two cases. In nine cases the trigger for restaging had not been reached. Conclusions: If post-implant dosimetry is generally within the optimal range, distant rather than local failure appears to be the main cause of BF. Hormone treatment is therefore the most commonly indicated secondary treatment intervention (STI). Delaying the start of STI prevents the unnecessary treatment of men who undergo PSA ‘bounce’ and have PSA dynamics initially mimicking those of BF

  1. 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...

  2. WE-A-17A-11: Implanted Brachytherapy Seed Movement Due to Transrectal Ultrasound Probe-Induced Prostate Deformation

    Energy Technology Data Exchange (ETDEWEB)

    Liu, D; Usmani, N; Sloboda, R [Cross Cancer Institute, Edmonton, Alberta (Canada); University of Alberta, Edmonton, Alberta (Canada); Meyer, T; Husain, S; Angyalfi, S [Tom Baker Cancer Centre, Calgary, Alberta (Canada); University of Calgary, Calgary, Alberta (Canada); Kay, I [Canterbury District Health Board, Christchurch (New Zealand)

    2014-06-15

    Purpose: To characterize the movement of implanted brachytherapy seeds due to transrectal ultrasound probe-induced prostate deformation and to estimate the effects on prostate dosimetry. Methods: Implanted probe-in and probe-removed seed distributions were reconstructed for 10 patients using C-arm fluoroscopy imaging. The prostate was delineated on ultrasound and registered to the fluoroscopy seeds using a visible subset of seeds and residual needle tracks. A linear tensor and shearing model correlated the seed movement with position. The seed movement model was used to infer the underlying prostate deformation and to simulate the prostate contour without probe compression. Changes in prostate and surrogate urethra dosimetry were calculated. Results: Seed movement patterns reflecting elastic decompression, lateral shearing, and rectal bending were observed. Elastic decompression was characterized by anterior-posterior expansion and superior-inferior and lateral contractions. For lateral shearing, anterior movement up to 6 mm was observed for extraprostatic seeds in the lateral peripheral region. The average intra-prostatic seed movement was 1.3 mm, and the residual after linear modeling was 0.6 mm. Prostate D90 increased by 4 Gy on average (8 Gy max) and was correlated with elastic decompression. For selected patients, lateral shearing resulted in differential change in D90 of 7 Gy between anterior and posterior quadrants, and increase in whole prostate D90 of 4 Gy. Urethra D10 increased by 4 Gy. Conclusion: Seed movement upon probe removal was characterized. The proposed model captured the linear correlation between seed movement and position. Whole prostate dose coverage increased slightly, due to the small but systematic seed movement associated with elastic decompression. Lateral shearing movement increased dose coverage in the anterior-lateral region, at the expense of the posterior-lateral region. The effect on whole prostate D90 was smaller due to the subset

  3. The In Vivo Pericapsular Tissue Response to Modern Polyurethane Breast Implants.

    Science.gov (United States)

    Frame, James; Kamel, Dia; Olivan, Marcelo; Cintra, Henrique

    2015-10-01

    Polyurethane breast implants were first introduced by Ashley (Plast Reconstr Surg 45:421-424, 1970), with the intention of trying to reduce the high incidence of capsular contracture associated with smooth shelled, high gel bleed, silicone breast implants. The sterilization of the polyurethane foam in the early days was questionable. More recently, ethylene oxide (ETO)-sterilized polyurethane has been used in the manufacturing process and this has been shown to reduce the incidence of biofilm. The improved method of attachment of polyurethane onto the underlying high cohesive gel, barrier shell layered, silicone breast implants also encourages bio-integration. Polyurethane covered, cohesive gel, silicone implants have also been shown to reduce the incidence of other problems commonly associated with smooth or textured silicone implants, especially with reference to displacement, capsular contracture, seroma, reoperation, biofilm and implant rupture. Since the introduction of the conical polyurethane implant (Silimed, Brazil) into the United Kingdom in 2009 (Eurosurgical, UK), we have had the opportunity to review histology taken from the capsules of polyurethane implants in three women ranging from a few months to over 3 years after implantation. All implants had been inserted into virgin subfascial, extra-pectoral planes. The results add to the important previously described histological findings of Bassetto et al. (Aesthet Plast Surg 34:481-485, 2010). Five distinct layers are identified and reasons for the development of each layer are discussed. Breast capsule around polyurethane implants, in situ for fifteen and 20 years, has recently been obtained and analysed in Brazil, and the histology has been incorporated into this study. After 20 years, the polyurethane is almost undetectable and capsular contracture may appear. These findings contribute to our understanding of polyurethane implant safety, and give reasoning for a significant reduction in clinical

  4. Three-dimensional verification of 125I seed stability after permanent implantation in the parotid gland and periparotid region

    International Nuclear Information System (INIS)

    Fan, Yi; Huang, Ming-Wei; Zheng, Lei; Zhao, Yi-Jiao; Zhang, Jian-Guo

    2015-01-01

    To evaluate seed stability after permanent implantation in the parotid gland and periparotid region via a three-dimensional reconstruction of CT data. Fifteen patients treated from June 2008 to June 2012 at Peking University School and Hospital of Stomatology for parotid gland tumors with postoperative adjunctive 125 I interstitial brachytherapy were retrospectively reviewed in this study. Serial CT data were obtained during follow-up. Mimics and Geomagic Studio software were used for seed reconstruction and stability analysis, respectively. Seed loss and/or migration outside of the treated area were absent in all patients during follow-up (23–71 months). Total seed cluster volume was maximized on day 1 post-implantation due to edema and decreased significantly by an average of 13.5 % (SD = 9.80 %; 95 % CI, 6.82–17.68 %) during the first two months and an average of 4.5 % (SD = 3.60 %; 95 % CI, 2.29–6.29 %) during the next four months. Volume stabilized over the subsequent six months. 125 I seed number and location were stable with a general volumetric shrinkage tendency in the parotid gland and periparotid region. Three-dimensional seed reconstruction of CT images is feasible for visualization and verification of implanted seeds in parotid brachytherapy

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

    International Nuclear Information System (INIS)

    Rella, L.; Telegrafo, M.; Nardone, A.; Milella, A.; Ianora, A.A. Stabile; Lioce, M.; Angelelli, G.; Moschetta, M.

    2015-01-01

    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

  6. Preoperative implant selection for unilateral breast reconstruction using 3D imaging with the Microsoft Kinect sensor.

    Science.gov (United States)

    Pöhlmann, Stefanie T L; Harkness, Elaine; Taylor, Christopher J; Gandhi, Ashu; Astley, Susan M

    2017-08-01

    This study aimed to investigate whether breast volume measured preoperatively using a Kinect 3D sensor could be used to determine the most appropriate implant size for reconstruction. Ten patients underwent 3D imaging before and after unilateral implant-based reconstruction. Imaging used seven configurations, varying patient pose and Kinect location, which were compared regarding suitability for volume measurement. Four methods of defining the breast boundary for automated volume calculation were compared, and repeatability assessed over five repetitions. The most repeatable breast boundary annotation used an ellipse to track the inframammary fold and a plane describing the chest wall (coefficient of repeatability: 70 ml). The most reproducible imaging position comparing pre- and postoperative volume measurement of the healthy breast was achieved for the sitting patient with elevated arms and Kinect centrally positioned (coefficient of repeatability: 141 ml). Optimal implant volume was calculated by correcting used implant volume by the observed postoperative asymmetry. It was possible to predict implant size using a linear model derived from preoperative volume measurement of the healthy breast (coefficient of determination R 2  = 0.78, standard error of prediction 120 ml). Mastectomy specimen weight and experienced surgeons' choice showed similar predictive ability (both: R 2  = 0.74, standard error: 141/142 ml). A leave one-out validation showed that in 61% of cases, 3D imaging could predict implant volume to within 10%; however for 17% of cases it was >30%. This technology has the potential to facilitate reconstruction surgery planning and implant procurement to maximise symmetry after unilateral reconstruction. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. 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...... the other diagnosed all implants as intact. The procedures of the feasibility study proved successful, and the results demonstrate the importance of a rigid image evaluation protocol with employment of well-defined rupture criteria, as well as the benefits of several image readers.......Cosmetic breast implants have become increasingly popular throughout the world. However, there is insufficient knowledge about the frequency and severity of local complications such as rupture and capsular contracture. A pilot study of 25 Finnish women with 50 cosmetic breast implants was organized...

  8. Implant salvage in breast reconstruction with severe peri-prosthetic infection.

    Science.gov (United States)

    Meybodi, Farid; Sedaghat, Negin; French, James; Keighley, Caitlin; Mitchell, David; Elder, Elisabeth

    2017-12-01

    Although treatment of mild peri-prosthetic infection in implant-based breast reconstruction results in high rates of resolution, successful management of severe peri-prosthetic infection remains a significant challenge. In this case series, a protocol utilizing a novel dressing - negative pressure wound therapy with instillation (NPWTi) - for the management of severe peri-prosthetic infection in breast reconstruction patients is described. This is an operative technique involving: (i) explantation of the breast prosthesis and application of the NPWTi dressing to the implant pocket; (ii) change of the NPWTi dressing; (iii) intraoperative fluid/tissue cultures; and (iv) reimplantation of the breast prosthesis when cultures yield no growth. This protocol was utilized in six cases of severe peri-prosthetic infection in five patients with immediate breast reconstruction for breast cancer or risk-reducing surgery. Cultures of fluid/tissue grew typical and/or unusual organisms. Only one case did not yield an organism. The hospital length of stay upon completion of the protocol ranged from 7-16 days (mean, 12 days). Successful implant salvage was achieved in five of six cases. The protocol was aborted in one case to allow for completion of adjuvant chemotherapy. Early findings from this case series suggest that in cases of severe peri-prosthetic infection this novel operative protocol may result in successful implant salvage for breast reconstruction patients. Further studies are needed to more fully elaborate the role of NPWTi to achieve implant salvage in challenging cases of peri-prosthetic infection. © 2015 Royal Australasian College of Surgeons.

  9. 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...

  10. Clinical analysis of 125I seed implants in worst-casts of the malignant tumors after radiography and chemotherapy

    International Nuclear Information System (INIS)

    Chen Zhijun; Tu Xinhua; Zhou Aiqing; Wang Xueqin

    2006-01-01

    Objective: To investigate the curative effect and side reaction after 125 I seed implanted among tissue were treated the malignant neoplasm by radiography and chemotherapy. Methods: Retrospective analysis the cancerous sufferer after the failure of radiography and chemotherapy, percutaneous puncture or intraoperative under gaze forward 125 I seed were implanted the bed of the tumour forever. Follow-up blood routine examination, symptom, sign, using USG or CT observe the change of the tumour and the distribution of the particles etc. Results: In 3 cases, treat 2 cases, tumour reduced obviously, symptoms improved obviously, the face of the ulcer cured, the particles did not shift, hemogram did not decline obviously. Conclusion: 125 I seed among the tissue implanted forever for the unsuccessful case after radiography and chemotherapy supply a new therapeutic methods. In the neat future curative effect is exactly, toxic reaction is small, which can remedy the deficiency of the treatment for radiography and chemotherapy. (authors)

  11. Nursing care for patients with local recurrent rectal cancer after CT-guided 125I seed implantation therapy

    International Nuclear Information System (INIS)

    Yuan Li; Wei Fan; Ren Caifeng; Tu Mingmei; Qian Guixiang

    2010-01-01

    Objective: To discuss the nursing care strategy for patients with local recurrent rectal cancer who has been treated with CT-guided 125 I seed implantation therapy. Methods: Twenty patients with local recurrent rectal cancer received a series of nursing interventions, including comfort care and pain care. The clinical results were observed and analyzed. Results: The therapy was smoothly accomplished in all patients. The pain was remarkably relived and the anxiety was alleviated. No displacement of implanted 125 I seed occurred. Conclusion: For patients with local recurrent rectal cancer occurred after CT-guided 125 I seed implantation therapy, careful nursing can effectively relieve the pain and anxiety feeling,and the living quality can also be markedly improved. (authors)

  12. 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.

  13. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Herborn, Christoph U. [Institute of Diagnostic Radiology, University Hospital, Zuerich (Switzerland); Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45128 Essen (Germany); Marincek, Borut; Erfmann, Daniel; Kubik-Huch, Rahel A. [Institute of Diagnostic Radiology, University Hospital, Zuerich (Switzerland); Meuli-Simmen, Claudia; Wedler, Volker [Department of Surgery, Clinic for Reconstructive Surgery, University Hospital, Zurich (Switzerland); Bode-Lesniewska, Beate [Department of Pathology, University Hospital, Zurich (Switzerland)

    2002-09-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction. (orig.)

  14. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy

    International Nuclear Information System (INIS)

    Herborn, Christoph U.; Marincek, Borut; Erfmann, Daniel; Kubik-Huch, Rahel A.; Meuli-Simmen, Claudia; Wedler, Volker; Bode-Lesniewska, Beate

    2002-01-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction. (orig.)

  15. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy.

    Science.gov (United States)

    Herborn, Christoph U; Marincek, Borut; Erfmann, Daniel; Meuli-Simmen, Claudia; Wedler, Volker; Bode-Lesniewska, Beate; Kubik-Huch, Rahel A

    2002-09-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction.

  16. Iodine-125 seed implantation (permanent brachytherapy) for clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Ebara, Shin; Katayama, Yoshihisa; Tanimoto, Ryuta

    2008-01-01

    From January 2004 to March 2007, 308 patients with clinically localized prostate cancer were treated using iodine-125 ( 125 I) seed implantation (permanent brachytherapy) at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. We evaluated the treatment's efficacy and morbidity in 300 prostate cancer patients who were followed up for more than 1 month after brachytherapy. Based on the National Comprehensive Cancer Network (NCCN) guidelines, patients with a prostate volume of less than 40 ml in transrectal ultrasound imaging were classified as low or intermediate risk. The median patient age was 67 years (range 50 to 79 years), the median prostate-specific antigen (PSA) value before biopsy was 6.95 ng/ml (range 1.13 to 24.7 ng/ml), and the median prostate volume was 24.33 ml (range 9.3 to 41.76 ml). The median follow-up was 18 months (range 1 to 36 months) and the PSA levels decreased in almost all patients after brachytherapy. Although 194 of 300 patients (64.7%) complained of difficulty in urination, pollakisuria/urgency, miction pain, and/or urinary incontinence, all of which might be associated with radiation prostatitis during the first month after brachytherapy, these symptoms gradually improved. 125 I seed implantation brachytherapy is safe and effective for localized prostate cancer within short-term follow up. (author)

  17. [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. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Bypassing the learning curve in permanent seed implants using state-of-the-art technology

    International Nuclear Information System (INIS)

    Beaulieu, Luc; Evans, Dee-Ann Radford; Aubin, Sylviane; Angyalfi, Steven; Husain, Siraj; Kay, Ian; Martin, Andre-Guy; Varfalvy, Nicolas; Vigneault, Eric; Dunscombe, Peter

    2007-01-01

    Purpose: The aim of this study was to demonstrate, based on clinical postplan dose distributions, that technology can be used efficiently to eliminate the learning curve associated with permanent seed implant planning and delivery. Methods and Materials: Dose distributions evaluated 30 days after the implant of the initial 22 consecutive patients treated with permanent seed implants at two institutions were studied. Institution 1 (I1) consisted of a new team, whereas institution 2 (I2) had performed more than 740 preplanned implantations over a 9-year period before the study. Both teams had adopted similar integrated systems based on three-dimensional (3D) transrectal ultrasonography, intraoperative dosimetry, and an automated seed delivery and needle retraction system (FIRST, Nucletron). Procedure time and dose volume histogram parameters such as D90, V100, V150, V200, and others were collected in the operating room and at 30 days postplan. Results: The average target coverage from the intraoperative plan (V100) was 99.4% for I1 and 99.9% for I2. D90, V150, and V200 were 191.4 Gy (196.3 Gy), 75.3% (73.0%), and 37.5% (34.1%) for I1 (I2) respectively. None of these parameters shows a significant difference between institutions. The postplan D90 was 151.2 Gy for I1 and 167.3 Gy for I2, well above the 140 Gy from the Stock et al. analysis, taking into account differences at planning, results in a p value of 0.0676. The procedure time required on average 174.4 min for I1 and 89 min for I2. The time was found to decrease with the increasing number of patients. Conclusion: State-of-the-art technology enables a new brachytherapy team to obtain excellent postplan dose distributions, similar to those achieved by an experienced team with proven long-term clinical results. The cost for bypassing the usual dosimetry learning curve is time, with increasing team experience resulting in shorter treatment times

  19. Evaluation of dose-volume histograms after prostate seed implantation. 4-year experience

    International Nuclear Information System (INIS)

    Hoinkis, C.; Lehmann, D.; Winkler, C.; Herrmann, T.; Hakenberg, O.W.; Wirth, M.P.

    2004-01-01

    Background and purpose: permanent interstitial brachytherapy by seed implantation is a treatment alternative for low-volume low-risk prostate cancer and a complex interdisciplinary treatment with a learning curve. Dose-volume histograms are used to assess postimplant quality. The authors evaluated their learning curve based on dose-volume histograms and analyzed factors influencing implantation quality. Patients and methods: since 1999, 38 patients with a minimum follow-up of 6 months were treated at the authors' institution with seed implantation using palladium-103 or iodine-125, initially using the preplan method and later real-time planning. Postimplant CT was performed after 4 weeks. The dose-volume indices D90, V100, V150, the D max of pre- and postplans, and the size and position of the volume receiving the prescribed dose (high-dose volume) of the postplans were evaluated. In six patients, postplan imaging both by CT and MRI was used and prostate volumes were compared with preimplant transrectal ultrasound volumes. The first five patients were treated under external supervision. Results: patients were divided into three consecutive groups for analysis of the learning curve (group 1: n = 5 patients treated under external supervision; group 2: n = 13 patients; group 3: n = 20 patients). D90 post for the three groups were 79.3%, 74.2%, and 99.9%, the V100 post were 78.6%, 73.5%, and 88.2%, respectively. The relationship between high-dose volume and prostate volume showed a similar increase as the D90, while the relationship between high-dose volume lying outside the prostate and prostate volume remained constant. The ratio between prostate volumes from transrectal ultrasound and CT imaging decreased with increasing D90 post , while the preplanning D90 and V100 remained constant. The different isotopes used, the method of planning, and the implanted activity per prostate volume did not influence results. Conclusion: a learning curve characterized by an increase

  20. Radiation safety and protection of close contacts from radiators after implantation of radioactive 125I seeds

    International Nuclear Information System (INIS)

    Sui Aixia; Li Jianmin; Tang Fulong; Zhang Hongtao; Ren Ju'na; Pang Linbin; Xia Haishui; Gao Zhen; Wu Lili; Wang Juan

    2012-01-01

    Objective: To study the effective dose and precaution time of the irradiation of the close contact from the radiators who underwent implantation of radioactive 125 I seeds so as to guide scientifically people how to avoid radiation damage. Methods: Twenty patients with different types of cancer underwent implantation of radioactive 125 I seeds with the median value of implantation depth of 2.16 cm. Within 24 h after the operations the dose rates 30 cm and 100 cm from the skin were measured with pocket-size radiometer so as to imitate the situations of the close contacts. The effective doses and precaution times of different persons were calculated according to relevant formula. Results: The dose rate a person received at the same time points (1, 54, 78, and 109 d, respectively) decreased along with the increase of the distance from the skin (t=5.962, 5.961, 5.961, 5.962, P<0.05), and the dose rate a person received at the same distance from the skin decreased along with the extension of time (30 cm: t=6.236, 6.236, 6.235, P<0.05; 100 cm: t=7.310, 7.315, 7.314, P<0.05). At different time points, the dose rates at 30 cm distance point were all significant higher than those at the 100 cm point (P <0.05). The adult living together, minors and pregnant women sharing the room, colleagues,adults who slept together with the patients began to reach the 50% dose constraint values 0, 54, 78 and 109 days after the operation. Conclusions: After their precaution time, it's safe to contact with the patients for the groups; otherwise, it's necessary to take some protect works within the precaution time. (authors)

  1. Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

    Directory of Open Access Journals (Sweden)

    Jiajun Feng

    2016-03-01

    Full Text Available BackgroundThe aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant.MethodsWe analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant.ResultsThe average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry.ConclusionsThis approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

  2. The diagnosis of breast implant rupture: MRI findings compared with findings at explantation

    International Nuclear Information System (INIS)

    Hoelmich, Lisbet R.; Vejborg, Ilse; Conrad, Carsten; Sletting, Susanne; McLaughlin, Joseph K.

    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 participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. Results: At MRI, 66 implants were diagnosed as ruptured, nine as possibly ruptured and 43 as intact. Among the ruptured implants, 27 were categorized as extracapsular. At surgery, on average 297 days after the MRI, 65 of the 66 rupture diagnoses were confirmed, as were 20 of the cases with extracapsular silicone. Eight of the nine possibly ruptured implants were in fact ruptured at surgery. Thirty-four of the 43 intact implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89%, 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 when evaluation of images are based on presence of well-defined rupture criteria

  3. The effect of interstitial 125I seeds implantation on intestinal wall: a pathological observation in experimental dogs

    International Nuclear Information System (INIS)

    Ning Houfa; Zhang Fenglian; Shen An; Cao Guiwen; Cui Xinjiang

    2010-01-01

    Objective: To observe the radiation injury of the bowel wall due to the implantation of interstitial 125 I seeds in experimental dogs. Methods: A total of 12 healthy male dogs were randomly and equally divided into 3 experimental groups and 1 control group, with 3 dogs in each group.In the experimental groups, two 125 I seeds with the active radiation dose of 0.8mCi were symmetrically implanted under the serous membrane of the dog's small intestinal wall. The dogs were fed for 14 days (group A), for one month (group B) and for two months (group C) respectively when the animals were scheduled to be sacrificed. The dogs' general condition was observed till they were sacrificed. The seed-implanting intestinal segments were then removed and dyed with HE staining method for electronic microscopic exam. The histopathologic findings were recorded and the results were compared between four groups. Results: No obvious histopathological changes were found in the dog's bowel wall 14 days after the implantation. One month after the procedure cellular injury was observed under electronic microscope, and two months after the operation partial fibrosis of the intestinal wall appeared but no ulceration or perforation occurred. Conclusion: The implantation of 125 I seeds can cause reversible cellular injuries of the intestinal wall in experimental dogs, the degree of the damage reaches its peak at one month after the implant when the partial fibrosis of bowel wall becomes evident. However, the seeds do not cause any serious complications, such as ulceration or perforation. (authors)

  4. Efficacy of Vancomycin-based Continuous Triple Antibiotic Irrigation in Immediate, Implant-based Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Lisa M. Hunsicker, MD, FACS

    2017-12-01

    Conclusions:. Continuous breast irrigation with a vancomycin-based triple antibiotic solution is a safe and effective accompaniment for immediate implant reconstruction. Use of intramuscular anesthetic injection for postoperative pain control allows the elastomeric infusion pump to be available for local tissue antibiotic irrigation.

  5. Early multicentre experience of pre-pectoral implant based immediate breast reconstruction using Braxon®.

    Science.gov (United States)

    Jafferbhoy, Sadaf; Chandarana, Mihir; Houlihan, Maria; Parmeshwar, Rishikesh; Narayanan, Sankaran; Soumian, Soni; Harries, Simon; Jones, Lucie; Clarke, Dayalan

    2017-12-01

    The last two decades have seen significant changes in surgical management of breast cancer. The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice. Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options. Prepectoral implant placement and complete coverage of implant with acellular dermal matrix (ADM) eliminates the need to detach the muscle from underlying chest wall in contrast to the subpectoral technique. We report short-term outcomes of a multicentre study from the United Kingdom (UK) using Braxon ® in women having an IBR. A prospective study was conducted from December 2015 to October 2016 and included all patients from three breast units in the UK who underwent a mastectomy and an implant-based IBR using Braxon ® . The demographic details, co-morbidities, operative details, immediate and delayed complications were recorded. Specific complications recorded were infection, seroma, unplanned readmission and loss of implant. A comparison was made with complications reported in the National Mastectomy and Reconstruction Audit. Seventy-eight IBRs were included in the analysis with a median follow-up of 9.98 months. Mean age of the cohort was 50 years with a mean body mass index of 25.7 kg/m 2 . Mean implant volume was 365 cc. The inpatient hospital stay was 1.48 days. About 23% of patients had a seroma, 30% had erythema requiring antibiotics and the explant rate was 10.2 percent. Bilateral reconstructions were significantly associated with implant loss and peri-operative complications on univariate analysis. Our early experience with this novel prepectoral technique using Braxon ® has shown it to be an effective technique with complication rates comparable to subpectoral IBR. The advantages of prepectoral implant-based IBR are quicker postoperative recovery and short post-operative hospital stay. Long-term studies are required to assess rippling, post

  6. Magnetic Resonance Imaging Screening Results Compared with Explantation Results in Poly Implant Prothese Silicone Breast Implants, Recalled from the European Market in 2010

    NARCIS (Netherlands)

    Maijers, M.C.; Niessen, F.B.; Veldhuizen, J.F.H.; Ritt, M.J.P.F.; Manoliu, R.A.

    2014-01-01

    BACKGROUND: In a prospective cohort study, the authors followed 112 women whose Poly Implant Prothèse silicone breast implants were recalled. Magnetic resonance imaging results and clinical consequences were previously published. The authors compared magnetic resonance imaging screening with

  7. Radiotherapy and breast reconstruction: complications and cosmesis with TRAM versus tissue expander/implant

    International Nuclear Information System (INIS)

    Chawla, Ashish K.; Kachnic, Lisa A.; Taghian, Alphonse G.; Niemierko, Andrzej; Zapton, Daniel T.; Powell, Simon N.

    2002-01-01

    Purpose: Radiotherapy (RT) has an important role in breast cancer treatment after modified radical mastectomy. Many of these patients also undergo breast reconstruction. We reviewed our institutions' experience to determine the outcome of patients treated with breast reconstruction and RT. Methods and Materials: Between 1981 and 1999, 48 breast cancer patients underwent modified radical mastectomy, breast reconstruction, and ipsilateral breast RT during their treatment course. Reconstruction either preceded or followed RT. Autologous reconstruction with a transverse rectus abdominus myocutaneous (TRAM) flap was performed in 30 patients, and 18 underwent expander and implant (E/I) reconstruction. The primary endpoint was the quality of the reconstructed, irradiated breast, as measured by analyzing the actuarial incidence of complications. The cosmetic outcome was also assessed by multidisciplinary review of the follow-up visits. Results: The median follow-up from reconstruction was 32 months. The actuarial 2-year complication rate was 53% for patients receiving E/I vs. 12% for those receiving TRAM reconstruction (p<0.01). No other patient or treatment-related factors had a significant impact on complications. The cosmetic outcome was also significantly better in the TRAM subgroup than in the E/I subgroup. Conclusion: The tolerance and cosmetic outcome of breast reconstruction for breast cancer patients in irradiated sites depends significantly on the type of reconstruction used

  8. Public health implications of differences in U.S. and European Union regulatory policies for breast implants.

    Science.gov (United States)

    Zuckerman, Diana; Booker, Nyedra; Nagda, Sonia

    2012-12-01

    The recall of tens of thousands of defective breast implants in Europe in 2011-12 as well as new data on risks have raised questions about regulatory standards for these and other medical implants in the United States (U.S.) and European Union (EU). In the U.S., breast implants are regulated as high-risk medical devices that must be proven reasonably safe and effective in clinical trials and subject to government inspection before they can be sold. In contrast, clinical trials and inspections have not been required for breast implants or other implanted devices in the EU; approval is based on other information. As a result of these differing standards, the PIP breast implants that were recalled across Europe had been removed from the market years earlier in the U.S. than in the EU, a decision U.S. government health agencies can point to with pride. Nevertheless, the FDA track record on post-marketing breast implant research indicates poorly implemented studies and little meaningful enforcement to ensure that studies have been conducted correctly or findings reported accurately or acted upon. In sum, neither the EU nor the US has used their regulatory authority to ensure the long-term safety of breast implants. However, in 2012 the EU announced regulatory changes that could improve that situation. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  9. Immunophenotypic characterization of human T cells after in vitro exposure to different silicone breast implant surfaces.

    Directory of Open Access Journals (Sweden)

    Giuseppe Cappellano

    Full Text Available The most common complication of silicone breast implants is capsular contracture (massive scar formation around the implant. We postulate that capsular contracture is always a sequel to inflammatory processes, with both innate and adaptive immune mechanisms participating. In general, fibroblasts and macrophages have been used as cell types to evaluate in vitro the biocompatibility of breast implant surfaces. Moreover, also T cells have been found at the implant site at the initial stage of fibrous capsule formation. However, only few studies have addressed the influence of surfaces with different textures on T-cell responses. The aim of the present study was to investigate the immune response of human peripheral blood mononuclear cells (PBMC to commercially available silicone breast implants in vitro. PBMC from healthy female blood donors were cultured on each silicone surface for 4 days. Proliferation and phenotype of cultured cells were assessed by flow cytometry. Cytokine levels were determined by multiplex and real-time assay. We found that silicone surfaces do not induce T-cell proliferation, nor do they extensively alter the proportion of T cell subsets (CD4, CD8, naïve, effector memory. Interestingly, cytokine profiling identified matrix specific differences, especially for IL-6 and TNF-α on certain surface topographies that could lead to increased fibrosis.

  10. Dosimetric effectiveness in implants with distinct HO166-seed distribution in prostate

    International Nuclear Information System (INIS)

    Braga, Viviane V. B.; Campos, Tarcísio P. R.

    2017-01-01

    Currently, there is a need to produce new therapeutic techniques for the treatment of prostate tumors, considering the high incidence of the disease and significant morbidity rates associated with surgery and radiotherapy. Simulations in brachytherapy produce essential information about the efficiency and dosimetric efficacy compared to other techniques. Computational simulation by Monte Carlo method has been used to evaluate the absorbed dose and effective dose in radiotherapy and radiology. Virtual, analytical or voxelized phantoms are useful in the internal assessment of the spatial distribution of absorbed dose. This study estimated the efficiency of dosimetry by parameters of merit generated from volumetric distributions of absorbed doses simulating various spatial distributions of Ho-166 seeds in a prostate model. A computer model of voxels was developed, using the code SISCODES (Computational System for Dosimetry by Neutrons and Photons by Stochastic Methods applied to radiology and radiotherapy), representative of a real physical simulator predefined as a calibration method. The virtual model reproduced a cubic box, filled with muscle equivalent tissue (TE), where a 5-cm diameter ball with TE-prostate was positioned 2-cm from the air interface. A Ho-166 seed distribution, produced by 16 filet-implants distributed regularly (10-mm pitch) containing 04 separate 8-mm seeds, was employed. Two pitch were considered: 9 and 10 mm, with same distance between seed in a fillet. Based on SISCODE database of chemical composition of tissues and nuclear data, The code allowed the association of nuclear and chemical data to the voxels of the model, by the selection of the tissue of each voxel, as well as the positioning of the sources and their spatial distribution and spectra. The code MCNP5 simulated the transport of photons and electrons in the model, generating the energy deposited per unit mass in each voxel for photons in MeV.g-1 and energy absorbed in MeV for beta

  11. Dosimetric effectiveness in implants with distinct HO166-seed distribution in prostate

    Energy Technology Data Exchange (ETDEWEB)

    Braga, Viviane V. B.; Campos, Tarcísio P. R., E-mail: Vitoriabraga06@gmail.com, E-mail: tprcampos@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2017-07-01

    Currently, there is a need to produce new therapeutic techniques for the treatment of prostate tumors, considering the high incidence of the disease and significant morbidity rates associated with surgery and radiotherapy. Simulations in brachytherapy produce essential information about the efficiency and dosimetric efficacy compared to other techniques. Computational simulation by Monte Carlo method has been used to evaluate the absorbed dose and effective dose in radiotherapy and radiology. Virtual, analytical or voxelized phantoms are useful in the internal assessment of the spatial distribution of absorbed dose. This study estimated the efficiency of dosimetry by parameters of merit generated from volumetric distributions of absorbed doses simulating various spatial distributions of Ho-166 seeds in a prostate model. A computer model of voxels was developed, using the code SISCODES (Computational System for Dosimetry by Neutrons and Photons by Stochastic Methods applied to radiology and radiotherapy), representative of a real physical simulator predefined as a calibration method. The virtual model reproduced a cubic box, filled with muscle equivalent tissue (TE), where a 5-cm diameter ball with TE-prostate was positioned 2-cm from the air interface. A Ho-166 seed distribution, produced by 16 filet-implants distributed regularly (10-mm pitch) containing 04 separate 8-mm seeds, was employed. Two pitch were considered: 9 and 10 mm, with same distance between seed in a fillet. Based on SISCODE database of chemical composition of tissues and nuclear data, The code allowed the association of nuclear and chemical data to the voxels of the model, by the selection of the tissue of each voxel, as well as the positioning of the sources and their spatial distribution and spectra. The code MCNP5 simulated the transport of photons and electrons in the model, generating the energy deposited per unit mass in each voxel for photons in MeV.g-1 and energy absorbed in MeV for beta

  12. 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....

  13. Risk of connective tissue disease and related disorders among women with breast implants: a nation-wide retrospective cohort study in Sweden.

    OpenAIRE

    Nyrén, O.; Yin, L.; Josefsson, S.; McLaughlin, J. K.; Blot, W. J.; Engqvist, M.; Hakelius, L.; Boice, J. D.; Adami, H. O.

    1998-01-01

    OBJECTIVE: To examine the relation between connective tissue disease and related conditions and breast implants. DESIGN: Retrospective cohort study of all women in the Swedish national inpatient registry who underwent breast augmentation surgery with artificial implants during 1964-93, compared with women who underwent breast reduction surgery during the same period. SETTING: Sweden. SUBJECTS: 7442 women with implants for cosmetic reasons or for reconstruction after breast cancer surgery and ...

  14. Does acellular dermal matrix really improve aesthetic outcome in tissue expander/implant-based breast reconstruction?

    Science.gov (United States)

    Ibrahim, Ahmed M S; Koolen, Pieter G L; Ganor, Oren; Markarian, Mark K; Tobias, Adam M; Lee, Bernard T; Lin, Samuel J; Mureau, Marc A M

    2015-06-01

    The expectation for improved results by women undergoing postmastectomy reconstruction has steadily risen. A majority of these operations are tissue expander/implant-based breast reconstructions. Acellular dermal matrix (ADM) offers numerous advantages in these procedures. Thus far, the evidence to justify improved aesthetic outcome has solely been based on surgeon opinion. The purpose of this study was to assess aesthetic outcome following ADM use in tissue expander/implant-based breast reconstruction by a panel of blinded plastic surgeons. Mean aesthetic results of patients who underwent tissue expander/implant-based breast reconstruction with (n = 18) or without ADM (n = 20) were assessed with objective grading of preoperative and postoperative photographs by five independent blinded plastic surgeons. Absolute observed agreement as well as weighted Fleiss Kappa (κ) test statistics were calculated to assess inter-rater variability. When ADM was incorporated, the overall aesthetic score was improved by an average of 12.1 %. In addition, subscale analyses revealed improvements in breast contour (35.2 %), implant placement (20.7 %), lower pole projection (16.7 %), and inframammary fold definition (13.8 %). Contour (p = 0.039), implant placement (p = 0.021), and overall aesthetic score (p = 0.022) reached statistical significance. Inter-rater reliability showed mostly moderate agreement. Mean aesthetic scores were higher in the ADM-assisted breast reconstruction cohort including the total aesthetic score which was statistically significant. Aesthetic outcome alone may justify the added expense of incorporating biologic mesh. Moreover, ADM has other benefits which may render it cost-effective. Larger prospective studies are needed to provide plastic surgeons with more definitive guidelines for ADM use. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the

  15. Radiation protective nursing intervene of 125I seed implantation in non-small cell lung carcinoma guided by CT

    International Nuclear Information System (INIS)

    Fu Li; Zhang Zuncheng; Yu Zhaochen; Zheng Guangjun; Tian Meirong

    2009-01-01

    Objective: To research radiation protective nursing intervene and important notice of 125 I seeds minimally invasive implantation in non-small cell lung carcinoma (NSCLC) by CT. Methods: Under the system of therapy planning system (TPS) and posologic validation, 125 I seeds were implanted in 89 cases of NSCLC patients. The consistent radiation protective nursing intervene was used in perioperative period management. The operative successful rate, therapeutic effect and complication rate, therapeutic effect and complication rate was observed. Results: The scientific radiation protective nursing intervene can ensure that the radioactive dose distribution of 125 I seed implantation brachytherapy is consistent with the principles of effective and minimally invasive. The operative successful rate was 100%. The local control rate and 1 year survival rate respectively was 97.4% and 92.2%. But the early and later incidence rate of radioactive damaging effect was 14.6% and 1.1% respectively. Leakage of radioactive contamination has not occurred. Conclusion: The consistent TPS and posologic validation 125 I seeds implantation integrated scientific radiation protective nursing intervene. It is very important to improve the therapeutic effect of NSCLC and reduce the incidence of complications. (authors)

  16. Comparison between different methods of breast implant volume choice and degree of postoperative satisfaction

    Directory of Open Access Journals (Sweden)

    RAFAEL DAIBERT DE SOUZA MOTTA

    2018-02-01

    Full Text Available ABSTRACT Objectives: to assess the degree of patient satisfaction after undergoing breast augmentation and compare three different, easy, inexpensive and universal methods of preoperative choice of breast implant volume. Methods: a prospective study was carried out at University Hospital Pedro Ernesto of State University of Rio de Janeiro, in 94 women from Rio de Janeiro, aged 18 to 49 years, submitted to breast augmentation mammaplasty with breast implant due to hypomastia. All implants were textured, with a round base and high projection and were introduced into the retroglandular space through an inframammary access. The patients were divided into three groups: Control, Silicone and MamaSize®, with 44, 25 and 25 patients, respectively. Satisfaction questionnaires were applied in the pre and postoperative periods by the same evaluator, through the visual analogue scale, in which ‘0’ meant very unsatisfied and ‘100’ very satisfied for the four variables: shape, size, symmetry and consistency. The degree of satisfaction with the surgical scar was also assessed in the postoperative period. Results: when the preoperative and postoperative satisfaction levels were compared, there was a difference in all variables for the three groups, with statistical significance. However, when the postoperative data were compared with each other, there was no significant difference. The degree of satisfaction with the surgical scar was high. Conclusion: the augmentation mammaplasty with breast implant had a high index of satisfaction among patients. However, there was no difference in the degree of satisfaction in the postoperative period between the three methodologies of breast volume measurement.

  17. Sustained Release Talazoparib Implants for Localized Treatment of BRCA1-deficient Breast Cancer.

    Science.gov (United States)

    Belz, Jodi E; Kumar, Rajiv; Baldwin, Paige; Ojo, Noelle Castilla; Leal, Ana S; Royce, Darlene B; Zhang, Di; van de Ven, Anne L; Liby, Karen T; Sridhar, Srinivas

    2017-01-01

    Talazoparib, a potent PARP inhibitor, has shown promising clinical and pre-clinical activity by inducing synthetic lethality in cancers with germline Brca1/2 mutations. Conventional oral delivery of Talazoparib is associated with significant off-target effects, therefore we sought to develop new delivery systems in the form of an implant loaded with Talazoparib for localized, slow and sustained release of the drug at the tumor site in Brca1 -deficient breast cancer. Poly(lactic-co-glycolic acid) (PLGA) implants (0.8 mm diameter) loaded with subclinical dose (25 or 50 µg) Talazoparib were fabricated and characterized. In vitro studies with Brca1 -deficient W780 and W0069 breast cancer cells were conducted to test sensitivity to PARP inhibition. The in vivo therapeutic efficacy of Talazoparib implants was assessed following a one-time intratumoral injection in Brca1 Co/Co ;MMTV-Cre;p53 +/- mice and compared to drug-free implants and oral gavage. Immunohistochemistry studies were performed on tumor sections using PCNA and γ-H2AX staining. Sustained release of Talazoparib was observed over 28 days in vitro . Mice treated with Talazoparib implants showed statistically significant tumor growth inhibition compared to those receiving drug-free implants or free Talazoparib orally. Talazoparib implants were well-tolerated at both drug doses and resulted in less weight loss than oral gavage. PARP inhibition in mice treated with Talazoparib implants significantly increased double-stranded DNA damage and decreased tumor cell proliferation as shown by PCNA and γ-H2AX staining as compared to controls. These results demonstrate that localized and sustained delivery of Talazoparib via implants has potential to provide superior treatment outcomes at sub-clinical doses with minimal toxicity in patients with BRCA1 deficient tumors.

  18. SU-F-T-314: Estimation of Dose Distributions with Different Types of Breast Implants in Various Radiation Treatment Techniques for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M; Lee, S; Suh, T [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, J [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Department of Radiation Oncology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, S; Cho, Y; Lee, I [Department of Radiation Oncology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2016-06-15

    Purpose: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. Methods: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment. The films were placed at various slices in the Rando phantom and between the body and breast surface OSLDs were used to measure skin dose at 18 positions spaced on the two (right/left) breast. The implant breast was placed on the left side and the phantom breast was remained on the right side. Each treatment technique was performed on different size of the breasts and different shape of the breast implant. The PTV dose was prescribed 50.4 Gy and V47.88≥95%. Results: In different shapes of the breast implant, because of the shadow formed extensive around the breast implant, dose variation was relatively higher that of prescribed dose. As the PTV was delineated on the whole breast, maximum 5% dose error and average 3% difference was observed averagely. VMAT techniques largely decrease the contiguous hot spot in the skin by an average of 25% compared with IMRT. The both IMRT and VMAT techniques resulted in lower doses to normal critical structures than tangential plans for nearly all dose analyzation. Conclusion: Compared to the other technique, IMRT reduced radiation dose exposure to normal tissues and maintained reasonable target homogeneity and for the same target coverage, VMAT can reduce the skin dose in all the regions of the body.

  19. SU-F-T-314: Estimation of Dose Distributions with Different Types of Breast Implants in Various Radiation Treatment Techniques for Breast Cancer

    International Nuclear Information System (INIS)

    Lee, M; Lee, S; Suh, T; Jung, J; Kim, S; Cho, Y; Lee, I

    2016-01-01

    Purpose: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. Methods: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment. The films were placed at various slices in the Rando phantom and between the body and breast surface OSLDs were used to measure skin dose at 18 positions spaced on the two (right/left) breast. The implant breast was placed on the left side and the phantom breast was remained on the right side. Each treatment technique was performed on different size of the breasts and different shape of the breast implant. The PTV dose was prescribed 50.4 Gy and V47.88≥95%. Results: In different shapes of the breast implant, because of the shadow formed extensive around the breast implant, dose variation was relatively higher that of prescribed dose. As the PTV was delineated on the whole breast, maximum 5% dose error and average 3% difference was observed averagely. VMAT techniques largely decrease the contiguous hot spot in the skin by an average of 25% compared with IMRT. The both IMRT and VMAT techniques resulted in lower doses to normal critical structures than tangential plans for nearly all dose analyzation. Conclusion: Compared to the other technique, IMRT reduced radiation dose exposure to normal tissues and maintained reasonable target homogeneity and for the same target coverage, VMAT can reduce the skin dose in all the regions of the body.

  20. 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

    2017-01-01

    BACKGROUND AND PURPOSE: To examine the risk of cardiac conduction abnormalities or severe ventricular arrhythmias requiring implantation of a cardiac implantable electronic device (CIED), either a pacemaker or an implantable cardioverter-defibrillator, subsequent to breast cancer (BC) radiotherapy...... (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...

  1. Mastectomy Skin Necrosis After Breast Reconstruction: A Comparative Analysis Between Autologous Reconstruction and Implant-Based Reconstruction.

    Science.gov (United States)

    Sue, Gloria R; Lee, Gordon K

    2018-05-01

    Mastectomy skin necrosis is a significant problem after breast reconstruction. We sought to perform a comparative analysis on this complication between patients undergoing autologous breast reconstruction and patients undergoing 2-stage expander implant breast reconstruction. A retrospective review was performed on consecutive patients undergoing autologous breast reconstruction or 2-stage expander implant breast reconstruction by the senior author from 2006 through 2015. Patient demographic factors including age, body mass index, history of diabetes, history of smoking, and history of radiation to the breast were collected. Our primary outcome measure was mastectomy skin necrosis. Fisher exact test was used for statistical analysis between the 2 patient cohorts. The treatment patterns of mastectomy skin necrosis were then analyzed. We identified 204 patients who underwent autologous breast reconstruction and 293 patients who underwent 2-stage expander implant breast reconstruction. Patients undergoing autologous breast reconstruction were older, heavier, more likely to have diabetes, and more likely to have had prior radiation to the breast compared with patients undergoing implant-based reconstruction. The incidence of mastectomy skin necrosis was 30.4% of patients in the autologous group compared with only 10.6% of patients in the tissue expander group (P care in the autologous group, only 3.2% were treated with local wound care in the tissue expander group (P skin necrosis is significantly more likely to occur after autologous breast reconstruction compared with 2-stage expander implant-based breast reconstruction. Patients with autologous reconstructions are more readily treated with local wound care compared with patients with tissue expanders, who tended to require operative treatment of this complication. Patients considering breast reconstruction should be counseled appropriately regarding the differences in incidence and management of mastectomy skin

  2. One-step breast reconstruction with polyurethane-covered implants after skin-sparing mastectomy.

    Science.gov (United States)

    Rancati, Alberto; Soderini, Alejandro; Dorr, Julio; Gercovich, Gustavo; Tessari, Luciano; Gonzalez, Eduardo

    2013-12-01

    Skin-sparing mastectomy (SSM) and immediate one-step breast reconstruction with implants has become an increasingly popular, effective treatment for selected patients with breast carcinoma. However, it is associated with high complication rates. Breast augmentation with polyurethane-covered implants (PCIs) has consistently had optimal short-term and long-term results with low rates of capsular contracture. The aim of this study was to evaluate the clinical and aesthetic outcomes of immediate one-step breast reconstruction with PCI after SSM in early breast cancer patients at a single institution. We reviewed the records of 221 consecutive breast cancer patients who underwent one-stage immediate reconstruction with PCI after SSM from 1995 through 2005. Patient and tumour characteristics, type of reconstruction, postoperative complications, aesthetic results and recurrence rate were analysed. The mean age of the patients was 52±11 years (range, 30-76; standard deviation (SD), 11). The American Joint Committee on Cancer (AJCC) pathologic stages were 0 (10%), I (63.3%) and II (26.7%). Thirty-nine (17.65%; confidence interval (CI)=13.04-23.1) of the 221 patients had complications; seven had prosthesis extrusion requiring an implant (five due to skin necrosis, one due to infection and one due to late haematoma). In six of these seven cases, the procedure was indicated for local recurrence after conservative breast surgery with adjunctive radiation therapy (rescue procedure). Thirty-two (14.4%) patients had minor complications: 12 had cutaneous rash, four had malpositioned implants and 16 had inadequate implant projection. At long-term follow-up, four (1.8%) patients had developed grade IV capsular contracture associated with postoperative radiation therapy. At a median follow-up of 98 months (range, 36-156), 14 (6.3%) patients had tumour recurrence and 12.2% had distant metastasis. Nineteen patients had died of cancer, and 192 (86.8%) remained disease free. One

  3. Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study.

    Science.gov (United States)

    Lipworth, Loren; Tarone, Robert E; Friis, Søren; Ye, Weimin; Olsen, Jørgen H; Nyren, Olof; McLaughlin, Joseph K

    2009-01-15

    No increased risks of specific types of cancer following breast implantation have been consistently reported, but data on risk beyond 15 years are limited. We have pooled the results of 2 nationwide cohort studies of 3,486 Swedish and 2,736 Danish women who underwent cosmetic breast implantation between 1965 and 1993. Cancer incidence through 2002 was ascertained through nationwide cancer registries. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated to compare cancer incidence among women with implants with women in the general population. Mean duration of follow up was 16.6 years (range 0.1-37.8 years). Over 50% of women were followed for 15 years or more after breast implantation and 13.3% for at least 25 years. There was a reduced incidence of breast cancer (SIR=0.73; 95% CI 0.58-0.90), whereas lung cancer was above expectation (SIR=1.64; 95% CI 1.10-2.36). The increased risk of lung cancer is expected due to the high prevalence of smoking among the women with implants in our study. With respect to other site-specific cancers, no significantly increased or decreased SIR was observed. This study, which includes women followed for almost 4 decades, represents the longest follow up of women with cosmetic breast implants to date. The results provide no evidence of an association between breast implants and any type of cancer. Copyright (c) 2008 Wiley-Liss, Inc.

  4. Assessment of I-125 seed implant accuracy when using the live-planning technique for low dose rate prostate brachytherapy

    Directory of Open Access Journals (Sweden)

    Moorrees Joshua

    2012-11-01

    Full Text Available Abstract Background Low risk prostate cancers are commonly treated with low dose rate (LDR brachytherapy involving I-125 seeds. The implementation of a ‘live-planning’ technique at the Royal Adelaide Hospital (RAH in 2007 enabled the completion of the whole procedure (i.e. scanning, planning and implant in one sitting. ‘Live-planning’ has the advantage of a more reliable delivery of the planned treatment compared to the ‘traditional pre-plan’ technique (where patient is scanned and planned in the weeks prior to implant. During live planning, the actual implanted needle positions are updated real-time on the treatment planning system and the dosimetry is automatically recalculated. The aim of this investigation was to assess the differences and clinical relevance between the planned dosimetry and the updated real-time implant dosimetry. Methods A number of 162 patients were included in this dosimetric study. A paired t-test was performed on the D90, V100, V150 and V200 target parameters and the differences between the planned and implanted dose distributions were analysed. Similarly, dosimetric differences for the organs at risk (OAR were also evaluated. Results Small differences between the primary dosimetric parameters for the target were found. Still, the incidence of hotspots was increased with approximately 20% for V200. Statistically significant increases were observed in the doses delivered to the OAR between the planned and implanted data; however, these increases were consistently below 3% thus probably without clinical consequences. Conclusions The current study assessed the accuracy of prostate implants with I-125 seeds when compared to initial plans. The results confirmed the precision of the implant technique which RAH has in place. Nevertheless, geographical misses, anatomical restrictions and needle displacements during implant can have repercussions for centres without live-planning option if dosimetric changes are not

  5. Numb chin syndrome as a manifestation of possible breast cancer metastasis around dental implants.

    Science.gov (United States)

    Orhan, Kaan; Bayndr, Hakan; Aksoy, Seçil; Seker, Basak Kusakci; Berberoğlu, Atilla; Ozan, Oğuz

    2011-05-01

    Numb chin syndrome, sometimes called numb lip syndrome, is an uncommon but well-recognized symptom in medical oncology. It may be a metastatic neurologic manifestation of malignancy, often with no clinically visible pathologic finding. The authors report a numb chin syndrome as a manifestation possible breast cancer metastasis around dental implants in a 69-year-old woman. The patient was presented with complaint of numbness in the lower jaw. Medical anamnesis revealed a metastatic breast carcinoma (CA). Radiographic imaging with conventional panoramic radiography and cone beam computed tomographic examination, revealed a moth-eaten shape, radiolucent, and radiopaque mixed appearance around the dental implants that was related with possible metastasis of the breast cancer. Numb chin syndrome is almost unknown within the dental and oral and maxillofacial community, despite being well reported in the medical literature. General dentists, oral medicine specialists, and oral and maxillofacial surgeons must be aware of this condition to consider metastatic cancer in patients with unexplained facial hypoesthesia. Moreover, although the development of metastatic lesions around implants is an uncommon pathologic finding, the examination of peri-implant lesion should be performed carefully considering the entire pathologic situations.

  6. SU-E-T-12: A Comparative Dosimetric Study of Pre and Post Prostate Iodine-125 Permanent Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Liu, X; Rahimian, J; Goy, B; Cosmatos, H; Qian, Y [Kaiser Permanente, Los Angeles, CA (United States)

    2015-06-15

    Purpose: Post-implant dosimetry has become the gold standard for prostate implant evaluation. The goal of this research is to compare the dosimetry between pre-plan and post-plan in permanent prostate seed implant brachytherapy. Methods: A retrospective study of 91 patients treated with Iodine-125 prostate seed implant between year 2012∼2014 were performed. All plans were created using a VariSeed 8.0 planning system. Pre-plan ultrasound images were acquired using 0.5 cm slice thickness. Post-plan CT images acquired about 1–4 weeks after implant, fused with the preplan ultrasound images. The prostate and urethra contours were generated using the fusion of ultrasound and CT images. Iodine-125 seed source activities varied between 0.382 to 0.414 mCi per seed. The loading patterns varied slightly between patients depending on the prostate size. Statistical analysis of pre and post plans for prostate and urethra volumes, V100%, V150% and D90, and urethra D10 were performed and reported. Results: The pre and post implant average prostate size was 36.90cc vs. 38.58cc; V100% was 98.33% vs. 96.89%; V150% was 47.09% vs. 56.95%; D90 was 116.35Gy vs. 116.12Gy, urethra volume was 1.72cc vs. 1.85cc, urethra D10% was 122.0% vs. 135.35%, respectively. There was no statistically significant difference between the pre and post-plan values for D90(p-value=0.43). However, there are significant differences between other parameters most likely due to post surgical edema; prostate size (p-value= 0.00015); V100% (p-value=3.7803E-07); V150% (p-value=1.49E-09); urethra volume (p-value= 2.77E-06); Urethra D10 (p-value=7.37E-11). Conclusion: The post-plan dosimetry using CT image set showed similar D90 dose coverage to the pre-plan using the ultrasound image dataset. The study showed that our prostate seed implants have consistently delivered adequate therapeutic dose to the prostate while sparing urethra. Future studies to correlate dose versus biochemical response using patients’ PSA

  7. MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

    Science.gov (United States)

    Quinn, S F; Neubauer, N M; Sheley, R C; Demlow, T A; Szumowski, J

    1996-01-01

    MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

  8. A Simple Flap Design for the Salvage of Immediate Implant-Based Breast Reconstruction.

    Science.gov (United States)

    Yazar, Sukru; Altinkaya, Altug; Karadag, Emine Cigdem; Kara, Halil; Uras, Cihan

    2018-02-01

    Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant. In this article, the use of local pedicled flap for the management of these situations was discussed. Between April 2010 and July 2015, 54 patients underwent breast reconstruction by inverted-T skin-reducing mastectomy and immediate implant-based breast reconstruction at our clinic. During the postoperative follow-up period, necrosis at the T-junction area was observed in 8 patients. All the patients received proper wound care, and the necrosis was surgically debrided. The defect was closed with Limberg-like rectangular flap. The mean age was 45.2 (range, 33-54) years. The mean body mass index was 25.57 ± 6.53 (range, 21.2-35.2) kg/m. The mean follow-up was 10.9 (range, 4-19) months. Two patients had implant exposure at the defect site after the debridement. There was no implant loss in any of the patients. The Limberg-like rectangular flap can be used as a salvage option in complicated skin-reducing mastectomies and can be considered as a safe and effective method because of its easy-to-use nature, low cost, and no need for microsurgery experience.

  9. The new opt-out Dutch National Breast Implant Registry - Lessons learnt from the road to implementation.

    Science.gov (United States)

    Rakhorst, Hinne A; Mureau, Marc A M; Cooter, Rodney D; McNeil, John; van Hooff, Miranda; van der Hulst, René; Hommes, Juliette; Hoornweg, Marije; Moojen-Zaal, Laura; Liem, Patricia; Mathijssen, Irene M J

    2017-10-01

    An estimated 1-3% of all women in the Netherlands carry breast implants. Since the introduction five decades ago, problems with a variety of breast implants have emerged with direct consequences for the patients' health. Plastic surgeons worldwide reacted through campaigning for auditing on long-term implant quality, surgeon performance, and institutional outcomes in implant registries. Especially, the PIP implant scandal of 2010 demonstrated the paucity of epidemiological data and uncovered a weakness in our ability to even 'track and trace' patients. In addition, a recent report of the Dutch Institute of National Health showed a lack of compliance of 100% of breast implant producers to CE requirements. These arguments stress the need for an independent implant registry. Insufficient capture rates or dependence from the implant producers made the variety of national and international patient registries unreliable. The Dutch Breast Implant Registry (DBIR) is unique because it is an opt-out registry without the need for informed consent and thus a high capture rate. Furthermore, an estimated 95% of breast implants are implanted by board-certified plastic surgeons. Funding was received from a non-governmental organisation to increase the quality of health care in the Netherlands, and maintenance is gathered by 25 euros per implant inserted. This article describes the way the Dutch have set up their system, with special attention to the well-known hurdles of starting a patient registry. Examples include: funding, medical ethical issues, opt out system, benchmarking, quality assurance as well as governance and collaboration. The Dutch consider their experience and data shareware for others to be used globally to the benefit of patient safety and quality improvement. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Fan, Lin-Jun; Jiang, Jun; Yang, Xin-Hua; Zhang, Yi; Li, Xing-Gang; Chen, Xian-Chun; Zhong, Ling

    2009-12-20

    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. 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. 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. 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.

  11. Destiny rides again: the reappearance of silicone gel-filled breast implant toxicity.

    Science.gov (United States)

    Brawer, A E

    2017-09-01

    Background Twenty-five years ago attorneys representing ailing women in class action litigation against silicone breast implant manufacturers made the procedural error of defining silicone-induced toxicity in the courtroom before it was properly studied in the exam room. This aberrant methodology perverted the proper research process, rendered verification of any real disease elusive, and cemented the groundwork for a repeat public health crisis potentially affecting two million women in the USA who possess new silicone gel devices inserted over the past 10 years. Patients and methods Six women, previously well, aged 27 to 53 (mean 42), were recipients of the new generations of cohesive silicone gel-filled breast implants approved for general use by the Food and Drug Administration (FDA) since December of 2006. They averaged seven years of total implantation time, and none experienced implant rupture. Results All six became ill on average 3.5 years from the time of implantation. By seven years the women manifested multiple types of skin rashes, polyarthritis, fatigue, protracted AM stiffness, myalgias, headaches, photosensitivity, hair loss, paresthesias, tinnitus, lymphadenopathy, chest pain, cognitive dysfunction, dry eyes, skin pigment changes, itching, muscle twitching, dizziness, nausea, easy bruising, and odor and smell sensitivity. Three of the four who were explanted noted improvement and/or resolution of at least 50% of their total disease manifestations. Conclusions These six women are representative of over 70,000 other breast implant recipients who, over the past three years, have had their new silicone devices permanently removed because of alleged gel-induced toxicity. The recurrence of this public health crisis has been fueled by manufacturers' research fraud, FDA ineptness, faulty informed consent, patient abandonment, proprietary manufacturing secrecy, misleading advertising, physician indifference, aberrant research methodology, and lax

  12. Development of measurement method using TLD for workers occupation personally exposed to 125I seed source in the implant

    International Nuclear Information System (INIS)

    Luo Suming; He Zhijian; Yuan Jilong; Yue Baorong; Wei Kedao

    2011-01-01

    Objective: To explore the method for measuring and calculating both absorbed dose and effective dose received in organ and tissues of occupational workers by using TLDs for the implantation of 125 I seed sources. Methods The experiments with 60 Co γ-rays were carried out for the stability. A group of TLD chips was exposed to 125 I seed sources to establish standard dose curve for air kerma. During the 125 I seed implantation, the TLD chips were pasted to 13 locations like thyroid inside and outside the lead aprons worn by occupational workers to measure average absorbed dose and calculate the absorbed doses and effective to organs and tissues. Results: For 3 cases of prostate cancers with implantation of 125 I seeds, the worker's organs and tissues received the absorbed dose 0.02 -3.80 μ Gy and effective dose 0.06- 1.81 μSv outside lead aprons and the highest absorbed dose 2.35 μ Gy and effective 0.02 μSv inside lead aprons, respectively, with more than 65.9% of rays shielded. For 3 cases of brain cancers with implantation of 125 I seeds, the workers received the absorbed dose 0.23 - 11.31 μGy and effective dose 0.88-4.07 μSv outside lead aprons and the highest absorbed dose 2.22 μ Gy and effective dose 0.09 μSv inside lead aprons, respectively, with more than 54.5% of rays shielded. For 3 cases of lung cancers with implantation of 125 I seeds, the workers received the absorbed dose 0.03 - 14.78 μGy and effective dose 0.35 -7.59 μSv outside lead aprons and the highest absorbed dose 4.09 μGy and effective 0.22 μSv inside lead aprons, respectively, with more than 58.4% of rays shielded. For 2 cases of mediastinum cancers with implantation of 125 Iseeds, the workers received the absorbed dose 0.06 - 74.91 μGy and effective dose 0.83-17.96 μSv outside lead aprons and the highest absorbed dose 10.29 μGy and effective 0.5 μSv inside lead aprons, respectively, with more than 85% of rays shielded. For one case of ovary cancer with implantation of 125

  13. ANTIPROLIFERATIVE EFFECT ON BREAST CANCER (MCF7) OF MORINGA OLEIFERA SEED EXTRACTS.

    Science.gov (United States)

    Adebayo, Ismail Abiola; Arsad, Hasni; Samian, Mohd Razip

    2017-01-01

    Moringa oleifera belongs to plant family, Moringaceae and popularly called "wonderful tree", for it is used traditionally to cure many diseases including cancer in Africa and Asia, however, there is limited knowledge on cytotoxic activity of Moringa oleifera seeds on MCF7 breast cancer cell. The present study evaluated antiproliferative effect on MCF7 of the seed. Seeds of Moringa oleifera were grinded to powder and its phytochemicals were extracted using water and 80% ethanol solvents, part of the ethanolic extract were sequentially partitioned to fractions with four solvents (hexane, dichloromethane, chloroform, and n-butanol). Antiproliferative effects on MCF7 of the samples were determined. Finally, potent samples that significantly inhibited MCF7 growth were tested on MCF 10A. Crude water extract, hexane and dichloromethane fractions of the seeds inhibited the proliferation of MCF7 with the following IC 50 values 280 μg/ml, 130 μg/ml and 26 μg/ml respectively, however, of the 3 samples, only hexane fraction had minimal cytotoxic effect on MCF 10A (IC 50 > 400μg/ml). Moringa oleifera seed has antiproliferative effect on MCF7.

  14. Poster — Thur Eve — 77: Implanted Brachythearpy Seed Movement due to Transrectal Ultrasound Probe-Induced Prostate Deformation

    International Nuclear Information System (INIS)

    Liu, D; Usmani, N; Sloboda, R; Meyer, T; Husain, S; Angyalfi, S; Kay, I

    2014-01-01

    The study investigated the movement of implanted brachytherapy seeds upon transrectal US probe removal, providing insight into the underlying prostate deformation and an estimate of the impact on prostate dosimetry. Implanted seed distributions, one obtained with the prostate under probe compression and another with the probe removed, were reconstructed using C-arm fluoroscopy imaging. The prostate, delineated on ultrasound images, was registered to the fluoroscopy images using seeds and needle tracks identified on ultrasound. A deformation tensor and shearing model was developed to correlate probe-induced seed movement with position. Changes in prostate TG-43 dosimetry were calculated. The model was used to infer the underlying prostate deformation and to estimate the location of the prostate surface in the absence of probe compression. Seed movement patterns upon probe removal reflected elastic decompression, lateral shearing, and rectal bending. Elastic decompression was characterized by expansion in the anterior-posterior direction and contraction in the superior-inferior and lateral directions. Lateral shearing resulted in large anterior movement for extra-prostatic seeds in the lateral peripheral region. Whole prostate D90 increased up to 8 Gy, mainly due to the small but systematic seed movement associated with elastic decompression. For selected patients, lateral shearing movement increased prostate D90 by 4 Gy, due to increased dose coverage in the anterior-lateral region at the expense of the posterior-lateral region. The effect of shearing movement on whole prostate D90 was small compared to elastic decompression due to the subset of peripheral seeds involved, but is expected to have greater consequences for local dose coverage

  15. Magnetic resonance imaging (MRI) evaluation of residual breast tissue following mastectomy and reconstruction with silicone implants.

    Science.gov (United States)

    Zippel, Douglas; Tsehmaister-Abitbol, Vered; Rundstein, Arie; Shalmon, Anat; Zbar, Andrew; Nardini, Gil; Novikov, Ilya; Sklair-Levy, Miri

    2015-01-01

    We present our use of magnetic resonance (MR) measurement to determine the amount of residual breast tissue (RBT) following total mastectomy with reconstruction. Breast MR images of 45 women who underwent surgery between January and November 2011 were reviewed. The cohort included therapeutic and prophylactic mastectomies. RBT was evaluated at four points with a digital caliper assessing T2-weighted and T1-weighted images. Patients undergoing mastectomy for carcinoma tended to have less RBT than in prophylactic surgery. Greater age and recent surgery both correlated with larger RBT. Variable thickness of RBT is demonstrable following mastectomy and implant reconstruction using MR imaging. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 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 ...

  17. 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...

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

    Directory of Open Access Journals (Sweden)

    Nikki Castel

    2015-03-01

    Full Text Available BackgroundPolyurethane 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.MethodsThis 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 months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation.ResultsNo patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation.ConclusionsAn inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.

  19. Postimplantation Analysis Enables Improvement of Dose-Volume Histograms and Reduction of Toxicity for Permanent Seed Implantation

    International Nuclear Information System (INIS)

    Wust, Peter; Postrach, Johanna; Kahmann, Frank; Henkel, Thomas; Graf, Reinhold; Cho, Chie Hee; Budach, Volker; Boehmer, Dirk

    2008-01-01

    Purpose: To demonstrate how postimplantation analysis is useful for improving permanent seed implantation and reducing toxicity. Patients and Methods: We evaluated 197 questionnaires completed by patients after permanent seed implantation (monotherapy between 1999 and 2003). For 70% of these patients, a computed tomography was available to perform postimplantation analysis. The index doses and volumes of the dose-volume histograms (DVHs) were determined and categorized with respect to the date of implantation. Differences in symptom scores relative to pretherapeutic status were analyzed with regard to follow-up times and DVH descriptors. Acute and subacute toxicities in a control group of 117 patients from an earlier study (June 1999 to September 2001) by Wust et al. (2004) were compared with a matched subgroup from this study equaling 110 patients treated between October 2001 and August 2003. Results: Improved performance, identifying a characteristic time dependency of DVH parameters (after implantation) and toxicity scores, was demonstrated. Although coverage (volume covered by 100% of the prescription dose of the prostate) increased slightly, high-dose regions decreased with the growing experience of the users. Improvement in the DVH and a reduction of toxicities were found in the patient group implanted in the later period. A decline in symptoms with follow-up time counteracts this gain of experience and must be considered. Urinary and sexual discomfort was enhanced by dose heterogeneities (e.g., dose covering 10% of the prostate volume, volume covered by 200% of prescription dose). In contrast, rectal toxicities correlated with exposed rectal volumes, especially the rectal volume covered by 100% of the prescription dose. Conclusion: The typical side effects occurring after permanent seed implantation can be reduced by improving the dose distributions. An improvement in dose distributions and a reduction of toxicities were identified with elapsed time between

  20. The clinical and diagnostic consequences of Poly Implant Prothèse silicone breast implants, recalled from the European market in 2010.

    Science.gov (United States)

    Maijers, Maria C; Niessen, Francisus B

    2013-03-01

    Recently, Poly Implant Prothèse silicone breast implants were recalled from the European market. The authors studied 112 women and previously published data on rupture prevalence. Women are presenting with symptoms they feel may be a result of ruptured implants. The authors' aim was to study the clinical consequences of Poly Implant Prothèse implants. One hundred twelve women with 224 proven Poly Implant Prothèse implants after 10 years of implantation were enrolled in this study. All women underwent physical examination and magnetic resonance imaging and were interviewed regarding symptoms. Details of the explantations of 35 women with at least one ruptured implant were documented. Tissue from 10 women was sent for pathologic investigation. Of 112 women, 34 (30.4 percent) had symptoms attributable to their implants. Physical examination showed that 12 of the 121 women (10.7 percent) had findings suggestive of rupture, most commonly pain. Three had lymphadenopathy that seemed to correlate with implant rupture or excessive "gel bleed." Pathologic findings showed no malignancies. Eight women who underwent explantation had no implant rupture. Excessive gel bleed was documented in half of them. Clinical consequences of women with Poly Implant Prothèse implants are comparable to those reported in the literature of other manufacturers. Neither complaints nor findings at physical examination had a significant correlation with implant rupture at explantation. Magnetic resonance imaging is still the preferred method compared with physical examination for diagnosing rupture. The low specificity was probably caused by the difficulty in differentiating between rupture and excessive gel bleed in these implants.

  1. CT-guided radioactive 125I-seed implantation for the treatment of pancreatic carcinoma: a clinical observation of 19 cases

    International Nuclear Information System (INIS)

    Lu Jian; Zheng Yunfeng; Zhang Huan; Wang Zhongmin; Chen Kemin

    2010-01-01

    Objective: To explore the dynamic changes of serum tumor markers after CT-guided radioactive 125 I-seed implantation treatment in patients with pancreatic carcinoma and to assess the therapeutic effectiveness of 125 I-seed implantation. Methods: CT-guided radioactive 125 I-seed implantation was performed in 19 patients with unresectable advanced pancreatic cancer. Treatment planning system was used to reconstruct 3-dimentional images of the tumor, and the quantity and distribution of 125 I-seeds to be implanted were thus determined. Under CT guidance 125 I-seeds were embedded into pancreatic cancer. Before and after the 125 I-seed implantation the levels of serum tumor markers, including CEA, CA19-9 and CA50, were determined by using radioimmunoassay method. The clinical effects were observed and the therapeutic results were statistically analyzed. Results: The pain stared to be relieved 2 to 5 days after implantation. The total effective rate (CR + PR) at one and three months after treatment was 68.42% (13 /19) and 63.16% (12 /19) respectively. One month after 125 I-seed implantation, the levels of serum CEA, CA19-9 and CA50 were significantly different to that determined before implantation in all cases (P 125 I-seed implantation is a safe and effective interventional treatment for advanced pancreatic cancer with reliable short-term result and remarkable pain-relieving effect. Moreover, this therapy can significantly lower the levels of many serum tumor markers, which play some suggestive roles in evaluating the clinical curativeness. (authors)

  2. [Breast augmentation by implants: a review of surgical practices. A study among French plastic surgeons].

    Science.gov (United States)

    Chekaroua, K; Delay, E

    2005-10-01

    In the framework of the 2005 report on mammary implants prepared by the Société française de chirurgie plastique reconstructrice et esthétique (SOF.CPRE), we conducted a survey among french plastic surgeons involved in the field. We elaborated a questionnaire that we distributed twice to the 600 members of the society; a total of 261 responded. Analysis of the data collected provides information on the socioprofessional characteristics of the responding surgeons, and on the devices, products and techniques they use. Finally, the survey has permitted to identify their qualitative perception of breast implant products currently available. Ranking these items by order of frequency provides a snapshot of the current procedures and practices in use for breast augmentation surgery in France.

  3. Long-term outcome of accelerated partial breast irradiation using a multilumen balloon applicator in a patient with existing breast implants.

    Science.gov (United States)

    Akhtari, Mani; Nitsch, Paige L; Bass, Barbara L; Teh, Bin S

    2015-01-01

    Accelerated partial breast irradiation is now an accepted component of breast-conserving therapy. However, data regarding long-term outcomes of patients treated with multilumen catheter systems who have existing breast implants are limited. We report the treatment and outcome of our patient who had existing bilateral silicone subpectoral implants at the time of presentation. Ultrasound-guided core needle biopsy of the right breast showed infiltrating mucinous carcinoma. Right breast lumpectomy revealed an 8 mm area of infiltrating ductal carcinoma with mucinous features and nuclear grade 1. A 4-5 cm Contura (Bard Biopsy Systems, Tempe, AZ) device was placed, and she was treated over the course of 5 days twice daily to a dose of 34 Gy using a high-dose-rate iridium-192 source. The planning target volume for evaluation was 73.9 cc. The percentage of the planning target volume for evaluation receiving 90%, 95%, and 100% of the prescribed dose was 99.9%, 99.3%, and 97.8%, respectively. The total implant volume was 234.5 cc and received a mean dose of 15.4 Gy and a maximum dose of 72.8 Gy. The percentage of implant volume receiving 50%, 75%, 100%, and 200% of the prescribed dose was 31.1%, 16.5%, 8.6%, 2.0%, and 0%, respectively. Maximum skin dose was 97% of the prescribed dose. With a followup of nearly 5 years, she continues to be cancer free with minimal late toxicities and good to excellent cosmetic outcome. Accelerated partial breast irradiation using a multilumen balloon applicator in patients with existing breast implants can safely be performed with excellent long-term cosmetic outcome. Further studies are needed to establish the absolute dosimetric tolerance of breast implants. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. Systematic review of the effectiveness of polyurethane-coated compared with textured silicone implants in breast surgery.

    Science.gov (United States)

    Duxbury, Paula J; Harvey, James R

    2016-04-01

    Silicone gel implants are used worldwide for breast augmentation and breast reconstruction. Textured silicone implants are the most commonly placed implant, but polyurethane-coated implants are increasingly being used in an attempt to ameliorate the long-term complications associated with implant insertion. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Electronic searches of MEDLINE, EMBASE, the Cochrane Library and www.ClinicalTrials.gov were undertaken in March 2014 using keywords. Following data extraction, 18 studies were included in the review, including four core studies of textured silicone implants and five studies reporting outcomes for polyurethane-coated silicone implants. There are no clear data reporting revision rates in patients treated with polyurethane implants. In the primary reconstructive setting, capsular contracture rates with silicone implants are 10-15% at 6 years, whilst studies of polyurethane implants report rates of 1.8-3.4%. In the primary augmentation setting, core studies show a capsular contracture rate of 2-15% at 6 years compared with 0.4-1% in polyurethane-coated implants; however, the polyurethane studies are limited by their design and poor follow-up. The use of polyurethane implants should be considered a safe alternative to textured silicone implants. It is likely that an implant surface does influence short- and long-term outcomes; however, the extent of any benefit cannot be determined from the available evidence base. Future implant studies should target the short- and long-term benefits of implant surfacing by procedure with defined outcome measures; a head-to-head comparison would help clarify outcomes. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. 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)

    Deo, S.V.S.; Shukla, N.K.; Mohanti, B.K.; Chawla, S.; Julka, P.K.; Rath, G.K.; Raina, V.

    2001-01-01

    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

  6. Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lourdes Alanis, MD, MPH

    2017-09-01

    Full Text Available Fibromatosis of the breast is a rare benign disease compromising <0.2% of all primary breast tumors. Although the chest wall is a common location, occurrences of implant-associated fibromatosis of the breast are extremely rare; only 33 cases have been reported. We present a case of a 42-year-old female who underwent breast augmentation with silicone breast implants, and 2 years later developed an aggressive implant-associated fibromatosis of the breast and chest wall. On imaging studies, the tumor mimicked breast carcinoma, and despite chemotherapy, the fibromatosis rapidly enlarged and was locally invasive requiring wide surgical excision. Unlike previously reported imaging findings, magnetic resonance imaging revealed an oval circumscribed mass with fringe-like internal architecture. We provide a review of the literature and discuss the imaging features of implant-associated fibromatosis of the breast.

  7. A multi-topographical-instrument analysis: the breast implant texture measurement

    Science.gov (United States)

    Garabédian, Charles; Delille, Rémi; Deltombe, Raphaël; Anselme, Karine; Atlan, Michael; Bigerelle, Maxence

    2017-06-01

    Capsular contracture is a major complication after implant-based breast augmentation. To address this tissue reaction, most manufacturers texture the outer breast implant surfaces with calibrated salt grains. However, the analysis of these surfaces on sub-micron scales has been under-studied. This scale range is of interest to understand the future of silicone particles potentially released from the implant surface and the aetiology of newly reported complications, such as Anaplastic Large Cell Lymphoma. The surface measurements were accomplished by tomography and by two optical devices based on interferometry and on focus variation. The robustness of the measurements was investigated from the tissue scale to the cellular scale. The macroscopic pore-based structure of the textured implant surfaces is consistently measured by the three instruments. However, the multi-scale analyses start to be discrepant in a scale range between 50 µm and 500 µm characteristic of a finer secondary roughness regardless of the pore shape. The focus variation and the micro-tomography would fail to capture this roughness regime because of a focus-related optical artefact and of step-shaped artefact respectively.

  8. Effect of Foley catheters on seed positions and urethral dose in 125I and 103Pd prostate implants

    International Nuclear Information System (INIS)

    Brezovich, Ivan A.; Pareek, Prem N.; Duan, Jun; Fiveash, John

    2001-01-01

    Purpose: To estimate the perturbation of seed position and urethral dose, subsequent to withdrawal of urethral catheters. Methods and Materials: A mathematical model based on the volume incompressibility of tissues was used to compute seed positions and doses following removal of the Foley. The model assumed that the central axis of the urethra remains stationary, and that prostate tissue and seeds move radially toward the center of the urethra to fill the void left by the catheter. Seed motion has also been measured using transrectal ultrasound. Results: Based on the computations, seeds located originally close to the urethra travel relatively large distances toward the urethra upon Foley removal, whereas seeds located further away move substantially less. This seed motion leads to higher urethral doses than shown in a standard treatment plan. Dose enhancements increase with catheter size, decrease with increasing prostate volume, are more pronounced for 103 Pd than for 125 I, and range between 3.5% and 32.4%. Postimplant dosimetry is equally affected if images are taken with urethral catheters in place, showing lower urethral doses than actually delivered. Preliminary ultrasound based measurements of seed motion agree with the theory. Conclusion: During the implantation procedure, 12 fr or smaller urethral catheters are preferable to larger diameter catheters if urine drainage is sufficient. Treatment planners should avoid planning seeds at 5 mm or closer from the urethra. Special caution is indicated in prostates having about 20 cm 3 or smaller volumes, and when 103 Pd is used. Postimplant dosimetry is susceptible to the same errors

  9. Evaluation of radioactive seeds implantation under PET-CT guidance for the treatment of central lung cancer with obstructive atelectasis

    International Nuclear Information System (INIS)

    Zhou Yi; Jiang Zhongpu; Wang Haiting; Zhang Yanjun; Jiang Qiang; Wang Jun; Ren Lijun; Xie Bin

    2010-01-01

    Objective: To evaluate percutaneous puncturing 125 I seed implantation by using PET-CT guided target localization technique in treating central lung cancer complicated by obstructive pulmonary atelectasis. Methods: A total of 30 patients with suspected central lung cancer complicated by obstructive pulmonary atelectasis on preoperative chest films were enrolled in this study. As no clear distinction existed between the tumor and the atelectatic consolidation shadow on plain chest films, CT scanning was carried out in all patients. If CT scan was still not able to determine the margin of the tumor, an additional PET-CT scanning was adopted. After ascertaining the location of the lung cancer, percutaneous puncturing implantation of 125 I seeds under PET-CT guidance was performed. The clinical data and the therapeutic results were evaluated. Results: A sharp distinction between the tumor and the atelectatic consolidation shadow was demonstrated on PET-CT scans in 21 cases. The mean volume of the targeted lesion reckoned from PET-CT scans was 26 cm 3 , and the 125 I seeds were implanted. The mean volume of the targeted lesion calculated on CT scans was 37 cm 3 . Six months after the treatment, the follow-up CT exam showed that the effective rate was 93% (28/30). The one-year survival rate was 100% . The complications included pneumothorax (n = 8), small amount of hemoptysis (n = 12) and fever (n = 2). No displacement or immigration of the implanted seeds occurred. Conclusion: PET-CT scanning is far superior to conventional CT scanning in determining the target area of the tumor in patients with central lung cancer complicated by obstructive pulmonary atelectasis. (authors)

  10. Optimum timing for image-based dose evaluation of 125I and 103Pd prostate seed implants

    International Nuclear Information System (INIS)

    Yue Ning; Chen Zhe; Peschel, Richard; Dicker, Adam P.; Waterman, Frank M.; Nath, Ravinder

    1999-01-01

    Purpose/Objective: Image-based dose evaluation of permanent brachytherapy implants for prostate cancer is important for optimal patient management after implantation. Because of edema caused by the surgical procedure in the implantation, if the dose evaluation is based on the images obtained too early after implantation, dose coverage will usually be underestimated. Conversely, if the images are obtained too late, the dose coverage will be overestimated. This study uses a biomathematical model to simulate edema and its resolution on 29 patients, so that the optimum time to obtain image scans and perform dose evaluation can be investigated and estimated. Methods and Materials: Edema of a prostate and its resolution has been shown to follow an exponential function V(t) = V(0)(1 + ΔV[e -0.693t/Te - 1]) where ΔV is the initial relative increase in the prostate volume due to edema (and is related to edema magnitude), and T e (edema half-life) is the time for the edema to decrease by half in volume. In this study, edema was simulated by increasing the volume of preimplant prostate (obtained from ultrasound volume study) to a given magnitude of edema. Similarly, the locations of planned seeds were changed to their corresponding locations in the edematous prostate proportionally. The edema was then allowed to resolve according to the exponential function. The correct dose distribution was calculated by taking into account the dynamic variations of the prostate volume, seed locations, and source strengths with respect to time. Dose volume histograms (DVHs) were then generated from this dose distribution. The conventional postimplant DVHs, which assume the prostate volume and seed locations are as in the image scans and constant in time, were also calculated based on the simulated image scans for various days postimplantation. The conventional DVHs of prostate on various days after implantation were compared to the DVH calculated assuming dynamic conditions. The optimum

  11. Automated matching of corresponding seed images of three simulator radiographs to allow 3D triangulation of implanted seeds

    Science.gov (United States)

    Altschuler, Martin D.; Kassaee, Alireza

    1997-02-01

    To match corresponding seed images in different radiographs so that the 3D seed locations can be triangulated automatically and without ambiguity requires (at least) three radiographs taken from different perspectives, and an algorithm that finds the proper permutations of the seed-image indices. Matching corresponding images in only two radiographs introduces inherent ambiguities which can be resolved only with the use of non-positional information obtained with intensive human effort. Matching images in three or more radiographs is an `NP (Non-determinant in Polynomial time)-complete' problem. Although the matching problem is fundamental, current methods for three-radiograph seed-image matching use `local' (seed-by-seed) methods that may lead to incorrect matchings. We describe a permutation-sampling method which not only gives good `global' (full permutation) matches for the NP-complete three-radiograph seed-matching problem, but also determines the reliability of the radiographic data themselves, namely, whether the patient moved in the interval between radiographic perspectives.

  12. The Effect of Sterile Acellular Dermal Matrix Use on Complication Rates in Implant-Based Immediate Breast Reconstructions

    Directory of Open Access Journals (Sweden)

    Jun Ho Lee

    2016-11-01

    Full Text Available BackgroundThe use of acellular dermal matrix (ADM in implant-based immediate breast reconstruction has been increasing. The current ADMs available for breast reconstruction are offered as aseptic or sterile. No published studies have compared aseptic and sterile ADM in implant-based immediate breast reconstruction. The authors performed a retrospective study to evaluate the outcomes of aseptic versus sterile ADM in implant-based immediate breast reconstruction.MethodsImplant-based immediate breast reconstructions with ADM conducted between April 2013 and January 2016 were included. The patients were divided into 2 groups: the aseptic ADM (AlloDerm group and the sterile ADM (MegaDerm group. Archived records were reviewed for demographic data and postoperative complication types and frequencies. The complications included were infection, flap necrosis, capsular contracture, seroma, hematoma, and explantation for any cause.ResultsTwenty patients were reconstructed with aseptic ADM, and 68 patients with sterile ADM. Rates of infection (15.0% vs. 10.3%, flap necrosis (5.0% vs. 7.4%, capsular contracture (20.0% vs. 14.7%, seroma (10.0% vs. 14.7%, hematoma (0% vs. 1.5%, and explantation (10.0% vs. 8.8% were not significantly different in the 2 groups.ConclusionsSterile ADM did not provide better results regarding infectious complications than aseptic ADM in implant-based immediate breast reconstruction.

  13. Effects of Grapefruit Seed Extract on Oxidative Stability and Quality Properties of Cured Chicken Breast.

    Science.gov (United States)

    Kang, Su-Tae; Son, Hee-Kyoung; Lee, Hyun-Joo; Choi, Jung-Seok; Choi, Yang-Il; Lee, Jae-Joon

    2017-01-01

    This study investigated the antioxidative and functional effects of a curing agent containing grapefruit seed extract (GSE) on the quality and storage characteristics of chicken breast. The total polyphenol and total flavonoid contents of GSE were 45.06 mg/g and 36.06 mg/g, respectively. The IC 50 value of 2,2-diphenyl-1-picrylhydrazyl hydroxyl scavenging of GSE was 333.33 μg/mL. The chicken breast comprised six groups: no-treatment (N), 0.2% ascorbic acid + 70 ppm sodium nitrite (C), 0.05% GSE (G0.05), 0.1% GSE (G0.1), 0.3% GSE (G0.3), and 0.5% GSE (G0.5). The pH and cooking loss of cured chicken breast decreased with increasing GSE levels, and the water holding capacity increased with increasing GSE levels. The hardness and chewiness of GSE-treated chicken breast were higher than those of N and C. Hunter's L and a color values increased significantly after GSE addition. Moreover, 0.1% GSE (G0.1) increased the flavor and total acceptability scores. The 2-thiobarbituric acid and volatile basic nitrogen values of the 0.5% GSE group decreased significantly compared with those of C group. Total microbial counts of GSE-treated chicken breast were higher than those of C, but that lower than those of N. Adding GSE to chicken breast delayed lipid peroxidation and had antimicrobial effects during cold storage. GSE improved shelf life and palatability; therefore, it could be used as a natural antioxidant and functional curing agent ingredient in meat products.

  14. {sup 125}I seed implant brachytherapy for the treatment of parotid gland cancers in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, L.; Zhang, J.; Song, T.; Zhang, J.; Yu, G.; Zhang, Y. [Peking University School and Hospital of Stomatology, Beijing (China). Dept. of Oral and Maxillofacial Surgery

    2013-05-15

    Background and purpose: There is a lack of optimal treatment strategies for managing salivary gland cancers in children and adolescents. This study is aimed at assessing the effect of {sup 125}I seed implantation for the treatment of parotid cancers in children and adolescents. Patients and methods: A total of 12 patients younger than 16 years with parotid gland malignant tumors underwent {sup 125}I seed implant brachytherapy between October 2003 and November 2008. All patients were assessed after treatment and at the local tumor control appointments. Facial nerve function, maxillofacial development, and radioactive side-effects were assessed. Results: The follow-up period ranged from 41-104 months. One patient with T4b died of pulmonary metastasis. The other patients were alive during the follow-up period. There were no serious radiation-related complications. The treatment did not affect facial nerve function and dentofacial growth in any of the children. Conclusion: For parotid gland cancers in children, {sup 125}I seed implant brachytherapy may be an acceptable treatment without serious complications and with satisfactory short-term effects. (orig.)

  15. Acute Immunologic Reaction to Silicone Breast Implant after Mastectomy and Immediate Reconstruction: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Massoome Najafi

    2014-08-01

    Full Text Available Background: Since the introduction of silicone based medical devices in to clinical practice, several reports appeared in the medical literature regarding their adverse effects. However, there are few reports of immunologic reactions to these implants.Case presentation: A case of systemic reaction to a breast implant inserted for immediate breast reconstruction in a breast cancer patient is presented. The patient developed fever and skin rash two months after the surgery. Investigations disclosed no infectious origin for the fever and a dramatic response to steroid therapy was observed.Conclusion: Immunologic reaction should be considered in case of systemic signs and symptoms after silicone breast implant placement as a rare complication. 

  16. Incidence of Internal Mammary Lymph Nodes with Silicone Breast Implants at MR Imaging after Oncoplastic Surgery.

    Science.gov (United States)

    Sutton, Elizabeth J; Watson, Elizabeth J; Gibbons, Girard; Goldman, Debra A; Moskowitz, Chaya S; Jochelson, Maxine S; Dershaw, D David; Morris, Elizabeth A

    2015-11-01

    To assess the incidence of benign and malignant internal mammary lymph nodes (IMLNs) at magnetic resonance (MR) imaging among women with a history of treated breast cancer and silicone implant reconstruction. The institutional review board approved this HIPAA-compliant retrospective study and waived informed consent. Women were identified who (a) had breast cancer, (b) underwent silicone implant oncoplastic surgery, and (c) underwent postoperative implant-protocol MR imaging with or without positron emission tomography (PET)/computed tomography (CT) between 2000 and 2013. The largest IMLNs were measured. A benign IMLN was pathologically proven or defined as showing 1 year of imaging stability and/or no clinical evidence of disease. Malignant IMLNs were pathologically proven. Incidence of IMLN and positive predictive value (PPV) were calculated on a per-patient level by using proportions and exact 95% confidence intervals (CIs). The Wilcoxon rank sum test was used to assess the difference in axis size. In total, 923 women with breast cancer and silicone implants were included (median age, 46 years; range, 22-89 years). The median time between reconstructive surgery and first MR imaging examination was 49 months (range, 5-513 months). Of the 923 women, 347 (37.6%) had IMLNs at MR imaging. Median short- and long-axis measurements were 0.40 cm (range, 0.20-1.70 cm) and 0.70 cm (range, 0.30-1.90 cm), respectively. Two hundred seven of 923 patients (22.4%) had adequate follow-up; only one of the 207 IMLNs was malignant, with a PPV of 0.005 (95% CI: 0.000, 0.027). Fifty-eight of 923 patients (6.3%) had undergone PET/CT; of these, 39 (67.2%) had IMLN at MR imaging. Twelve of the 58 patients (20.7%) with adequate follow-up had fluorine 18 fluorodeoxyglucose-avid IMLN, with a median standardized uptake value of 2.30 (range, 1.20-6.10). Only one of the 12 of the fluorodeoxyglucose-avid IMLNs was malignant, with a PPV of 0.083 (95% CI: 0.002, 0.385). IMLNs identified at

  17. Tumour bed delineation for partial breast/breast boost radiotherapy: What is the optimal number of implanted markers?

    International Nuclear Information System (INIS)

    Kirby, Anna NM.; Jena, Rajesh; Harris, Emma J.; Evans, Phil M.; Crowley, Clare; Gregory, Deborah L.; Coles, Charlotte E.

    2013-01-01

    Purpose: International consensus has not been reached regarding the optimal number of implanted tumour bed (TB) markers for partial breast/breast boost radiotherapy target volume delineation. Four common methods are: insertion of 6 clips (4 radial, 1 deep and 1 superficial), 5 clips (4 radial and 1 deep), 1 clip at the chest wall, and no clips. We compared TB volumes delineated using 6, 5, 1 and 0 clips in women who have undergone wide-local excision (WLE) of breast cancer (BC) with full-thickness closure of the excision cavity, in order to determine the additional margin required for breast boost or partial breast irradiation (PBI) when fewer than 6 clips are used. Methods: Ten patients with invasive ductal BC who had undergone WLE followed by implantation of six fiducial markers (titanium clips) each underwent CT imaging for radiotherapy planning purposes. Retrospective processing of the DICOM image datasets was performed to remove markers and associated imaging artefacts, using an in-house software algorithm. Four observers outlined TB volumes on four different datasets for each case: (1) all markers present (CT 6M ); (2) the superficial marker removed (CT 5M ); (3) all but the chest wall marker removed (CT CW ); (4) all markers removed (CT 0M ). For each observer, the additional margin required around each of TB 0M , TB CW , and TB 5M in order to encompass TB 6M was calculated. The conformity level index (CLI) and differences in centre-of-mass (COM) between observers were quantified for CT 0M , CT CW , CT 5M , CT 6M . Results: The overall median additional margins required to encompass TB 6M were 8 mm (range 0–28 mm) for TB 0M , 5 mm (range 1–13 mm) for TB CW , and 2 mm (range 0–7 mm) for TB 5M . CLI were higher for TB volumes delineated using CT 6M (0.31) CT 5M (0.32) than for CT CW (0.19) and CT 0M (0.15). Conclusions: In women who have undergone WLE of breast cancer with full-thickness closure of the excision cavity and who are proceeding to PBI or

  18. Subcutaneously Placed Breast Implants after a Skin-Sparing Mastectomy: Do We Always Need ADM?

    Directory of Open Access Journals (Sweden)

    Apresh Singla, MBBS, MSc

    2017-07-01

    Full Text Available Background:. Immediate breast reconstruction is an acceptable treatment option after mastectomy for prophylaxis of early breast cancer. Different options exist for implant placement, incision technique, patient suitability, and institutional experience. This article is a case series exploring the feasibility and outcomes of patients undergoing immediate breast reconstruction using skin-sparing mastectomy without mesh or acellular dermal matrix (ADM and with a vertical inframammary incision. Methods:. A single-institution retrospective analysis was performed for all patients who underwent immediate single-stage reconstruction with subcutaneous silicon implants without ADM between 2009 and 2014 inclusive. Patient, operative and treatment variables were extracted. All patients with viable mastectomy skin flaps intraoperatively and at least 5 mm of subcutaneous tissue were eligible except for patients who were deemed too slim by the senior surgeon preoperatively and thus at risk of implant visibility or skin rippling. Results:. There were 26 patients (bilateral n = 12 and unilateral n = 14 eligible for analysis, with a median long-term follow-up of 51.5 months. The majority of complications were classified as minor affecting 46.2% of the cohort (n = 12. There were 20 episodes of complications overall. The most frequent episodes were contour defects (x = 5, minor seroma (x = 4, and malrotation and minor infection (x = 3. There was 1 episode of capsular contracture. Conclusion:. Skin-sparing mastectomy with immediate subcutaneous silicon implant reconstruction with a vertical incision and without the need for mesh or ADM is an acceptable and safe treatment option. Accurate patient selection and skin flap viability is the key to achieving optimal outcomes with this approach.

  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

    2017-01-01

    BACKGROUND AND PURPOSE: To examine the risk of cardiac conduction abnormalities or severe ventricular arrhythmias requiring implantation of a cardiac implantable electronic device (CIED), either a pacemaker or an implantable cardioverter-defibrillator, subsequent to breast cancer (BC) radiotherapy...... (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...... ratios (SIR) of CIED implantation were estimated for women receiving RT and compared to women not receiving RT for BC. Uni- and multivariate Poisson regression models were used to estimate incidence rate ratios (IRR) among irradiated women compared to non-irradiated. RESULTS: Of 44,423 BC patients, 179...

  20. Five-Year Safety Data for More than 55,000 Subjects following Breast Implantation: Comparison of Rare Adverse Event Rates with Silicone Implants versus National Norms and Saline Implants.

    Science.gov (United States)

    Singh, Navin; Picha, George J; Hardas, Bhushan; Schumacher, Andrew; Murphy, Diane K

    2017-10-01

    The U.S. Food and Drug Administration has required postapproval studies of silicone breast implants to evaluate the incidence of rare adverse events over 10 years after implantation. The Breast Implant Follow-Up Study is a large 10-year study (>1000 U.S. sites) evaluating long-term safety following primary augmentation, revision-augmentation, primary reconstruction, or revision-reconstruction with Natrelle round silicone breast implants compared with national norms and outcomes with saline implants. Targeted adverse events in subjects followed for 5 to 8 years included connective tissue diseases, neurologic diseases, cancer, and suicide. The safety population comprised 55,279 women (primary augmentation, n = 42,873; revision-augmentation, n = 6837; primary reconstruction, n = 4828; and revision-reconstruction, n = 741). No targeted adverse events occurred at significantly greater rates in silicone implant groups versus national norms across all indications. The standardized incidence rate (observed/national norm) for all indications combined was 1.4 for cervical/vulvar cancer, 0.8 for brain cancer, 0.3 for multiple sclerosis, and 0.1 for lupus/lupus-like syndrome. Silicone implants did not significantly increase the risk for any targeted adverse events compared with saline implants. The risk of death was similar with silicone versus saline implants across all indications. The suicide rate (10.6 events per 100,000 person-years) was not significantly higher than the national norm. No implant-related deaths occurred. Results from 5 to 8 years of follow-up for a large number of subjects confirmed the safety of Natrelle round silicone implants, with no increased risk of systemic disease or suicide versus national norms or saline implants. Therapeutic, II.

  1. Release of low molecular weight silicones and platinum from silicone breast implants.

    Science.gov (United States)

    Lykissa, E D; Kala, S V; Hurley, J B; Lebovitz, R M

    1997-12-01

    We have conducted a series of studies addressing the chemical composition of silicone gels from breast implants as well as the diffusion of low molecular weight silicones (LM-silicones) and heavy metals from intact implants into various surrounding media, namely, lipid-rich medium (soy oil), aqueous tissue culture medium (modified Dulbecco's medium, DMEM), or an emulsion consisting of DMEM plus 10% soy oil. LM-silicones in both implants and surrounding media were detected and quantitated using gas chromatography (GC) coupled with atomic emission (GC-AED) as well as mass spectrometric (GC/MS) detectors, which can detect silicones in the nanogram range. Platinum, a catalyst used in the preparation of silicone gels, was detected and quantitated using inductive argon-coupled plasma/mass spectrometry (ICP-MS), which can detect platinum in the parts per trillion range. Our results indicate that GC-detectable low molecular weight silicones contribute approximately 1-2% to the total gel mass and consist predominantly of cyclic and linear poly-(dimethylsiloxanes) ranging from 3 to 20 siloxane [(CH3)2-Si-O] units (molecular weight 200-1500). Platinum can be detected in implant gels at levels of approximately 700 micrograms/kg by ICP-MS. The major component of implant gels appears to be high molecular weight silicone polymers (HM-silicones) too large to be detected by GC. However, these HM-silicones can be converted almost quantitatively (80% by mass) to LM-silicones by heating implant gels at 150-180 degrees C for several hours. We also studied the rates at which LM-silicones and platinum leak through the intact implant outer shell into the surrounding media under a variety of conditions. Leakage of silicones was greatest when the surrounding medium was lipid-rich, and up to 10 mg/day LM-silicones was observed to diffuse into a lipid-rich medium per 250 g of implant at 37 degrees C. This rate of leakage was maintained over a 7-day experimental period. Similarly, platinum was

  2. Moving toward focal therapy in prostate cancer: dual-isotope permanent seed implants as a possible solution.

    Science.gov (United States)

    Todor, Dorin A; Barani, Igor J; Lin, Peck-Sun; Anscher, Mitchell S

    2011-09-01

    To compare the ability of single- and dual-isotope prostate seed implants to escalate biologically effective dose (BED) to foci of disease while reducing prescription dose to the prostate. Nine plans, using 125I, 103Pd, and 131Cs alone and in combination were created retrospectively for 2 patients. Ultrasound and MRI/MRS datasets were used for treatment planning. Voxel-by-voxel BED was calculated for single- and dual-isotope plans. Equivalent uniform BED (EUBED) was used to compare plans. The MRS-positive planning target volumes (PTVi) were delineated along with PTV (prostate+5 mm), rectum, and urethra. Single-isotope implants, prescribed to conventional doses, were generated to achieve good PTV coverage. The PTVi were prospectively used to generate implants using mixtures of isotopes. For mixed-radioisotope implants, we also explored the impact on EUBED of lowering prescription doses by 15%. The EUBED of PTVi in the setting of primary 125I implant increased 20-66% when 103Pd and 131Cs were used compared with 125I boost. Decreasing prescription dose by 15% in mixed-isotope implants results in a potential 10% reduction in urethral EUBED with preservation of PTV coverage while still boosting PTVi (up to 80%). When radiobiologic parameters corresponding to more-aggressive disease are assigned to foci, faster-decaying isotopes used in mixed implants have the potential to preserve the equivalent biological effect of mono-isotope implants considering less-aggressive disease distributed in the entire prostate. This is a hypothesis-generating study proposing a treatment paradigm that could be the middle ground between whole-gland irradiation and focal-only treatment. The use of two isotopes concurrent with decreasing the minimal peripheral dose is shown to increase EUBED of selected subvolumes while preserving the therapeutic effect at the level of the gland. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Dosimetry consequences of the accuracy at the position of the seeds in a seeds implant of I-125 in prostate; Consecuencias dosimetricas de la exactitud en la posicion de las semilla en un implante de semillas de I-125 en prostata

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    The quality control of equipment used to carry out implants of seeds of low rate in prostate, van destined to watch, the activity of seeds and the calculation of planning both positioning them on the inside of the patient. The objective of this work is, using the Nucletron Spot Pro and SeedSelectron, rating dosimetry possible consequences related to the position of the seeds. (Author)

  4. Complementary method of analyzing the quality of the implant I-125 seeds for prostate brachytherapy using ultrasound imaging post-implant

    International Nuclear Information System (INIS)

    Jimenez Dominguez, M.; Carrasco Herrera, M.; Baeza Trujillo, M.; Herrador Cordoba, M.

    2011-01-01

    In this paper we propose a complementary method based on Longitudinal mode ultrasound images acquired the same day of surgery, at the end of the implant. This option will allow us to evaluate the dosimetry end of treatment with the patient in the same position he was planning and to the rectum and bladder just as full. This will permit the identification of bodies and the seeds of interest more easily and will have a reference with which to compare one month later, when the CT images can also detect whether there has been some migration.

  5. WE-AB-BRA-11: Improved Imaging of Permanent Prostate Brachytherapy Seed Implants by Combining an Endorectal X-Ray Sensor with a CT Scanner

    International Nuclear Information System (INIS)

    Steiner, J; Matthews, K; Jia, G

    2016-01-01

    Purpose: To test feasibility of the use of a digital endorectal x-ray sensor for improved image resolution of permanent brachytherapy seed implants compared to conventional CT. Methods: Two phantoms simulating the male pelvic region were used to test the capabilities of a digital endorectal x-ray sensor for imaging permanent brachytherapy seed implants. Phantom 1 was constructed from acrylic plastic with cavities milled in the locations of the prostate and the rectum. The prostate cavity was filled a Styrofoam plug implanted with 10 training seeds. Phantom 2 was constructed from tissue-equivalent gelatins and contained a prostate phantom implanted with 18 strands of training seeds. For both phantoms, an intraoral digital dental x-ray sensor was placed in the rectum within 2 cm of the seed implants. Scout scans were taken of the phantoms over a limited arc angle using a CT scanner (80 kV, 120–200 mA). The dental sensor was removed from the phantoms and normal helical CT and scout (0 degree) scans using typical parameters for pelvic CT (120 kV, auto-mA) were collected. A shift-and add tomosynthesis algorithm was developed to localize seed plane location normal to detector face. Results: The endorectal sensor produced images with improved resolution compared to CT scans. Seed clusters and individual seed geometry were more discernable using the endorectal sensor. Seed 3D locations, including seeds that were not located in every projection image, were discernable using the shift and add algorithm. Conclusion: This work shows that digital endorectal x-ray sensors are a feasible method for improving imaging of permanent brachytherapy seed implants. Future work will consist of optimizing the tomosynthesis technique to produce higher resolution, lower dose images of 1) permanent brachytherapy seed implants for post-implant dosimetry and 2) fine anatomic details for imaging and managing prostatic disease compared to CT images. Funding: LSU Faculty Start-up Funding

  6. WE-AB-BRA-11: Improved Imaging of Permanent Prostate Brachytherapy Seed Implants by Combining an Endorectal X-Ray Sensor with a CT Scanner

    Energy Technology Data Exchange (ETDEWEB)

    Steiner, J; Matthews, K; Jia, G [Louisiana State University, Baton Rouge, LA (United States)

    2016-06-15

    Purpose: To test feasibility of the use of a digital endorectal x-ray sensor for improved image resolution of permanent brachytherapy seed implants compared to conventional CT. Methods: Two phantoms simulating the male pelvic region were used to test the capabilities of a digital endorectal x-ray sensor for imaging permanent brachytherapy seed implants. Phantom 1 was constructed from acrylic plastic with cavities milled in the locations of the prostate and the rectum. The prostate cavity was filled a Styrofoam plug implanted with 10 training seeds. Phantom 2 was constructed from tissue-equivalent gelatins and contained a prostate phantom implanted with 18 strands of training seeds. For both phantoms, an intraoral digital dental x-ray sensor was placed in the rectum within 2 cm of the seed implants. Scout scans were taken of the phantoms over a limited arc angle using a CT scanner (80 kV, 120–200 mA). The dental sensor was removed from the phantoms and normal helical CT and scout (0 degree) scans using typical parameters for pelvic CT (120 kV, auto-mA) were collected. A shift-and add tomosynthesis algorithm was developed to localize seed plane location normal to detector face. Results: The endorectal sensor produced images with improved resolution compared to CT scans. Seed clusters and individual seed geometry were more discernable using the endorectal sensor. Seed 3D locations, including seeds that were not located in every projection image, were discernable using the shift and add algorithm. Conclusion: This work shows that digital endorectal x-ray sensors are a feasible method for improving imaging of permanent brachytherapy seed implants. Future work will consist of optimizing the tomosynthesis technique to produce higher resolution, lower dose images of 1) permanent brachytherapy seed implants for post-implant dosimetry and 2) fine anatomic details for imaging and managing prostatic disease compared to CT images. Funding: LSU Faculty Start-up Funding

  7. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants

    International Nuclear Information System (INIS)

    Clarke, Daniel H.; Banks, Stephen J.; Wiederhorn, A. Roger; Klousia, John W.; Lissy, Jeanne M.; Miller, Michelle; Able, Arnold M.; Artiles, Carlos; Hindle, William V.; Blair, Deborah N.; Houk, Russell R.; Sheridan, Michael J.

    2002-01-01

    Purpose: To assess the role of endorectal coil magnetic resonance imaging (MRI) staging for patients undergoing seed implantation (SI) with or without external beam radiotherapy (EBRT). Methods and Materials: Between October 1994 and December 1998, 390 patients underwent prostate SI (98% Pd-103, 2% I-125). Seventy-six percent of patients had a prostate serum antigen (PSA) 20. Ten percent of patients had a Gleason score (GS) of 4-5, 54% had GS 6, 29% had GS 7, and 7% had GS ≥ 8. Monotherapy was employed in 46% of patients, and the remaining 54% received combined EBRT and SI. Three hundred twenty-seven were staged by high-resolution phased array pelvic coil, or in most cases, an endorectal coil MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of seed distributions. The criteria utilized to determine MRI-based stage were founded on the reported literature from the University of Pennsylvania. All MRI studies were reviewed by C.A., D.B., or W.H., who were unaware of clinical stage at the time of their review. The biopsy report was available to them as the only clinical correlate. Results: Of the 327 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 26% of T 1 , T 2 patients were upstaged to T 3 . Perineural invasion and the percentage of positive cores predicted for T 3 MRI stage (p 3 intermediate-risk group patients treated by combined therapy with a previous study of T 3 intermediate-risk group treated by radical prostatectomy (RP) at the University of Pennsylvania. Our 36-month PSA FFP was 94% compared with 21% for the previous study's RP patients. Conclusion: MRI is a valuable staging procedure for prostate cancer patients treated by SI. PSA FFP results appear to be improved by MRI staging. MRI T 3 disease can be treated more effectively by SI + EBRT than by RP

  8. Comparison of Outcomes in Immediate Implant-Based Breast Reconstruction Versus Mastectomy Alone.

    Science.gov (United States)

    Sousa, Janelle; Sood, Ravi; Liu, Daniel; Calhoun, Kristine; Louie, Otway; Neligan, Peter; Said, Hakim; Mathes, David

    2018-02-01

    Immediate implant-based techniques are common practice in post-mastectomy breast reconstruction. Previous studies have shown an increased complication rate in the setting of immediate versus delayed, MD reconstruction. We aimed to quantify any additional risk in complications when implant-based immediate breast reconstruction (IBR) is performed versus mastectomy alone. We retrospectively reviewed all IBR cases and all mastectomies without reconstruction from 2007 to 2011. Patient characteristics, operative details, and complication rates were reviewed and analyzed. IBR was performed in 315 consecutive women; mastectomy alone was performed in 401 women. Patients undergoing mastectomy alone were more often older, diabetic, and more frequently underwent neoadjuvant chemotherapy or radiation. Overall complications were higher in the IBR group, most commonly reoperation and delayed wound healing. In a multivariate analysis, IBR, increasing age, body mass index, history of radiation therapy, smoking, and nipple-sparing mastectomy were independently associated with increased risk of complications. However, IBR was only independently associated with increased risk of major complications such as reoperation or readmission for intravenous antibiotics, not minor complications. Patients selected for IBR are inherently different than those undergoing mastectomy alone. After adjusting for these differences, the increased risk of complications seen in IBR is moderately increased over the risk of complications in mastectomy alone. The observed increased risk of major complications after IBR is largely due to the aggressive management of complications in the setting of a prosthetic implant. IBR is a safe reconstructive strategy with only a slightly increased risk over mastectomy alone.

  9. The biocompatibility of titanium cardiovascular devices seeded with autologous blood-derived endothelial progenitor cells: EPC-seeded antithrombotic Ti implants.

    Science.gov (United States)

    Achneck, Hardean E; Jamiolkowski, Ryan M; Jantzen, Alexandra E; Haseltine, Justin M; Lane, Whitney O; Huang, Jessica K; Galinat, Lauren J; Serpe, Michael J; Lin, Fu-Hsiung; Li, Madison; Parikh, Amar; Ma, Liqiao; Chen, Tao; Sileshi, Bantayehu; Milano, Carmelo A; Wallace, Charles S; Stabler, Thomas V; Allen, Jason D; Truskey, George A; Lawson, Jeffrey H

    2011-01-01

    Implantable and extracorporeal cardiovascular devices are commonly made from titanium (Ti) (e.g. Ti-coated Nitinol stents and mechanical circulatory assist devices). Endothelializing the blood-contacting Ti surfaces of these devices would provide them with an antithrombogenic coating that mimics the native lining of blood vessels and the heart. We evaluated the viability and adherence of peripheral blood-derived porcine endothelial progenitor cells (EPCs), seeded onto thin Ti layers on glass slides under static conditions and after exposure to fluid shear stresses. EPCs attached and grew to confluence on Ti in serum-free medium, without preadsorption of proteins. After attachment to Ti for 15 min, less than 5% of the cells detached at a shear stress of 100 dyne / cm(2). Confluent monolayers of EPCs on smooth Ti surfaces (Rq of 10 nm), exposed to 15 or 100 dyne/cm(2) for 48 h, aligned and elongated in the direction of flow and produced nitric oxide dependent on the level of shear stress. EPC-coated Ti surfaces had dramatically reduced platelet adhesion when compared to uncoated Ti surfaces. These results indicate that peripheral blood-derived EPCs adhere and function normally on Ti surfaces. Therefore EPCs may be used to seed cardiovascular devices prior to implantation to ameliorate platelet activation and thrombus formation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

    Directory of Open Access Journals (Sweden)

    Ignacio Cifuentes

    2017-08-01

    Full Text Available Resumen El uso de implantes mamarios con propósitos estéticos y reconstructivos se ha convertido en uno de los procedimientos más comunes realizados por los cirujanos plásticos. Existen diversos modelos de implantes mamarios, los cuales difieren en su tamaño, relleno, forma y característica de la envoltura, pudiendo ser lisa o texturizada. La contractura capsular es una de las principales complicaciones del uso de implantes mamarios y se ha planteado que las prótesis texturizadas podrían disminuir la incidencia de contractura capsular. Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Identificamos cinco revisiones sistemáticas que en conjunto incluyen 15 estudios primarios, 13 de ellos correspondientes a ensayos aleatorizados pertinentes a la pregunta de interés. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de prótesis mamaria texturizada probablemente disminuye el riesgo de contractura capsular, sin embargo, podría asociarse a un aumento en el riesgo de linfoma anaplásico de células grandes.

  11. Simulation of measurement absorbed dose on prostate brachytherapy with radius of prostate 2 cm using MCNP5 with seed implant model isoaid AdvantageTM IAPd-103A

    International Nuclear Information System (INIS)

    Poundra Setiawan; Suharyana; Riyatun

    2015-01-01

    Simulation of measurement absorbed dose on prostate brachytherapy with radius of prostate 2 cm using MCNP5 with seed implant model IsoAid Advantage TM IAPd-103A has been conducted. 103 Pd used as a radioactive source in the seed implant and it has energy gamma emission 20,8 keV with half live 16,9 days and has activity 4 mCi. The prostate cancer is modeled with spherical and it has radius 3 cm, after planting the seed implant 103 Pdover 24,4 days, prostate cancer has absorbed dose 2,172Gy. Lethal dose maximum use 103 Pd is 125 Gy and it was reached with 59 seeds. (author)

  12. Seeding after ultrasound-guided percutaneous biopsy of liver metastases in patients with colorectal or breast cancer

    DEFF Research Database (Denmark)

    Chen, Inna; Lorentzen, Torben; Linnemann, Dorte

    2016-01-01

    BACKGROUND: Neoplasm seeding is a serious complication after liver metastases biopsy. Reported incidences vary between 10% and 19% for colorectal cancer (CRC) and are unknown for breast cancer (BC). The aim of this retrospective study was to determine the frequency of tumor seeding after ultrasound...... retrospectively reviewed. The endpoint was the development of abdominal wall recurrence following liver biopsy. RESULTS: Of total 2981 biopsies we identified 278 patients with CRC and 155 patients with BC biopsy-verified liver metastases. During the median follow-up of 25 months after biopsy (range 3-253 months......), no seeding was recorded in patients with BC. Within the median follow-up of 34 months (3-111 months), seeding was registered in 17/278 (6%) of patients with CRC; three patients of 278 (1%) had undoubtedly biopsy-related seeding, which became apparent six, nine, and 26 months after biopsy, respectively...

  13. SU-E-T-301: Dosimetric Comparison Between Adaptive and Rectilinear Template-Based Prostate Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Sugar, E Neubauer; Buzurovic, I; O’Farrell, D; Hansen, J; Devlin, P; Cormack, R; Nguyen, P [Brigham and Women’s Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: To compare the dosimetry of a standard rectilinear and an adaptive technique used in I125 prostate seed implants. Methods: To achieve favorable dosimetry in prostate implants we used adaptive needle updates to match actual positions in real-time. The seed locations were optimized based on actual needle locations. The seeds were delivered automatically with a robotic device seedSelectron™ (Elekta Brachytherapy). In this study, we evaluated the former approach against the standard rectilinear technique in which the needles have a parallel distribution. The treatment plans for 10 patients were analyzed. For comparison, the actual treatment plans were revised so each needle was repositioned to its original parallel location through the template. The analysis was performed by comparing the target coverage and dose to the organs at risk. The comparison was done using the following planning goals: the target D90> 90%, V100% > 90%, V50% <70% and V200% <30%; the urethra V125% < 1cm3 and V150%= 0cm3; and the Rectum V100%<1cm3 and V69% < 8cm3. The prescription dose to the target was 145Gy. Results: The average target volume and number of seeds were 44.39cm3(SD=11.14) and 74(SD=12), respectively. The D90 for adaptive and rectilinear plans was 159.9Gy(SD=2.99) and 155.53Gy(SD=4.04) resulting in a 2.74% difference for the average target coverage. A similar difference (1.75%) was noticed in the target V100[%]. No significant difference was noticed in the dose to the urethra and rectum. All planning goals were met with both the adaptive and rectilinear approach for each plan. Conclusion: The study reveals enhanced coverage of the target when using the adaptive needle adjustments as compared to the rectilinear approach for the analyzed cases. However, the differences in dosimetry did not translate to meaningful clinical outcomes.

  14. SU-F-J-09: Radioactive Seed Localization for Breast Lumpectomy - Towards Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Aima, M; Viscariello, N; Patton, T; Bednarz, B [University of Wisconsin, Madison, WI (United States)

    2016-06-15

    Purpose: The aim of this work is to propose a method to optimize radioactive source localization (RSL) for non-palpable breast cancer surgery. RSL is commonly used as a guiding technique during surgery for excision of non-palpable tumors. A collimated hand-held detector is used to localize radioactive sources implanted in tumors. Incisions made by the surgeon are based on maximum observed detector counts, and tumors are subsequently resected based on an arbitrary estimate of the counts expected at the surgical margin boundary. This work focuses on building a framework to predict detector counts expected throughout the procedure to improve surgical margins. Methods: A gamma detection system called the Neoprobe GDS was used for this work. The probe consists of a cesium zinc telluride crystal and a collimator. For this work, an I-125 Best Medical model 2301 source was used. The source was placed in three different phantoms, a PMMA, a Breast (25%- glandular tissue/75%- adipose tissue) and a Breast (75-25) phantom with a backscatter thickness of 6 cm. Counts detected by the probe were recorded with varying amounts of phantom thicknesses placed on top of the source. A calibration curve was generated using MATLAB based on the counts recorded for the calibration dataset acquired with the PMMA phantom. Results: The observed detector counts data used as the validation set was accurately predicted to within ±3.2%, ±6.9%, ±8.4% for the PMMA, Breast (75-25), Breast (25–75) phantom respectively. The average difference between predicted and observed counts was −0.4%, 2.4%, 1.4% with a standard deviation of 1.2 %, 1.8%, 3.4% for the PMMA, Breast (75-25), Breast (25–75) phantom respectively. Conclusion: The results of this work provide a basis for characterization of a detector used for RSL. Counts were predicted to within ±9% for three different phantoms without the application of a density correction factor.

  15. No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction

    International Nuclear Information System (INIS)

    Liljegren, Annelie; Unukovych, Dmytro; Gagliardi, Giovanna; Bjöhle, Judith; Wickman, Marie; Johansson, Hemming; Sandelin, Kerstin

    2014-01-01

    The aim of this study was to quantify the variation in doses to organs at risk (ipsilateral lung and heart) and the clinical target volume (CTV) in the presence of breast implants. In this retrospective cohort study, patients were identified through the National Breast Cancer Register. Consecutive breast cancer patients undergoing mastectomy between 2009 and 2011 and completing a full course of postmastectomy radiotherapy (PMRT) were eligible. All included patients (n = 818) were identified in the ARIA© oncology information system and further stratified for immediate breast reconstruction (IBR+, n = 162) and no immediate breast reconstruction (IBR-, n = 656). Dose statistics for ipsilateral lung, heart and CTV were retrieved from the system. Radiation plans for patients with chest wall (CW) only (n = 242) and CW plus lymph nodes (n = 576) irradiation were studied separately. The outcome variables were dichotomized as follows: lung, V 20Gy ≤ 30% vs. V 20Gy > 30%; heart, D mean ≤ 5 Gy vs. D mean > 5 Gy; CTV, V 95% ≥ median vs. V 95% < median. In the univariate and multivariate regression models no correlation between potential confounders (i.e. breast reconstruction, side of PMRT, CW index) and the outcome variables was found. Multivariate analysis of CW plus lymph nodes radiation plans, for example, showed no association of breast reconstruction with dosimetric outcomes in neither lung nor heart- lung V 20Gy (odds ratio [OR]: 0.6, 95%CI, 0.4 to 1.0, p = 0.07) or heart D mean (OR: 1.2, 95%CI, 0.5 to 3.1, p = 0.72), respectively. CTV was statistically significantly larger in the IBR+ group (i.e. included breast implant), but no correlation between the implant type and dosimetric characteristics of the organs at risk was revealed. In the current study, the presence of breast implants during postmastectomy radiotherapy was not associated with increased doses to ipsilateral lung and heart, but CTV definition and its dosimetric characteristics urge further

  16. TU-AB-201-11: A Novel Theoretical Framework for MRI-Only Image Guided LDR Prostate and Breast Brachytherapy Implant Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

    Purpose: To propose a novel framework for accurate model-based dose calculations using only MR images for LDR prostate and breast seed implant brachytherapy. Methods: Model-based dose calculation methodologies recommended by TG-186 require further knowledge about specific tissue composition, which is challenging with MRI. However, relying on MRI-only for implant dosimetry would reduce the soft tissue delineation uncertainty, costs, and uncertainties associated with multi-modality registration and fusion processes. We propose a novel framework to address this problem using quantitative MRI acquisitions and reconstruction techniques. The framework includes three steps: (1) Identify the locations of seeds(2) Identify the presence (or absence) of calcification(s)(3) Quantify the water and fat content in the underlying tissueSteps (1) and (2) consider the sources that limit patient dosimetry, particularly the inter-seed attenuation and the calcified regions; while step (3) targets the quantification of the tissue composition to consider the heterogeneities in the medium. Our preliminary work has shown that the seeds and the calcifications can be identified with MRI using both the magnitude and the phase images. By employing susceptibility-weighted imaging with specific post-processing techniques, the phase images can be further explored to distinguish the seeds from the calcifications. Absolute quantification of tissue, water, and fat content is feasible and was previously demonstrated in phantoms and in-vivo applications, particularly for brain diseases. The approach relies on the proportionality of the MR signal to the number of protons in an image volume. By employing appropriate correction algorithms for T1 - and T2*-related biases, B1 transmit and receive field inhomogeneities, absolute water/fat content can be determined. Results: By considering calcification and interseed attenuation, and through the knowledge of water and fat mass density, accurate patient

  17. Value of contrast-enhanced MRI of breast after silicone implant

    International Nuclear Information System (INIS)

    Heinig, A.; Heywang-Koebrunner, S.H.; Viehweg, P.; Spielmann, R.P.; Lampe, D.; Buchmann, J.

    1997-01-01

    Early recognition of recurrence and work-up of clinically indeterminate lesions may be impaired after reconstruction with silicone implants due to superimposition of the implant or to scarring. This study was undertaken to evaluate the use of contrast-enhanced MRI in patients with silicone implant after breast cancer. Contrast-enhanded MRI was offered to 169 patients. Comparative two- to three-view mammography was also performed in 169 patients, as well as comparative sonography in 144 patients. Conventional imaging and clinical examination detected only 8/13 recurrences, whereas 12/13 were detected by MRI. One recurrence had been visible as a strongly enhancing 2-mm dot in a previous examination (2 years before), but was not called. It was therefore counted as false negative. In addition, multicentricity was detected by MRI alone in two of three cases. MRI correctly diagnosed scar tissue in all cases with indeterminate findings. However, due to false-positive calls caused by enhancing granulomas specificity could not be improved. Contrast-enhanded MRI allowed decisive additional information in our study group and improved the sensitivity significantly (concerning all diagnoses). Contrast-enhanded MRI allowed decisive additional information in our study group and improved the sensitivity significantly (concerning all diagnoses). Contrast-enhanded MRI is recommended in patients with diagnostic problems or high risk of recurrence after silicone implants. (orig.) [de

  18. 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.

  19. Intraoperative Ir-192 implantation for early breast cancer. Techniques and results

    International Nuclear Information System (INIS)

    Mansfield, C.M.

    1990-01-01

    Patients with early breast cancer (T1-2 N0-1) can be treated by lumpectomy and irradiation with a local control and survival equal to more radical surgery. Between 1982 and 1988, 323 patients with early breast cancer were treated, when possible, with Ir-192 implants at the time of lumpectomy to a local dose of 2000 cGy in 40-50 hours. Ten to 14 days later, the whole breast was treated to 4500 cGy at 180 per fraction in 5 weeks. The 6-year actuarial survival for stages I and II disease was 98% and 91%, respectively, and the recurrence-free survival was 96% and 98%, respectively. When these 323 patients were evaluated by T status, a local control of 97% was the same for T1 and T2 lesions. The cosmetic results were good to excellent in 95% of the patients. This approach has improved our ability to accurately place the boost dose in the breast

  20. A prospective study on silicone breast implants and the silicone-related symptom complex.

    Science.gov (United States)

    Contant, C M E; Swaak, A J G; Obdeijn, A I M; van der Holt, B; Tjong Joe Wai, R; van Geel, A N; Eggermont, A M M

    2002-06-01

    This cohort study prospectively evaluated the prevalence of the silicone-related symptom complex (SRSC) in relation to antinuclear antibodies (ANA) and magnetic resonance imaging (MRI) of silicone breast implants (SBI) 1 year after implantation. A total of 57 women undergoing mastectomy followed by immediate breast reconstruction (IBR) and SBI between March 1995 and March 1997 at the University Hospital Rotterdam/Daniel den Hoed Cancer Centre, were prospectively evaluated. Just before and 1 year after IBR the sera of these women were tested for the presence of ANA and they were screened for the prevalence of SRSC-related symptoms by questionnaire. All prostheses were evaluated by MRI 1 month and 1 year after IBR. Just before operation 11% of the women had a Sjögren score of more than 2, whereas 30% had such a score 1 year after IBR ( P = 0.01). One year postoperatively women had significantly more RA/Raynaud-related complaints: 21% preoperatively versus 40% 1 year after IBR ( P = 0.03). Within the undefined complaints-related group 19% had a score of 2 or more preoperatively and 33% 1 year after IBR ( P = 0.09). There were no new cases of ANA positivity 1 year after IBR. The linguine sign was seen by MRI in three implants: one 1 month after IBR and two 1 year after IBR. There was no relation to changes in SRSC expression and these MRI findings. In conclusion, 1 year after SBI implantation women had more SRSC-related complaints, especially Sjögren's and RA/Raynaud's. Moreover there was no correlation between elevated SRSC expression and changes in the presence of ANA or changes in MRI of the SBI 1 year after IBR.

  1. Inflammation by Breast Implants and Adenocarcinoma: Not Always a Bad Company.

    Science.gov (United States)

    Orciani, Monia; Sorgentoni, Giulia; Olivieri, Fabiola; Mattioli-Belmonte, Monica; Di Benedetto, Giovanni; Di Primio, Roberto

    2017-07-01

    Inflammation and tumor are now an inseparable binomial. Inflammation may also derive by the use of breast implants followed by the formation of a periprosthetic capsule. It is known that tumor cells, in an inflamed microenvironment, can profit by the paracrine effect exerted also by mesenchymal stem cells (MSCs). Here we evaluated the role of inflammation on the immunobiology of MSCs before and after cocultures with cells derived from breast adenocarcinoma. MSCs derived from both inflamed (I-MSCs) and control (C-MSCs) tissues were isolated and cocultured with MCF7 cells derived from breast adenocarcinoma. Before and after cocultures, the proliferation rate of MCF7 cells and the expression/secretion of cytokines related to inflammation were tested. Before cocultures, higher levels of cytokine related to chronic inflammation were detected in I-MSCs than in C-MSCs. After cocultures with MCF7, C- and I-MSCs show a variation in cytokine production. In detail, IL-2, IL-4, IL-5, IL-10, IL-13, TGF-β and G-CSF were decreased, whereas IL-6, IL-12, IFN-γ, and IL-17 were oversecreted. Proliferation of MCF7 was significantly increased after cocultures with I-MSCs. Inflammation at the site of origin of MSCs affects their immunobiology. Even if tumor cells increased their proliferation rate after cocultures with I-MSCs, the analysis of the cytokines, known to play a role in the interference of tumor cells with the host immune system, absolves completely the breast implants from the insult to enforce the risk of adenocarcinoma. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Complex radial folds versus subtle signs of intracapsular rupture of breast implants: MR findings with surgical correlation.

    Science.gov (United States)

    Soo, M S; Kornguth, P J; Walsh, R; Elenberger, C D; Georgiade, G S

    1996-06-01

    Detection of intracapsular rupture of silicone breast prostheses using MR imaging is often performed by identifying the "linguine sign" [1]. The linguine sign is easily differentiated from simple radial folds that are seen in intact implants. However, more subtle signs of intracapsular rupture, including undulating subcapsular lines and the "teardrop sign," are less often recognized [2-5] and may prove difficult for the less experienced radiologist to differentiate from complex radial folds of intact implants. In this essay, we illustrate the MR imaging findings of complex radial folds in intact implants and compare them with findings of incomplete shell collapse in ruptured implants in a surgically confirmed series of explanted silicone breast prostheses.

  3. 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.

  4. A radioactive seed implant on a rabbit's liver following a voxel model representation for dosimetric proposals

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Tarcisio P.R.; Andrade, Joao Paulo Lopes de; Costa, Igor Temponi; Teixeira, Cleuza H. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Programa de Pos-graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg

    2005-07-01

    Animal models have been used in experimentation with ionizing radiation. The evaluation of the energy absorbed per unit tissue mass in vivo transported by nuclear particles is a task to be performed before experimentation. Stochastic or deterministic methodology can be applied, however the dosimetric protocols applied in radiotherapy center cannot be applied directly due to the inherent small geometry and chemical composition of the animal distinct from human. The present article addresses a method in development that will predict the dose distribution into the rabbit thorax based on the solution of the transport phenomena in a voxel model. The model will be applied to simulate a seed implant experiment on a rabbit. Herein, the construction of the three-dimensional voxel model anthropomorphic -anthropometrics to the rabbit is presented. The model is assembling from a set of computer tomography of the rabbit. The computational phantom of the thorax starts at the digitalisation of the CT images, tissue definition, and color image representation of each tissue and organ. The chemical composition and mass density of each tissue is evaluated as similar date presented by ICRU-44. To treat the images, a code namely SISCODES, developed in house, was used. The in vivo experiment that will be simulated is also described. That is a implant of five seeds of 1.6x2 mm performed in a rabbit's liver. The perspective of this work is the application of the model in dosimetric studies predicting the dose distribution around the seed's implanted in vivo experiments. (author)

  5. Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Zheng-Yu, E-mail: linsinlan@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Chen, Jin, E-mail: snow8968851@163.com [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Deng, Xiu-Fen, E-mail: dxf197286@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China)

    2012-11-15

    Objective: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation. Methods: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35 {+-} 1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels ({>=}3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels. Results: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1 {+-} 6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased. Conclusion: The 1.5T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.

  6. Long term results of ultrasonically guided implantation of 125-I seeds combined with external irradiation in localized prostatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Iversen, P; Rasmussen, F; Holm, H H [Depts. of Urology and Ultrasound, Herlev Hospital, Univ. of Copenhagen (Denmark)

    1991-01-01

    Transperineal 125-iodine seed implantation guided by transrectal ultrasonography and subsequent external beam irradiation was employed in the treatment of 32 patients with localized prostatic carcinoma (16 poorly differentiated). Follow-up is currently 35-98 months with a median of 65 months. Distant metastases have developed in 18 patients, of whom 11 have died from prostatic cancer. Median change in prostatic volume was a reduction of 35%. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after 1-4 years, revealing still malignant histology in 10 (40%), of whom 8 have developed distant metastases or died from prostatic cancer. Fourteen patients suffered from late complications of which surgical intervention was indicated in five cases. Nine patients are presently free of progression and prostate specific antigen is bigger than 0.5 ng/ml in 8 of these. The future role of ultrasonically guided implantation in the management of prostatic cancer is discussed. (au).

  7. The side effects and complications of percutaneous iodine-125 seeds implantation under CT-guide for patients with advanced pancreatic cancer.

    Science.gov (United States)

    Lv, Wei-Fu; Lu, Dong; Xiao, Jing-Kun; Mukhiya, Gauri; Tan, Zhong-Xiao; Cheng, De-Lei; Zhou, Chun-Ze; Zhang, Xing-Min; Zhang, Zheng-Feng; Hou, Chang-Long

    2017-12-01

    The present study investigates the side effects and complications of computed tomography (CT)-guided percutaneous iodine-125 (I-125) seeds implantation for advanced pancreatic cancer. The clinical data were retrospectively analyzed for patients treated with implantation of I-125 seeds under CT-guide in our hospital from May 2010 to April 2015. The side effects and complications were collected and their possible reasons were analyzed. A total of 78 patients were enrolled. The side effects were categorized as fever in 29 cases (37.18%), abdominal pain in 26 cases (33.33%), nausea and vomiting in 9 cases (11.54%), diarrhea in 5 cases (6.41%), and constipation in 4 cases (5.13%). Complications were composed of pancreatitis in 9 cases (11.54%), infection in 5 cases (6.41%), seed migration in 2 cases (2.56%), intestinal perforation in 1 case (1.28%), and intestinal obstruction in 1 case. The incidence of complication was 23.08% (18/78). The difference in incidence of complication was statistically significant between patients implanted with ≤27 seeds and those with >27 seeds (P = .032). The side effects and complications frequently occur in implantation of I-125 seeds for patients with advanced pancreatic cancer. More concern should be given to the patients treated by this technique. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  8. Permanent Seed Implant Dosimetry (PSID)TM 4.5 version as isodose and Treatment Planning System (TPS) programme for brachytherapy

    International Nuclear Information System (INIS)

    Indra Saptiama; Moch Subechi; Anung Pujiyanto; Hotman Lubis; Herlan Setiawan

    2014-01-01

    The medical treatment using radiation therapy for cancer diseases is increasingly developed. One of the method used in radiotherapy is brachytherapy. Brachytherapy is radiation therapy method in which a radiation source is implanted in cancer cell directly so the dose accepted by cancer cell is the highest dose and the dose accepted by normal cell is the lowest dose. I-125 Seed have been made successfully in domestic. To support the implant of I-125 seed for brachytherapy needs computer programme for the isodose calculation and Treatment Planning System (TPS). Permanent Seed Implant Dosimetry (PSID) 4.5 is one of the isodose calculation and Treatment Planning System (TPS) programme that is owned by Center for Radioisotope and Radiopharmaceutical-BATAN. In isodose calculation, PSID 4.5 uses 1D formalism and 2D formalism based on AAPM-TG43 (Association of American Physicist in Medicine- Task Group No.43). Anisotropic function on 1D formalism depend on distance function while on 2D formalism count on distance and angle function therefore 2D formalism has isodose calculation better than 1D formalism usage. PSID 4.5 can display the isodose contour of the seed I-125 radiation source in 2 dimension (2D) and 3 dimension (3D). The computer programme of isodose calculation and TPS uses PSID 4.5 is expected able to help planning for seed I-125 implantation process for brachytherapy that used by paramedics and to support the usage of seed I-125 as domestic product. (author)

  9. Survey of breast implant patients: characteristics, depression rate, and quality of life.

    Science.gov (United States)

    Kalaaji, Amin; Bjertness, Cecilie Bergsmark; Nordahl, Cathrine; Olafsen, Kjell

    2013-02-01

    Quality of life (QOL) among breast augmentation patients is a growing research area, with newly worrisome data on psychological health in this group. The authors investigate characteristics of breast implant patients, including motivations for surgery, depression rate, effect of surgery on daily activity and work activity, and overall psychosocial and cosmetic changes through a self-reported survey. Of 121 consecutive breast augmentation patients treated by the senior author (AK) between 2005 and 2008, a total of 93 patients were reachable via e-mail and were sent a 47-question survey, which they could return anonymously. Answers were processed by QuestBack mail system (QuestBack AS, Oslo, Norway) and sent to the authors as diagrams and figures, rather than as raw data. The response rate for this survey was 67%. Average follow-up was 2.8 years. For 65%, the motivation for surgery was cosmetic; 48% replied it was for emotional reasons (reduced self-esteem), 22% for intimate reasons, and 10% for physical reasons. Before the operation, 6% of respondents reported diagnosed depression. The postoperative changes were equal between improved and worsened depression. In 27%, the operation increased motivation for daily activities; 73% felt like a "whole" person, and 26% experienced improvement in social skills. In terms of the cosmetic result, 93% were satisfied or very satisfied. However, 27% indicated they were unsatisfied or very unsatisfied with skin sensation. Although in some cases depression increased postoperatively, the depression rate in our study was still lower than the published range in the general population in Norway. Breast enlargement increased motivation to perform daily activities in our patients. The procedure improved QOL in both psychosocial and cosmetic aspects. However, the relatively high percentage of patients who experienced reduced breast skin sensitivity postoperatively can represent a challenge for the surgeon. Multicenter/clinic studies are

  10. An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Shen X

    2015-05-01

    Full Text Available Xinying Shen,1,2 Yong Li,2 Yanfang Zhang,2 Jian Kong,2 Yanhao Li1 1Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2Department of Interventional Radiology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, People’s Republic of China Background: 125I seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC, and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT-guided permanent implantation of 125I seeds in the treatment of patients with the recurrence of NPC.Methods: A total 30 patients (20 male and ten female at the median age of 55 (range 25–80 years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median ~11 months after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for ~2–38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors.Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of 125I seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30, 30.0% (9/30, and 6.7% (2/30, respectively, with a median survival period of 18 months (17.6±8.6 months. Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8±7.9 and 24.3±7.9 months, respectively. Kaplan–Meier survival analysis demonstrated that χ2 (log rank was 7.555, with very significant difference (P<0.01. The survival periods of patients in tumor stages I, II, III, and IV were 25.4±8.7, 19.8±9.4, 16.1±4.5, and 12.8±7.8 months, respectively, with

  11. Breast Tomosynthesis

    Science.gov (United States)

    ... in distinguishing non-cancerous breast conditions from breast cancers. Breast implants may also impede accurate mammogram readings because both ... view as much as possible without rupturing the implant. top of ... discuss breast cancer screening options with their doctors: Breast Density and ...

  12. Textured saline-filled breast implants for augmentation mammaplasty: does overfilling prevent deflation? A long-term follow-up.

    Science.gov (United States)

    Al-Sabounchi, Shareef; De Mey, Albert M G; Eder, Helga

    2006-07-01

    Augmentation mammaplasty is the second most commonly performed aesthetic operation. Since the moratorium on gel-filled devices in 1992, saline-filled devices have become the prosthesis of choice in the United States. Although inflatable breast implants have been available since 1965, high rates of complete implant deflation have been reported. In this retrospective study, the authors highlight the effect of filling volume on the incidence of implant deflation, other implant-related trade-offs, and implant survival. Forty-nine women who had undergone aesthetic augmentation mammaplasty were followed up for up to 139 months. Twelve implants were underfilled (group 1), 47 devices were filled within the recommended volume (group 2), and 37 implants were overfilled beyond the manufacturer's maximum recommended volume (group 3). All the implants used were of the same type and from the same manufacturer (Siltex by Mentor, 2600). Through an inframammary approach, subpectoral placement of the device was used exclusively. Nineteen women experienced complete deflation of their implants, with an overall implant complete deflation rate of 19.79 percent. This complication occurred in 16.6 percent of group 1 patients, 21.2 percent of group 2, and 18.9 percent of group 3. Skin wrinkling and rippling were encountered in 50 percent of group 1, 29.78 percent of group 2, and 43.2 percent of group 3, with an overall incidence of 37.5 percent. In this series, the authors could not find a protective effect of overfilling on complete deflation (p = 0.925) nor on the avoidance of rippling and wrinkling (p = 0.285). Moreover, overfilling by more than 25 ml beyond the maximum recommended dose showed no statistical significance for the frequency of complete deflation (p = 0.982) or for the incidence of wrinkling and rippling (p = 0.828). However, Kaplan-Meier survival analysis revealed that overfilling the implants prolonged their longevity and had a statistically significant effect on the

  13. Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients.

    Science.gov (United States)

    Miranda, Roberto N; Aladily, Tariq N; Prince, H Miles; Kanagal-Shamanna, Rashmi; de Jong, Daphne; Fayad, Luis E; Amin, Mitual B; Haideri, Nisreen; Bhagat, Govind; Brooks, Glen S; Shifrin, David A; O'Malley, Dennis P; Cheah, Chan Y; Bacchi, Carlos E; Gualco, Gabriela; Li, Shiyong; Keech, John A; Hochberg, Ephram P; Carty, Matthew J; Hanson, Summer E; Mustafa, Eid; Sanchez, Steven; Manning, John T; Xu-Monette, Zijun Y; Miranda, Alonso R; Fox, Patricia; Bassett, Roland L; Castillo, Jorge J; Beltran, Brady E; de Boer, Jan Paul; Chakhachiro, Zaher; Ye, Dongjiu; Clark, Douglas; Young, Ken H; Medeiros, L Jeffrey

    2014-01-10

    Breast implant-associated anaplastic large-cell lymphoma (ALCL) is a recently described clinicopathologic entity that usually presents as an effusion-associated fibrous capsule surrounding an implant. Less frequently, it presents as a mass. The natural history of this disease and long-term outcomes are unknown. We reviewed the literature for all published cases of breast implant-associated ALCL from 1997 to December 2012 and contacted corresponding authors to update clinical follow-up. The median overall survival (OS) for 60 patients was 12 years (median follow-up, 2 years; range, 0-14 years). Capsulectomy and implant removal was performed on 56 of 60 patients (93%). Therapeutic data were available for 55 patients: 39 patients (78%) received systemic chemotherapy, and of the 16 patients (28%) who did not receive chemotherapy, 12 patients opted for watchful waiting and four patients received radiation therapy alone. Thirty-nine (93%) of 42 patients with disease confined by the fibrous capsule achieved complete remission, compared with complete remission in 13 (72%) of 18 patients with a tumor mass. Patients with a breast mass had worse OS and progression-free survival (PFS; P = .052 and P = .03, respectively). The OS or PFS were similar between patients who received and did not receive chemotherapy (P = .44 and P = .28, respectively). Most patients with breast implant-associated ALCL who had disease confined within the fibrous capsule achieved complete remission. Proper management for these patients may be limited to capsulectomy and implant removal. Patients who present with a mass have a more aggressive clinical course that may be fatal, justifying cytotoxic chemotherapy in addition to removal of implants.

  14. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. 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.

  16. Disease-related effects of perioperative blood transfusions associated with 125I seed implantation for prostate carcinoma

    International Nuclear Information System (INIS)

    Petersen, J.P.; Schellhammer, P.F.; el-Mahdi, A.M.

    1990-01-01

    In some retrospective studies perioperative transfusions during oncologic surgery have been shown to decrease the time interval between surgery and local and/or distant recurrence of cancer. This study examines the disease-related effect, if any, of perioperative blood transfusions among 108 patients with localized carcinoma of the prostate treated by radioactive iodine-125 seed implantation of the prostate and lymphadenectomy. When all subjects were analyzed, there was no statistical difference of local and distant failure between the transfused and nontransfused groups. Patients with well-differentiated tumors had statistically fewer local recurrences (0% vs 22%, p = 0.036) if they were transfused perioperatively. However, the difference in distant metastases (0% vs 11%) was not statistically significant (p = 0.21). In contrast, patients with moderately and poorly differentiated disease receiving transfusions had more local recurrences and metastases, though this was not statistically significant. Our data suggest that there is no obvious evidence that perioperative blood transfusions have an adverse effect on local recurrence or distant metastases for iodine-125 seed implantation of carcinoma of the prostate

  17. Deleterious effects on MDAMB-231 breast adenocarcinoma cell lineage submitted to Ho-166 radioactive seeds at very low activity

    Energy Technology Data Exchange (ETDEWEB)

    Falcao, Patricia L.; Campos, Tarcisio P.R., E-mail: campos@nuclear.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear; Sarmento, Eduardo V. [Centro de Desenvolvimento de Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Cuperschmid, Ethel M. [Universidade Federal de Minas Gerais (CEMEMOR/UFMG), Belo Horizonte, BR (Brazil). Fac. de Medicina. Centro de Memoria da Medicina

    2011-07-01

    Herein, the deleterious effect of ionizing radiation provided by Ho-166 radioactive seeds at low activity were addressed, based on experimental in vitro assays at the MDA MB231 cell lineage, a breast adenocarcinoma, compared to PBMC - peripheral blood cells. The methodology involves of the MDBMB-231 and PBMC expansion in culture in suitable environment in 30mm well plates and T-25 flasks. Seeds were synthesized with Ho-165 incorporated and characterized previously. Activation was processed at IPR1 reactor at the peripheral table, at 8h exposition. Three groups of seeds were tested: 0,34 mCi, 0,12 mCi activity, and control group. Such seeds were placed on culture and held to a period of 05 half-lives of the radionuclide. The biological responses at these exposure were documented by inverse microscopic photographic in time. Also, MTT essay were performed. A fast response in producing deleterious effects at cancer cell was observed even if for the low activity seeds. Also, a biological response dependent to a radial distance of the seed was observed. At conclusion, viability clonogenic control of MDAMB231 is identified at the exposition to Ho-166 ceramic seeds, even if at low activity of 0,1 to 0,3mCi. (author)

  18. Deleterious effects on MDAMB-231 breast adenocarcinoma cell lineage submitted to Ho-166 radioactive seeds at very low activity

    International Nuclear Information System (INIS)

    Falcao, Patricia L.; Campos, Tarcisio P.R.; Cuperschmid, Ethel M.

    2011-01-01

    Herein, the deleterious effect of ionizing radiation provided by Ho-166 radioactive seeds at low activity were addressed, based on experimental in vitro assays at the MDA MB231 cell lineage, a breast adenocarcinoma, compared to PBMC - peripheral blood cells. The methodology involves of the MDBMB-231 and PBMC expansion in culture in suitable environment in 30mm well plates and T-25 flasks. Seeds were synthesized with Ho-165 incorporated and characterized previously. Activation was processed at IPR1 reactor at the peripheral table, at 8h exposition. Three groups of seeds were tested: 0,34 mCi, 0,12 mCi activity, and control group. Such seeds were placed on culture and held to a period of 05 half-lives of the radionuclide. The biological responses at these exposure were documented by inverse microscopic photographic in time. Also, MTT essay were performed. A fast response in producing deleterious effects at cancer cell was observed even if for the low activity seeds. Also, a biological response dependent to a radial distance of the seed was observed. At conclusion, viability clonogenic control of MDAMB231 is identified at the exposition to Ho-166 ceramic seeds, even if at low activity of 0,1 to 0,3mCi. (author)

  19. Study to the presence of antipolymer antibodies in a group of Dutch women with a silicone breast implant. Part II

    NARCIS (Netherlands)

    Jong WH de; Kallewaard M; Verhoef CM; Bijlsma JWJ; Schouten JSAG; Loveren H van; Afdeling Reumatologie en; LPI; LGM

    2002-01-01

    The presence of antipolymer antibodies (APA) was reported in women with severe symptoms and a silicone breast implant (SBI). The aim of the present study was to determine whether there exists a population of symptomatic SBI recipients with a high prevalence of APA in the Netherlands. Participants

  20. Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C

    2017-01-01

    BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satis...

  1. seeds

    African Journals Online (AJOL)

    Owner

    peptidohydrolase (8.0%) from mung bean seedlings. (Baumgartner and Chrispeels, 1977), EP-HG (4.5%) from horse gram seedlings ( Rajeswari, 1997), acidic protease (15%) from germinating winged-bean seeds. (Usha and Singh, 1996) and EP-1 (1.6%) from barley seedlings and GA3-induced cysteine protease (3.38%).

  2. 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

    PURPOSE: Numerous epidemiologic studies have demonstrated that breast implants are not associated with connective tissue diseases (CTDs). However, many CTDs are rare, and continued follow-up of women with breast implants is warranted. METHODS: We extended by 5 years the follow-up of our earlier...... 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...... rheumatic conditions in the implant and comparison groups were compared with those in the general Danish population. Additionally, CTDs and fibromyalgia were confirmed through medical chart review, and direct comparisons of the breast implant cohort with the comparison cohort were performed. RESULTS: When...

  3. Study of percutaneous 125I seeds implantation guided by CT in elderly patients of stage I peripheral non-small cell lung cancer

    International Nuclear Information System (INIS)

    Ke Mingyao; Yong Yazhi; Luo Bingqing; Wu Xuemei; Chen Lingling; Xie Hongqi

    2011-01-01

    Objective: To evaluate the efficacy, feasibility and safety of CT guided percutaneous 125 I seeds implantation in elderly patients of stage I peripheral non-small cell lung cancer (NSCLC). Methods: Clinical data of 16 elderly peripheral stage I NSCLC patients (10 squamous carcinoma and 6 adenocarcinoma; 13 stage I A and 3 stage I B ) who received radioactive 125 I seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 - 160 Gy. Under CT guidance, 125 I seeds were implanted percutaneously into tumors for interstitial radiotherapy according to treatment plan system. Results: Mean number of 125 I seeds each patient received was 21.1. 12 complete response (CR) and 4 partial response (PR) were achieved. Total response rate (CR + PR) was 100%. 100% patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years' follow-up, respectively. The median local progression free time was 14 months. The 1-, 2-, 3-and 4-year overall survival rate were 60%, 54%, 50% and 33%, respectively (median : 14 months). 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. Conclusions: CT guided 125 I seeds implantation is a safe, reliable and effective radical treatment method for elderly stage I peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy. (authors)

  4. 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

  5. Clinical Study on Using 125I Seeds Articles Combined with Biliary Stent Implantation in the Treatment of Malignant Obstructive Jaundice.

    Science.gov (United States)

    Wang, Tao; Liu, Sheng; Zheng, Yan-Bo; Song, Xue-Peng; Sun, Bo-Lin; Jiang, Wen-Jin; Wang, Li-Gang

    2017-08-01

    Aim: To study the feasibility and curative effect of 125 I seeds articles combined with biliary stent implantation in the treatment of malignant obstructive jaundice. Patients and Methods: Fifty patients with malignant obstructive jaundice were included. Twenty-four were treated by biliary stent implantation combined with intraluminal brachytherapy by 125 I seeds articles as the experimental group, while the remaining 26 were treated by biliary stent implantation only as the control group. The goal of this study was to evaluate total bilirubin, direct bilirubin and tumor markers (cancer antigen (CA)-199, CA-242 and carcinoembryonic antigen (CEA)), as well as biliary stent patency status and survival time before and after surgery. Results: Jaundice improved greatly in both groups. The decreases of CA-199 and CA-242 had statistical significance (p=0.003 and p=0.004) in the experimental group. The ratio of biliary stent patency was 83.3% (20/24) in the experimental group and 57.7% (15/26) in the control group (p=0.048). The biliary stent patency time in the experimental group was 1~15.5 (mean=9.84) months. The biliary stent patency time in the control group was 0.8~9 (mean=5.57) months, which was statistically significant (p=0.018). The median survival time was 10.2 months in the experimental group, while 5.4 months in control group (pjaundice possibly by inhibiting the proliferation of vascular endothelial cells and the growth of tumor. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  6. Clinical feasibility study for the use of implanted gold seeds in the prostate as reliable positioning markers during megavoltage irradiation

    International Nuclear Information System (INIS)

    Dehnad, Homan; Nederveen, Aart J.; Heide, Uulke A. van der; Moorselaar, R. Jeroen A. van; Hofman, Pieter; Lagendijk, Jan J.W.

    2003-01-01

    Background and purpose: The aim of this study was to assess the feasibility of using gold seed implants in the prostate for position verification, using an a-Si flat panel imager as a detector during megavoltage irradiation of prostate carcinoma. This is a study to guarantee positioning accuracy in intensity-modulated radiotherapy. Methods and materials: Ten patients with localized prostate carcinoma (T2-3) received between one and three fiducial gold markers in the prostate. All patients were treated with 3-D conformal radiotherapy with an anterior-posterior (AP) and two lateral wedge fields. The acute gastrointestinal (GI) and genitourinary (GU) toxicities were scored using common toxicity criteria scales (CTC). Using three consecutive CT scans and portal images obtained during the treatment we have studied the occurrence of any change in prostate shape (deformation), seed migration and the magnitude of translations and rotations of the prostate. Results: We observed no acute major complications for prostate irradiation regarding the seed implantation. The maximum acute GU toxicity grade 2 (dysuria and frequency) was observed in seven patients during the treatment. The maximum grade 2 (diarrhoea) was scored in two patients regarding the acute GI toxicities. No significant prostate deformation could be detected in the consecutive CT scans. It appeared that the distances between the markers only slightly changed during treatment (S.D. 0.5 mm). Random prostate translations were (1 S.D.) 2.1, 3.2 and 2.2 mm in the lateral (LR), AP and cranial-caudal (CC) directions, respectively, whereas systematic translations were 3.3, 4.8 and 3.5 mm in the LR, AP and CC directions, respectively. Random prostate rotations were (1 S.D.) 3.6, 1.7 and 1.9 deg. around the LR, AP and CC axis, respectively, whereas systematic rotations were 4.7, 2.0 and 2.7 deg. around the LR, AP and CC axis, respectively. Conclusions: We found that the fiducial gold seeds are a safe and appropriate

  7. 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.

  8. 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.

  9. Vivo dosimetry using TLD detectors in prostate seed implants of I-125: preliminary results

    International Nuclear Information System (INIS)

    Sanchez-Reyes, A.; Pedro, A.; Bassas, P.; Duch, M. A.; Cros, M.; Mane, S.

    2011-01-01

    We present preliminary results of a new in vivo dosimetry technique that could allow to know immediately after implantation of the prostate if the dose distribution determined by the scheduler is similar to the actual dose measured with TLD detectors.

  10. 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.)

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

    International Nuclear Information System (INIS)

    Maijers, M.C.; Ritt, M.J.P.F.; Niessen, F.B.; Veldhuizen, J.F.H.; Manoliu, R.A.

    2014-01-01

    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.)

  12. Silicone-induced granuloma of breast implant capsule (SIGBIC: similarities and differences with anaplastic large cell lymphoma (ALCL and their differential diagnosis

    Directory of Open Access Journals (Sweden)

    Fleury EF

    2017-03-01

    Full Text Available Eduardo de Faria Castro Fleury,1 Milena Morais Rêgo,1 Luciana Costa Ramalho,1 Veronica Jorge Ayres,1 Rodrigo Oliveira Seleti,2 Carlos Alberto Pecci Ferreira,2 Decio Roveda Jr 2 1Radiology Department, IBCC – Instituto Brasileiro de Controle do Câncer, 2Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil Abstract: Primary breast lymphoma is a rare disease and accounts for 0.5% of cases of breast cancer. Most primary breast lymphomas develop from B cells, and the involvement of T cells is rare. Anaplastic large cell lymphoma (ALCL is a recently discovered T-cell lymphoma associated with breast implants. Only a few cases have been reported to date. It is believed that the incidence of ALCL is increasing because of the increasing number of breast implants. The clinical presentation is variable and can manifest as a palpable mass in the breast or armpit, breast pain, or capsular contracture. Because of the rarity of the disease and the lack of knowledge to date, clinical diagnosis is often delayed, with consequent delays in treatment. The cause and pathogenesis have not been fully elucidated, and there are no evidence-based guidelines for diagnosis, treatment, or follow-up of this disease. We present a review of cases of patients with silicone breast implants, including ALCL, a rare type of breast cancer that is still under study, and silicone-induced granuloma of breast implant capsule and its differential diagnosis, and discuss if a silicone-induced granuloma of breast implant capsule could be the precursor of the disease. Keywords: lymphoma, granuloma, breast cancer, implant

  13. Appearance of low signal intensity lines in MRI of silicone breast implants.

    Science.gov (United States)

    Stroman, P W; Rolland, C; Dufour, M; Grondin, P; Guidoin, R G

    1996-05-01

    Magnetic resonance (MR) images of five explanted mammary prostheses were obtained with a 1.5 T GE Signa system using a conventional spin-echo pulse sequence, in order to investigate the low-intensity curvilinear lines which may be observed in MR images of silicone gel-filled breast implants under pressure from fibrous capsules. MR images showed ellipsoid prostheses, often containing multiple low-intensity curvilinear lines which in some cases presented an appearance very similar to that of the linguine sign. Upon opening the fibrous capsules, however, all of the prostheses were found to be completely intact demonstrating that the appearance of multiple low signal intensity curvilinear lines in MR images of silicone gel-filled prostheses is not necessarily a sign of prosthesis rupture. The MR image features which are specific to the linguine sign must be more precisely defined.

  14. Anticancer Screening of Various Seed Extract of Cardiospermum halicacabum on Human Colorectal, Skin and Breast Cancer Cell Lines

    Directory of Open Access Journals (Sweden)

    Behzad Mohaddesi

    2015-08-01

    Full Text Available Background: In the modern lifestyle, the increase in cancer and related chronic disorders is a major public health problem. In spite of different methods used for the treatment of these conditions, natural medicines have high demands due to their significant effects as immune enhancement and therapeutic agents and fewer side effects in comparison with other treatment methods. Hence, this study was undertaken to evaluate the cytotoxic effect of cardiospermum halicacabum Linn. seeds, based on traditional claims.Methods: A Soxhlet extractor was used to obtain different extracts from seeds of C. halicacabum Linn. Sulforhodamine B colorimetric (SRB assay used for the evaluation of the cytotoxic effect of the various extracts on HT-29, HCT-15 colon carcinoma, SK-MEL-2 skin carcinoma, and MCF-7 breast carcinoma. The results were compared against Doxorubicin as a standard drug.Results: The results of the present study showed the potent cytotoxic activity of n-hexane extract of seeds of C. halicacabum Linn. against the MCF-7 breast cancer cell line with 50% growth inhibition value (GI50 of 12.8 μg/ml but other extracts showed poor activity in other tested cell lines.Conclusions: The results indicated the potential medicinal value of C. halicacabum Linn. seeds oil with the highest extractive yield as an antineoplastic agent. However, further studies are needed for the isolation of the active anticancer compounds and evaluating the mechanism of action of the responsible compound.

  15. Radio-guided occult lesion localisation using iodine-125 seeds ('ROLLIS') for removal of impalpable breast lesions: first Australian experience

    International Nuclear Information System (INIS)

    Taylor, Donna B.; Bourke, Anita G.; Westcott, Eliza

    2015-01-01

    Approximately one-third of breast cancers are impalpable and require pre-operative image-guided localisation. Hook-wire localisation (HWL) is commonly used but has several disadvantages. Use of a low-activity radioactive iodine-125 seed is a promising alternative technique used in the USA and the Netherlands. This pilot study describes the first use of this in Australia. In this prospective pilot study, 21 participants with biopsy-proven breast cancer underwent radio guided occult lesion localisation using iodine-125 seed(s) (ROLLIS) with insertion of a hook-wire for back up. Sentinel node biopsy was performed where indicated. Ease of hook-wire and seed insertion, duration of the procedure, dependence on the seed versus hook-wire during surgery, lesion location within the specimen, histopathology including size of radial margins, the ease of seed retrieval in pathology, and safe return of seeds for disposal were documented. Radiation dosimetry of staff was performed. All seeds were placed within 3.5 mm of the lesion. All lesions and seeds were removed. One participant needed re-excision for involved margins. Radiologists and surgeons both preferred ROLLIS. Surgeons were able to depend on the seed for localisation in all but one case. Sentinel node biopsy was successfully performed when required. Pathologists found seed retrieval quick and easy, with no detrimental effect on tissue processing. No radiation doses measurably above background were received by staff. ROLLIS is an easily learnt, safe and effective alternative technique to standard HWL.

  16. Quality control of system of imaging for rectal ultrasound for implants seed prostate low rate; Control de calidad del sistem de imagen por ecografia rectal para implantes de semillas de prostata de baja tasa

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    In this work, the objective is the evaluation of the image system used in implants of prostate of low rate held at our hospital, for maximum control on the placement of the seeds in the patient and therefore carried out dosimetry. (Author)

  17. Effect of implanted radioactive 125I seeds on normal tissue structures of bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus in dogs

    International Nuclear Information System (INIS)

    Qi Liangchen; Han Zhenguo; Yang Bin; Heersitai

    2008-01-01

    Objective: To investigate the effect of implanted radioactive 125 I seeds on normal tissue structures of bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus in dogs. Methods: Nine healthy male dogs weighing 17-21 kg were randomly divided into three groups: 30 d, 60 d experimental groups and control group. Radioactive 125 I seeds (3.7 x 10 7 Bg, 1.0 mCi) were implanted into the sides of bronchus, esophagus, pulmonary artery, pulmonary vein respectively, the samples of bronchus, esophagus, pulmonary artery, pulmonary vein were taken 30 and 60 d after transplantation, HE staining was used to observe the pathologic changes of the tissues under light microscope. Results: The damages of normal bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus after radioactive 125 I seeds implantation in 30 d group were weaker than those in control group and 60 d group, there were no complications such as perforation, hemorrhage, necrosis, etc. Histopathological score indicated that the scores of bronchus, esophagus and alveolar in 30 d group and 60 d group were higher than those in control group (P 0.05); there was no significant difference in histopathological score of pulmonary vein among all groups (P>0.05). Conclusion: The implanted radioactive 125 I seeds can damage all kinds of tissues at different degrees, but this kind of damage is reversible, the dog may repair the damage through its own repair ability, its clinical application is safe. (authors)

  18. Therapeutic value of 3-D printing template-assisted 125I-seed implantation in the treatment of malignant liver tumors

    Directory of Open Access Journals (Sweden)

    Han T

    2017-07-01

    Full Text Available Tao Han,1,* Xiaodan Yang,1,* Ying Xu,2,* Zhendong Zheng,1,* Ying Yan,2 Ning Wang2 1Department of Oncology, 2Department of Radiotherapy, General Hospital of Shenyang Military Region, Shenyang, China *These authors contributed equally to this work Objective: To explore the therapeutic value of 3-D printing template-assisted 125I-seed implantation in the treatment of malignant liver tumors.Materials and methods: Fifteen liver cancer patients with 47 total lesions were treated with 3-D printing template-assisted radioactive seed implantation (group A, and 25 liver-tumor patients with 66 total lesions were treated with 125I-seed implantation without a template auxiliary (group B. Operation time, in-hospital time, operation complications, dose distribution, and response rate (number were compared between the two groups. Results: Shorter operation times and better dose distribution were observed in group A than in group B, and the differences were statistically significant. The response rate after 2 months was 86.7% (13 of 15 in group A and 84% (21 of 25 in group B; differences between the two groups were not significant.Conclusion: Application of 3-D printing template-assisted radioactive seed implantation in the treatment of malignant liver tumors can help shorten operation time and optimize radiation-dose distribution, is worthy of further study, and has clinical significance. Keywords: brachytherapy, stereotactic techniques, iodine isotopes, liver, carcinoma 

  19. 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.

  20. 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.

  1. The metabolism of 32P-CP-PLLA seed implanted in the liver and its damage to the normal liver tissue: a study in the experimental dogs

    International Nuclear Information System (INIS)

    Tan Zhongbao; Liu Lu; Guo Jinhe; Zhu Guangyu; Wang Fuan; Nie Qi; Gao Hailin; Teng Gaojun

    2010-01-01

    Objective: To investigate the effects of intratumoral implantation of 32 P -CP-PLLA seeds on the normal canine liver tissue and to explore the metabolism of 32 P-CP-PLLA seeds implanted in the liver of experimental dogs. Methods: Twelve beagles were enrolled in this study. The dogs were randomly and equally divided into four groups: group A (185 MBq), group B (370 MBq), group C (740 MBq) and group D (0 MBq). By using laparotomy procedure 32 P-CP-PLLA seeds were implanted into dog's liver. CT scan was performed before operation as well as before the dog was sacrificed. All dogs were sacrificed three months after the implantation. Before the procedure and 1, 2, 4, 8 and 12 weeks after the procedure the blood tests and serum biochemical tests were conducted. One dog from group B and group C was selected respectively and was fed in a metabolic cage. Within one month after the procedure the cpm in feces and in urine was determined every 24 hours. One dog was picked out from each of the three groups and was punctured to get its liver tissue for pathologic exam each time at 1, 2, 4, 8 and 12 weeks after the implantation, and SPECT imaging was also performed at the same time. Pathologic study, both macroscopic and microscopic (including optical and electronic microscopy) was made to observe the liver damage after the dog was sacrificed. The statistical analysis was processed by using SPSS 13.0 software and the measuring data were expressed with mean ± standard deviation (x ± s). Results: Two months after the procedure, serological examination found that the serum alkaline phosphatase (BKP) in both group B and group C was significantly higher than that in other groups, the difference was statistically significant (P 32 P-CP-PLLA seeds was manifested as a spherical lesion which was encysted by a layer of fibrous tissue with an edematous zone peripherally. Conclusion: The implantation of 32 P-CP-PLLA seeds in dog's liver causes only localized hepatic damage with no general

  2. Biological effects and application of proton beam (H+) implantation on melon seeds

    International Nuclear Information System (INIS)

    Sun Xun; Ren Ruixing; Meng Hui; Shi Jinguo; Tang Zhangxiong; Tao Xianping

    2006-01-01

    Various doses and energy of the proton beam (H + ) were used to treat dry seeds of melon (Cucumis melo L.). Results show that, the proton beam irradiation can induced structural variations of chromosomes and abnormal behaviors during mitosis and meiosis. The percentage of cells with chromosomal aberration increased with the increment of energy and dose of the proton. The micronuclei, chromosomal bridge and chromosomal fragments were included in chromosomal aberration. The proton beam was effective in inducing mutants of early maturity. A early maturity line T 63-1-17-8-1-3 was selected from the progenies of the seeds treated with the proton beam. (authors)

  3. 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.

  4. Long-term results of ultrasonically guided implantation of 125-I seeds combined with external irradiation in localized prostatic cancer

    DEFF Research Database (Denmark)

    Iversen, P; Rasmussen, F; Holm, H H

    1991-01-01

    Transperineal 125-iodine seed implantation guided by transrectal ultrasonography and subsequent external beam irradiation was employed in the treatment of 32 patients with localized prostatic carcinoma (16 poorly differentiated). Follow-up is currently 35-98 months with a median of 65 months....... Distant metastases have developed in 18 patients, of whom 11 have died from prostatic cancer. Median change in prostatic volume was a reduction of 35%. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after 1-4 years, revealing still malignant histology in 10 (40......%), of whom 8 have developed distant metastases or died from prostatic cancer. Fourteen patients suffered from late complications of which surgical intervention was indicated in five cases. Nine patients are presently free of progression and prostate specific antigen is less than 0.5 ng/ml in 8 of these...

  5. Long-term results of ultrasonically guided implantation of 125-I seeds combined with external irradiation in localized prostatic cancer

    DEFF Research Database (Denmark)

    Iversen, P; Rasmussen, F; Holm, H H

    1991-01-01

    %), of whom 8 have developed distant metastases or died from prostatic cancer. Fourteen patients suffered from late complications of which surgical intervention was indicated in five cases. Nine patients are presently free of progression and prostate specific antigen is less than 0.5 ng/ml in 8 of these......Transperineal 125-iodine seed implantation guided by transrectal ultrasonography and subsequent external beam irradiation was employed in the treatment of 32 patients with localized prostatic carcinoma (16 poorly differentiated). Follow-up is currently 35-98 months with a median of 65 months....... Distant metastases have developed in 18 patients, of whom 11 have died from prostatic cancer. Median change in prostatic volume was a reduction of 35%. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after 1-4 years, revealing still malignant histology in 10 (40...

  6. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... Cancer Prevention Genetics of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Reconstruction After Mastectomy On This Page What is breast reconstruction? How do surgeons use implants to reconstruct a woman’s breast? How do surgeons ...

  7. Dosimetric results in implant and post-implant and low rate in brachytherapy prostate cancer with loose seeds and attached; Resultados dosimetricos en el implante y post-impante en braquiterapia de baja tasa en cancer de prostata con semillas sueltas y unidas

    Energy Technology Data Exchange (ETDEWEB)

    Juan-Senabre, X. J.; Albert Antequera, M.; Lopez-Tarjuelo, J.; Santos Serra, A.; Perez-Mestre, M.; Sanchez Iglesias, A. L.; Conde Moreno, A. J.; Gonzalez Vidal, V.; Beltran Persiva, J.; Muelas Soria, R.; Ferrer Albiach, C.

    2015-07-01

    The objective is determine differences dosimetry statistics on the dosimetry of the implant and post-implant in brachytherapy of low rate with implants permanent in prostate using seed of 125-I loose and attached Both in lives and in the post-prostatic plans dosimetric coverage is good and restrictions in urethra and rectum for both groups of patients are met. Not migrating with joined is evident, as well as better dosimetric homogeneity. (Author)

  8. Method of localization and implantation of the lumpectomy site for high dose rate brachytherapy after conservative surgery for T1 and T2 breast cancer

    International Nuclear Information System (INIS)

    Perera, F.; Chisela, F.; Engel, J.; Venkatesan, V.

    1995-01-01

    Purpose: This article describes our technique of localization and implantation of the lumpectomy site of patients with T1 and T2 breast cancer. Our method was developed as part of our Phase I/II pilot study of high dose rate (HDR) brachytherapy alone after conservative surgery for early breast cancer. Methods and Materials: In March 1992, we started a pilot study of HDR brachytherapy to the lumpectomy site as the sole radiotherapy after conservative surgery for clinical T1 or T2 invasive breast cancer. Initially, the protocol required intraoperative placement of the interstitial needles at the time of definitive surgery to the breast. The protocol was then generalized to allow the implantation of the lumpectomy site after definitive surgery to the breast, either at the time of subsequent axillary nodal dissection or postoperatively. To date, five patients have been implanted intraoperatively at the time of definitive breast surgery. Twelve patients were implanted after definitive breast surgery, with 7 patients being done at the time of axillary nodal dissection and 5 patients postoperatively. We devised a method of accurately localizing and implanting the lumpectomy site after definitive breast surgery. The method relies on the previous placement of surgical clips by the referring surgeon to mark the lumpectomy site. For each patient, a breast mold is made with radio-opaque angiocatheters taped onto the mold in the supero-inferior direction. A planning CT scan is then obtained through the lumpectomy site. The volume of the lumpectomy site, the number of implant planes necessary, and the orientation of the implants are then determined from the CT scan. The angiocatheters provide a reference grid on the CT films to locate the entry and exit points of the interstitial needles on the plastic mold. The entry and exit points for reference needles are then transferred onto the patient's skin enabling implantation of the lumpectomy site. Needle positions with respect to

  9. CT-guided percutaneous vertebroplasty combined with 125I-seed implantation for metastatic vertebral carcinoma involving the spinal canal: analysis of 23 cases

    International Nuclear Information System (INIS)

    Xie Xiaoxi; Lu Yinxiang; Ji Yong; Wang Xiaowei; Zhang Guodong

    2014-01-01

    Objective: To evaluate the safety and efficacy of CT-guided percutaneous vertebroplasty (PVP) combined with 125 I-seed implantation for the treatment of metastatic vertebral carcinoma involving the spinal canal. Methods: A total of 28 involved vertebrae were detected in 23 patients with metastatic vertebral carcinoma. Each patient had 1-2 diseased vertebrae. The lesions included cervical vertebra (n=4), thoracic vertebra (n=13) and lumbar vertebra (n=11). Destroyed posterior vertebral wall was seen in all involved vertebrae. Thirteen vertebrae found in 12 patients showed involvement of the epidural space. According to treatment planning system (TPS) CT-guided implantation of 125 I seeds was carried out first for cervical lesions, which was followed by PVP. For the thoracic and lumbar lesions, unilateral or bilateral puncturing with several particle needles was employed to implant the 125 I seeds, then, PVP with bone cement injection was performed. The complications and the clinical efficacy were analyzed. Results: Successful operation was obtained in all patients. The number of implanted 125 I seeds ranged from 4 to 30 per vertebra, and the volume of injected bone cement was 1-6 ml per vertebra. After the operation the pain relief rate was 86.9% (n=20). The incidence of bone cement leakage was 17.8% (5/28). One patient had radicular pain caused by neuropore leakage, which was relieved after medication. No serious complications, such as spinal cord injury or radiation myelitis, occurred. Conclusion: CT-guided PVP combined with 125 I-seed implantation is effective and safe for the treatment of metastatic vertebral carcinoma involving the spinal canal. This therapy can effectively relieve the pain and control the deterioration of tumor, besides, the incidence of bone cement leakage is very low. (authors)

  10. A comparison of outcomes involving highly cohesive, form-stable breast implants from two manufacturers in patients undergoing primary breast augmentation.

    Science.gov (United States)

    Jewell, Mark L; Jewell, James L

    2010-01-01

    Although there have been reports of single-surgeon outcomes with highly cohesive, form-stable silicone gel implants in women undergoing primary breast augmentation, there has been only one study published that compares the outcomes between the Allergan 410 and the Mentor CPG devices. The goal of the study is to compare outcomes in each cohort and to determine if quality systems and processes would have an impact on lowering the surgical revision rate, as compared to published reports for round gel implants and form-stable implants. Patients selected for the study were required to meet predefined inclusion criteria and general indications for breast augmentation. All subjects were treated uniformly with extensive informed consent prior to surgery. The entire process of breast augmentation (patient assessment, informed consent, the surgical procedure itself and postoperative instructions) was identical between the two groups. Patients were not randomized, as the studies did not start at the same time. The process for management of each patient was based on adaptation of the Toyota Production System and Lean Manufacturing, with emphasis on achieving operational excellence in the use of planning templates for surgery, including accurate management of patient expectations regarding size outcome. Outcomes data included physical breast measurements, quality of life metrics, and patient/surgeon satisfaction assessment. Adverse events were compared against published data for breast implants. Follow-up ranged between 20-77 months (Allergan 410) and 16-77 months (Mentor CPG). The outcome data indicate that these devices produce natural-appearing breasts with extremely low aggregate reoperation rate (4.2%). Only 0.8% of the reoperations were attributable to surgeon-related factors. There were no reoperations to correct mismanaged size expectations during the course of each study. There were 13 pregnancies and no difficulties with lactation were reported. Rippling (lateral

  11. Absence of muscle regeneration after implantation of a collagen matrix seeded with myoblasts

    NARCIS (Netherlands)

    van Wachem, PB; Brouwer, LA; van Luyn, MJA

    Collagens are widely used as biomaterials for e.g. soft tissue reconstruction. The present study was aimed at reconstruction of abdominal wall muscle using processed dermal sheep collagen (DSC) and myoblast seeding. Myoblasts were harvested from foetal quadriceps muscle of an inbred rat strain,

  12. Description and features of a technique of seeds implantation with 3D real time planning connected to an automatic afterloading and quality control device

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz Seidal, M.; Cantera de Frutos, C.

    2002-07-01

    According to statistics, 9% of males older than 50 years will develop prostate cancer and 33% of them will finally die of their disease. Detection can be based on digital rectal examination, tumoral markers measurements as PSA (Prostate Specific Antigen). CT/MR or Ultra sound imaging. Treatments may be radical prostatectomy (usually combined with chemotherapy), external radiation therapy, brachytherapy, or a combination of the former two techniques. In the last years permanent seed implantation is becoming an attractive alternative for treatment of prostate cancer at early stages, either as monotherapy (total prescribed dose of 145 Gy) or as an additional boost after external beam irradiation (95-100Gy after external beam delivery of 50Gy). But not all cases are suitable for seed treatment. Tumors must be at an early state and not very active (low tumoral markers values), without extra-capsular spreading and no metastasis in surrounding area. There must be no trans-urethral resection, no calcifications nor public arc interference and, finally, the volume should not be bigger than 50 cm''3. The technique consists on the permanent implantation of radioactive seeds into the prostate that, while decaying, will deliver the prescribed dose to the tumor. Isotopes mostly used are I-125 and Pd-103. Procedures for seed implantation vary but traditional ones generally imply two stages. The first one is the manual pre-loading of needles which can be performed either by composing loose seeds and spacers, either by cutting off strands of seeds and re absorbable spacers. This process can be done according to a previously approved pre plan or based on the accumulated experience about the number of needles and loading usually needed. Second stage consist on the implantation of these preloaded needles on the operation room. (Author)

  13. Giant desmoid tumour of the thorax following latissimus dorsi and implant breast reconstruction: case report and review of the literature

    LENUS (Irish Health Repository)

    Collins, AM

    2017-03-01

    The case of a giant thoracic desmoid tumour in a 44-year-old woman, who presented two years following a breast reconstruction with a latissimus dorsi (LD) flap and implant, is reported. Clinical findings included a rapidly growing, painless mass. Computed tomography (CT) suggested skin and intercostal soft tissue invasion. The tumour was resected en bloc with the LD muscle, implant capsule and underlying rib segments. The resultant thoracic and abdominal wall defects were reconstructed with Dualmesh® and polypropylene meshes respectively. There was no evidence of recurrence at thirty-six months follow-up.

  14. SU-E-J-166: Sensitivity of Clinically Relevant Dosimetric Parameters to Contouring Uncertainty During Post Implant Dosimetry of Prostate Permanent Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S [Sunnybrook Odette Cancer Centre, Toronto, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada); Ravi, A; Morton, G; Song, W [Sunnybrook Odette Cancer Centre, Toronto, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada); Sunnybrook Research Institute, Toronto, ON (Canada)

    2015-06-15

    Purpose: There is a strong evidence relating post-implant dosimetry for permanent seed prostate brachytherpy to local control rates. The delineation of the prostate on CT images, however, represents a challenge as it is difficult to confidently identify the prostate borders from soft tissue surrounding it. This study aims at quantifying the sensitivity of clinically relevant dosimetric parameters to prostate contouring uncertainty. Methods: The post-implant CT images and plans for a cohort of 43 patients, who have received I–125 permanent prostate seed implant in our centre, were exported to MIM Symphony LDR brachytherapy treatment planning system (MIM Software Inc., Cleveland, OH). The prostate contours in post-implant CT images were expanded/contracted uniformly for margins of ±1.00mm, ±2.00mm, ±3.00mm, ±4.00mm and ±5.00mm (±0.01mm). The values for V100 and D90 were extracted from Dose Volume Histograms for each contour and compared. Results: The mean value of V100 and D90 was obtained as 92.3±8.4% and 108.4±12.3% respectively (Rx=145Gy). V100 was reduced by −3.2±1.5%, −7.2±3.0%, −12.8±4.0%, −19.0±4.8%, − 25.5±5.4% for expanded contours of prostate with margins of +1mm, +2mm, +3mm, +4mm, and +5mm, respectively, while it was increased by 1.6±1.2%, 2.4±2.4%, 2.7±3.2%, 2.9±4.2%, 2.9±5.1% for the contracted contours. D90 was reduced by −6.9±3.5%, −14.5±6.1%, −23.8±7.1%, − 33.6±8.5%, −40.6±8.7% and increased by 4.1±2.6%, 6.1±5.0%, 7.2±5.7%, 8.1±7.3% and 8.1±7.3% for the same set of contours. Conclusion: Systematic expansion errors of more than 1mm may likely render a plan sub-optimal. Conversely contraction errors may Result in labeling a plan likely as optimal. The use of MRI images to contour the prostate should results in better delineation of prostate organ which increases the predictive value of post-op plans. Since observers tend to overestimate the prostate volume on CT, compared with MRI, the impact of the

  15. Breast lift

    Science.gov (United States)

    ... and areola may be moved. Sometimes, women have breast augmentation (enlargement with implants) when they have a breast lift. Why the ... MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed ...

  16. Breast cancer

    Science.gov (United States)

    ... can help you know how to prevent breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct ...

  17. 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

  18. A modified Seeded Region Growing algorithm for vessel segmentation in breast MRI images for investigating the nature of potential lesions

    Science.gov (United States)

    Glotsos, D.; Vassiou, K.; Kostopoulos, S.; Lavdas, El; Kalatzis, I.; Asvestas, P.; Arvanitis, D. L.; Fezoulidis, I. V.; Cavouras, D.

    2014-03-01

    The role of Magnetic Resonance Imaging (MRI) as an alternative protocol for screening of breast cancer has been intensively investigated during the past decade. Preliminary research results have indicated that gadolinium-agent administrative MRI scans may reveal the nature of breast lesions by analyzing the contrast-agent's uptake time. In this study, we attempt to deduce the same conclusion, however, from a different perspective by investigating, using image processing, the vascular network of the breast at two different time intervals following the administration of gadolinium. Twenty cases obtained from a 3.0-T MRI system (SIGNA HDx; GE Healthcare) were included in the study. A new modification of the Seeded Region Growing (SRG) algorithm was used to segment vessels from surrounding background. Delineated vessels were investigated by means of their topology, morphology and texture. Results have shown that it is possible to estimate the nature of the lesions with approximately 94.4% accuracy, thus, it may be claimed that the breast vascular network does encodes useful, patterned, information, which can be used for characterizing breast lesions.

  19. Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study.

    Science.gov (United States)

    Eriksen, C; Frisell, J; Wickman, M; Lidbrink, E; Krawiec, K; Sandelin, K

    2011-06-01

    Physicians are still concerned about the oncological safety regarding immediate breast reconstruction (IBR) in breast cancer patients. This study aimed to evaluate possible differences between local, regional, and distant recurrences between women having implant-based reconstruction versus women operated with mastectomy alone. Secondary aims were to evaluate time to oncological treatment as well as disease-free and breast-cancer-specific survival. In a retrospective cohort designed study, 300 reconstructed patients with invasive breast cancer were matched with 300 patients from the population-based Regional Breast Cancer Register of the Stockholm-Gotland health-care region operated with mastectomy alone. They were matched for age, tumor size, nodal stage, and year of operation. Also included were patients treated with neoadjuvant chemotherapy and postoperative radiotherapy. The median follow-up for both the groups was 11.5 years (range 2-20). There were no significant differences in the local recurrence rate, 8.2% in the IBR group and 9.0% in the control group or in the regional recurrence rate, 8.2% versus 9.7%. Distant metastases occurred more frequently in the control group (27.1%) when compared to the IBR group (20.3%). There were no significant differences in time to treatment or in complications rate. Breast cancer mortality was 17% for the IBR group and 23% in the control group during follow-up. This long-term follow-up survey with a well-matched control group demonstrates that IBR with implants is safe to offer patients with invasive breast cancer without any negative effect on the oncological safety.

  20. Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment.

    Science.gov (United States)

    Veronesi, Paolo; De Lorenzi, Francesca; Loschi, Pietro; Rietjens, Mario; Veronesi, Umberto

    2016-04-01

    Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular-subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  1. 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)

    Woerdeman, Leonie A. E.; Hage, J. Joris; Smeulders, Mark J. C.; Rutgers, Emiel J. Th; van der Horst, Chantal M. A. M.

    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

  2. Fluorodeoxyglucose--positive internal mammary lymph node in breast cancer patients with silicone implants: is it always metastatic cancer?

    Science.gov (United States)

    Soudack, Michalle; Yelin, Alon; Simansky, David; Ben-Nun, Alon

    2013-07-01

    Patients with breast cancer following mastectomy and silicone implant reconstruction may have enlarged internal mammary lymph nodes with pathological uptake on positron emission tomography with (18)F-fluorodeoxyglucose. This lymphadenopathy is usually considered as metastatic in nature, but has also been reported to be related to other conditions, including silicon migration. The purpose of this study was to determine the rate of metastatic disease in this unique group of patients. A retrospective comparative study of 12 female patients with breast cancer with silicone implants referred for biopsy due to isolated internal mammary lymph node fluorodeoxyglucose uptake on positron emission tomography. Five patients (41.6%) had histological findings related to silicone (n = 4) or non-specific inflammation (n = 1). The remaining 7 (58.3%) had histological evidence of cancer recurrence. There was no significant difference in the fluorodeoxyglucose-standardized uptake value between the two groups. Fluorodeoxyglucose-positive mammary lymph nodes in patients with breast cancer following silicone implant reconstruction may be due to metastatic deposits, non-specific inflammation or silicone migration. Clinical and imaging characteristics are insufficient in differentiating between these conditions. Biopsy is recommended prior to initiation of further treatment.

  3. [A scanning electron microscopy study of the surface of porous-textured breast implants and their capsules. Description of the "velcro" effect of porous-textured breast prostheses].

    Science.gov (United States)

    Danino, A; Rocher, F; Blanchet-Bardon, C; Revol, M; Servant, J M

    2001-02-01

    The efficacy of breast prosthesis texturing in the prevention of capsular contracture has been established for about 20 years. This successful procedure has led to the development and marketing of a number of different models. In the present study, four porous-textured breast prostheses have been examined: the Arion monoblock implant, the CUI (McGahn), the Biocell (Mcgahn), and the Sebbin LS21. Scanning electron microscopic (SEM) investigation of the implant surfaces of the different prostheses was carried out on new samples received from the manufacturers. During a prospective study on eight patients, capsule samples corresponding to the four above-mentioned prostheses were taken to determine whether a secondary intervention was necessary for correction of asymmetry or malpositioning. These samples were analyzed by SEM to investigate whether there could be a correlation between prosthesis texturing and the aspect of the corresponding capsules. Significant ultrastructural differences were found between the various prostheses examined: the results showed that only the CUI and Biocell prostheses presented a mirror image of the capsule texturing, with a correspondence between the depressions on the prosthesis and the contacts on the capsule. This finding seems to be linked to the existence of a critical size for the pores that constitute the implant surface. This observation led to the hypothesis of an adhesive "velcro" effect between the prosthesis and its capsule. Although the latter may not be directly linked to the prevention of capsular contracture it can, however, have a major effect on implant stabilization in cases of primary breast reconstruction and in possible secondary adjustments of asymmetry and malpositioning.

  4. 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. © 2015 Wiley Periodicals, Inc.

  5. Evaluation of chemopreventive and cytotoxic effect of lemon seed extracts on human breast cancer (MCF-7) cells.

    Science.gov (United States)

    Kim, Jinhee; Jayaprakasha, Guddadarangavvanahally K; Uckoo, Ram M; Patil, Bhimanagouda S

    2012-02-01

    Extracts from lemon seed were investigated for the radical scavenging activity and apoptotic effects in human breast adenocarcinoma (MCF-7) cells and non-malignant breast (MCF-12F) cells for the first time. Defatted seed powder was successively extracted with ethyl acetate (EtOAc), acetone, methanol (MeOH), and MeOH:water (80:20). The chemical constituents were identified and quantified by LC-MS and HPLC analysis, respectively. The highest radical scavenging activity of 62.2% and 91.3% was exhibited by MeOH:water (80:20) at 833μg/mL in 1,1-diphenyl-2-picryl hydrazyl (DPPH) and 2,2'-azino-di-(3-ethylbenzothiazoline)-6-sulfonic acid (ABTS(+)), respectively. In addition, the MeOH:water (80:20) extract showed the highest (29.1%, Pwater (80:20) extract induced DNA fragmentation and poly(ADP-ribose) polymerase (PARP) cleavage. Increased levels of Bax and cytosolic cytochrome C and decreased levels of Bcl2 were also observed in MeOH:water (80:20) treated MCF-7 cells. In conclusion, the MeOH:water (80:20) extract from lemon seed has potent antioxidant activity and induces apoptosis in MCF-7 cells, leading to the inhibition of proliferation. These results suggest that aglycones and glucosides of the limonoids and flavonoid present in MeOH:water (80:20) extract may potentially serve as a chemopreventive agent for breast cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. A dynamic model for the estimation of optimum timing of computed tomography scan for dose evaluation of 125I or 103Pd seed implant of prostate

    International Nuclear Information System (INIS)

    Yue Ning; Dicker, Adam P.; Corn, Benjamin W.; Nath, Ravinder; Waterman, Frank M.

    1999-01-01

    Purpose/Objective: The dosimetric evaluation of permanent 125 I or 103 Pd prostate implant is based on the assumption that both prostate and seeds are static throughout the entire treatment time which lasts months. However, the prostate is often edematous after the surgical implantation of seeds. Therefore, both the volume of the prostate and the seed locations change dynamically as the edema resolves. This effect has impact on the validity of postimplant analysis based upon a CT scan. If a CT scan is taken too early after implantation while there is edema in the prostate, the dose delivered by the implant may be underestimated. If the imaging is delayed too long, the dose may be overestimated. The magnitude of this effect depends on both of the half-life of the isotope used and the half-life and magnitude of the edema. This study describes a dynamic biomathematical model which takes edema into account in calculating the dose delivered by the implant and is used to investigate the optimum time to obtain the postimplant CT scan. Materials and Methods: The dynamic biomathematical model is a numerical integration of the accumulated dose in which the prostate dimensions, the seed locations, and the source strength are all functions of time. The function which describes the change in prostate dimensions and seed locations as a function of time was determined in a separate study by analysis of serial postimplant CT scans. Dose-volume histograms (DVH) of the prostate for the total dose generated by the dynamic model are compared to DVHs generated by CT scans simulated for postimplant intervals ranging from 0 to 300 days after the implantation for 30 different combinations of the magnitude and duration of edema. Results: DVHs of the prostate calculated by taking edema into account show that the time of obtaining a CT scan for postimplant analysis is critical to the accuracy of dose evaluations. The comparison of the DVHs generated by the dynamic model to those generated by

  7. Edema-induced increase in tumour cell survival for 125I and 103Pd prostate permanent seed implants - a bio-mathematical model

    International Nuclear Information System (INIS)

    Yue Ning; Chen Zhe; Nath, Ravinder

    2002-01-01

    Edema caused by the surgical procedure of prostate seed implantation expands the source-to-point distances within the prostate and hence decreases the dose coverage. The decrease of dose coverage results in an increase in tumour cell survival. To investigate the effects of edema on tumour cell survival, a bio-mathematical model of edema and the corresponding cell killing by continuous low dose rate irradiation (CLDRI) was developed so that tumour cell surviving fractions can be estimated in an edematous prostate for both 125 I and 103 Pd seed implants. The dynamic nature of edema and its resolution were modelled with an exponential function V(T)=V p (1+M exp(-0.693T/T e )) where V p is the prostate volume before implantation, M is the edema magnitude and T e is edema half-life (EHL). The dose rate of a radioactive seed was calculated according to AAPM TG43, i.e. D radical S k Δg(r) φ-bar an /r 2 , where r is the distance between a seed and a given point. The distance r is now a function of time because of edema. The g(r) was approximated as 1/r 0.4 and 1/r 0.8 for 125 I and 103 Pd, respectively. By expanding the mathematical expression of the resultant dose rate in a Taylor series of exponential functions of time, the dose rate was made equivalent to that produced from multiple fictitious radionuclides of different decay constants and strengths. The biologically effective dose (BED) for an edematous prostate implant was then calculated using a generalized Dale equation. The cell surviving fraction was computed as exp(-αBED), where α is the linear coefficient of the survival curve. The tumour cell survival was calculated for both 125 I and 103 Pd seed implants and for different tumour potential doubling time (TPDT) (from 5 days to 30 days) and for edemas of different magnitudes (from 0% to 95%) and edema half-lives (from 4 days to 30 days). Tumour cell survival increased with the increase of edema magnitude and EHL. For a typical edema of a half-life of 10 days

  8. Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant-Associated Anaplastic Large-Cell Lymphoma.

    Science.gov (United States)

    Clemens, Mark W; Medeiros, L Jeffrey; Butler, Charles E; Hunt, Kelly K; Fanale, Michelle A; Horwitz, Steven; Weisenburger, Dennis D; Liu, Jun; Morgan, Elizabeth A; Kanagal-Shamanna, Rashmi; Parkash, Vinita; Ning, Jing; Sohani, Aliyah R; Ferry, Judith A; Mehta-Shah, Neha; Dogan, Ahmed; Liu, Hui; Thormann, Nora; Di Napoli, Arianna; DiNapoli, Arianna; Lade, Stephen; Piccolini, Jorge; Reyes, Ruben; Williams, Travis; McCarthy, Colleen M; Hanson, Summer E; Nastoupil, Loretta J; Gaur, Rakesh; Oki, Yasuhiro; Young, Ken H; Miranda, Roberto N

    2016-01-10

    Breast implant-associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. The median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL. © 2015 by American Society of Clinical Oncology.

  9. Anti-tumor effects of 125I radioactive particles implantation on transplantated tumor model of human breast cancer cells in nude mice

    International Nuclear Information System (INIS)

    Xiao Zhongdi; Liang Chunlin; Zhang Guoli; Jing Yue; Zhang Yucheng; Gai Baodong

    2011-01-01

    Objective: To study the anti-tumor effects of 125 I radioactive particles implantation on transplantated tumor model of human breast cancer cells in nude mice and clarify their anti-tumor mechanisms. Methods 120 nude mice transplantated with human breast cancer cells MCF-7 were randomly divided into 3 groups (n=40): 125 I radioactive particles implanted group, non-radioactive particles implanted group and non-particles implanted group. The articles were implanted into mice according to Pairs system principle. The expressions of Fas mRNA and protein and the activaties of caspase-3 and caspase-8 enzyme were detected by RT-PCR and Western blotting. The changes of cell cycle were detected by flow cytometry. Results: Compared with non-radioactive particles implanted group and non-particles implanted group, the size of cancer tissues in 125 I radioactive particles implanted group was reduced significantly (P 0 /G 1 phase was significantly increased (P 125 I radioactive particles into transplantated tumor model of human breast cancer cells can kill tumor cells, inhibit the growth cycle of tumor cells and induce the apoptosis of tumor cells in nude mice. (authors)

  10. Quantifying shape changes of silicone breast implants in a murine model using in vivo micro-CT.

    Science.gov (United States)

    Anderson, Emily E; Perilli, Egon; Carati, Colin J; Reynolds, Karen J

    2017-08-01

    A major complication of silicone breast implants is the formation of a capsule around the implant known as capsular contracture which results in the distortion of the implant. Recently, a mouse model for studying capsular contracture was examined using micro-computed tomography (micro-CT), however, only qualitative changes were reported. The aim of this study was to develop a quantitative method for comparing the shape changes of silicone implants using in vivo micro-CT. Mice were bilaterally implanted with silicone implants and underwent ionizing radiation to induce capsular contracture. On day 28 post-surgery mice were examined in vivo using micro-CT. The reconstructed cross-section images were visually inspected to identify distortion. Measurements were taken in 2D and 3D to quantify the shape of the implants in the normal (n = 11) and distorted (n = 5) groups. The degree of anisotropy was significantly higher in the distorted implants in the transaxial view (0.99 vs. 1.19, p = 0.002) and the y-axis lengths were significantly shorter in the sagittal (9.27 mm vs. 8.55 mm, p = 0.015) and coronal (9.24 mm vs. 8.76 mm, p = 0.031) views, indicating a deviation from the circular cross-section and shortening of the long axis. The 3D analysis revealed a significantly lower average thickness (sphere-fitting method) in distorted implants (6.86 mm vs. 5.49 mm, p = 0.002), whereas the volume and surface area did not show significant changes. Statistically significant differences between normal and distorted implants were found in 2D and 3D using distance measurements performed via micro-CT. This objective analysis method can be useful for a range of studies involving deformable implants using in vivo micro-CT. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1447-1452, 2017. © 2016 Wiley Periodicals, Inc.

  11. 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

    Directory of Open Access Journals (Sweden)

    Nikolaos Manoloudakis

    2015-03-01

    Full Text Available 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.

  12. Double-blind, placebo-controlled, randomised phase II trial of IH636 grape seed proanthocyanidin extract (GSPE) in patients with radiation-induced breast induration

    International Nuclear Information System (INIS)

    Brooker, Sonja; Martin, Susan; Pearson, Ann; Bagchi, Debasis; Earl, Judith; Gothard, Lone; Hall, Emma; Porter, Lucy; Yarnold, John

    2006-01-01

    Background and purpose: Tissue hardness (induration), pain and tenderness are common late adverse effects of curative radiotherapy for early breast cancer. The purpose of this study was to test the efficacy of IH636 grape seed proanthocyanidin extract (GSPE) in patients with tissue induration after high-dose radiotherapy for early breast cancer in a double-blind placebo-controlled randomised phase II trial. Patients and methods: Sixty-six eligible research volunteers with moderate or marked breast induration at a mean 10.8 years since radiotherapy for early breast cancer were randomised to active drug (n=44) or placebo (n=22). All patients were given grape seed proanthocyanidin extract (GSPE) 100 mg three times a day orally, or corresponding placebo capsules, for 6 months. The primary endpoint was percentage change in surface area (cm 2 ) of palpable breast induration measured at the skin surface 12 months after randomisation. Secondary endpoints included change in photographic breast appearance and patient self-assessment of breast hardness, pain and tenderness. Results: At 12 months post-randomisation, ≥50% reduction in surface area (cm 2 ) of breast induration was recorded in13/44 (29.5%) GSPE and 6/22 (27%) placebo group patients (NS). At 12 months post-randomisation, there was no significant difference between treatment and control groups in terms of external assessments of tissue hardness, breast appearance or patient self-assessments of breast hardness, pain or tenderness. Conclusions: The study failed to show efficacy of orally-adminstered GSPE in patients with breast induration following radiotherapy for breast cancer

  13. Early therapy monitoring of 125I seed interstitial implant in a pancreatic cancer xenograft by 18F-FDG Micro-PET/CT

    International Nuclear Information System (INIS)

    Wang Zhongmin; Liu Yu; Chen Kemin; Lu Jian; Gong Ju; Zheng Yunfeng; Zhang Liyun; Liu Fenju

    2011-01-01

    Objective: To investigate the application value of early evaluation and monitoring of 125 I interstitial implantation in a pancreatic cancer xenograft. Methods: Xenograft models were created by subcutaneous injection of Sw 1990 human pancreatic cancer cell suspensions into the right hind limbs of the immunodeficient BABL/c nude mice. The tumors size were about 8-10 mm after two weeks. The mice were randomly divided into 3 groups,including control group (n=4), empty seed implantation group (n=4) and 125 I implantation group (n=4). Before treatment and one week after treatment, 18 F-FDG Micro-PET/CT scan was performed and then maximum standardized uptake values (SUV max ), mean standardized uptake values (SUV mean ), tumor size and necrosis rate were measured. HE staining and TK1 immunohistochemistry examination were carried out in the paraffin-embedded sample. Results: Before treatment the SUV max and SUV mean values of three groups did not reach statistical significance. One week after treatment the SUV max and SUV mean values of three groups were 3.53±1.20 and 0.57±0.26 vs. 3.83±2.13 and 0.59 ±0.24 vs. 0.29±0.23 and 0.016±0.001, respectively, with a significant difference (F=7.62, P=0.01; F=10.34, P=0.005). The SUV max and SUV mean values of 125 I implant group were significantly lower than empty seed implant group and control group and were significantly lower than before treatment. Before treatment, tumor necrosis rate of three groups were not significantly different. Immunohistochemical staining found the TK1 positive staining index of three groups were respectively (64.25±1.71)%, (62.25±2.22)% and (38.25±1.71)% with statistically significant difference (F=233.67, P<0.001). The TK1 positive staining index of 125 I implant group was significantly lower than empty seed implant group and control group. The SUV max values had some positive correlation with TK1 positive staining index (r=0.85, P=0.001). Conclusions: 18 F-FDG Micro-PET/CT may be useful as a

  14. 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

  15. Comparative studies on permanent prostate brachytherapy: pre-plan and real-time transrectal ultrasound guided iodine-125 seed implants at Korle-Bu Teaching Hospital, Ghana

    International Nuclear Information System (INIS)

    Kalolo, L.T.

    2013-06-01

    This research was carried out to investigate and compare the real-time and pre-plan implant at the Radiotherapy Department of the Korle Bu Teaching Hospital, Ghana. Prowess Panther 4.5 treatment planning system and variseed 7.2 software were used for pre-plan and real-time implant respectively. The study was conducted for eighty three (83) patients treated for prostate cancer through real-time implant brachytherapy between september, 2008 to April, 2013. Thirty one patients (31) patients whose ultrasound images were available were selected for the pre-plan study. The slices of ultrasound images were re-drawn on transparent A-4 sheets and later on scanned, contoured and registered in the treatment planning system (prowess 4.5). After planning, the volume to be implanted, total number of needles, seeds and the total activity of the source were displayed. Comparison was done withe the pre-plan and real-time implant. In both cases the variation was below 5% as recommended in dosimetry. About 30% - 40% of the imported seeds were left un-used due to over-estimation of seeds ordered from the manufacturer (BARD Company-USA). Hence this work (pre-plan) aims to solve this problem. The comparison for dosimetric parameters was assessed for prostate, urethra and rectum as (V 95%, V 100%, V 150%, D90Gy, D90%), (D90Gy, D90%, D30Gy, D30% ) and (V 100%, D30Gy and D30%) respectively and the variation were within the limit of ± 5%. Comparison of dosimetric values for this work were done with other institutions, like Karolinska university hospital, Sweden, The institute of Curie/ hospital Cochin Group Paris-France and European recommendations. The values reported at Korle - Bu teaching hospital (this work) were in good agreement with the international guidelines. (au)

  16. The evolution of FDA policy on silicone breast implants: a case study of politics, bureaucracy, and business in the process of decision-making.

    Science.gov (United States)

    Palley, H A

    1995-01-01

    The central issue facing federal regulation of breast implants is that while such devices are not functionally necessary or needed for survival, the side effects may be harmful and have not been proven unharmful. The Medical Device Amendments of 1976 appear to require such evidence prior to the FDA permitting the unrestricted marketing of these devices. However, only recently have such requirements been imposed by the FDA. The author examines the FDA's decision-making process, particularly as applied to silicone breast implants, and the factors that appears to have affected such decisions. In pursuing this study, the activities of a number of interest-group actors, as well as congressional responses and the role of federal bureaucratic actors, were examined. In 1992, the FDA established a regulatory protocol that effectively withdrew most silicone breast implants from the market for the purpose of breast augmentation and allows for the monitoring of the impact of new implants on women's health. This increase concern for determining the safety of breast implants is due to a number of factors, which are examined in this article.

  17. Evaluation of the perceptions and cosmetic satisfaction of breast cancer patients undergoing totally implantable vascular access device (TIVAD) placement.

    Science.gov (United States)

    Liberale, Gabriel; El Houkayem, Michel; Viste, Claire; Bouazza, Fikri; Moreau, Michel; El Nakadi, Issam; Veys, Isabelle

    2016-12-01

    Totally implantable vascular access devices (TIVADs) are widely used to administer chemotherapy to cancer patients. While great progress has been made with respect to breast surgical reconstruction to take into account both aesthetics and patients' perceptions of body integrity, these aspects have not been considered with regard to the impact of TIVAD. In order to address this practice gap, we have adapted our TIVAD implantation technique to improve cosmetic results. The aim of this study was to assess breast cancer patients' comfort level and aesthetic satisfaction with regard to TIVAD insertion. Patients with breast cancer admitted for chemotherapy at an outpatient clinic completed a previously validated survey evaluating three main domains: symptoms (pain, discomfort) related to the TIVAD itself in daily activity, information received before and during the surgical procedure, and cosmetic aspects regarding the port insertion site (scar, port, and catheter location). Between September 2010 and June 2011, 232 patients were evaluated. Cosmetic satisfaction with scar location was high (93.3 %). Information given to patients before and during the procedure had a major impact on both symptom perception in daily activity and on cosmetic satisfaction. Obtaining a more aesthetic scar by placing the TIVAD in the deltopectoral groove contributed to a high rate of cosmetic satisfaction. Furthermore, the relevance of information given to patients before and/or during surgery had a major impact on symptom perception. Therefore, we suggest including a pre-operative information session in the care pathway.

  18. Genetics analysis of mutagenic effect on M1 and M2 of arabidopsis thaliana derived from the seeds implanted by low energy ion

    International Nuclear Information System (INIS)

    Chen Donghua; Liang Qianjin; Zhang Genfa; Zhang Wenjun; Zhang Xiangqi

    2001-01-01

    Ameliorated RAPD technique was used to analyze the variations and their genetic stability of the gene pool DNAs of M 1 generation of different ion implanted (into seeds) Arabidopsis thaliana and the individual plant DNAs of generations M 1 and M 2 . The analysis of the gene pool DNAs of generation M 1 suggested that: 53 of 178 random primers amplified differential fragments, and multiplication experiments testified that the PCR results of some primers showed considerable stability. The results revealed that variation percentages, within a certain limit, relates to implanting dosage. Particularly, the genetic stability analysis of generation M 2 certificates that: performing PCR analysis by means of the same primers of generation M 1 brought about variation bands identical with that of generation M 1 , so it is possible that variations induced by ion implanting may be truly hereditary

  19. Protocol for a systematic review and meta-analysis on the clinical outcomes and cost of deep inferior epigastric perforator (DIEP flap versus implants for breast reconstruction

    Directory of Open Access Journals (Sweden)

    Ankur Khajuria

    2017-11-01

    Full Text Available Abstract Background Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman’s self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness. Methods A comprehensive search will be undertaken of EMBASE, MEDLINE, Google Scholar, CENTRAL and Science citation index databases (1994 up to August 2017 to identify studies relevant for the review. Primary human studies evaluating clinical outcomes and cost of DIEP and implant-based reconstruction in context of breast malignancy will be included. Primary outcomes will be patient satisfaction and cosmetic outcome from patient-reported outcome measures (scores from validated tools, e.g. BREAST-Q tool, complications and cost-analysis. The secondary outcomes will be duration of surgery, number of surgical revisions, length of stay, availability of procedures and total number of clinic visits. Discussion This will be the first systematic review and meta-analysis in available literature comparing the clinical outcomes and cost-effectiveness of DIEP and implants for breast reconstruction. This review is expected to guide worldwide clinical practice for breast reconstruction. Systematic review registration PROSPERO CRD42017072557 .

  20. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; Transverse upper gracilis flap; TUG; Mastectomy - breast reconstruction with natural tissue; Breast cancer - breast reconstruction with natural tissue

  1. 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.

  2. 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.)

  3. Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

    Science.gov (United States)

    Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C; Wamberg, Peter; Thomsen, Jørn Bo

    2017-09-01

    Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. Therapeutic, IV.

  4. Locoregional recurrences following radical external beam irradiation and interstitial implantation for operable breast cancer - a twenty three year experience

    International Nuclear Information System (INIS)

    Leung, S.; Otmezguine, Y.; Calitchi, E.; Mazeron, J.J.; Le Bourgeois, J.P.; Pierquin, B.

    1986-01-01

    Locoregional recurrences are reported in 493 consecutive with T1 T2 N0 N1 breast cancer patients who were treated with radical external beam irradiation and interstitial 192 Ir implant between 1961 and 1979. Follow-up ranges from 5-23 years (mean 10 years) with 195 patients having 10-23 years follow up (mean 12 years). There were 51 (10%) locoregional recurrences with 34 mammary, 14 combined mammary/axillary and 3 isolated axillary recurrences. The 10 year relapse rate was 20/195 (10%). The results have been compared with other series in the literature and changes in the authors' current protocol are described. (Auth.)

  5. Identification of complications in mastectomy with immediate reconstruction using tissue expanders and permanent implants for breast cancer patients.

    Science.gov (United States)

    Ota, Daisuke; Fukuuchi, Atsushi; Iwahira, Yoshiko; Kato, Takao; Takeuchi, Masashi; Okamoto, Joji; Nishi, Tsunehiro

    2016-05-01

    Since complications of postmastectomy breast reconstruction may reduce patient satisfaction, we investigated complications of reconstruction with tissue expanders (TEs), particularly surgical site infections requiring TE/permanent implant (PI) removal. A retrospective review was performed of 234 primary breast cancer patients undergoing 239 postmastectomy breast reconstructions with TEs/PIs from 1997 to 2009. Clinicopathological findings and postoperative complications, particularly infections, were analyzed. Data were analyzed by the Chi-square test and a multivariate logistic regression model. TE infection risk factors considered for model inclusion were excisional biopsy, (neo) adjuvant chemotherapy, lymph node resection, body mass index (BMI), simultaneous bilateral reconstructions, and seroma aspiration. Removal of TEs/PIs was observed in 15.5% (37/239) of reconstructions, and 18/37 underwent re-reconstructions. Of the 19/37 reconstructions that were not achieved completely, the most frequent reason was TE infection (11 reconstructions). The completion rate was 92% (220/239 reconstructions) and it was significantly higher in reconstructions without TE infection than with infection (96 vs. 54%, p breast reconstruction, prevention of TE infection plays a key role. We should reduce unnecessary seroma aspirations and delay elevation/exercise of the ipsilateral arm.

  6. Carmustine Implant

    Science.gov (United States)

    ... works by slowing or stopping the growth of cancer cells in your body. ... are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving carmustine implant, call your doctor. Carmustine may harm the fetus.

  7. SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H; Lee, S; Diwanji, T; Amin, P; Krudys, K; Guerrero, M [University of Maryland School of Medicine, Baltimore, MD (United States)

    2016-06-15

    Purpose: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured. This study investigates if CBCT taken during EBRT includes the volume change information and therefore beats CT in estimating the prostate OR volumes. Methods: 9 prostate patients treated with EBRT (45Gy in 1.8Gy per fractions to the whole pelvis) and I-125 seed implants (108Gy) were involved in this study. During EBRT, CBCT image guidance was performed on a weekly basis. For each patient, the prostate volumes on the first and the last available CBCT images were manually contoured by a physician. These volumes were then compared to each other and with the contoured volumes from the planning CT and from the ultrasound images in the OR. Results: The first and the last CBCT images did not show significant prostate volume change. Their average +/− standard deviation of prostate volumes were 24.4cc+/−14.6cc and 29.9cc+/−16.1cc, respectively (T-test p=0.68). The ratio of the OR volume to the last CBCT (0.71+/−0.21) was not significantly different from the ratio of OR volumes to the planning CT (0.61+/−0.13) (p=0.25). Conclusion: In this study, CBCT does not show significant prostate volume changes during EBRT. CBCT and CT volumes are quite consistent and no improvement of volume estimation using CBCT is observed. The advantage of CBCT as a replacement of CT for volume study of boost LDR brachytherapy is limited.

  8. SU-G-JeP1-10: Feasibility of CyberKnife Tracking Using the Previously-Implanted Permanent Brachytherapy Seed Cloud

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, J; Cunha, J; Sudhyadhom, A; McGuinness, C; Roach, M; Descovich, M [University of California San Francisco, San Francisco, CA (United States)

    2016-06-15

    Purpose: Robotic radiosurgery is a salvage treatment option for patients with recurrent prostate cancer. We explored the feasibility of tracking the bolus of permanent prostate implants (PPI) using image recognition software optimized to track spinal anatomy. Methods: Forty-five inert iodine seeds were implanted into a gelatin-based prostate phantom. Four superficial gold seeds were inserted to provide ground-truth alignment. A CT scan of the phantom (120 kVp, 1 mm slice thickness) was acquired and a single-energy iterative metal artifact reduction (MAR) algorithm was used to enhance the quality of the DRR used for tracking. CyberKnife treatment plans were generated from the MAR CT and regular CT (no-MAR) using spine tracking. The spine-tracking grid was centered on the bolus of seeds and resized to encompass the full seed cloud. A third plan was created from the regular CT scan, using fiducial tracking based on the 4 superficial gold seeds with identical align-center coordinates. The phantom was initially aligned using the fiducial-tracking plan. Then the MAR and no-MAR spine-tracking plans were loaded without moving the phantom. Differences in couch correction parameters were recorded in the case of perfect alignment and after the application of known rotations and translations (roll/pitch of 2 degrees; translations XYZ of 2 cm). Results: The spine tracking software was able to lock on to the bolus of seeds and provide couch corrections both in the MAR and no-MAR plans. In all cases, differences in the couch correction parameters from fiducial alignment were <0.5 mm in translations and <1 degree in rotations. Conclusion: We were able to successfully track the bolus of seeds with the spine-tracking grid in phantom experiments. For clinical applications, further investigation and developments to adapt the spine-tracking algorithm to optimize for PPI seed cloud tracking is needed to provide reliable tracking in patients. One of the authors (MD) has received research

  9. SU-G-JeP1-10: Feasibility of CyberKnife Tracking Using the Previously-Implanted Permanent Brachytherapy Seed Cloud

    International Nuclear Information System (INIS)

    Cheung, J; Cunha, J; Sudhyadhom, A; McGuinness, C; Roach, M; Descovich, M

    2016-01-01

    Purpose: Robotic radiosurgery is a salvage treatment option for patients with recurrent prostate cancer. We explored the feasibility of tracking the bolus of permanent prostate implants (PPI) using image recognition software optimized to track spinal anatomy. Methods: Forty-five inert iodine seeds were implanted into a gelatin-based prostate phantom. Four superficial gold seeds were inserted to provide ground-truth alignment. A CT scan of the phantom (120 kVp, 1 mm slice thickness) was acquired and a single-energy iterative metal artifact reduction (MAR) algorithm was used to enhance the quality of the DRR used for tracking. CyberKnife treatment plans were generated from the MAR CT and regular CT (no-MAR) using spine tracking. The spine-tracking grid was centered on the bolus of seeds and resized to encompass the full seed cloud. A third plan was created from the regular CT scan, using fiducial tracking based on the 4 superficial gold seeds with identical align-center coordinates. The phantom was initially aligned using the fiducial-tracking plan. Then the MAR and no-MAR spine-tracking plans were loaded without moving the phantom. Differences in couch correction parameters were recorded in the case of perfect alignment and after the application of known rotations and translations (roll/pitch of 2 degrees; translations XYZ of 2 cm). Results: The spine tracking software was able to lock on to the bolus of seeds and provide couch corrections both in the MAR and no-MAR plans. In all cases, differences in the couch correction parameters from fiducial alignment were <0.5 mm in translations and <1 degree in rotations. Conclusion: We were able to successfully track the bolus of seeds with the spine-tracking grid in phantom experiments. For clinical applications, further investigation and developments to adapt the spine-tracking algorithm to optimize for PPI seed cloud tracking is needed to provide reliable tracking in patients. One of the authors (MD) has received research

  10. Breast MRI scan

    Science.gov (United States)

    ... or breast ultrasound Evaluate for possible rupture of breast implants Find any cancer that remains after surgery or chemotherapy Show blood ... Mean Abnormal results may be due to: Breast cancer Cysts Leaking or ruptured breast implants Abnormal breast tissue that is not cancer Scar ...

  11. SU-F-J-157: Effect of Contouring Uncertainty in Post Implant Dosimetry of Low-Dose-Rate Prostate Permanent Seed Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S; Merino, T; Ravi, A; Morton, G; Song, W [Sunnybrook Health Sciences Center, Odette Cancer Centre, Toronto, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada); Safigholi, H; Soliman, A [Sunnybrook Research Institute, Toronto, ON (Canada)

    2016-06-15

    Purpose: There is strong evidence relating post-implant dosimetry for low-dose-rate (LDR) prostate seed brachytherapy to local control rates. The delineation of the prostate on CT images, however, represents a challenge due to the lack of soft tissue contrast in order to identify the prostate borders. This study aims at quantifying the sensitivity of clinically relevant dosimetric parameters to uncertainty in the contouring of prostate. Methods: CT images, post-op plans and contours of a cohort of patients (n=43) (low risk=55.8%, intermediate risk=39.5%, high risk=4.7%), who had received prostate seed brachytherapy, were imported into MIM Symphony treatment planning system. The prostate contours in post-implant CT images were expanded/contracted uniformly for margins of ±1.00 mm, ±2.00 mm, ±3.00 mm, ±4.00 mm and ±5.00 mm. The values for V100 and D90 were extracted from Dose Volume Histograms for each contour and compared. Results: Significant changes were observed in the values of D90 and V100 as well as the number of suboptimal plans for expansion or contraction margins of only few millimeters. Evaluation of coverage based on D90 was found to be less sensitive to expansion errors compared to V100. D90 led to a lower number of implants incorrectly identified with insufficient coverage for expanded contours which increases the accuracy of post-implant QA using CT images compared to V100. Conclusion: In order to establish a successful post implant QA for LDR prostate seed brachytherapy, it is necessary to identify the low and high thresholds of important dose metrics of the target volume such as D90 and V100. Since these parameters are sensitive to target volume definition, accurate identification of prostate borders would help to improve accuracy and predictive value of the post-implant QA process. In this respect, use of imaging modalities such as MRI where prostate is well delineated should prove useful.

  12. SU-F-J-157: Effect of Contouring Uncertainty in Post Implant Dosimetry of Low-Dose-Rate Prostate Permanent Seed Brachytherapy

    International Nuclear Information System (INIS)

    Mashouf, S; Merino, T; Ravi, A; Morton, G; Song, W; Safigholi, H; Soliman, A

    2016-01-01

    Purpose: There is strong evidence relating post-implant dosimetry for low-dose-rate (LDR) prostate seed brachytherapy to local control rates. The delineation of the prostate on CT images, however, represents a challenge due to the lack of soft tissue contrast in order to identify the prostate borders. This study aims at quantifying the sensitivity of clinically relevant dosimetric parameters to uncertainty in the contouring of prostate. Methods: CT images, post-op plans and contours of a cohort of patients (n=43) (low risk=55.8%, intermediate risk=39.5%, high risk=4.7%), who had received prostate seed brachytherapy, were imported into MIM Symphony treatment planning system. The prostate contours in post-implant CT images were expanded/contracted uniformly for margins of ±1.00 mm, ±2.00 mm, ±3.00 mm, ±4.00 mm and ±5.00 mm. The values for V100 and D90 were extracted from Dose Volume Histograms for each contour and compared. Results: Significant changes were observed in the values of D90 and V100 as well as the number of suboptimal plans for expansion or contraction margins of only few millimeters. Evaluation of coverage based on D90 was found to be less sensitive to expansion errors compared to V100. D90 led to a lower number of implants incorrectly identified with insufficient coverage for expanded contours which increases the accuracy of post-implant QA using CT images compared to V100. Conclusion: In order to establish a successful post implant QA for LDR prostate seed brachytherapy, it is necessary to identify the low and high thresholds of important dose metrics of the target volume such as D90 and V100. Since these parameters are sensitive to target volume definition, accurate identification of prostate borders would help to improve accuracy and predictive value of the post-implant QA process. In this respect, use of imaging modalities such as MRI where prostate is well delineated should prove useful.

  13. Breast Prothesis Leakage and Malignant Changes of the Breast

    OpenAIRE

    Al-Lawati, Taha; Kutty, Rajyashree

    2009-01-01

    A breast implant is a prosthesis used to enhance the size of a woman’s breasts. Silicon implants are most commonly used, but as with all surgical implants it has some complications. The question is whether it can induce breast cancer? During the last year, a case of reconstructed breast with prosthesis which leaked was presented. The aim of this report is to review current literature to evaluate whether there are reported correlations between breast cancer and breast implants. The conclusion ...

  14. 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...... there is a learning curve, this simple modified technique does not demand any perforator or other vessel dissection. Any trained plastic surgeon should be able to adopt the technique into the growing armamentarium of breast reconstruction possibilities....

  15. 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.

  16. Killing effect of EGFR-TKI combined with 125I seed implantation therapy on ⅢB-Ⅳ stage lung cancer tissue

    Directory of Open Access Journals (Sweden)

    Ai-Sheng Xiang

    2016-12-01

    Full Text Available Objective: To analyze the killing effect of EGFR-TKI combined with 125I seed implantation therapy on ⅢB-Ⅳ stage lung cancer tissue. Methods: A total of 78 patients with ⅢB-Ⅳ stage lung cancer were randomly divided into observation group and control group (n=39, control group received EGFR-TKI treatment and observation group received EGFR-TKI combined with 125I seed implantation therapy. Differences in apoptosis gene, invasion gene and autophagy gene expression in lung tissue were compared between two groups after 1 month of treatment. Results: Apoptosis genes PDCD5, bax and bcl-xS mRNA expression levels in lung tissue of observation group after 1 month of treatment were higher than those of control group while Bag-1, survivin and bcl-xL mRNA expression levels were lower than those of control group; invasion genes CD147, EGFR and DDX17 mRNA expression levels were lower than those of control group while Bin1, E-cadherin and Ovol2 mRNA expression levels were higher than those of control group; autophagy genes ARHI, Beclin1, Atg5, LC3B, pULK and PI3KC3 mRNA expression levels were higher than those of control group. Conclusions: EGFR-TKI combined with 125I seed implantation therapy can enhance the tumor killing effect on patients with ⅢB-Ⅳ stage lung cancer, and contribute to the optimization of overall condition and the extension of survival time.

  17. Seeds of Peganum Harmala L. chemical analysis, antimalarial and antioxidant activities, and cytotoxicity against human breast cancer cells.

    Science.gov (United States)

    Chabir, Naziha; Ibrahim, Hany; Romdhane, Hany; Valentin, Alexis; Moukarzel, Beatrice; Mars, Mohamed; Bouajila, Jalloul

    2014-01-01

    The present study evaluated the levels of total phenolics, flavonoids, tannins and anthocyanins from Peganum harmala L. seeds and determined their antioxidant, antiplasmodial and anticancer potentials. Antioxidant activity was determined by DPPH and ABTS assays. Extracts of P. harmala seeds from Oudref and Djerba (two places in Tunisia) were obtained by successive extraction solvents: petroleum ether, chloroform, ethyl acetate, ethanol and water. Their composition was evaluated for phenolics (gallic acid equivalent 2.48 to 72.52 g/kg), tannins (catechin equivalent 0 to 25.27 g/kg), anthocyanins (cyanidin equivalent 0 to 20.56 mg/kg) and flavonoids (quercetin equivalent 0 to 3.12 g/kg). Ethanolic extract exerted the highest activities against a chloroquine-resistant strain of Plasmodium falciparum (IC₅₀=23 mg/L), against human breast cancer cells MCF7 (IC₅₀=32 mg/L) and against free radical (IC₅₀=19.09±3.07 mg/L). Correlations were studied between each chemical family and the three activities. Total phenolics content exhibited the highest correlation with antiplasmodial activity (R²=0.92) and with anticancer activity (R²=0.86), respectively.

  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. Comparison of CT- and radiograph-based post-implant dosimetry for transperineal 125I prostate brachytherapy using single seeds and a commercial treatment-planning software

    International Nuclear Information System (INIS)

    Siebert, F.A.; Kohr, P.; Kovacs, G.

    2006-01-01

    Background and purpose: the objective of this investigation was a direct comparison of the dosimetry of CT-based and radiograph-based postplanning procedures for seed implants. Patients and methods: CT- and radiograph-based postplans were carried out for eight iodine-125 ( 125 I) seed implant patients with a commercial treatment-planning system (TPS). To assess a direct comparison of the dosimetric indices (D90, V100, V400), the radiograph-based seed coordinates were transformed to the coordinate system of the CT postplan. Afterwards, the CT-based seed positions were replaced by the radiograph-based coordinates in the TPS and the dose distribution was recalculated. Results: the computations demonstrated that the radiograph-based dosimetric values for the prostate (D p 90, V p 100, and V p 400) were on average lower than the values of the CT postplan. Normalized to the CT postplan the following mean values were found: D p 90: 90.6% (standard deviation [SD]: 9.0%), V p 100: 86.1% (SD: 14.7%), and V p 400: 79.4% (SD: 14.4%). For three out of the eight patients the D p 90 decreased to 90% of the initial CT postplan values. The reason for this dosimetric difference is supposed to be evoked by an error of the reconstruction software used. It was detected that the TPS algorithm assigned some sources to wrong coordinates, partly out of the prostate gland. Conclusion: the radiograph-based postplanning technique of the investigated TPS should only be used in combination with CT postplanning. Furthermore, complex testing procedures of reconstruction algorithms are recommended to minimize calculation errors. (orig.)

  20. Role of hormonal therapy in the management of intermediate- to high-risk prostate cancer treated with permanent radioactive seed implantation

    International Nuclear Information System (INIS)

    Lee, Lucille N.; Stock, Richard G.; Stone, Nelson N.

    2002-01-01

    Purpose: To study the impact of hormonal therapy (HTx) on intermediate- to high-risk prostate cancer treated with permanent radioactive seed implantation. Methods and Materials: Patients with Stage T1b-T3bN0 prostate cancer, and Gleason score ≥7 or prostate-specific antigen (PSA) level >10 ng/mL were treated with seed implantation with or without HTx. Their disease was defined as intermediate risk (PSA 10-20, Gleason score 7, or Stage T2b) or high risk (two or more intermediate criteria, or PSA >20 ng/mL, Gleason score 8-10, or Stage T2c-T3). The median follow-up for 201 eligible patients was 42 months (range 18-110). Biochemical failure was defined as a rising PSA >1.0 ng/mL. Pretreatment disease characteristics, implant dose, and HTx were evaluated using univariate and multivariate analyses. Results: HTx significantly improved 5-year actuarial freedom from biochemical failure rate, 79% vs. 54% without HTx. In addition, high-dose, PSA ≤15 ng/mL, intermediate risk, and Stage T2a or lower significantly improved outcome in the univariate analyses. HTx was the most significant predictor of 5-year actuarial freedom from biochemical failure (p <0.0001) in a multivariate analysis. The best outcome was in the intermediate-risk patients treated with a high implant dose and HTx, resulting in a 4-year actuarial freedom from biochemical failure rate of 94%. Conclusion: In this retrospective review, HTx improved outcome in intermediate- to high-risk prostate cancer patients treated with brachytherapy. HTx was the most important prognostic factor in the univariate and multivariate analyses

  1. Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Lene Nyhøj Heidemann, MD

    2018-01-01

    Conclusion:. The use of acellular dermal matrix in nipple-sparing mastectomy and implant-based breast reconstruction can be done with acceptable complication rates in selected patients. We recommend future studies to include specific definitions when reporting complication rates. Furthermore, future studies should elaborate on demographic characteristics of the included study samples and include predictor analysis to enhance knowledge of high risk patients.

  2. Clinical outcomes after cell-seeded autologous chondrocyte implantation of the knee: when can success or failure be predicted?

    Science.gov (United States)

    Pestka, Jan M; Bode, Gerrit; Salzmann, Gian; Steinwachs, Mathias; Schmal, Hagen; Südkamp, Norbert P; Niemeyer, Philipp

    2014-01-01

    Autologous chondrocyte implantation (ACI) has been associated with satisfying results. Still, it remains unclear when success or failure after ACI can be estimated. To evaluate the clinical outcomes of cell-seeded collagen matrix-supported ACI (ACI-Cs) for the treatment of cartilage defects of the knee at 36 months and to determine a time point after ACI-Cs at which success or failure can be estimated. Cohort study; Level of evidence, 3. A total of 80 patients with isolated full-thickness cartilage defects of the knee joint treated with ACI-Cs were prospectively assessed before surgery as well as postoperatively by use of the International Knee Documentation Committee (IKDC) score and Lysholm knee score. Preoperative IKDC and Lysholm scores increased from 49.6 and 59.5, respectively, to 79.1 and 83.5, respectively, at 36 months. Only half the patients (46.6%) with poor IKDC scores (ie, <70) at 6 months postoperatively showed continued poor or fair scores at 36 months' follow-up. The probability of poor scores at 36 months