Primary lymphoma involving the breast accounts for only 0.04-0.5%of malignant breast tumors,constituting 1-2%of all non-Hodgkin lymphomas(NHL).Here,we report a case of breast ALK-positive ALCL arising in a 21-year-old...Primary lymphoma involving the breast accounts for only 0.04-0.5%of malignant breast tumors,constituting 1-2%of all non-Hodgkin lymphomas(NHL).Here,we report a case of breast ALK-positive ALCL arising in a 21-year-old woman in pregnancy with single abscess as the first clinical manifestation.展开更多
选注者言:本文信息极为丰富。首先,我们得知当今美国的三大整容外科是:eyelid surgery,breast reduction and nose reshaping。其次,文章告诉读者,去年(2002年)美国施行隆胸手术的妇女达25万之众;再次,就是本文的标题所言,要求进行隆胸...选注者言:本文信息极为丰富。首先,我们得知当今美国的三大整容外科是:eyelid surgery,breast reduction and nose reshaping。其次,文章告诉读者,去年(2002年)美国施行隆胸手术的妇女达25万之众;再次,就是本文的标题所言,要求进行隆胸手术的女性中的自杀者比例高于不要求隆胸者。而且,更值得注意的是:If women have a psychological problem and they are given breast implantsthey will still have that problem.(假如一个女性存在心理问题,而且进行了隆胸手术,她们的心理问题依旧存在。)展开更多
Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast aug...Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods： the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 （＋ 5） years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results： considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series S1DAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test （patch test） were negative, ultrasound and MR have shown that no hearing was damaged or broken. Blood test showed no abnormalities. Discussion： comparing the authors＇ study with other similar works in the literature, they noted that the reported cases of hypersensitivity type 4 silicone prosthesis was not only initially accompanied by specific symptoms such as urticaria and blistering, but mostly it was found to be a net positive patch test. The absence of urticaria, the low values of lgE and total negativity of patch test confirmed the purely inflammatory nature of the lesions in our patients.展开更多
Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anat...Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anatomical understanding.The reconstructive choice is made by the patient after a discussion with the plastic surgeon covering all the available options.Advantages and disadvantages of each technique along with long-term oncologic outcome are reviewed.展开更多
Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve ...Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve a good cosmetic result,reconstruction must be performed simultaneously with radical surgical treatment.Currently,there are a large number of methods for performing breast reconstruction.One of the most commonly used is radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction with a silicone endoprosthesis.Grand W Carlson type technique is used,with skin incisions in the form of an inverted T is usually performed in patients with large mammary gland with severe grade III ptosis,as the patients usually require reduction of excess skin.However,the most vulnerable aspects of this type of reconstruction is the impossibility of preserving the nipple-areolar complex(NAC),which is associated with a high risk of developing such complications as partial/complete necrosis of the NAC.The current study provides an overview of an original method to decrease the risk of necrosis of NAC with evaluation of blood supply of the nipple and inferior deepithelialized flap using real-time intraoperative Doppler ultrasonography and indocyanine green fluorescence system.展开更多
<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can pr...<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MAC</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), violet (60</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s) and blue (120</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method showed improvement in signs and symptoms</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">—</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">t</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he sensation of prosthesis stiffness in the lower and medial region, local temperature, and pain in the right breast. The patient was followed up after treatment and currently, she has no complaints. There was also no need for surgical intervention. In the present case report, the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method proved to be effective. Further research is suggested with a cohort of patients with capsular contracture, with randomization and evaluation of a larger number of patients with the referred method.</span></span></span>展开更多
Background Breast conserving surgery （BCS） has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy （ESM） plus immediate reconstruction with implants is...Background Breast conserving surgery （BCS） has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy （ESM） plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting. Methods From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. Results There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups （P 〉0.05）. The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM （88.4%, 38/43） and BCS （92.6%, 50/54） patients （P 〉0.05）. During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence -- one of these patients died of multiple organ metastasis. Conclusions After considering the wide indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants -- the new surgery of choice for breast cancer -- warrants serious consideration as the prospective next standard surgical procedure.展开更多
Understanding cell-material interactions is crucial for advancing biomedical applications,influencing cellular behavior and medical device performance.Material properties can be manipulated to direct cell responses,be...Understanding cell-material interactions is crucial for advancing biomedical applications,influencing cellular behavior and medical device performance.Material properties can be manipulated to direct cell responses,benefiting applications from regenerative medicine to implantable devices such as silicone breast implants.Knowledge about the interaction differences between healthy and cancer cells with implants may guide implant design to more precisely influence cell adhesion and proliferation of healthy cells while inhibiting cancer cells,tailoring outcomes to specific cellular responses.To show-case this potential,breast epithelial cells and breast cancer cells were investigated regarding their interaction with a broad range of combined physicochemical properties.This study employed a silicone-based high-throughput screening method utilizing Double Orthogonal Gradients(DOGs)to investigate the influence of topography,stiffness,and wettability on breast epithelial cells(MCF10a)and breast cancer cells(MCF7).Results show distinct cellular responses,including decreased prolif-eration rates in both MCF10a and MCF7 cells with the introduction of surface topography and the dominant influence of wettability on cell adhesion,proliferation,and cluster formation.The screening identified specific regions of interest(ROIs)where MCF10a cell proliferation outperformed MCF7 cells and that topography inhibits cluster formation(tumorigenesis),offering potential prospects for the creation of novel implant surfaces.展开更多
Background：The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation.The aim of this study was to introduce a new method to determine the wid...Background：The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation.The aim of this study was to introduce a new method to determine the width of the implant （W） and explain the reasons to do so in details.Methods：From January 2006 to June 2014,the authors have found and applied ＂CD-4＂ theory to determine the width of breast implant （W） in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 560 patients.＂CD＂ is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line （AAL） on the lateral chest wall through the horizontal level on inferior mammary fold.W =CD-4 （or 3.5） cm.Results：The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm.Their CDs are from 14.5 cm to 17 cm.About 78％ of the patients have got followed up from 1 month to 5 years postoperatively.Except for four patients who got unilateral capsular contractions,all the other patients are satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm,and lateral borders of the breast are on the area of the AAL.Conclusions：W （width of the implant） =CD-4 （cm） when doing dual plan Ⅰ or Ⅱ breast augmentation.For the very thin patient,4 should be 3.5.展开更多
文摘Primary lymphoma involving the breast accounts for only 0.04-0.5%of malignant breast tumors,constituting 1-2%of all non-Hodgkin lymphomas(NHL).Here,we report a case of breast ALK-positive ALCL arising in a 21-year-old woman in pregnancy with single abscess as the first clinical manifestation.
文摘选注者言:本文信息极为丰富。首先,我们得知当今美国的三大整容外科是:eyelid surgery,breast reduction and nose reshaping。其次,文章告诉读者,去年(2002年)美国施行隆胸手术的妇女达25万之众;再次,就是本文的标题所言,要求进行隆胸手术的女性中的自杀者比例高于不要求隆胸者。而且,更值得注意的是:If women have a psychological problem and they are given breast implantsthey will still have that problem.(假如一个女性存在心理问题,而且进行了隆胸手术,她们的心理问题依旧存在。)
文摘Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods： the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 （＋ 5） years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results： considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series S1DAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test （patch test） were negative, ultrasound and MR have shown that no hearing was damaged or broken. Blood test showed no abnormalities. Discussion： comparing the authors＇ study with other similar works in the literature, they noted that the reported cases of hypersensitivity type 4 silicone prosthesis was not only initially accompanied by specific symptoms such as urticaria and blistering, but mostly it was found to be a net positive patch test. The absence of urticaria, the low values of lgE and total negativity of patch test confirmed the purely inflammatory nature of the lesions in our patients.
文摘Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anatomical understanding.The reconstructive choice is made by the patient after a discussion with the plastic surgeon covering all the available options.Advantages and disadvantages of each technique along with long-term oncologic outcome are reviewed.
文摘Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients.In order to achieve a good cosmetic result,reconstruction must be performed simultaneously with radical surgical treatment.Currently,there are a large number of methods for performing breast reconstruction.One of the most commonly used is radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction with a silicone endoprosthesis.Grand W Carlson type technique is used,with skin incisions in the form of an inverted T is usually performed in patients with large mammary gland with severe grade III ptosis,as the patients usually require reduction of excess skin.However,the most vulnerable aspects of this type of reconstruction is the impossibility of preserving the nipple-areolar complex(NAC),which is associated with a high risk of developing such complications as partial/complete necrosis of the NAC.The current study provides an overview of an original method to decrease the risk of necrosis of NAC with evaluation of blood supply of the nipple and inferior deepithelialized flap using real-time intraoperative Doppler ultrasonography and indocyanine green fluorescence system.
文摘<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MAC</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), violet (60</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s) and blue (120</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method showed improvement in signs and symptoms</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">—</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">t</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he sensation of prosthesis stiffness in the lower and medial region, local temperature, and pain in the right breast. The patient was followed up after treatment and currently, she has no complaints. There was also no need for surgical intervention. In the present case report, the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method proved to be effective. Further research is suggested with a cohort of patients with capsular contracture, with randomization and evaluation of a larger number of patients with the referred method.</span></span></span>
文摘Background Breast conserving surgery （BCS） has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy （ESM） plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting. Methods From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. Results There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups （P 〉0.05）. The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM （88.4%, 38/43） and BCS （92.6%, 50/54） patients （P 〉0.05）. During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence -- one of these patients died of multiple organ metastasis. Conclusions After considering the wide indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants -- the new surgery of choice for breast cancer -- warrants serious consideration as the prospective next standard surgical procedure.
基金the UMCG Microscopy and Imaging Center(UMIC)for use of microscopy equipment(sponsored by NWO 40-00506-98-9021)the Graduate School Medical Sciences(GSMS).
文摘Understanding cell-material interactions is crucial for advancing biomedical applications,influencing cellular behavior and medical device performance.Material properties can be manipulated to direct cell responses,benefiting applications from regenerative medicine to implantable devices such as silicone breast implants.Knowledge about the interaction differences between healthy and cancer cells with implants may guide implant design to more precisely influence cell adhesion and proliferation of healthy cells while inhibiting cancer cells,tailoring outcomes to specific cellular responses.To show-case this potential,breast epithelial cells and breast cancer cells were investigated regarding their interaction with a broad range of combined physicochemical properties.This study employed a silicone-based high-throughput screening method utilizing Double Orthogonal Gradients(DOGs)to investigate the influence of topography,stiffness,and wettability on breast epithelial cells(MCF10a)and breast cancer cells(MCF7).Results show distinct cellular responses,including decreased prolif-eration rates in both MCF10a and MCF7 cells with the introduction of surface topography and the dominant influence of wettability on cell adhesion,proliferation,and cluster formation.The screening identified specific regions of interest(ROIs)where MCF10a cell proliferation outperformed MCF7 cells and that topography inhibits cluster formation(tumorigenesis),offering potential prospects for the creation of novel implant surfaces.
文摘Background：The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation.The aim of this study was to introduce a new method to determine the width of the implant （W） and explain the reasons to do so in details.Methods：From January 2006 to June 2014,the authors have found and applied ＂CD-4＂ theory to determine the width of breast implant （W） in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 560 patients.＂CD＂ is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line （AAL） on the lateral chest wall through the horizontal level on inferior mammary fold.W =CD-4 （or 3.5） cm.Results：The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm.Their CDs are from 14.5 cm to 17 cm.About 78％ of the patients have got followed up from 1 month to 5 years postoperatively.Except for four patients who got unilateral capsular contractions,all the other patients are satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm,and lateral borders of the breast are on the area of the AAL.Conclusions：W （width of the implant） =CD-4 （cm） when doing dual plan Ⅰ or Ⅱ breast augmentation.For the very thin patient,4 should be 3.5.
