MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'breasts'. Sat, 03 Sep 2011 01:55:38 +0100 http://www.medworm.com/index.php?rid=5159654&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fgood-character-or-great-body-what-are-we-teaching-our-kids%2F When I was a teenager, all the girls my age were concerned about the size of their breasts, their weight, and how they looked. Thirty years later, teenage girls are still obsessed with the same thing. How sad — if only young women were more interested in becoming intelligent, caring human beings! Not that these young women don’t care about both their bodies and global issues, it is just that body image has such an effect on how they feel about themselves and can even impact what they accomplish with their education and careers. Breast cancer has a dual effect on women who are diagnosed. On the one hand it affects our wellbeing and health, but on the other it impacts how we feel about ourselves as women especially because of the disfigurement of our breasts. I wonder if it would be ... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=5159654 Wed, 24 Aug 2011 18:56:04 +0100 5159654 http://www.medworm.com/index.php?rid=5096282&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F00YvPBcMlds%2Ftiming-of-radiotherapy-in-implant-based.html This study demonstrated that a higher total failure rate affects breast reconstructions that undergo irradiation during tissue expansion. For this reason, we suggest that if tissue expansion can be performed during postoperative chemotherapy, chest wall irradiation should be delivered on permanent implants. The second surgical step can be scheduled 3 weeks after the end of chemotherapy, and the irradiation should not begin more than 3 weeks later. Patients whose need for radiotherapy is not known preoperatively can, in this way, improve their surgical outcome.         REFERENCES Outcome of Different Timings of Radiotherapy in Implant-Based Breast Reconstructions; Nava, Maurizio B.; Pennati, Angela E.; Lozza, Laura; Spano, Andrea; Zambetti, Milvia; Catanuto, Giuseppe; P... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=5096282 Thu, 04 Aug 2011 11:15:00 +0100 5096282 http://www.medworm.com/index.php?rid=5086233&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fnif0Us-_iWY%2Fis-prophylactic-mastectomy-worth-it.html There is a recent article which asks this question (full reference below).  I think it is a question which must be answered on an individual basis.   For someone like me, the answer would be no.  I have no family history or personal history of breast cancer.  I have small, more dense than fatty breast, but have always had normal mammograms.  I have never had any lesions which needed biopsy. For an individual woman with a strong family history of breast cancer (especially genetically proven, BRCA1 and BRCA2) and a person history of breast cancer (ie right mastectomy for lobular carcinoma), then it is easy to say “Yes, a prophylactic left mastectomy would be worth it for you.” In between these two examples is the gray area, and this article doesn’t nece... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=5086233 Mon, 01 Aug 2011 11:15:00 +0100 5086233 http://www.medworm.com/index.php?rid=5077731&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fj6kzAUAU-nY%2Fmore-on-implant-related-alcl-of-breast.html This article notes (as did the recent FDA report) most investigations performed to date suggest an association between breast implants and primary ALCL of the breast.  The specifics regarding this relationship remain poorly defined. A review of all reported cases of implant-related primary ALCL of the breast demonstrates no obvious correlation with implant fill type (silicone vs. saline), surface morphology (smooth vs. textured), implant position (subpectoral vs. subglandular), or indication for implant placement (cosmetic vs. reconstructive). The FDA notes (bold emphasis is mine): ALCL is a very rare condition; when it occurs, it has been most often identified in patients undergoing implant revision operations for late onset, persistent seroma. Because it is so rare and most often ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=5077731 Thu, 28 Jul 2011 11:15:00 +0100 5077731 http://www.medworm.com/index.php?rid=5008262&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F7kYcZDwBvws%2Fis-personalizing-mammogram-screening.html I read the LA Times article by Shari Roan, Study urges more individual mammogram guidelines, with interest.  As Roan notes, guidelines to date have mainly focused on a woman’s age and not her other risks factors. The American Cancer Society recommends that healthy women undergo screening mammograms every one to two years beginning at age 40 regardless of risk factors. In 2009, the U.S. Preventive Services Task Force recommended a different schedule which urged the inclusion of an individual’s personal risks:  screening for women ages 40 to 49 should be based on individual risk factors and women ages 50 to 74 should be screened every two years. Monday, a paper was published in the Annals of Internal Medicine (full reference below) which argues for a more personalized approach ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=5008262 Wed, 06 Jul 2011 11:15:01 +0100 5008262 http://www.medworm.com/index.php?rid=4968553&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F1a2yYKT2U04%2Ffda-updates-safety-data-for-silicone.html Yesterday, the FDA published this press release:  FDA provides updated safety data on silicone gel-filled breast implants In November 2006, the FDA approved silicone gel-filled breast implants for breast augmentation in women over age 22 and for breast reconstruction in all women.  This latest report includes preliminary safety data from post-approval studies conducted by each of the two breast implant manufacturers (Allergan and Mentor), a summary and analysis of adverse events received over the years by the FDA, and a comprehensive review and analysis of recent scientific publications that discuss the safety and effectiveness of silicone gel-filled breast implants. Based on the report, women should know: Breast implants are not lifetime devices. The longer a woman has silic... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4968553 Thu, 23 Jun 2011 17:01:00 +0100 4968553 http://www.medworm.com/index.php?rid=4934731&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fback-to-bra-shopping-to-fit-new-breasts%2F Now that my revised, reconstructed breasts are settling down, I once again need a new bra. I have learned through my transformation that shopping for a bra is a real task. The one black lace bra that worked in the past no longer fits my new breasts, and most of the bras I have tried on lately just don’t work either. It wasn’t until I had breast cancer that I learned how important a properly fitted bra is. First, I needed a good sturdy bra when I was using just a molded prosthesis for the first breast I lost. Then after the initial reconstruction surgery, I didn’t need as much support, but I needed a bra that would give me the shape I wanted. Now I need a new bra that has the right amount of coverage and can show off the cleavage without pushing my breasts together. What I really ne... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=4934731 Thu, 16 Jun 2011 16:39:16 +0100 4934731 http://www.medworm.com/index.php?rid=4934277&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FzJNDoYh9Ovk%2Fimpact-of-obesity-on-breast-surgery.html Obesity is an ever increasing presence in today’s world.  Thirty-four percent of U.S. adults are now estimated to be obese (BMI>30), up from just 15% three decades ago. Obesity increases the risk of complications in many medical/surgical situations which has pushed some Ob-Gyns in Florida to refuse to care for pregnant women over a certain weight. Martin A. Makary, MD and colleagues designed a study to measure the impact on complication rates in obese patients presenting for a set of elective breast procedures. The PRS journal article referenced below has been published online ahead of print and looks at the impact obesity has on breast surgery complication. The researchers used claims data from seven Blue Cross and Blue Shield Plans covering individuals with employer-provided co... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4934277 Thu, 16 Jun 2011 11:16:00 +0100 4934277 http://www.medworm.com/index.php?rid=4883675&cid=t_116958_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F31%2Fbad-research-popular-sex-search-terms%2F People like sex. They like sex so much, they spend a lot of time searching for it online. Go figure. (You can tell I’m about to delve into really highbrow, heady stuff here…) Researchers Ogi Ogas and Sai Gaddam recently published a book, A Billion Wicked Thoughts, detailing their analysis of 400 million searches they collected from the Dogpile search engine. Of those 400 million searches, 13 percent (55 million) were for erotic content. How did those 55 million searches break down? Let’s find out… but let’s also look at the methodology of these researchers to see if their findings are worth the paper that they are printed on. (If you think not, you’re probably right.) So here’s what people on Dogpile search for when it comes to sexual interests. N... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4883675 Tue, 31 May 2011 17:53:38 +0100 4883675 http://www.medworm.com/index.php?rid=4883734&cid=t_116958_117_f&fid=38856&url=http%3A%2F%2Fwww.timemastermd.com%2F%3Fp%3D2402 Sperm can be quite surprising sometimes! Men produce 1500 sperm every second, and depending on the environment surrounding them, they can be fast or slow.  (This is quite independent of how fast or slow a guy gets to orgasm!) We have always known that nutrition is important to health, but we underestimated how important vitamins and minerals are to the speed of sperm and enhancing reproductive success. In sperm and sex, most men start out pretty fast but peeter out quickly.  Sperm ejaculated in the vagina may last a week, but outside the body survives only a few hours.  Average time to ejaculation during intercourse – 2 -3 minutes!  All in all, this is a sprint race to say the least! Cameron, what’s good for making babies may not be that good for making beautiful locks. S... Timemaster MD blogs http://www.medworm.com/rss/comments.php?id=4883734 Sun, 29 May 2011 14:39:37 +0100 4883734 http://www.medworm.com/index.php?rid=4862610&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fc5PLtjyXfLs%2Ftransaxillary-breast-augmentation-and.html I’m not a huge fan of transaxillary breast augmentation (TABA).  One of the major selling points for the transaxillary approach is the lack of scars on the breasts.  As a woman living in the south, my arm pits are much more likely to be seen in public than my breasts.  As a surgeon, I also know that when revisions need to be done (capsule issues, etc) most recommend using an inframammary approach so why not just start there.  In my opinion, all women with implants will have a repeat surgery at some point in the future – implant failure (deflation, rupture) being a given. I admit I had not thought about how the incision might interfere with future sentinel lymph node assessment prior to this article (full reference below). Dr. Ana Claudia Weck Roxo, Rio de Janeiro S... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4862610 Wed, 25 May 2011 11:11:00 +0100 4862610 http://www.medworm.com/index.php?rid=4789308&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fu4R23934B3k%2Fwomen-dont-regret-prophylactic.html I was alerted to the presentation at the American Society of Breast Surgeons meeting (first reference below) by Judy Boughey, MD by @MedicalNews’ tweet: ASBS: Prophylactic Mastectomy Good Even Years Later (CME/CE) http://bit.ly/kMCsdr Boughey and colleagues note that previous researchers using cross-sectional surveys have found that the majority of women are satisfied with their decision to have contralateral prophylactic mastectomy (CPM) one to several years after the procedure. Their study chose to look at the consistency of satisfaction and changes in adverse effects in the same women with longer term follow-up. To do this, they surveyed a previously established cohort of women with unilateral breast cancer who had contralateral prophylactic mastectomy at the Mayo Clinic between 19... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4789308 Thu, 05 May 2011 11:15:00 +0100 4789308 http://www.medworm.com/index.php?rid=4758777&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FjQVLZDeG5Ww%2Fadvances-in-nipple-sparing-mastectomy.html There is a very nice review article of the advances in nipple-sparing mastectomy surgery in the March 2011 issue of the Aesthetic Surgery Journal (full reference below). Dr. Patrick Maxwell and colleagues includes some history of nipple-sparing mastectomy (NSM): NSM was attempted in the 1980s but never gained popularity owing to the controversies surrounding oncological safety. Now, better technologies for preoperative staging and assessment of lesion distance from the NAC, along with an increased understanding of the anatomy of the breast ducts with relation to the nipple, are encouraging a return to the concept. One of the key publications that renewed and increased enthusiasm for this technique was the multicenter publication of 192 patients undergoing NSM with only four recurrences, ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4758777 Wed, 27 Apr 2011 11:14:00 +0100 4758777 http://www.medworm.com/index.php?rid=4747636&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F_YOLfQGE8RA%2Fmore-on-link-between-breast-implants.html I have written about this previously.  ALCL and Breast Implants – an article review (March 9, 2011) ALCL and Breast Implants (January 31, 2011) Breast Implants and Lymphoma Risk (June 29, 2009)   A quick review:  In January, the Food and Drug Administration (FDA) released a safety alert warning of the possible association of acute large cell lymphoma (ALCL) with breast implants. After the Plastic Surgery Societies got through being defensive, they did the right thing  reviewed the literature (4th reference below) and the Plastic Surgery Foundation and the Aesthetic Surgery Education and Research Foundation commissioned RAND to conduct an exhaustive review of the medical literature and organize a panel of medical experts to evaluate the evidence for a potential link ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4747636 Mon, 25 Apr 2011 11:15:00 +0100 4747636 http://www.medworm.com/index.php?rid=4684412&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FNI-z-U3d6mU%2Fbreast-self-exam-poster.html HT to Street Anatomy for the link to this great poster (photo credit)  by iHeartGuts! Related posts: Breast Self-Exam (October 8, 2009) October – Breast Cancer Awareness Month (October 2, 2008) Mammograms (October 13, 2008) Breast Cancer Screen in Childhood Cancer Survivors – An Article Review (February 2009) Indications for Breast MRI – an Article Review (March 2009) (Source: Suture for a Living) Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4684412 Thu, 07 Apr 2011 11:15:00 +0100 4684412 http://www.medworm.com/index.php?rid=4664215&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FK0pL3nzOhuA%2Ffat-grafting-to-breast-and-oncologic.html This study investigated an orthotopic model of breast cancer in which human breast cancer cells were implanted into the mammary fat pad of immunodeficient animals, followed by placement of a human fat graft (with or without noncultured supplemental cells) immediately adjacent to the mammary fat pad containing the nascent tumor. The study found no increase in tumor growth with either an estrogen receptor-positive or an estrogen receptor-negative human breast cancer line. This is consistent with the absence of evidence for increased cancer risk in the many reports of fat grafting for breast reconstruction and augmentation. However, at this time, the number of patients with prolonged follow-up is only approximately 1000 and appropriate caution in proceeding is indicated. ……….In the cl... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4664215 Thu, 31 Mar 2011 11:15:00 +0100 4664215 http://www.medworm.com/index.php?rid=4642912&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Ffinishing-the-fight-against-breast-cancer%2F I have been writing this blog for 5 years now and last week was the first week that I missed posting one. I think I finally crashed and burned. Not from writing the blog — this is something I love — but from trying to be superwoman. I had follow-up reconstructive surgery a week ago last Thursday, and Friday I was right back to business. By Monday I was feeling the fatigue that comes after surgery, which I could have avoided by resting Friday and Saturday. I stumbled through the rest of the week barely accomplishing anything. Generally I bounce back quickly from surgery. I need at least a day of rest after, but I didn’t give myself that privilege this time. I am always encouraging breast cancer survivors to take their time healing and to give themselves as much time and spac... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=4642912 Mon, 28 Mar 2011 14:39:16 +0100 4642912 http://www.medworm.com/index.php?rid=4600657&cid=t_116958_117_f&fid=38856&url=http%3A%2F%2Fwww.timemastermd.com%2F%3Fp%3D2246 FOTB – Food of the Boob Sweet shaved ice!  You know, the kind that’s extremely bad for you that contains all that goodness – namely: condensed milk and vanilla ice cream mixed with sugar , then drenched in a double coat of brown sugar?   It’s ridiculously good and ridiculously bad, and should come with about 10 IU of insulin and a syringe.  Well, a London ice cream parlor is titillating its customers with a new flavor of ice cream made from human breast milk, and that don’t need no sugar – it is already home sweetened! The new ice cream flavor, which is named “Baby Gaga,”  is made from a mix of cream made from 75 percent human breast milk and 25 percent cream from old Bossy the cow, herself. The taste of human breast milk varies enormously, bas... Timemaster MD blogs http://www.medworm.com/rss/comments.php?id=4600657 Thu, 17 Mar 2011 01:36:19 +0100 4600657 http://www.medworm.com/index.php?rid=4566126&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F1jdEPytyDNY%2Falcl-and-breast-implants-article-review.html In light of the recent new regarding the FDA safety alert on the possible association of acute large cell lymphoma (ALCL) with breast implants, the authors of the recently Plastic and Reconstructive Surgery Journal article (full reference below, published online ahead of print) conducted a systematic literature search on the topic. The search included the literature of PubMed, Embase, and Web of Science (Science Journals & Proceedings) databases.  Dates searched included references from 1966 for PubMed and Embase ; from 1980 for Web of Science; and from 1990 for Web of Science Proceedings, through July 2010 for all of them. Research (categorized as epidemiologic studies or scientific papers) and non-research (case reports or case series) articles from peer-reviewed journals, conf... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4566126 Wed, 09 Mar 2011 12:15:00 +0100 4566126 http://www.medworm.com/index.php?rid=4527759&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FcTLG5-Lp0Gs%2Fare-patients-making-good-decisions.html The objective of the study was to “measure women's knowledge about reconstruction and to evaluate the degree to which treatments reflected patients' goals and preferences.” Their conclusion (bold emphasis is mine): Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients' goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making. Granted the study was small, but it left me wondering if we the medical community fails to educate these women.   The study involved a cross-sectional survey of early-stage breast cancer survivors from four university medic... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4527759 Mon, 28 Feb 2011 12:15:00 +0100 4527759 http://www.medworm.com/index.php?rid=4419177&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FqvAYgWXZqds%2Falcl-and-breast-implants.html Last week, the U.S. Food and Drug Administration requested health care professionals to report confirmed cases of anaplastic large cell lymphoma (ALCL) in women with breast implants. The FDA made this request as they continue to investigate a possible association between breast implants, both saline and silicone gel-filled, and ALCL. The definition given of ALCL by the National Cancer Institute calls ALCL an aggressive type of non-Hodgkin lymphoma, but oncologist Elaine Schattner, M.D. concludes after studying the FDA’s assessment (bold emphasis is mine) Most of the ALCL tumors were limited to the area of the implant cap­sules, and could – as best I can tell from the few reports – be treated by removal of the implants and affected, adjacent breast tissue. These don’t appear to b... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4419177 Mon, 31 Jan 2011 13:10:19 +0100 4419177 http://www.medworm.com/index.php?rid=4405813&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FZQ6cRrAn0h8%2Fdetermining-implant-size-preop.html There is an interesting debate going on regarding bra stuffing for implant size at PRSonally Speaking.  In the interest of full disclosure, I use normal saline implant sizers which I place inside a thin sleep bra.  I then inflate with sizer (usually use two different sizes for comparison) with air.  I then have the woman place her shirt on and stand in front of the full length mirror.  It has worked well for me over the years.  And, yes, I know it is not perfect, but it allows the two (or three if a friend or spouse has come with her) to assess how she looks AND presents herself. (photo credit) It has amazed me over the years how some women will decide on larger implants when I show them what a “C” cup for their body really is [the volume for a 34C is not the s... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4405813 Thu, 27 Jan 2011 12:15:00 +0100 4405813 http://www.medworm.com/index.php?rid=4399560&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FtVdI1tBW4Tk%2Fuspstf-breast-screening-guidelines.html The question continues as to when breast screening should begin.  The current pushback comes from radiologists Dr. Mark Helvie of the University of Michigan Health System and colleague Dr. Edward Hendrick of the University of Colorado. The two researchers have published an article (full reference below) in the February issue of the American Journal of Roentgenology questioning the U.S. advisory panel’s breast cancer screening guidelines and suggesting the panel ignored scientific evidence that more frequent mammograms save lives. For the article, the two conducted a review of the risk models used by the U.S. Preventive Services Task Force (USPSTF) to issue controversial breast screening guidelines in 2009.  They used Cancer Intervention and Surveillance Modeling Network modeli... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4399560 Wed, 26 Jan 2011 18:51:00 +0100 4399560 http://www.medworm.com/index.php?rid=4294711&cid=t_116958_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F12%2F26%2F8-ways-to-pitch-perfectionism%2F Although it can lead to imperfect — or even damaging — consequences, many of us strive for perfection anyway. Procrastination, ironically enough, is one of those unfortunate consequences. “In our pursuit of unreachable standards, we endlessly spin our wheels rather than move forward. In some cases, we never even start. The quest for perfection can be so intimidating that our productivity screeches to a halt,” said Debbie Jordan Kravitz, professional organizer and author of Everything I Know About Perfectionism I Learned from My Breasts. For some people, perfectionism can become all-consuming, so “reaching perfection is all they can see, feel, want or even need,” she said. Fear of failure is part of perfectionism. It stops us from seeking adventure and exploring... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4294711 Sun, 26 Dec 2010 13:57:21 +0100 4294711 http://www.medworm.com/index.php?rid=4241752&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FNVOoknPDUQQ%2Fgynecomastia-is-pathologic-examination.html Most medical centers routinely perform or require that breast tissue be sent to pathology for histologic examination.  The authors of the article (referenced below) question whether this is useful when the breast tissue excised comes from an adolescent male with gynecomastia considering the benign nature of the condition. Furthermore, the authors point out male breast cancer is rare and when it does occur it is most often in older males, not adolescent males. In 2009, there were an estimated 1,910 new cases and 440 deaths related to male breast cancer, accounting for just 0.25% and 0.15% of all new cases of cancer and cancer deaths for males in the entire United States, respectively, with historical cohorts demonstrating that the peak incidence of male breast cancer occurs at approx... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4241752 Wed, 08 Dec 2010 12:14:01 +0100 4241752 http://www.medworm.com/index.php?rid=4190431&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fwhen-prosthetic-breasts-raise-travel-concerns%2F The big buzz in the news lately has been about increased airport screening through pat-downs and body scans and its effects on people’s privacy. One report about a cancer survivor and her experience with screening has created a lot of discussion. This past August, in a Charlotte, North Carolina airport, a flight attendant who also happens to be a breast cancer survivor was directed to a private area by the Transportation Security Administration (TSA) for screening. Two women TSA agents conducted a pat-down and after feeling her prosthetic breast, demanded that she remove it from her bra for inspection. This appalling incident is something I know I can relate to. I wore a prosthetic breast for a couple of years, and I think having to show it to a stranger who was suspicious of me harborin... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=4190431 Mon, 22 Nov 2010 20:26:03 +0100 4190431 http://www.medworm.com/index.php?rid=4190208&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FWU2DY-YNwLo%2Frisks-of-fat-grafting-in-breast-cancer.html Fat grafting as a means of either (cosmetically) enlarging breasts or (reconstructively) correcting defects / asymmetries after breast cancer surgery/radiation therapy has been gaining ground as an acceptable method in the past few years.  True, much debate is still occurring but research is being encouraged to answer questions regarding safety (short and long-term) and efficacy. The two articles (full references below) from researchers at the University of Pittsburgh School of Medicine suggests that it is NOT safe to use adipose-derived stem cells (ADSC) that may be part of fat grafting in any patient with active tumor cells.  From the first article’s abstract (bold emphasis is mine): Adipose-derived stem cells (ASCs) have been proposed to stabilize autologous fat grafts fo... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4190208 Mon, 22 Nov 2010 12:15:00 +0100 4190208 http://www.medworm.com/index.php?rid=4179352&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FPI6gmu2-Rb0%2Fsaline-or-silicone.html This study wasn’t planned to discern those answers though it did note that the addition of radiation to the mix lowered the satisfaction scores.   The article by Scott Spear, MD is a wonderful review of the pros and cons of each.  It is well worth reading.  He summarizes at the end of his article: As implant choices have evolved, certain concepts have proven useful. When the main determinant for patient satisfaction is the shape and feel of the implant (and in cases where the implant might be especially visible), a silicone gel implant is the better choice. In cases where the primary concerns are safety (real or perceived), minimal access incisions, and ease of monitoring, saline may prove to be a better choice.     Related posts Patient Satisfaction Following... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4179352 Thu, 18 Nov 2010 12:14:00 +0100 4179352 http://www.medworm.com/index.php?rid=4159270&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F8PRGw_zIH3o%2Fphysician-threatened-by-libel-action.html I was alerted to this issue by a couple of tweets: @mariawolters: @rlbates please blog this if you can RT @DrEvanHarris: Libel threat to Doc w/ concerns abt  "Boob job" cream! http://bit.ly/a4bM5U   @baapsmedia: @beachbumbeauty @cosmetic_candy @rlbates Pls RT 2help defend medical scrutiny on unsubstantiated claims: http://tinyurl.com/37u6wal   Shouldn’t it be possible to voice a concern about a medical treatment, procedure, or claim without the fear of retaliation?  If the claims are backed by science, then simply addressing my concerns would be enough. Fear of retaliation silences discussion.  Fear of retaliation makes it difficult to do the “right thing” when the public or an individual patient is at risk. This incidence involves a British pl... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4159270 Thu, 11 Nov 2010 18:02:00 +0100 4159270 http://www.medworm.com/index.php?rid=4133973&cid=t_116958_117_f&fid=38856&url=http%3A%2F%2Fwww.timemastermd.com%2F%3Fp%3D1236  In Case of Emergency – Borrow a Bra from the Biggest Breasted Woman you can Find! Dr. Elena Bodnar won an Ignoble (aka Stupid) Award for her invention of a bra that can be used for a dust mask for just $29.95.  The fibers on the cups might hold back large dust particles but they are not woven tight enough to prevent bacteria, colds, or the bird flu as many foolishly hoped.  And then you have to share with some other fool?  No thanks! Bras can be quite utilitarian however, and have been around for over 103 years now!  Thanks Italy! The Real Baconator Double! Move over Wendy’s – there’s a new sheriff in town!  Throw out your 980 calorie two pattie and  6 bacon strip sandwich and let’s have some real dining pleasure with this bacon bra.  I guess, if y... Timemaster MD blogs http://www.medworm.com/rss/comments.php?id=4133973 Thu, 04 Nov 2010 19:38:55 +0100 4133973 http://www.medworm.com/index.php?rid=4098024&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F7H-54aQbUzg%2Ftuberous-breasts.html The latest edition of the Aesthetic Surgery Journal (Sept/Oct 2010) has a really nice article (first reference below) on this tuberous breasts. One of the best things about the article is the great photos, both of the deformity (includes this one to the right) and the corrective procedure. Another nice thing the article has is the review of the breast’s embryology which is critical to understanding the formation of the deformity (bold emphasis is mine). The breast originates from the mammary ridge, which develops in utero from the ectoderm during the fifth week. Shortly after its formation (in the seventh to eighth weeks), most parts of this ridge disappear, except for a small portion in the thoracic region, which persists and penetrates the underlying mesenchyme around 10 to 14 weeks... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4098024 Thu, 21 Oct 2010 11:12:00 +0100 4098024 http://www.medworm.com/index.php?rid=4065404&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fi1asIgrt-8I%2Fpyoderma-gangrenosum-of-breast.html I was prompted to delve into this topic not because I had a patient with the problem, but because of a MDLink to an article (the first one listed below, subscription required).  The eMedicine article states: Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous condition of uncertain etiology. Pyoderma gangrenosum was first described in 1930. It is associated with systemic diseases in at least 50% of patients who are affected. The diagnosis is made by excluding other causes of similar appearing cutaneous ulcerations, including infection, malignancy, vasculitis, collagen vascular diseases, diabetes, and trauma. Ulcerations of pyoderma gangrenosum may occur after trauma or injury to the skin in 30% of patients; this process is termed pathergy. The 2 primary variants of pyode... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4065404 Wed, 13 Oct 2010 11:13:00 +0100 4065404 http://www.medworm.com/index.php?rid=4025690&cid=t_116958_117_f&fid=38856&url=http%3A%2F%2Fwww.timemastermd.com%2F%3Fp%3D1187 Please Shay it isn’t so Shay-la Hershey – Size 38KKK!  (World’s Largest Breasts Record) No need to hit the GYM – just head to the beach instead! Just 10 minutes of staring at the charms of a well-endowed female is equivalent to a 30-minute aerobics work-out,” said author Dr. Karen Weatherby, a gerontologist. So, since Shayla’s chest is over 7 sizes larger than a D cup,  you can get get a 3 1/2 workout by looking at her bust for just ten minutes! Boob oglers have a lower blood pressure, slower resting pulse rates and decreased risk of coronary artery disease.  Of course, right after seeing large breasts there usually is a temporary increase in blood pressure and heart rate, but then it settles down with time.  Playboy King, Hugh Hefner may therefore ... Timemaster MD blogs http://www.medworm.com/rss/comments.php?id=4025690 Sat, 02 Oct 2010 05:29:04 +0100 4025690 http://www.medworm.com/index.php?rid=3954161&cid=t_116958_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F09%2Fwoman-worlds-largest-breast-implants-removed%2F Sheyla Hershey traveled to Brazil this past June in an attempt to obtain the world’s largest breast implants. In addition to gaining her M cup-size breasts she also picked up something else – life-threatening staph and strep infections. Only now when her life is being threatened has she agreed to have her implants removed. Her US physicians Drs. Shazia Gill and Ron Bucek comment. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3954161 Fri, 10 Sep 2010 00:31:44 +0100 3954161 http://www.medworm.com/index.php?rid=3929207&cid=t_116958_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fburn-calories-like-heidi-klum-and-eat-pasta-like-mark-bittman-%25e2%2580%2593-morning-news-roundup%2F It’s OK to Have Small Breasts – According to the New York Times, an A-cup is fashionable. (New York Times) American Teeth Aren’t Well Tended – This infographic shows woeful dental care stats. (Good Blog) Mark Bittman Likes to Carb-Load – The cook/writer/runner blogged about loading on carbs before long runs, plus a recipe for pasta with onion and bacon. (Runner’s World) Burn Calories Like Heidi Klum – By pushing a… stroller? People Magazine demonstrates basic human activity through Hollywood stars. (People) Post from: BlissTree Burn Calories Like Heidi Klum and Eat Pasta Like Mark Bittman – Morning News Roundup (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3929207 Thu, 02 Sep 2010 15:15:25 +0100 3929207 http://www.medworm.com/index.php?rid=3891666&cid=t_116958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstudy-what-makes-a-sports-bra-most-comfortable%2F2010.08.22 Many women will tell you that large breasts are an impediment to exercise, both in terms of discomfort and embarrassment. According to a study of 20 women with C+ breasts in Medicine & Science in Sports & Exercise (MSSE), sports bras which provide breast encapsulation, compression, and elevation (whereas traditional sports bras only provide compression and encapsulation) are more comfortable during physical activity. Breast motion tracking was done via “infrared light-emitting diodes (2-mm diameter)…placed directly on both nipples under each bra using double-sided surgical tape, as the nipples have been found to be the best indicator of vertical breast displacement.” (more…) *This blog post was originally published at Medgadget* (Source: Better Healt... Better Health blogs http://www.medworm.com/rss/comments.php?id=3891666 Mon, 23 Aug 2010 01:13:23 +0100 3891666 http://www.medworm.com/index.php?rid=3885379&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FV3IymbFlsRQ%2Fprimary-breast-abscess-risk-factors.html A recent article in the July issue of the Journal of the American College of Surgeons (full reference below) looked at the risk factors for developing a breast abscess. It is a case control study of 68 patients with a primary breast abscess. Several (36/68) developed a recurrence as defined by the need for repeated drainage within 6 months. They found Univariate analysis indicated that smoking (odds ratio [OR] 8.0 [95% CI 3.4 to 19.4]), obesity (OR 3.6 [95% CI 1.5 to 9.2]), diabetes mellitus (OR 5.7 [95% CI 1.1 to 54.9]), and nipple piercing (OR 10.2 [95% CI 1.3 to 454.4]) were significant risk factors for development of primary breast abscess. Recurrent breast abscess occurred in 36 (53%) patients. Multivariate logistic regression identified significant OR for an increase in recurre... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3885379 Thu, 19 Aug 2010 11:15:00 +0100 3885379 http://www.medworm.com/index.php?rid=3862038&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FTlYnWH6RrdA%2Fpalpable-implant-valve.html I received a call recently from a patient who is one month postop from an augmentation mammoplasty. She and her family physician had found a “lump” in her left breast on a wellness exam. The patient who loves her new implants was worried she something was wrong and she would have to have the implants removed. I asked her to come in and allow me to do an exam. She happily agreed. My first thought was not breast cancer. All her mammograms prior to surgery had been normal. Her breast exam prior to surgery had not revealed any abnormal lumps. My first thought was a palpable implant valve. Fortunately, I was right. This patient is thin, has little breast tissue, submuscular saline implants. She did not want silicone implants. While the valve is flat and non-projecting on the surface of the ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3862038 Thu, 12 Aug 2010 11:22:00 +0100 3862038 http://www.medworm.com/index.php?rid=3823117&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fthe-benefits-of-female-friendship%2F Every year the girls get together for an up-north vacation. There are seven of us in a two-bedroom, one-bathroom cottage — and it works! Hosted by a dear friend who owns the cottage and supplies all of our needs, this yearly getaway provides lots of camaraderie, talk, and tears. It is always a treat and we have a great cook among us. This past weekend was the annual event. We spent Friday on a three-hour kayaking trip down the river. Seven middle-aged women kayaking in a line, dodging fallen trees and sandbars, provided lots of laughs and challenges. Needless to say, it also allowed us to feel no guilt curling up on couches and chairs in the large living room to watch movies and graze on tons of snacks on the rainy Saturday that followed. Our fireside chats are always fun too. We e... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3823117 Wed, 04 Aug 2010 20:01:00 +0100 3823117 http://www.medworm.com/index.php?rid=3813161&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fbreast-cancer-treatment-and-recovery-are-rights-for-all-women%2F Although breast cancer can develop in men, it is a disease that strikes at the heart of women’s rights. In my previous blog entry, I wrote about the law that protects a woman’s right to reconstruction after a mastectomy — the Women’s Health and Cancer Rights Act of 1998. I was new to America and still navigating the complex world of insurance companies with co-pays and deductibles when my mother-in-law brought me the pamphlet following my mastectomy. I was so relieved to learn that there was a law that would ensure I could feel whole again. The Women’s Health and Cancer Rights Act covers women who have lost a breast or breasts because of cancer or non-cancerous diseases. The law requires all group health insurance plans to cover: All stages of reconstruction of the breast on whi... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3813161 Mon, 02 Aug 2010 19:41:58 +0100 3813161 http://www.medworm.com/index.php?rid=3798754&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fgetting-the-best-breasts-possible%2F I had a great doctor’s appointment last week. I got to tell my plastic surgeon how I wanted my redesigned breasts to look. Dr. Studinger is an amazing, patient, and understanding doctor. She is really skilled in the DIEP flap breast reconstruction procedure and committed to helping me get the best possible results from the touch-ups I want. Although I had two surgeries to reconstruct my breasts, I still need to finalize the shape and size of my breasts; one breast is a little bigger than the other. This is in part because one breast was reconstructed from a prophylactic mastectomy, while the other was removed with cancer and my surgeon did not want to leave much skin that could harbor cancer cells. One thing Dr. Studinger reviewed with me the fact that under law, insurance is required to... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3798754 Wed, 28 Jul 2010 20:25:37 +0100 3798754 http://www.medworm.com/index.php?rid=3794751&cid=t_116958_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fracktrap%25e2%2584%25a2-bra-storage-to-get-your-breasts-on-double-duty%2F Storing money in your bra used to be sexy, but Racktrap™ has made it as asexual as possible. Carrying around keys and quarters in our B-cups was ever going to be that titillating, but the new wonder-product – a small pouch that can store a credit card, ID, money, and other small goods (Snickers, anyone?) – has officially made our “rack” utilitarian. Here’s how the website says to use the small pouches (which now come in a sweatproof sports version, the only one we can fathom wanting to use): How to Use the Racktrap™ 1. Locate your breasts . Are you a righty or a lefty? Decide what breast is most easily accessible. 2. Place your essentials (cash, credit cards, drivers license etc.) in The Racktrap™. 3. Insert The Racktrap™ in your bra between the cup and your ... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3794751 Tue, 27 Jul 2010 15:37:43 +0100 3794751 http://www.medworm.com/index.php?rid=3790884&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fdoes-it-matter-when-we-get-breast-cancer%2F A radio news program I heard this morning reported that a greater percentage of women today develop breast cancer under the age of sixty-one. Having gone through the treatment and aftermath of the disease as well as reading comments on this blog, I can well attest to that fact — many women who develop breast cancer these days are in their forties and fifties. We are mothers with younger children, we are in the prime of our careers, and we are not expecting to be hit with this disease. I was diagnosed with breast cancer when I was 44. It sure wasn’t anything I was expecting at that time in my life. Like a lot of people, I thought of breast cancer as a disease that only older women had to worry about. I am just getting into my fifties, and breast cancer will dog me for the rest of m... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3790884 Mon, 26 Jul 2010 18:02:22 +0100 3790884 http://www.medworm.com/index.php?rid=3767271&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fin-search-of-a-tattoo-artist%2F The next big thing coming up for me is additional surgery to finish my breast reconstruction. I delayed getting touch-ups and nipples for various reasons, but that didn’t diminish my desire for more attractive and normal breasts. I have been lucky though because I did work initially with great surgeons at Johns Hopkins in Baltimore and really have a well-placed and wonderful-looking set. Along with putting off the final cosmetic surgery, I have put off thinking about the nipple construction and tattooing that generally accompanies the finishing touches. So recently I have been searching out websites and other material to learn how this is done. Surprisingly, there are a number of ways to get new nipples and areolas. Nipple reconstruction by most surgeons is done by cutting the skin in th... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3767271 Mon, 19 Jul 2010 18:28:43 +0100 3767271 http://www.medworm.com/index.php?rid=3761592&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fhair-paste-for-chemo-hair%2F Yesterday I went to the salon to get my hair done for a family wedding this weekend. It reminded me that when I was at the BRCA conference earlier this summer in Toronto, I sat beside a woman whose hair had just begun to grow back — it was barely three-fourths of an inch long. She lamented that she had a wedding to go to that coming weekend and had no idea how she was going to look good with the limited amount of hair she had to work with. I recommended that she try using a hair product that my hairstylist recommended and showed me how to use when my hair began growing back. It’s a fun product called hair paste. When hair starts growing back, it isn’t quite the hairdo we were dreaming about during chemotherapy. My hair was curly and looked like I had four tufted patches on my... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3761592 Fri, 16 Jul 2010 16:03:59 +0100 3761592 http://www.medworm.com/index.php?rid=3754035&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fis-cancer-gone-or-just-waiting-to-get-me%2F Every now and then I struggle with the question of whether cancer will come back or if it is hiding inside of me and is just looking for an opportunity to plant its ugly, insidious self in some organ. I don’t understand if the cancer went away or if it is just dormant. When it comes to breast cancer no one likes to tell you that you are cured, and when the word remission is used it just sounds like the cancer has gone into hiding. Like most breast cancer survivors, I say things like “I had cancer,” or “I don’t have breast cancer anymore,” but this doesn’t speak to the actual status of cancer in my body. Some experts like to say that we all have cancer cells in our bodies — it is just a matter of whether it develops or not. I tested positive for the BRCA... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3754035 Wed, 14 Jul 2010 18:50:38 +0100 3754035 http://www.medworm.com/index.php?rid=3746932&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Falternative-medicine-vs-conventional-cancer-treatment%2F Driving back from visiting my family outside Toronto yesterday, I listened to an interview with Suzanne Somers. She survived breast cancer and has gone on to become a self-styled expert in health and wellness. I like this woman — she is funny, pretty, and interesting to listen to. What I don’t like is that she is espousing cancer treatment outside the medical community. She is somewhat antagonistic towards medical research and uses her own experts and studies. I think we all need to have an open mind about alternative treatments, but I also believe we need to focus on what is working and saving lives when it comes to cancer. Although Ms. Somers gives positive testimony regarding the treatments she pushes, she cannot point to the countless number of hours of research or the thousands of... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3746932 Mon, 12 Jul 2010 19:45:41 +0100 3746932 http://www.medworm.com/index.php?rid=3733249&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fempowered-to-decide-for-breast-reconstruction-or-against%2F Surgery for my touch-up breast reconstruction is planned for August, so I am scheduled to see the doctor in a few weeks to discuss the changes I want. This surgery is exciting to me, but I waited a long time to have it. I had the original DIEP flap surgery in 2006, then the follow-up in March 2007 — since then I haven’t had any additional work, cosmetic or otherwise, on my breasts. When you take into account the fact that it took me almost 13 years to grow the first set, it doesn’t seem like this new set is really taking that long to perfect. Breast cancer survivors get to do what a lot of women wish they could — get a new set of designer boobs. It is a hollow triumph, really, when you realize what we had to go through to earn them. But if you can get past the horror of the dia... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3733249 Wed, 07 Jul 2010 16:00:16 +0100 3733249 http://www.medworm.com/index.php?rid=3718363&cid=t_116958_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fchristina-hendricks-seems-like-a-normal-woman%2F In the latest issue of Health, Mad Men’s Christina Hendricks graces on the cover, looking totally natural. Her face isn’t overly made-up, her hair’s blowing in the breeze, and, of course, her curves are kickin’. But she does feel weird when people talk about her body, which we think is a normal reaction to the tons of attention focused on her boobs, butt, and thighs. Hendricks says she felt even more womanly (in a good way) when she weighed 15 pounds more. Finally, a happy medium: A not obese, not rail-thin woman who’s getting some attention for her looks – and her talent. via CBS Post from: BlissTree Christina Hendricks Seems Like a Normal Woman (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3718363 Thu, 01 Jul 2010 22:53:52 +0100 3718363 http://www.medworm.com/index.php?rid=3714394&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fbreast-obsessed-after-breast-cancer%2F I have become a boob person. I am obsessed with breasts! I catch myself staring at women’s chests all the time. It is easy to find a pair to look at these days, with all the skimpy summer tops and t-shirts exposing cleavage. I wasn’t always like this. Before I had breast cancer, boobs weren’t a big deal. After my mastectomy, my interest began to grow, and I became fully obsessed while I was deciding on reconstruction. The only other time I developed a minor obsession was when I was 13 years old and my first set wasn’t growing as fast as those of my classmates. This is also similar to when I was bald during chemotherapy and I became obsessed with hair, especially blonde hair. Fortunately, I have more to do in my life than stare at women’s bodies, but when the opportunity arise... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3714394 Wed, 30 Jun 2010 17:54:49 +0100 3714394 http://www.medworm.com/index.php?rid=3690870&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FBA22GqCd1_4%2Facute-hematoma-seven-years-postop.html There is a unique case presented in the Canadian Journal of Plastic Surgery of an acute, symptomatic hematoma occurring 7 years postoperatively.  Most unique is the well defined mechanism of injury which caused the hematoma. For background, the article reminds us that hematoma formation is a complication of augmentation mammoplasty whether for cosmetic or reconstructive purposes.  Most of these will occur in the immediate postoperative period.  The incidence is reported to range from 2-10.3% in this immediate postoperative period. In their review of the literature, the authors found only 20 cases reported to have occurred in the late postoperative period.  Most of these cases did not have a definitive mechanism of injury or develop symptoms immediately after the trigger... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3690870 Wed, 23 Jun 2010 11:01:00 +0100 3690870 http://www.medworm.com/index.php?rid=3560443&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fsomething-is-missing-from-my-reconstructed-breasts%2F A breast without a nipple is like a car without an engine — it is beautiful to look at but you can’t turn it on! I miss my real nipples. Talking to several women at the BRCA conference I attended in Toronto, many of them had the same lament. Regardless of the reconstructive procedure, we all miss the sensation we used to get from our nipples. I can’t conjure up that same feeling, and I have to honestly say sex is not the same. It is still great, don’t get me wrong, but that special effect that came from sensitive breasts is — well, regretfully gone. I have tried to view all the new changes to my body and psyche that came from breast cancer with curiosity. It compels me to research and study the effects of surgery and the drugs on my body and mind. I find it interesting ... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3560443 Wed, 12 May 2010 19:14:34 +0100 3560443 http://www.medworm.com/index.php?rid=3515300&cid=t_116958_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2010%2F04%2F29%2Fbreast-lumps-in-men-are-they-dangerous%2F Filed under: Breast CancerMen who have tender lumps in their breasts are probably suffering from gynecomastia, a benign breast enlargement that usually involves both breasts, but they should still be evaluated by their doctor because they could have breast cancer. About 2,000 men will be diagnosed with the disease this year. Once diagnosed, men are more likely than women to die from breast cancer. Many times men will have prominent breasts simply because they are overweight. But, true gynecomastia is caused by an enlargement of glandular tissues in the breast, not excess fat. This tissue is concentrated under the nipple, but fat is spread around the whole breast. About one-third of all teenage boys will show some breast enlargement during puberty, but less than one percent of men will no... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=3515300 Wed, 28 Apr 2010 23:00:00 +0100 3515300 http://www.medworm.com/index.php?rid=3471817&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FvYYLI8TmECg%2Fcapsular-contracture.html In this study, no cases of Baker grade 3 or 4 capsular contractures were reported. Ventura and Marcello retrospectively analyzed 100 patients who had received primary breast enlargement with textured implants positioned in the subfascial compartment and found that only two patients (2 percent) experienced Baker grade 2 capsular contractures. Finally, in a retrospective multicenter study of more than 500 patients, Gutowski et al. found that the use of subglandular positioning of the prosthesis increased the risk of capsular contractures by almost eight times. It is a nice review of the literature which points out the short comings of our knowledge. Although it is apparent from the articles studied in this review that a great deal of progress has been made over the past few decades to... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3471817 Thu, 15 Apr 2010 11:01:00 +0100 3471817 http://www.medworm.com/index.php?rid=3463546&cid=t_116958_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2010%2F04%2F13%2Fwhy-do-i-keep-getting-breast-lumps%2F Filed under: Breast CancerIf you're like many women, you may routinely find benign breast lumps during your self-exam. It is not cause for concern. Breasts contain glands which naturally form lumps. Some women form more lumps than others. If you have this tendency, you are said to have "fibrocystic breasts." Limiting caffeine seems to lessen the lumpiness, but the difference is not dramatic. If you have lumps as a normal part of your breast exam, you have an added challenge when it comes to self-breast exams for the early detection of cancer. Continue to tell your doctor about any lumps you feel, particularly if any feel unusually firm or irregular in shape. Getting regular mammograms is also important. Check out AOL Health for more breast cancer information.Permalink | Em... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=3463546 Mon, 12 Apr 2010 23:00:00 +0100 3463546 http://www.medworm.com/index.php?rid=3435065&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F70WCpogtd-4%2Felated.html Crying she says, “Dr. Bates, my right implant has deflated. Help!” “Don’t panic. It’ll be okay.” We review the options and risks. Fortunately, her 9 year old implants are covered by the 10 year plan. “Dr. Bates, can I go bigger this time?” “Yes, that’s an option.” Smiling, “Then let’s do it.” (Source: Suture for a Living) Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3435065 Sat, 03 Apr 2010 11:47:00 +0100 3435065 http://www.medworm.com/index.php?rid=3378688&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fchemotherapy-shows-us-at-our-worst%2F The only thing more challenging than living with a teenager is living with a college kid home for spring break. Like most parents I get to see a side of my son that no one else does. If you were to meet the Big Guy you would tell me that I had a polite, charming, intelligent and sensitive young man and congratulate me for raising such a great kid, most people do. If you do meet that kid, please send him home because I think I got the wrong one. Actually though, I need to cut him some slack since he is cranky because of the pain he is experiencing from his recovering knee injury. I can relate to that. When I was going through chemotherapy there were times when I was a little cranky too. Trying to handle chemotherapy and the world at the same time can be a little overwhelming. We are run dow... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3378688 Wed, 17 Mar 2010 20:08:47 +0100 3378688 http://www.medworm.com/index.php?rid=3366229&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F4flHV87eL6c%2Fdouble-bubble-breast-deformity.html Recently a Staten Island woman was awarded $3.5 million after developing a double-bubble breast deformity after a breast augmentation/mastopexy surgery. I don’t know if the award was warranted, but I do know that the deformity is a known risk of breast augmentation surgery. I try very hard to tell patients about possible risks of surgery, but none of us go into surgery thinking we will be the half or one or two percent. As the surgeon, I take pride in my work and give the best I can. It is never my intention for a patient to have a poor result. It is not good for them or for me. So let’s talk a minute about double-bubble deformities. What is it? In a double bubble deformity the implants are usually positioned too superiorly under the muscle (first bubble) with an overhang of skin/brea... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3366229 Mon, 15 Mar 2010 11:01:00 +0100 3366229 http://www.medworm.com/index.php?rid=3362542&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fincluding-family-in-breast-cancer-decisions%2F My son – The Big Guy – injured his knee last fall and had minor surgery to repair a torn meniscus. This is huge in his world because he is a college football player attending school on an athletic scholarship. This past week he injured his knee again and I am beside myself with worry about him, his emotions, and his future. Of course I am not at all concerned about his football, that is the least important to me, but not to him. We have different perspectives and different priorities. Truthfully though this is a minor injury and if we can get him to rest and stay off his knee this should clear on its own, but I still worry. The Big Guy is only 18 and can’t see beyond the next few years. For many of us that face breast cancer we often find that our priorities are different than our fa... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3362542 Fri, 12 Mar 2010 22:26:00 +0100 3362542 http://www.medworm.com/index.php?rid=3342677&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FcnkcbeI9OaQ%2Fpossible-implant-rupture-is-mri-useful.html This article (full reference below) reports a retrospective review study devised to “evaluate its utility in diagnosing ruptured silicone implants in the setting of capsular contracture and to correlate the preoperative assessment of implant integrity with or without magnetic resonance imaging with operative findings.” The study involved 171 patients with capsular contractures with a total of 319 capsulectomies.  Preoperative MRIs was done on 160 implants, whereas the remaining 159 were evaluated using only physical examination and/or mammography. The authors then analyzed postoperative results  to determine the sensitivity, specificity, and accuracy of preoperative MRI in comparison with clinical and/or mammography evaluation alone. They found that while the MRI was occasion... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3342677 Mon, 08 Mar 2010 12:01:00 +0100 3342677 http://www.medworm.com/index.php?rid=3331327&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FsdgI-nTfZFg%2Fautoaugmentation-mastopexy-after-breast.html This is a nice article, but I take exception to the  term “autoaugmentation”  as it is simply a repositioning of the breast tissue as part of the mastopexy.  I would say the term “autoaugmentation” is simply marketing as no augmentation has taken place.   The mastopexy helps reshape the breast, making it look better – higher, firmer, more tissue behind the nipple. Autoaugmentation of the breast can be achieved following implant removal when mastopexy is planned without insertion of a new implant. This procedure corrects ptosis and increases the projection and apparent volume of the breast. The advantages of the technique are that it both minimizes the skin scar and optimizes the shape following upper-pole fullness and suture fixation of the pillars of t... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3331327 Thu, 04 Mar 2010 12:01:00 +0100 3331327 http://www.medworm.com/index.php?rid=3314773&cid=t_116958_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Feveryone-deserves-a-lifetime%2F I am starting to hear ads in Michigan for the 3-day walk to end breast cancer. Many of you have written to me about your participation in this event and how rewarding it is. The one thing that I love about this year’s ad is the line at the end when the announcer says that “everybody deserves a lifetime.” I am sure that I have heard this line before, but it really hit me this week. The whole medical community, all the research and info sites like everydayhealth.com are dedicated to the premise that everyone deserves a lifetime. No one’s life should be cut short because a tumor began to grow in their breasts. The United States has a 5- year survival rate of over 90%. This is so exciting when you think about it. People are surviving the disease. My concern is how well we recover after... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3314773 Sat, 27 Feb 2010 03:36:43 +0100 3314773 http://www.medworm.com/index.php?rid=3290826&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F-NawXZZh1qc%2Fnot-what-she-wanted-to-hear.html Her complaints:  “My back aches.  I can’t find a bra that fits. I have trouble exercising.” Her Exam:   Moderate size, slightly ptotic breasts. No palpable masses.  No skin changes. Her Measurements:  33 inch rib cage, 37 inch bust, 24 cm SNN (38C bra) “Insurance won’t pay for a breast lift.” (Source: Suture for a Living) Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3290826 Sat, 20 Feb 2010 12:01:00 +0100 3290826 http://www.medworm.com/index.php?rid=3227787&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FKVkLrTQWdjU%2Fstem-cells-in-breast-augmentation.html There is a short article, Using Stem Cells in Breast Augmentation, in the January 2010 issue of the PSP Newsletter.  It is more an interview of Todd Malan, MD by Connie Jennings than a scientific article (and that’s okay).  It is an interesting read which includes some of the history of fat grafting for breast augmentation, particularly in the United States but also world wide.  It will be interesting to watch as this procedure/method evolves.  I hope it will be done with scientific protocol that really looks at how it works, if it works, the risks, etc. Dr. Malan quotes the costs: Cost wise, liposuction with fat transfer to the breasts is only about $5,000 over the cost of just liposuction.  It is comparable in cost to a breast augmentation with implants and ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3227787 Mon, 01 Feb 2010 12:01:00 +0100 3227787 http://www.medworm.com/index.php?rid=3193967&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F01%2Flobbing-a-ball-into-play.html As I mentioned the other day, I have a new friend, a woman who just had a double mastectomy and is now facing both radiation and chemo. She has three adopted children, all from different foreign countries, and I adopted Older Son in Japan almost 25 years ago. So we have a lot in common, and we've been e-mailing each other every day. Sometimes there are several separate e-mail conversations going back and forth at the same time. I'm having fun, and getting to talk about issues that are very close to my heart as well. One thing I'm doing, since she is dealing with a lot right now, is generally not bringing up topics that she hasn't brought up. Once she brings it up, it's fair game, to my way of thinking. But if there's something she doesn't want to tal... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3193967 Thu, 21 Jan 2010 01:45:02 +0100 3193967 http://www.medworm.com/index.php?rid=3139066&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FmjLF41sO5_w%2Fclinical-and-radiographic-poland.html The authors of the recent Aesthetic Surgery Journal article (full reference below) have proposed a new classification of Poland Syndrome based on both clinical and radiographic presentation (CRPS). Using their CRPS classification, they present an algorithm for planning surgical treatment. The article begins with a review of Poland Syndrome: Classically, it consists of a combination of unilateral aplasia of the sternocostal portion of the pectoralis major muscle (PMM) and hypoplasia of the ipsilateral hand, with syndactyly and synbrachydactyly. The reported incidence of Poland Syndrome (PS) is one in 30,000 live births. Male-to-female ratio is 3:1. The right side is affected twice as often as the left. The etiology of PS is still unknown, but recently a vascular hypothesis suggests hypo... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3139066 Mon, 04 Jan 2010 12:01:00 +0100 3139066 http://www.medworm.com/index.php?rid=3067279&cid=t_116958_136_f&fid=39025&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Feverythingchangesbook%2F%7E3%2FMdnPRXewdW8%2Fprosthetics-baldness-cancer It isn’t couth, compassionate, and politically correct to ogle over a woman’s breasts, whether they come in a pair or not.  Standing around the food table at a house party last night, I tried but couldn’t help steal glances.  I loved that the woman across from me had the audacity to walk through the world with a cute small boob on the right, and a pancake flat space on the left. The woman with a mastectomy and no prosthesis turned out to be S.L. Wisenberg.  She’s the author of The Adventures of Cancer Bitch, a book I have seen on the shelf next to my book in many stores.  We spent most of the evening by each others side talking about exercise, book readings, cancer fundraising, pink washing, and more.  I adored her immediately. I learned that during cancer treatment, she nixed... Everything Changes blogs http://www.medworm.com/rss/comments.php?id=3067279 Mon, 07 Dec 2009 20:44:22 +0100 3067279 http://www.medworm.com/index.php?rid=3059706&cid=t_116958_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D8105 More drivel in our Mainstream media. Are these reporters n00bs or what? I am referring to rubbish medical misinformation like Boob-staring good for men Study: It boosts their lifespan HERE’s a simple “secret” to ensure longevity for men – stare at women’s breasts for 10 minutes a day to live an additional five years. Both Sin Chew Daily and China Press reported that a German research published in the New England Journal of Medicine showed that men ogling at breasts for 10 minutes a day was equivalent to a 30-minute gym workout. Sin Chew Daily reported yesterday that the team had spent five years researching 200 men. This BS drivel came out quite some time ago - you might have gotten it as some viral email. Simply put, it NEVER was published in the New England Journal of Medicine... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=3059706 Fri, 04 Dec 2009 00:00:00 +0100 3059706 http://www.medworm.com/index.php?rid=3052164&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F4PmjGXyJgbc%2Fcase-report-of-cystosarcoma-phyllodes.html Flipping through my current copy of The Journal of the Arkansas Medical Society, I was surprised to see this case report (full reference below) of a 30.8 pound cystosarcoma phyllodes of the breast. The accompanying photos are impressive. Many questions filled my head – Why did the woman wait so long to seek care? How did she manage to physically do her daily chores on the farm? How did she manage to find clothing to wear? I scanned this photo in from the article. The patient’s history is as follows: A 54-year-old self-employed cattle farmer first noticed a small tumor in her left breast at age 19. Over time, the tumor grew from the size of a small pea to a massive size. Finally, family members convinced the patient to seek medical attention. …. Also, there was no family hist... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3052164 Thu, 03 Dec 2009 12:01:00 +0100 3052164 http://www.medworm.com/index.php?rid=3023376&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F11%2Fmore-on-mammograms-and-40something-women.html The New York Times has a really excellent article on the whole mammogram debate. It goes into the whole "over-diagnosis" issue, which I find fascinating. Scary, but fascinating.  Because I still remember the scary early days when I was told I had DCIS, and no one could tell me whether or not it was harmful and should be treated. Then, of course, during my biopsy of the DCIS, an invasive tumor popped up on the screen, making that whole issue moot, and I had a mastectomy.  There's one paragraph in the NYT article that intrigues me, though, because I don't think my cancer fits into any of these three categories. If it does, it's the first category, the fast growing ones that are FUTILE to diagnosis early. One way of looking at cancer is as three different ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3023376 Mon, 23 Nov 2009 18:15:39 +0100 3023376 http://www.medworm.com/index.php?rid=3012591&cid=t_116958_136_f&fid=38061&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FBreastCancerReconstructionBlog%2F%7E3%2FivJfga5eg24%2Fgrow-breasts-from-fat-future-of-breast.html A new form of breast reconstruction that allows women to re-grow breasts from their own fat cells after a mastectomy could be offered to British and Australian breast cancer patients for the first time in 2010. A human trial of the new technique is being planned by plastic surgeons at a London hospital. The trial will study whether fat cells can be induced to multiply and fill a breast-shaped mold implanted under the chest skin to recreate a breast after mastectomy. Australian scientists also recently announced that they would start similar treatments on women within six months, following animal studies involving mice and pigs that successfully re-grew breasts from fat. If the human trials are as successful, this new technique could transform breast reconstruction surgery,... Breast Cancer Reconstruction Blog blogs http://www.medworm.com/rss/comments.php?id=3012591 Fri, 20 Nov 2009 15:39:12 +0100 3012591 http://www.medworm.com/index.php?rid=3012510&cid=t_116958_117_f&fid=38158&url=http%3A%2F%2Fwww.drneedles.comhttp%3A%2F%2Famericanacupuncture.blogspot.com%2F2009%2F11%2Fquit-checking-your-breasts-honey.html Why did that  government panel turn a thumbs down to teaching women breast self-examination—a low-tech, simple way to check for breast cancer?As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs.Visit http://www.americanacupunctu... Dr. Needles Medical Blogs blogs http://www.medworm.com/rss/comments.php?id=3012510 Fri, 20 Nov 2009 02:19:00 +0100 3012510 http://www.medworm.com/index.php?rid=2999559&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FjLwp0wvK3y4%2Fnew-breast-cancer-screening-guidelines.html Yesterday,  the U.S. Preventive Services Task Force’s announced it’s new recommendations for Screening for Breast Cancer (November 2009).  The uproar has been loud and mostly against.  The summary of the USPSTF’s recommendations: Recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. Recommends biennial screening mammography for women aged 50 to 74 years. Concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2999559 Tue, 17 Nov 2009 16:36:37 +0100 2999559 http://www.medworm.com/index.php?rid=2995759&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F3tU49M_A9Xw%2Fexercises-for-breast-implant-capsule.html Implant movement or massage is often recommended to help prevent capsular contracture after breast augmentation surgery.   I try to show patients how to do this, but often it is simply easier to hand them a copy of this photo from the first referenced article below.  If they seemed to have difficultly with the exercises, I have told them to lay on a hard floor using their body weight to “flatten” the implants as an alternative method.  To view a video of implant massage go here. As this quote from the second article below points out, it is important for the implant to be moved or massaged rather than simply the breast tissue: Implant Movement (as Opposed to Breast Massage) Early implant movement (within 2 days of surgery) is recommended, and aggressive movement ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2995759 Mon, 16 Nov 2009 12:01:00 +0100 2995759 http://www.medworm.com/index.php?rid=2995996&cid=t_116958_136_f&fid=38061&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FBreastCancerReconstructionBlog%2F%7E3%2FivJfga5eg24%2Fgrow-breasts-from-fat-future-of-breast.html A new form of breast reconstruction that allows women to re-grow breasts from their own fat cells after a mastectomy could be offered to British and Australian breast cancer patients for the first time in 2010. A human trial of the new technique is being planned by plastic surgeons at a London hospital. The trial will study whether fat cells can be induced to multiply and fill a breast-shaped mold implanted under the chest skin to recreate a breast after mastectomy. Australian scientists also recently announced that they would start similar treatments on women within six months, following animal studies involving mice and pigs that successfully re-grew breasts from fat. If the human trials are as successful, this new technique could transform breast reconstruction surgery,... Breast Cancer Reconstruction Blog blogs http://www.medworm.com/rss/comments.php?id=2995996 Sun, 15 Nov 2009 22:21:25 +0100 2995996 http://www.medworm.com/index.php?rid=2984831&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FXftkxgiQVV0%2Fprevalence-of-persistent-pain-following.html Conclusions Based on the results of our study together with previously reported findings, chronic pain after breast cancer surgery and adjuvant therapy may predominantly be characterized as a neuropathic pain state and probably related to intraoperative injury of the intercostal-brachial nerve. In accordance with these findings, preliminary observations with nerve-sparing techniques may suggest such approaches to reduce the risk of developing a chronic neuropathic pain state. ……… So far, analgesic and other interventions with paravertebral blocks, topical capsaicin, gabapentin and local anesthetics, N-methyl-D-aspartate–receptor antagonists,  or glucocorticoids may suggest certain benefits, but large-scale studies including well-characterized relevant subpopulations are req... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2984831 Thu, 12 Nov 2009 12:01:00 +0100 2984831 http://www.medworm.com/index.php?rid=2958889&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FIqMwt4Dgnr8%2Fasps-news-on-breast-reductions.html The ASPS News Brief section has two updates listed related to breast reductions regarding papers presented at last week’s American Society of Plastic Surgeons (ASPS) Plastic Surgery 2009 conference which I wasn’t able to attend.  According to ASPS statistics, nearly 89,000 breast reductions were performed in 2008, up 5 percent since 2000. The first one is a pilot study conducted to “determine the extent to which reduction mammaplasty surgery produces a change in biomechanical stress of the spine and level of disability in women with macromastia.”  In the study,  eleven women (ages 27 to 71 yrs, mean age 44.18) who had been determined to need breast reduction surgery, participated in a biomechanical analysis/task that involved lifting a 5 lb. weight and responded t... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2958889 Wed, 04 Nov 2009 11:01:00 +0100 2958889 http://www.medworm.com/index.php?rid=2950756&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F9F0qaYzMgEU%2Fupdate-on-breast-augmentation-using-fat.html A new study on fat grafting for breast augmentation was presented at last week’s American Society of Plastic Surgeons (ASPS) Plastic Surgery 2009 conference which I wasn’t able to attend.  The ASPS News Brief section gave an update on the presentation with a pdf of the abstract. The main study author, Roger Khouri, MD, FACS, is featured in a video explaining the study and technique.  He feels that his study of 50 women is enough to settle the question of safety and effectiveness of fat injections for cosmetic breast augmentation.  Even though his results are good, I remain a skeptic.  The study involved 50 women, ages 17-63.  Initially the length of surgery was 5 hours.  This decreased as their learning curve and technique improved to 1.5 hours.  E... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2950756 Mon, 02 Nov 2009 11:01:00 +0100 2950756 http://www.medworm.com/index.php?rid=2943833&cid=t_116958_106_f&fid=34805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAwfulPlasticSurgery%2F%7E3%2FtRIWYRak9pU%2F Why do some women have such a... [[ This is a content summary only. Visit MyWebsite.com for full links, other content, and more! ]] (Source: Awful Plastic Surgery) Awful Plastic Surgery blogs http://www.medworm.com/rss/comments.php?id=2943833 Thu, 29 Oct 2009 22:54:48 +0100 2943833 http://www.medworm.com/index.php?rid=2927329&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FomLbDmTJN5I%2Fmale-breast-cancer.html October is Breast Cancer Awareness Month.  Most of the focus is on women.  There was a wonderful essay from a male breast cancer patient/survivor.  Here’s the beginning of the essay.  Unfortunately, you need a “subscription” for full access. I talked with a man recently about my cancer. He had trouble finding words. He didn't know what to say and looked to the ground. The "breast" part of it all made him noticeably uncomfortable. When I first felt pain, and later a lump, below my left nipple, it didn't sink in that I, a man, could actually have breast cancer. Years from now I may very well be able to count myself as a cancer survivor simply because the tumor in my breast caused pain. (Something very rare, in fact, for both men and women.) The pain, l... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2927329 Mon, 26 Oct 2009 11:05:31 +0100 2927329 http://www.medworm.com/index.php?rid=2923231&cid=t_116958_87_f&fid=34872&url=http%3A%2F%2Fwww.blisstree.com%2Fhealthbolt%2Fcall-a-sex-organ-for-what-it-is%2F What is it with the cutesy names or the “anything but the real name” issues we have in our society? From news pieces headlined that a woman cut off her lovers “sex organ” to little girls being told to call their vaginas their “ta-tas,” or whatever cutesy name – it really makes me wonder how advanced we really are. For the record, penis, testicles, vagina, breasts – heck, even clitoris – are all words that mean something about the human body. Hoo-hoos, boobies, weiner, hose, snake, front bum or whatever you want to make up, are not. I work with seniors much of the time and I can understand their reluctance to name their body parts, but with younger people, it makes me really wonder. And what makes me wonder even more is what parents thin... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=2923231 Sat, 24 Oct 2009 13:29:55 +0100 2923231 http://www.medworm.com/index.php?rid=2883038&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FVTyYScifTt8%2F1908-view-of-solid-tumors-of-breast.html I continue to be fascinated by the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD.  As October is Breast Cancer Awareness Month, I’m going to share the section from the book on that topic. Solid Tumors of the Breast Hypertrophy Sometimes during adolescence one of the breasts will become abnormally firm and larger than its fellow and rather more sensitive to pressure, but without acute pain.  The enlargement is diffuse and uniform, and there is no adhesion of the breast to the structures either beneath or superficial to it.  Such a condition has a tendency to resolve in the course of time.  This return to the normal state may be hastened by an application of ichthyol ointment. Adenoma An adenoma or an adenofibroma of the breast is a tumor w... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2883038 Mon, 12 Oct 2009 11:01:00 +0100 2883038 http://www.medworm.com/index.php?rid=2871717&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F4BsULUC5TOs%2Fbreast-self-exam.html Conclusions: Most breast cancers (75%) were found by self-examination, even among women who had regular mammography. We did not find any demographic factor that predicted mammography as the primary method of tumor identification. These findings suggest that self-examination remains an important method of breast cancer identification." Photo credit. The Five Steps of a Breast Self Exam: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Look for any changes in the size, shape, and color. Look for any dimpling, puckering, or bulging of the skin. Has the nipple changed position or become inverted? Is there redness, soreness, a rash, or swelling? Now, raise your arms and look for the same changes. While you're at the mi... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2871717 Thu, 08 Oct 2009 11:01:00 +0100 2871717 http://www.medworm.com/index.php?rid=2757788&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F_A703yn3Efw%2Fradiation-therapy-and-breast.html This article attempted to review the most recent literature on breast reconstruction in patients receiving postmastectomy radiation therapy.  They did a nice job. To find articles for review, we performed a search of the MEDLINE database for studies of radiation therapy and breast reconstruction. We then read the reference lists of the identified articles to find additional articles for review. Studies were included if most patients were treated after 1985 and the mean follow-up period was more than 1 year. Forty-nine articles were reviewed. Just from the headings in the article you can get a sense of the complexities of this topic: Indications for Postmastectomy Radiation Therapy: Consensus and Controversies Design of Postmastectomy Radiation Therapy: Consensus, Controversies, ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2757788 Wed, 02 Sep 2009 11:01:00 +0100 2757788 http://www.medworm.com/index.php?rid=2727145&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F8mWqYFeUN9M%2Fmastectomy-flap-necrosis-article-review.html This study (full reference below) comes out of Memorial Sloan-Kettering Cancer Center.  Flap necrosis following mastectomy and reconstruction using a tissue expander has always concerned me.  I will never (due to the size of my practice) have the numbers they have or experience.  They state their purpose as The purpose of this study was to assess the outcomes of our approach to mastectomy flap necrosis and to establish an algorithm that may be useful to other surgeons faced with this complication. They were able to use the “prospectively maintained database” of all patients treated at Memorial Sloan-Kettering Cancer Center to identify patients with documented mastectomy flap necrosis following immediate tissue expander placement between January of 1995 and March of 20... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2727145 Mon, 24 Aug 2009 11:01:00 +0100 2727145 http://www.medworm.com/index.php?rid=2715988&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F6z_L75BZDIk%2Fnipple-sharing-sparing-breast-surgery.html Two nice articles in the June edition of the Journal of Plastic and Reconstructive Surgery.   Full references are given for both below. There are many techniques used for nipple reconstruction which should tell you that none is perfect.  One of the main issues is loss of nipple projection over time.  So if it is safe to spare the nipple when doing a mastectomy so no nipple reconstruction is needed – perfect!  The first article below looks at when it can be safely spared in prophylactic mastectomy (risk-reduction mastectomy) and therapeutic mastectomy clinical scenarios.   Spear and colleagues did a literature review and came to the following conclusion: It is clear from a review of the literature of the past 15 years that the subject of nipple-sparin... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2715988 Thu, 20 Aug 2009 11:01:00 +0100 2715988 http://www.medworm.com/index.php?rid=2712141&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FypAT_Zz4KXE%2Fweight-lifting-good-for-breast-cancer.html Historically, we healthcare providers have cautioned breast cancer patients to avoid weight training after a mastectomy and or axillary dissection.  We often use 15 lbs as a guideline for a save weight to lift using the arm on the mastectomy side.  A new study suggests this advice turns out to be misguided. The study has been published in the August 13 issue of the New England Journal of Medicine.  It is a small study, but the results do challenge our current reluctance to allow lymphedema patients to weight-lift. Kathryn Schmitz, PhD, MPH and colleagues enrolled 141  breast cancer survivors with lymphedema.   The enrollees were then placed into two groups.  One was assigned to a weight-lifting group who lifted twice-weekly for 13 weeks.  The other g... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2712141 Wed, 19 Aug 2009 11:01:00 +0100 2712141 http://www.medworm.com/index.php?rid=2705153&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FkAuDRhAqcLg%2Fshould-excised-mastectomy-scars-be.html Surgeons are commonly faced with the question of whether or not a surgical specimen should be submitted for histologic analysis. Routine histologic examination of clinically unsuspected mastectomy scars that are excised during secondary corrective surgery is considered good practice, but in this era of cost containment in medicine should it be done?  Locoregional recurrence of breast cancer following mastectomy occurs mainly in the first 3 to 5 years at an incidence rate of  3 to 7%.    That risk after breast-conserving therapy is 1.5 to 2 % per year, stabilizing around 10 to 20 % at 10 to 15 years.  The first reference article below involved a retrospective review of 433 patients with a history of breast cancer whose mastectomy or breast-conserving surgery ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2705153 Mon, 17 Aug 2009 11:01:00 +0100 2705153 http://www.medworm.com/index.php?rid=2695396&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FD_F5FTVWoLU%2Fasps-task-force-updates-position-on-fat.html CONCLUSIONS Clinical Applications Based on a review of the current literature and a lack of strong data, the Task Force cannot make specific recommendations for the clinical use of fat grafts. Although fat grafts may be considered for use in the breast and other sites, the specific techniques of graft harvesting, preparation, and injection are not standardized. The results therefore may vary depending on the surgeon’s technique and experience with the procedure. Although there are little data to provide evidence for long-term safety and efficacy of fat grafting, the reported complications suggest that there are associated risks. Regarding fat grafting to the breast, there are no reports suggesting an increased risk of malignancy associated with fat grafting. There is a potential ris... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2695396 Thu, 13 Aug 2009 11:01:00 +0100 2695396 http://www.medworm.com/index.php?rid=2725010&cid=t_116958_117_f&fid=38856&url=http%3A%2F%2Fwww.timemastermd.com%2F%3Fp%3D357   Algae makes you feel good inside and on the outside too!  But, it can be really stinky! A new carotenoid has received much attention lately – astaxanthin.   It would be what’s known as a vitamin light-  chemically, astaxanthin is classified as a non-provitamin A.  It is a fat-soluble nutrient and excellent antioxidant.  The richest source of astaxanthin by far is the algae Haemococcus pluvialis.  In skin treatment salons, algae is not only an exfoliant that cleans pores and scrubs off dead skin, but acts as a prime source of dermal nutrients.  This dietary supplement is a therapeutic tool for a variety of conditions and diseases, including heart disease, immune problems, inflammation states,  and neuro-degenerative issues – such as dementia.   When compar... Timemaster MD blogs http://www.medworm.com/rss/comments.php?id=2725010 Thu, 13 Aug 2009 10:00:55 +0100 2725010 http://www.medworm.com/index.php?rid=2653789&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fnp8cHp3VuVE%2Fraynauds-phenomenon-of-nipple.html This article would have been off my radar had it not been for the interaction on twitter. jeffreyleow RT @paulinechen: Camera Phones [patients taking pics] helps doctor make rare diagnosis http://3.ly/CXr (via @EllenRichter) Granted I am not generally asked about nipple pain in pregnant women.  Those questions tend to go to folk like TBTAM or ER’s Mom.  The article describes a case report of a 25 yo woman in her 2nd trimester with “frequent episodes of extreme bilateral nipple pain. A typical episode lasted between 5 and 15 minutes and was so painful as to bring her to tears.” The article discusses Raynaud’s phenomenon of the nipple and share these photos (credit) taken with a camera phone with us.  The text with the photo: Vasospasm of the arterioles manifest... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2653789 Thu, 30 Jul 2009 11:01:00 +0100 2653789 http://www.medworm.com/index.php?rid=2641474&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F07%2Fboob-shopping-a-reader-weighs-in.html A reader left this comment on my post, Shopping for a New Boob:It's like tile shopping at Home Depot. You know how they tell you to buy extra because you will never find the same exact color again? Well it turns out, this is true with breast implants as well. I had a bilateral mastectomy in 1989. 14 years later one needed to be replaced only that company had gone out of business. So I have one under the skin and one under muscle and they are different sizes and shapes. Now the old one, over 20 years old, has ruptured. I have decided to just get everything removed and am shopping on the internet for mastectomy clothes and breast forms. Loved your article.Read more: Breasts and Boobs @ Jeanne Sather 2009.  (Source: The Assertive Cancer Patient) The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2641474 Sun, 26 Jul 2009 20:25:34 +0100 2641474 http://www.medworm.com/index.php?rid=2616710&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FLgbhxhxzn2w%2Fimpact-of-partial-breast-reconstruction.html I wanted to share this article (1st reference below) with you.  I feel it is important as we continue to improve the treatment of breast cancer.  Our surgical treatments can change the surveillance. The authors begin their article by pointing out breast conservation therapy has grown in popularity and scope.  In saving the majority of the breast tissue, some of the reconstructive procedures significantly alter the architecture of the breasts.  How does this affect surveillance postoperatively?  The article’s stated purpose was to look at this question. The purpose of this review was to evaluate long-term postoperative cancer surveillance techniques in a group of patients with breast cancer who underwent partial breast reconstruction using reduction techniques. ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2616710 Mon, 20 Jul 2009 11:01:00 +0100 2616710 http://www.medworm.com/index.php?rid=2594451&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FVsMJMg7pP3I%2Fover-diagnosis-of-breast-cancers.html Are breast cancers over-diagnosed?  If so, how often?  Those are the questions looked at by the systematic review of incidence reported data/articles done by Karsten Juhl Jørgensen & colleagues.  Their results are published online in the June 9th issue of the British Medical Journal.   Their review shows an estimated 52% over-diagnosis of breast cancer. The researchers’ objective was to estimate the extent of over-diagnosis.  Screening for breast cancer is meant to detect lethal cancers earlier.  Unfortunately it also detects harmless ones that will not cause death or symptoms. As it is not possible to distinguish between lethal and harmless cancers, all detected cancers are treated. Over-diagnosis and overtreatment are therefore inevitable. They ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2594451 Mon, 13 Jul 2009 11:01:00 +0100 2594451 http://www.medworm.com/index.php?rid=2584180&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FbEvQX8fsVos%2Fuse-of-zafirlukast-for-capsular.html Conclusions Zafirlukast appears effective in treating early capsular contracture after primary submuscular breast augmentation using saline-filled, smooth-walled implants. Further prospective studies with control groups and long-term follow-up will be needed to address many unanswered questions, including whether leukotriene inhibitors have long-term effects on capsular contracture following breast augmentation. If this patient and I decide to proceed with zafirlukast treatment, I will be sure she is aware of the potential side effects (minor and major) of the drug.   For photos of a removed capsule and implant check here.   REFERENCES 1.  A new treatment for capsular contracture. (Letter to the editor);  Aesthetic Surg. J. 2002; 21: 164-165; Schlesinger SL and Heck... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2584180 Thu, 09 Jul 2009 11:01:00 +0100 2584180 http://www.medworm.com/index.php?rid=2553057&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F2Q94C6M3OmA%2Fbreast-implants-and-lymphoma-risk.html This article was published in the March issue of the Plastic and Reconstructive Surgery Journal. The article is the summary of a literature review using PubMed to review the evidence from all epidemiologic cohort studies of cancer incidence among women with cosmetic breast implants that include results on the incidence of non-Hodgkin's lymphoma, with specific attention to lymphomas arising in the breast. The review was prompted by the article from The Netherlands (second reference below) which suggested an association of breast implants with anaplastic large T-cell lymphoma. Primary breast lymphoma is a rare malignancy. Most of them are of B-cell origin. It is important for anecdotal reports not to alarm providers or patients. This review article found only five long-term cohort studies w... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2553057 Mon, 29 Jun 2009 11:01:03 +0100 2553057 http://www.medworm.com/index.php?rid=2523072&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FAXchYFfvWug%2Fhow-polands-syndrome-was-named.html Poland's syndrome is a congenital disorder. The classic ipsilateral features of Poland syndrome include the following: absence of sternal head of the pectoralis major, hypoplasia and/or aplasia of breast or nipple, deficiency of subcutaneous fat and axillary hair, abnormalities of rib cage, and upper extremity anomalies. These upper extremity anomalies include short upper arm, forearm, or fingers (brachysymphalangism). (photo credit) Additional features of Poland syndrome include the following: hypoplasia or aplasia of serratus, external oblique, pectoralis minor, latissimus dorsi, infraspinatus, and supraspinatus muscles; total absence of anterolateral ribs and herniation of lung; and symphalangism with syndactyly and hypoplasia or aplasia of the middle phalanges. (photo credit) The name... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2523072 Thu, 25 Jun 2009 11:01:02 +0100 2523072 http://www.medworm.com/index.php?rid=2523271&cid=t_116958_117_f&fid=37824&url=http%3A%2F%2Fwww.doctorkalitenko.com%2Fblog%2Fantiaging%2Fprogesterone-deficiency-can-lead-to-tender-breasts Hormone Replacement Can Be the Cure Many women are suffering from tender and swollen breasts right before their period. Usually, it is one of the many symptoms, that include bloating, fatigue, even moodiness in some. A low progesterone level can be the cause of this tenderness. Replacement with progesterone, not progestine, may help. (Source: Doctor Kalitenko antiaging blog) Doctor Kalitenko antiaging blog blogs http://www.medworm.com/rss/comments.php?id=2523271 Tue, 23 Jun 2009 23:25:49 +0100 2523271 http://www.medworm.com/index.php?rid=3146083&cid=t_116958_117_f&fid=37824&url=http%3A%2F%2Fwww.doctorkalitenko.com%2Fblog%2Fantiaging%2Festrogen-and-progesterone-can-help-with-droopy-breasts Nobody argues that breasts are a very important part of a woman’s body. Therefore, maintaining their proper shape and consistency is crucial. The main hormone responsible for their texture as well as volume is estrogen. If a woman has enough estrogen, she can generate breast tissue to maintain its shape and density. However it is not always the case. Estrogen deficiency is probably the most important cause of breast shape, volume and consistency problems. If there is no enough estrogen from the beginning, breasts are small after periods are started. If estrogen deficiency develops at menopausal age, it results in droopy breasts. What can be done? The first thing that comes to my mind is to replace missing estrogen with hormone replacement therapy. Of course I’m talking about hormones ... Doctor Kalitenko antiaging blog blogs http://www.medworm.com/rss/comments.php?id=3146083 Tue, 23 Jun 2009 23:24:45 +0100 3146083 http://www.medworm.com/index.php?rid=2523272&cid=t_116958_117_f&fid=37824&url=http%3A%2F%2Fwww.doctorkalitenko.com%2Fblog%2Fantiaging%2Festrogen-and-progesterone-can-help-with-droopy-breasts Estrogen, the main female sex hormone is responsible for duct formation and status in breast tissue while progesterone is needed for the rest, including regulating the menstrual cycle. As hormone levels start declining with age there is no hormonal support for the breast tissue anymore. The result is droopy breasts. So at an age when most are looking to consider breast implants and reduction, this may be the opportunity to look into bioidentical hormone replacement first. (Source: Doctor Kalitenko antiaging blog) Doctor Kalitenko antiaging blog blogs http://www.medworm.com/rss/comments.php?id=2523272 Tue, 23 Jun 2009 23:24:45 +0100 2523272 http://www.medworm.com/index.php?rid=2452609&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FvTB42sZd8U4%2Ftennis-star-brings-breast-reduction.html Earlier this week I caught a small news blip which reported that 17 year old Romanian tennis star Simona Halep will be having a breast reduction operation this fall.  Halep won the junior French Open title last year.  She is reported to say (and photo credit): "'This fall I'll have a breast reduction operation," the 17-year-old Romanian said. "The breasts make me uncomfortable when I play. It's the weight that troubles me - my ability to react quickly." It is easy for me to see how her 34DD (probably DDD) size breast do make it harder for her to play tennis.  I’m going to use this as a chance to repost on breast reduction surgery.  So here is my post from December 2007.  It is still relevant.   Breast reduction (or reduction mammopla... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2452609 Thu, 04 Jun 2009 11:01:00 +0100 2452609 http://www.medworm.com/index.php?rid=2452608&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FXbUsbwRKIDE%2Frecent-npr-stories-on-plastic-surgery.html I want to say these two stories were well done (both aired on June 1, 2009).  I was actually interviewed, but not quoted, for the story on fat-grafting.  I pointed Allison Aubry to Dr Scott Spear as her expert.  He is involved in one of the U.S. studies on breast augmentation using fat grafting.  Sculpting the Body with Recycled Fat by Allison Aubry. Doctors Still Unsure Of Long-Term Risks Surgeons like Dr. Scott Spear of Georgetown University Hospital want to know more about the techniques used to transfer fat for breast augmentation. "We're at the beginning of the learning curve," he says. He has initiated a clinical trial to answer some questions about the best way to perform the procedure and whether there are any measurable risks. To date, there are... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2452608 Wed, 03 Jun 2009 11:01:00 +0100 2452608 http://www.medworm.com/index.php?rid=2448073&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F05%2Fmy-mastectomy-photo.html My friend Monica shot this for me this afternoon. I decided to post it out of solidarity with Sharon Adams, the British woman who stirred things up when she posted a photo of herself, post-mastectomy, on Facebook. See: Fight Back: Post Your Mastectomy Photo Online! @ Jeanne Sather 2009.  (Source: The Assertive Cancer Patient) The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2448073 Sun, 31 May 2009 23:22:47 +0100 2448073 http://www.medworm.com/index.php?rid=2448074&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F05%2Ffight-backpost-your-mastectomy-photos-online.html To its credit, Facebook reversed itself and allowed a British woman to post photo of her chest, post-mastectomy, to the social networking site. BUT, when it originally removed the photos, which look very much like what I see in the mirror every morning, it labeled them SEXUAL and ABUSIVE.Huh? What I'm I missing? The Web is full of porn, and very explicit ads seeking sex partners for all sorts of behavior, behavior that I would probably call abusive, and certainly sexual, but photos of a woman's chest minus one breast? Anyway, my solution is simple: Let's all of us who can post photos of our own mastectomy scars to the Web. In solidarity with Sharon Adams.For now, I'll have to post the mosaic that I made out of pink M&Ms as a protest to the M&Ms com... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2448074 Sat, 30 May 2009 17:00:27 +0100 2448074 http://www.medworm.com/index.php?rid=2424169&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FHoryPGh08lg%2F10-year-old-girl-with-breast-cancer.html I caught this story on ABC Good Morning America Tuesday while sitting with my mother.  Life is often tough, isn’t it and Hannah Powell-Auslam, 10 years old, is finding that out early.  It is estimated that at least 180,000 women will be told by their doctors this year that they have breast cancer.  Most of these women are over 30 years old.  As Hannah’s mother Carrie Auslam told reports from KCAL-TV in Los Angeles. "Ten-year-olds don't get breast cancer." So now 10 year old Hannah has to face a disease which woman 4 times her age find difficult to face.  It is a time when she should simply have to worry about which clothes to wear and what music to listen to and which movie to see.  The family has a  Web site documenting Hannah's fight ag... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2424169 Wed, 20 May 2009 11:01:00 +0100 2424169 http://www.medworm.com/index.php?rid=2405917&cid=t_116958_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2FaLLViCJ6RpA%2Fairline-chicken-breasts.php In some of my recipes that call for chicken, you'll often find me using airline chicken breasts.  I've had a lot of inquiries about what exactly airline chicken breasts are, so I thought it would be a great idea to provide a little information about my favorite cut of chicken.What are airline chicken breasts?Airline chicken can be several things, depending upon who you talk to. It can be a fancy... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2405917 Thu, 14 May 2009 12:00:00 +0100 2405917 http://www.medworm.com/index.php?rid=2326692&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F04%2Ftime-for-a-rerun-or-two-or-three.html It's time for a couple of good reruns, for those of you who are new to my blog and may not have noticed all the categories off there to the right ... First, the series that started it all: Jeanne's Diary. I wrote this when I was first diagnosed, so more than 10 years ago, but I think it holds up pretty well. Don't read it for treatment info, because that part is out of date. I think you will see shadows of the woman who later became the Assertive Cancer Patient--she was struggling to get out in those days, still intimidated by medical authority figures, for example. Jeanne's Diary Boycott OctoberI'm thinking of Debutaunt almost constantly today, and that reminds me that she won my "How LOW Will Komen GO?" contest two years in a row--and Deb d... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2326692 Wed, 08 Apr 2009 23:41:39 +0100 2326692 http://www.medworm.com/index.php?rid=2311842&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FXsT7TUEA_kM%2Fdo-screening-mammograms-save-lives.html There is a recently published article in the open access journal journal BMC Medical Informatics and Decision Making that questions whether “mammograms save lives.”  The analysis of data from the the Surveillance, Epidemiology and End Results Program  was done by two British doctors, John Keen and James Keen.  The study was done to analyze the claim "mammography saves lives."   The researchers calculated the absolute benefit by first estimating the screen-free absolute death risk from breast cancer.  They used data from .  They then calculated the absolute risk reduction (reduction in absolute death risk), the number needed to screen assuming repeated screening, and the survival percentages without and with screening. They feel that only 1... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2311842 Wed, 08 Apr 2009 11:10:00 +0100 2311842 http://www.medworm.com/index.php?rid=2311832&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fk3zQ5Ou1g_w%2Fcomplications-after-autologous-fat.html I reviewed a couple of articles on fat injections to the breast back in November.  Now I’ll like to review an article published in the January issue of the Journal of Plastic and Reconstructive Surgery  (PRS).  The full reference for the article is listed below. The authors began by pointing out that autologous fat injection (fat grafting) to the breast has a history of being performed widely throughout the twentieth century, but  in 1987, the American Society of Plastic and Reconstructive Surgeons indicated that because of the side effects (i.e., tissue scarring, oil cysts, and calcification), autologous fat grafting to the breast might compromise breast cancer surveillance and should therefore be prohibited.  Most plastic surgeons stopped performing the procedu... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2311832 Thu, 02 Apr 2009 11:01:00 +0100 2311832 http://www.medworm.com/index.php?rid=2299214&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F03%2Fmore-on-brassage.html The Good Morning America piece on the brassage, for which ABC flew me to NYC for an interview, has gotten lots of pick up. Thanks, Teri, for finding these for me. (Teri, the Cheeky Librarian, is a demon researcher.)WebMD: The Brassage for Wellness? Chicago Sun-Times: 'Brassage' pulled from market after 'GMA' report Your Tango: The Brassage Is a Scam Examiner.com: Buyer Beware of the Brassage KSTP.com: A bra that improves your health? WZZM.com: Need a Brassage? Associated Content: The Brassage and Other Medically Dubious Clothing The Inquisitr: The Brassage Bra: Little Support for Self-Massaging Lingerie College News: The Brassage Wow. All this coverage is a good example of the "food chain" theory of journ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2299214 Tue, 31 Mar 2009 17:47:22 +0100 2299214 http://www.medworm.com/index.php?rid=2299215&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F03%2Fthe-brassage-interview-airs.html I'm putting this one under "quacks." Also under "breasts and boobs" and "cancer myths."The interview that I did last December with JuJu Chang at ABC finally aired this morning, and I think it was a good piece. The story was about a product called the "brassage," which I blogged about quite awhile ago. The manufacturers of the bra claimed that it could prevent breast cancer, which of course it can't. When interviewed by JuJu, the woman behind the bra said she didn't claim that, but asked "could it hurt"? Well, that's not good enough, as I said in the piece. Watch it online: Wellness LingerieTo find the video, go to the link above, and then look at the upper right corner where it says "watch video.... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2299215 Mon, 30 Mar 2009 17:51:24 +0100 2299215 http://www.medworm.com/index.php?rid=2257808&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FbbEtRE-cSAM%2Fmammostat.html I find this to be a fascinating instrument. It is to be used during the de-epithelization of the breast pedicle of a reduction mammoplasty. (photo credit)I was taught to use an Esmark bandage to wrap the base of the breast to aid in the de-epithelization. It acts as both a tourniquet and makes the process simpler as the breast remains “fuller.” I saw the ad in a journal recently and went to their website. The site shows how to use the Mammostat. I wonder if it is easier to use than the Esmark (which is very easy to use). Curious about the cost, I called and was told it is $299. It is reusable which the Esmark is not. So it might have long term cost savings. Other Posts:Breast Reduction (December 19, 2007) (Source: Suture for a Living) Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2257808 Wed, 11 Mar 2009 11:17:00 +0100 2257808 http://www.medworm.com/index.php?rid=2257806&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FOAYG1tTuVgo%2Findications-for-breast-mri-article.html The full title is “Indications for Breast MRI in the Patient with Newly Diagnosed Breast Cancer.” It is a Medscape CME article. The article discussed exactly what the title implies. It does so by looking at the published research. Some of their findings:MRIs have a high sensitivity for detecting otherwise occult cancers in women recently diagnosed with breast cancer. MRIs can improve assessment of disease extent in the breast known to be affected with cancer and may detect mammographically occult cancer in the contralateral breast.Nothing published suggests that breast MRI should be used as a substitute for screening or diagnostic mammography. MRIs should be used as an adjunct to mammography and not in lieu of standard breast imaging with mammography and, when indicated, diagnostic bre... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2257806 Mon, 09 Mar 2009 11:13:00 +0100 2257806 http://www.medworm.com/index.php?rid=2249604&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fy87kJA0_V0M%2Fbreast-surgery.html The “throw away” journal Plastic Surgery Practice has two really well written informative article on breast surgery in the February 2009 issue.  The first is “Reconstructing the Radiated Breast” written by Dr Jane Petro.  The article makes the point that surgery on the radiated breast includes “all the pitfalls of any breast procedure.”  The topic is important as many women opt for breast-conservation therapy (ie lumpectomy followed by radiation therapy) hopeful that they will maintain breast integrity and not need reconstruction. This works for many, but not all.  In reality, the appearance of the breast after this treatment may be unsatisfactory, due to a number of factors. Lumpectomy may deform the breast, leaving unsightly and poorly planned scars in ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2249604 Thu, 05 Mar 2009 12:06:00 +0100 2249604 http://www.medworm.com/index.php?rid=2223387&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FYH8r-7ueLrw%2Fbreast-implant-deflation.html Recently I had a patient call to tell me to report that her right breast implant had deflated.  She is a patient from the early years of my practice.  This is her second deflation, but this one is complicated by pregnancy.  She has listened to my “lectures” over the years and was not panicked.  She wanted to check in with me. I reminded her Your body will simply absorb the IV saline that was used to fill the implant. It isn’t a medical emergency though it can be embarrassing. We can take our time and fit it into your life/work schedule (If patient is pregnant, it can safely wait until the delivery of her baby). Put a shoulder pad or some other padding in your bra to even it out for now. I told her I would report the deflation to the implant company and g... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2223387 Thu, 26 Feb 2009 12:15:00 +0100 2223387 http://www.medworm.com/index.php?rid=2187649&cid=t_116958_106_f&fid=34805&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FAwfulPlasticSurgery%2F%7E3%2F539479800%2F No breast implants for tv... [[ This is a content summary only. Visit MyWebsite.com for full links, other content, and more! ]] (Source: Awful Plastic Surgery) Awful Plastic Surgery blogs http://www.medworm.com/rss/comments.php?id=2187649 Sat, 14 Feb 2009 08:32:18 +0100 2187649 http://www.medworm.com/index.php?rid=2173638&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F535588237%2Fintegrating-radiation-therapy-breast.html This article does a nice job of making some sense of it. Implant-Based Breast Reconstruction in Patients Receiving PMRTStudies evaluating the outcomes of 2-stage breast reconstruction (placement of a tissue expander followed by placement of a permanent breast implant after PMRT) consistently reveal high rates of acute and chronic complications and poor aesthetic outcomes. Capsular contracture that results from PMRT can distort the appearance of the breast and cause potentially significant chronic chest wall pain and tightness. Many surgeons attribute the poor outcomes with implant-based breast reconstruction to older, less precise techniques of radiation delivery. However, even with modern radiation delivery techniques, complication rates with implant-based reconstruction are high. In addi... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2173638 Mon, 09 Feb 2009 14:20:12 +0100 2173638 http://www.medworm.com/index.php?rid=2149639&cid=t_116958_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D6046 In the UK, they’re calling it “moobs” and the embarrassment they cause men is resulting in an increase in plastic surgery on men with moobs. The latest figures from the British Association of Aesthetic Plastic Surgeons (Baaps) seem to bear out this obsession. Surgeons carried out 323 male breast reduction procedures in 2008, up a staggering 44% from 2007. Asians are more pragmatic I guess. Many don’t want to go under the knife. Heck why not just join the girls? In Japan apparently Bras for men are selling well. from the Malaysian Medical Resources What’s all the fuss about man boobs? (Source: Malaysian Medical Resources) Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=2149639 Sat, 31 Jan 2009 05:00:00 +0100 2149639 http://www.medworm.com/index.php?rid=2141757&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F525324579%2Fprophylactic-mastectomy.html The article recently published online in the journal Cancer (due in print in their March issue) looks at the risks factors that increase the likelihood of a woman being diagnosed with breast cancer in her “other” breast after being diagnosed with breast cancer. The article was done at MD Anderson Cancer Center in Houston.  It looked at 542 women with breast cancer diagnosed in one breast (unilateral breast).  All of the women decided to have this and the other breast (contralateral prophylactic mastectomy). The researchers identified are three factors that increases the chance of cancer in the other breast.  These three factors are: having more than one tumor in the same breast at the time of initial diagnosis of breast cancer having invasive lobular breast cance... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2141757 Wed, 28 Jan 2009 12:11:01 +0100 2141757 http://www.medworm.com/index.php?rid=2101643&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F509758094%2Fuams-develops-breast-cancer-vaccine.html Scientists at my alma mater, the University of Arkansas for Medical Sciences, plan to begin clinical trials this spring on a vaccine to prevent the recurrence of breast cancer. Thomas Kieber-Emmons, director of basic breast cancer research at the UAMS Winthrop P. Rockefeller Cancer Institute, and his team used a $2.9 million grant from the U.S. Department of Defense to develop the vaccine. It took more than a decade of study on the immune system to do so. The immunotherapy is designed to trick the body into doing something it wouldn’t naturally do - produce antibodies that fight breast cancer cells. Traditional treatment will not be replaced by the vaccine even if it is successful. Dr Laura Hutchins who will be the principle investigator of the trial, points out that the vaccine could be... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2101643 Mon, 12 Jan 2009 12:14:00 +0100 2101643 http://www.medworm.com/index.php?rid=2067317&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F12%2Fthoughts-on-not-expanding-my-horizons.html FULL TITLE: Thoughts on NOT Expanding My Horizons (or how I got, then got rid of, expanders) By Cathy McDonald When I received my breast cancer diagnosis on 10/13 (both breasts), I knew right then that I would have a bilateral mastectomy. I also knew that, given my age (52), family situation (married), lifelong breast size (40 DD), I was not interested in reconstruction. Visions of tiny tank tops danced in my head. Wearing a blouse that buttoned down the front and didn’t gap became a welcome possibility! I was not happy about the cancer but, yes, I could be happy without the breasts. One week later. General surgeon’s office. This is a very nice man, good bedside manner, very detailed information offered about the surgery – okay, I’m satisfied with this doctor. Then he mentioned ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2067317 Sun, 28 Dec 2008 02:03:02 +0100 2067317 http://www.medworm.com/index.php?rid=2065737&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F494064595%2Fdo-overs.html Earlier this year I saw a breast reduction patient whose surgery I did early in my career and with her permission I am sharing this.I did her breast reduction using an inferior pedicle technique for the safety of the blood supply to the nipple-areolar complex. She came back to see me because her nipple “sits too high”. Actually, the nipple doesn’t set too high. The distance from the sternal notch to the nipple (SN-N) is the correct length for her height. She has what we call “bottoming out”. Notice how the breast tissue seems to have slipped down the chest and no longer sits behind the nipple/areolar complex. When I saw her again, I couldn’t help but think about how I would do her surgery differently today. I am at a different point on the learning curve than I was then, so I ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2065737 Wed, 24 Dec 2008 13:57:53 +0100 2065737 http://www.medworm.com/index.php?rid=2052539&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F12%2Fhow-accurate-are-mammograms.html Here's the answer to yesterday's quiz, which only one person answered, by the way. So I guess it wasn't a very good quiz. Either that, or everyone but me is out getting ready for the holidays. The snow and freezing temperatures are pretty much keeping me homebound. Anyway, according to a press release from M. D. Anderson, mammograms are only accurate in detecting breast cancer between 16 and 40 percent of the time. I have to admit I was shocked. I have never heard this figure. Now, granted, the release is touting the advantages of alternating between conventional mammograms and MRIs for high-risk women, but still ... Read the release:M. D. Anderson press release Support This Blog @ Jeanne Sather 2008. (Source: The Assertive Cancer Patient) The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2052539 Fri, 19 Dec 2008 17:30:14 +0100 2052539 http://www.medworm.com/index.php?rid=2052542&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F12%2Fa-quiz-how-accurate-are-mammograms.html So, I've lived with breast cancer for 10 years, and I'd never seen this statistic until now.  How accurate do you think mammograms are at detecting breast cancer--90 percent? 80 percent? 50 percent?E-mail me your guesses: jeanne.sather@gmail.com And come back tomorrow for the answer.@ Jeanne Sather 2008.  (Source: The Assertive Cancer Patient) The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2052542 Thu, 18 Dec 2008 16:51:02 +0100 2052542 http://www.medworm.com/index.php?rid=2026799&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F12%2Fblogging-from-nyc.html I'm writing this from a very elegant hotel in Manhattan, lying on the bed and dressed in only my jammies--my favorite way to blog!I moved over here last night from Jacqueline's place, a loft in Brooklyn, after spending Sunday night with her. Monday afternoon I tried on all the new clothes she made for me, and then we took lots of photos for Jacqueline to use in her store.She made me three beautiful new tops, all designed for my "one-breasted architecture," and they are GREAT. Great fit, great colors, great designs. I'll post a couple of photos here, and will add the links to the store when Jacqueline has these up for sale. Or if you're in a hurry, just shoot her an e-mail and tell her which top you want: rebel1in8@hotmail.comMy Etsy StoreJacqueline also help... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2026799 Tue, 09 Dec 2008 14:25:27 +0100 2026799 http://www.medworm.com/index.php?rid=1969582&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F455920207%2Feffects-of-breastfeeding-on-breast.html This article is an attempt to look at the issue in an objective manner.  They did this by a retrospective study of charts. Methods: Charts were reviewed of all patients seeking consultation for aesthetic breast surgery between 1998 and 2006. History of pregnancies, breastfeeding, and weight gain were obtained via telephone interview.  Degree of breast ptosis was determined from preoperative photos. Nulliparous women were excluded.  Logistic regression analysis was performed to identify independent predictors of postpregnancy breast ptosis. That is the main weakness of the article, but they realize that limitation. This is a retrospective study with inherent limitations. The patients were not randomized to breastfeeding and nonbreastfeeding groups, and some differences... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1969582 Mon, 17 Nov 2008 12:15:00 +0100 1969582 http://www.medworm.com/index.php?rid=1940025&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F444282844%2Ffat-injections-for-breast-augmentation.html This study was designed to determine the viability of fat grafts harvested and refined by the Coleman technique.Methods: Sixteen adult white women were enrolled in this study. In group 1 (n = 8), fat grafts were harvested and processed with the Coleman technique by a single surgeon from the abdomen of each patient according to his standardized method. In group 2 (n = 8), fat grafts were harvested with the conventional liposuction by another surgeon. After centrifugation, the resulting middle layer of tissue was collected. All fat graft samples were analyzed for the following studies: trypan blue vital staining for viable adipocyte counts, glycerol-3-phophatase dehydrogenase assay, and routine histologic examination. Autologous fat grafts have been used successfully for structural fat graft... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1940025 Thu, 06 Nov 2008 11:28:00 +0100 1940025 http://www.medworm.com/index.php?rid=1920873&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F10%2Fhow-low-will-komen-go-debutaunts-entry.html Debutaunt, always on the lookout for the truly awful in cancer marketing, sent in this entry to our "How LOW WIll Komen GO?" contest. Translation of text on this mousepad: ENGLISH TRANSLATION: Frequent massaging breasts enables you to detect breast cancer before it strikes. Before you protest that Komen had nothing to do with this particular product, which was made in Hong Kong and features a sexy blonde with Asian eyes, let me remind you that Komen IS responsible for the whole cause-marketing pink-ribbon-merchandising phenomenon, and, for that reason, the contest is named for Komen, whether Komen collects money from a particular product entered in the contest or not. Glad we cleared that up. Another reason the contest is named for Komen: Komen refuses to take ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=1920873 Thu, 30 Oct 2008 19:44:59 +0100 1920873 http://www.medworm.com/index.php?rid=1915212&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F433484661%2Farticle-review-highlights-breast-cancer.html This post is a review of several articles from Medscape on the 2008 Breast Cancer Symposium.  It will just give you some of what I thought were the highlights from the articles.  I have listed the articles with links for those of you who wish to read the full articles.     From New Concepts and Therapeutic Approaches for Early-Stage Breast Cancer by Michaela Higgins MD and Antonio Wolff MD Risk, Screening, and Prevention These include not only those related to BRCA1 and BRCA2 mutations, but also other genes whose roles have yet to be fully defined. CDH1 mutations are associated with a lifetime breast cancer risk of about 40%, as well as with diffuse gastric carcinomas, and CDH1-related carcinomas are usually of lobular histology. The lifetime ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1915212 Mon, 27 Oct 2008 11:22:01 +0100 1915212 http://www.medworm.com/index.php?rid=1905845&cid=t_116958_87_f&fid=34872&url=http%3A%2F%2Fwww.healthbolt.net%2F2008%2F10%2F24%2Fstinky-farts-shrinking-breasts-and-cancer-fighting-beer%2F Medical research boring? Not with headlines like these… MSNBC led with a new study reporting how Stinky farts may help regulate blood pressure. Seems that a smelly rotten-egg gas (scientific name - hydrogen sulfide) in farts controls blood pressure, at least in mice. This gas, made natural in cells lining the mice’s blood vessels, apparently relaxes the blood vessels which, in turn, helps prevent hypertension (high blood pressure). Wow, wonder if this will open up a whole new avenue of treatments for hypertension based on ’stinky farts”? Meanwhile, the Telegraph wrote about how Drinking too much coffee ‘could shrink women’s breasts’,  based on a recent Swedish study which focused on the caffeine consumption and breast size of 300 women. After rec... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=1905845 Fri, 24 Oct 2008 11:24:08 +0100 1905845 http://www.medworm.com/index.php?rid=1889215&cid=t_116958_167_f&fid=36994&url=http%3A%2F%2Fnutrition-news.blogspot.com%2F2008%2F10%2Fstem-cells-used-to-make-breasts.html IFATS Series: FGF-2-induced HGF Secretion By Adipose-Derived Stromal Cells Inhibits Post-Injury Fibrogenesis Through A JNK-Dependent Mechanism -- Suga et al., 10.1634/stemcells.2008-0261 -- Stem CellsDr Kotaro Yoshimura at the Department of Plastic Surgery, Tokyo University Japan has created new breast tissue from stem cells. It's hoped this could provide an important development for women who have had their breasts removed due to breast cancer. Cynics believe it will just fuel a new craze for a healthier alternative to silicon for a more natural small breasts enhancement."This is undoubtably very reassuring" says Nutritionist Yvonne Bishop-Weston "but personally I prefer to work on prevention to reduce implicated toxins and checking for a balanced hormone levels to reduce the risks of bre... Healthy Eating & Nutrition News blogs http://www.medworm.com/rss/comments.php?id=1889215 Sun, 19 Oct 2008 20:35:00 +0100 1889215 http://www.medworm.com/index.php?rid=1880429&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F421479602%2Farm-technique.html In this study, lymphazurin will be used to find the drainage routes from your arm, rather than your breast. AXILLARY REVERSE MAPPING: Before axillary lymph node surgery, your surgeon will inject lymphazurin into your arm. Your surgeon will watch how the dye flows and find the channels and nodes draining the arm. You will then have standard axillary lymph node (lymph nodes found under the arm) surgery. Any lymph nodes found that are dyed blue (lymph nodes that have traveled down the drainage pathways) that would normally be removed will be removed and sent to the pathology department. Pathologists will check the nodes to see if they have breast cancer cells in them. Also as part of routine care, all other axillary lymph nodes draining the breast will be removed and checked for breast canc... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1880429 Wed, 15 Oct 2008 11:20:00 +0100 1880429 http://www.medworm.com/index.php?rid=1873326&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F419437971%2Fmammograms.html Last October, I wrote this post on Mammograms.  I am reposting it today.   First, please, refer to my post on breast self-exam. It is important to do your monthly self-exam. It is important to do it properly. Also, check out this article on breast changes during your lifetime that are not cancer from the National Cancer Institute. Mammography is a low-dose x-ray system to examine breasts. A mammography exam, commonly known as a mammogram, is used to aid in the diagnosis of breast diseases in women. Mammograms are used for both screening and diagnosis. (normal, credit) Screening Mammogram Mammography can show changes in the breast up to two years before a patient or physician can feel them. Cure rates are much higher when the breast cancer can be found at this stage. Current gui... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1873326 Mon, 13 Oct 2008 11:25:00 +0100 1873326 http://www.medworm.com/index.php?rid=1856616&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F412719473%2Fbreast-self-exam-bse.html Conclusions: Most breast cancers (75%) were found by self-examination, even among women who had regular mammography. We did not find any demographic factor that predicted mammography as the primary method of tumor identification. These findings suggest that self-examination remains an important method of breast cancer identification." Photo credit. The Five Steps of a Breast Self Exam: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Look for any changes in the size, shape, and color. Look for any dimpling, puckering, or bulging of the skin. Has the nipple changed position or become inverted? Is there redness, soreness, a rash, or swelling? Now, raise your arms and look for the same changes. While you're at the mir... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1856616 Mon, 06 Oct 2008 11:25:00 +0100 1856616 http://www.medworm.com/index.php?rid=1848253&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F409175891%2Foctober-breast-cancer-awareness-month.html This post from last October, Breast Cancer Information, is still very relevant, so I am reposting it unchanged.  However, at the end I have added some additional references to other posts by myself and others.   As a plastic surgeon, I don't treat breast cancer. So I'm going to give you some nice references. These first five are blog posts from Dr. Sid Schwab, Surgeonsblog. They are nice discussions of breast cancer form the basics to the treatment choices. (photo) Breast Cancer: Some Basics Breast Cancer: Scary Tales Breast Cancer Women Breast Cancer, Prologue The Old Man and the C This next one is a blog post from Buckeye Surgeon. It is the handout he gives to his new breast cancer patients to aid in his discussions with them. It, also, gives them something for later, if they a... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1848253 Thu, 02 Oct 2008 11:25:00 +0100 1848253 http://www.medworm.com/index.php?rid=1845264&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F408171802%2Fchronic-pain-following-breast-surgery.html I was doing some on-line reading of Plastic & Reconstructive Surgery as one of the Beta-testers for the website. In doing so, I stumbled across the second reference below – Post Breast Reduction Pain Syndrome. I hadn’t heard of the syndrome. I have seen a few patients whose pain lasted for six months, but none that have complained (at least to me) about pain for longer than that time frame. The timing was such that I had just been reviewing RSD / CRPS. I decided to do seek more information. The information I found is summarized here.Chronic phantom breast syndrome following mastectomy may be separated into phantom pain and non-painful phantom sensations, with an incidence of 17.4 percent and 11.8 percent at 6 years respectively. The patients describe paroxysms of lancinating pain a... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1845264 Wed, 01 Oct 2008 11:25:00 +0100 1845264 http://www.medworm.com/index.php?rid=1775920&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F386603212%2Fmondor-disease.html Mondor's disease is an uncommon condition of the pectoral region. Fage (2nd reference) first described this condition in 1870, but in 1939 it was characterized by Henry Mondor. It is a benign condition. (photo credit) It is manifest by thrombophlebitis of the superifical veins of the thoracic and abdominal walls (lateral thoracic, thoracoepigastric, and superior epigastric veins). These superficial veins are painful, string-like subcutaneous cords on and around the breast. Occasionally there may be redness along the cord. The cord may be between 3-5 mm in diameter and 5-30 mm in length. One or more or the above mentioned veins may be involved. Involvement of the upper inner portions of the breast have never been described. The etiology is not known. Female to male ratio is 3:1. Most patie... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1775920 Mon, 08 Sep 2008 11:29:00 +0100 1775920 http://www.medworm.com/index.php?rid=1730838&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F374193543%2Fbreast-reduction-safe-in-morbidly-obese.html I found the article regarding breast reduction in the morbidly obese (reference #1) to be quite interesting. It does seem to be an important question with the increasing obese population and with the "never events" list being expanded. They give their reason for looking at the topic: Background: With an increasing obese population, plastic surgeons are consulted by women requesting larger breast reductions, with body mass indices in the obese to morbidly obese range (30 to ≥40 kg/m2) and breasts considered gigantomastic (>2000 g resected from each breast). There have been few descriptions of outcomes in the morbidly obese population. Previous literature reports high complication rates in obese women and large-volume breast reductions. The article is a retrospective review of 179 conse... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1730838 Mon, 25 Aug 2008 11:25:00 +0100 1730838 http://www.medworm.com/index.php?rid=1714251&cid=t_116958_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2Fwkmft6j5gus%2F Thelma and Louise? Lucy and Ethel? Have you given your “girls” a nickname? Does your nursling have a special name for your breasts? My breasts — and I am sure the world really needs to know this — are called “mum-mums” (interestingly, the same as the name for nursing, “mum-mum,” while the breast milk is called “mum-mum milk,” as opposed to cow’s milk). As a child (long after I weaned) I called my mother’s breasts Mount Fujis! Leave a comment and humor us with your own nicknames! Tags: angela white, breast, breastfeeding humor, breasts, humorShare This (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1714251 Tue, 19 Aug 2008 07:01:41 +0100 1714251 http://www.medworm.com/index.php?rid=1714448&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F368023584%2Finverted-nipple-and-insurance.html A recent reader of my inverted nipple post has asked for a reference to give to her insurance company. "i've also been in contact with my insurance company, and they're telling me that if i can come up with an article proving that the severity of my nipple retraction will most likely prevent me from breast feeding, then they will cover my procedure. if you know of any articles that would be helpful. thanks!" I have had no luck in finding such a reference. All the ones I have found use terms like may or might or can. Does anyone have such a reference? Nipple inversion can cause functional problems. The condition can be a source of irritation and inflammation, and it may prevent lactation. (reference #1) Moderate to severe inversion means that the nipple retracts deeply when the areola is ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1714448 Mon, 18 Aug 2008 11:25:00 +0100 1714448 http://www.medworm.com/index.php?rid=1671992&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F351462269%2Fgynecomastia-repost.html This is a repost from last August with a few additions.     Gynecomastia is defined as benign, excess breast tissue development in male individuals. Recent studies have reported an overall incidence of 32 - 36 %, and up to 64.6 % in adolescent boys. The incidence of bilateral involvement also varies in the literature from 25 -75 percent of patients. The underlying cause seems to be an increase in the ratio of estrogen to androgen activity. Photo credit   In general physiologic gynecomastia can be observed in three peaks during life. The neonatal period: 60-90% of infants have transient gynecomastia due to transplacental transfer of maternal estrogens. Puberty: 48-64% of boys at puberty have gynecomastia. Usually peak age of onset is between 13 and 14 years, followed by a de... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1671992 Thu, 31 Jul 2008 11:25:00 +0100 1671992 http://www.medworm.com/index.php?rid=1649457&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F344511872%2Fbreast-masses-in-adolescent-girls.html Breast masses in adolescent girls are usually benign. Fibroadenoma is the most common discrete breast mass in the adolescent female (70%). As many as 15% of patients may have multiple fibroadenomas. On examination, these masses are smooth, mobile, and round. They may occasionally become larger just before the patient's menstrual period. They are well-circumscribed lesions that can be enucleated from the surrounding tissue at surgery. A true capsule is not typically present. If the mass has the characteristics of a fibroadenoma, then it may be monitored with repeated careful physical examination every 1-3 months. Alternatively, an excisional biopsy may be performed if the patient and family request it. Juvenile, or giant, Fibroadenomas are unusually large (>5 cm) and are termed giant w... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1649457 Thu, 24 Jul 2008 11:29:00 +0100 1649457 http://www.medworm.com/index.php?rid=1556606&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F323186421%2Fretracted.html One of the scrub techs that I worked with this past week, asked me "Dr Bates, what causes a nipple to be inverted?"So I begin to launch into the different grades of inverted nipples and how they can be treated, but I reined myself in. "Usually the problem is the ducts are too short. Why?""I have a friend who has an inverted nipple. She called and asked me. Why do they do that -- I'm just a scrub tech.""How long has hers been inverted? And how old is she?" I ask."Only a little over a month. She's 35 yo."Not an inverted nipple, but a retracted one. One of the changes you look for during a breast exam. "She needs to go see her doctor and get a mammogram. She will most likely need a biopsy of the nipple. She very likely will have breast cancer.""I think that's what she was afraid of. Me, I'd w... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1556606 Mon, 30 Jun 2008 12:52:22 +0100 1556606 http://www.medworm.com/index.php?rid=1521906&cid=t_116958_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2008%2F06%2Fjacquelines-new.html Jacqueline, my good friend in Brooklyn, has a new slideshow to highlight her Rebel1in8 clothing line for one-breasted women (also no-breasted, and she will sell clothes to women who have both breasts ... she doesn't discriminate, but I'm getting off topic here). Jacqueline has a couple of photos of me in the slideshow wearing a beautiful shirt she made for me. The slideshow also stars Laurie and another woman named Megan who I don't know. Watch: Rebel1in8/Rhea Belle slideshow New Earrings Jacqueline is making me a new pair of earrings in the same style as those pictured here, except with amber beads in place of the turquoise. I wear the turquoise ones almost everyday, and when I was in New York with Younger Son a couple of months ago, Jacqueline restrung them for me, just to be safe... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=1521906 Sun, 15 Jun 2008 18:50:40 +0100 1521906 http://www.medworm.com/index.php?rid=1517003&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSutureForALiving%2F%7E3%2F311098889%2Fi-received-my-quilt.html Back in April I was invited to participate in "Another Little Quilt Swap". I finished my little quilt (laced ribbons quilt) in May and mailed it to ____. Wednesday I got home to find I had received my quilt. Paula Dennee, otherwise known as Paula the quilter, is the maker of mine. She named it "One of These Things is Not Like the Others" and you can see it posted on her site here. I absolutely love it! She sent a note along with the quilt to explain her inspiration. She gave me permission to share it. It makes me love it even more.I wanted to include a note about your little quilt. The first time I went to your blog was April 18. That picture stayed in my mind and this little quilt was the result.In an email she shared this regarding the quilting which you can appreciated in the picture o... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1517003 Fri, 13 Jun 2008 11:30:02 +0100 1517003 http://www.medworm.com/index.php?rid=1501511&cid=t_116958_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F307048414%2F The Pregnancy Journal: A Day-to-Day Guide to a Healthy and Happy Pregnancy is the journal I have used to document each of my three pregnancies. I love the daily bits of information it shares and how easy it is to write short journal entries as my pregnancy progresses. Many of the daily tips pertain to breastfeeding. Here is one fun fact: The calcium-to-phosphorus ratio of breast milk is ideal for moving calcium into the baby’s skeleton and promoting growth. In addition, breast milk is low in sodium, and iron and zinc from breast milk is absorbed better than from cow’s milk. - by A. Christine Harris, Ph.D., The Pregnancy Journal: A Day-to-Day Guide to a Healthy and Happy Pregnancy, p. 134. Tags: angela whtie, breast, breast feeding, breastfeeding, breastfeeding blog, breastfeedi... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1501511 Sun, 08 Jun 2008 00:10:20 +0100 1501511 http://www.medworm.com/index.php?rid=1382732&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Frlbatesmd.blogspot.com%2F2008%2F04%2Fbreast-reconstruction-webcast.html Yale Surgery Update Blog featured a copy of webcasts recently that were nominated for awards. The one of interest to me was Breast Cancer: Reconstruction Immediately Following Radical Mastectomy from Thomas Jefferson University Hospital, originally broadcast October 18, 2007. It shows breast reconstruction using a latissimus dorsi flap with expander. It is worthy of the award and is well worth watching.You may also wish to review my past post on Breast Reconstruction--Part I and Part II (Source: Suture for a Living) Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1382732 Fri, 18 Apr 2008 12:06:00 +0100 1382732 http://www.medworm.com/index.php?rid=1281137&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Frlbatesmd.blogspot.com%2F2008%2F03%2Fsilicone-implants-and-health-issues.html There are many questions and concerns about silicone gel implants and the effects on the health of the woman or her child. The Supplement to the Journal of Plastic and Reconstructive Surgery covers several of these. I will try to hit the high points and conclusions. If you want more, then these articles have very nice reference lists themselves. Silicone Implants and Connective Tissue DiseaseDr Hölmich and colleagues did a comprehensive search of PubMed, EMBASE, and The Cochrane Library. They added manual searches using the related link facility to extend the number of references identified. They identified additional references by cross-checking the reference lists of the identified publications. Here are their conclusions:There appears to be little scientific basis for any association b... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1281137 Wed, 05 Mar 2008 15:19:00 +0100 1281137 http://www.medworm.com/index.php?rid=1278581&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Frlbatesmd.blogspot.com%2F2008%2F03%2Fsilicone-vs-saline-breast-implants.html With the reintroduction of silicone implants into more general use and not simply in controlled studies, comparisons between silicone and saline are inevitable. Any comparison seems to be potentially biased, but I will try to give a fair one. To try to keep it simpler, I will stick to a comparison in augmentation use not reconstructive.In general, normal saline implants are not thought of as first or second generation implants. Silicone gel implants are. Depending on who you read, silicone gel implants are either in their third or fifth generation. I'll give you the information from the first reference below (Supplement, page 45S):ImplantDescription1st generation,1962-1970Thick, two-piece shellSmooth surface with Dacron fixation patchesAnatomically shaped (teardrop)Viscous silicone gel2nd ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1278581 Tue, 04 Mar 2008 13:21:00 +0100 1278581 http://www.medworm.com/index.php?rid=1275050&cid=t_116958_106_f&fid=36682&url=http%3A%2F%2Frlbatesmd.blogspot.com%2F2008%2F03%2Fbreast-implants-some-history.html One of AOL News stories this morning is "Making a Comeback: 20 Trends to Watch in 2008". The number one listed is Silicone Implants. So I am going to try to look at "just the facts". I will try to cover some of the history of implants and the controversy.Here is a time line of breast implants in the United States:1962 -- Silicone gel-filled implants first available as a result of Tom Cronin, MD and Frank Gerow, MD's work with Dow Corning1976 -- US Food & Drug Administration (FDA) given Congressional authority to regulate medical devices. Silicone gel-filled breast implants were "grandfathered in" pending further review.1988 -- FDA classified breast implants as Class III medical devices. This set in motion a process requiring manufacturers to demonstrate safety and effectiveness in a pr... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=1275050 Mon, 03 Mar 2008 16:40:00 +0100 1275050