I. Ulusal Meme Kanseri Konsensusu
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Breast-Reconstruction-For-Deformities
ASPS Recommended Insurance Coverage Criteria for Third-Party Payers Breast Reconstruction for Deformities Unrelated to AMERICAN SOCIETY OF PLASTIC SURGEONS Cancer Treatment BACKGROUND Burn of breast: For women, the function of the breast, aside from the brief periods when it ■ Late effect of burns of other specified sites 906.8 serves for lactation, is an organ of female sexual identity. The female ■ Acquired absence of breast V45.71 breast is a major component of a woman’s self image and is important to her psychological sense of femininity and sexuality. Both men and women TREATMENT with abnormal breast structure(s) often suffer from a severe negative A variety of reconstruction techniques are available to accommodate a impact on their self esteem, which may adversely affect his or her well- wide range of breast defects. The technique(s) selected are dependent on being. the nature of the defect, the patient’s individual circumstances and the surgeon’s judgment. When developing the surgical plan, the surgeon must Breast deformities unrelated to cancer treatment occur in both men and correct underlying deficiencies as well as take into consideration the goal women and may present either bilaterally or unilaterally. These of achieving bilateral symmetry. Depending on the individual patient deformities result from congenital anomalies, trauma, disease, or mal- circumstances, surgery on the contralateral breast may be necessary to development. Because breast deformities often result in abnormally achieve symmetry. Surgical procedures on the opposite breast may asymmetrical breasts, surgery of the contralateral breast, as well as the include reduction mammaplasty and mastopexy with or without affected breast, may be required to achieve symmetry. -
Análise De Receptores Hormonais De Estrógeno E Progesterona Em
NUBERTO HOPFGARTNER TEIXEIRA Análise de receptores hormonais de estrógeno e progesterona em hipertrofia mamária versus normomastia, avaliação de presença e densidade com uma nova proposta de classificação das hipertrofias mamárias Tese apresentada à Faculdade de Medicina da Universidade de São Paulo para obtenção do Título de Doutor em Ciências Programa de Clínica Cirúrgica Orientador: Prof. Dr. Marcio Paulino Costa São Paulo 2019 Autorizo a reprodução e divulgação total ou parcial deste trabalho, por qualquer meio convencional ou eletrônico, para fins de estudo e pesquisa, desde que citada a fonte. Dedico esta tese A minha esposa Vivian. Ao meu filho Henri. Ao meu falecido pai que me modelou para vida. À minha mãe que sempre se mostrou uma batalhadora. AGRADECIMENTOS Agradeço ao meu orientador Prof. Dr. Marcio Paulino Costa e ao Departamento de Patologia nas pessoas dos patologistas: Evelin Sanchez, Profa. Dra. Sheila Siqueira e Prof. Dr. Venâncio Avancini Ferreira Alves, os quais possibilitaram esta tese e cujas análises me permitiram concluir. Aos pacientes que concederam suas mamas para participação deste estudo. Ao Prof. Dr. Rolf Gemperli, Professor Titular da Disciplina de Cirurgia Plástica. “A tarefa não é tanto ver aquilo que ninguém viu, mas pensar o que ninguém ainda pensou sobre aquilo que todo mundo vê”. Arthur Schopenhauer NORMALIZAÇÃO ADOTADA Esta tese está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver). Universidade de São Paulo. Faculdade de Medicina. Divisão de Biblioteca e Documentação. Guia de apresentação de dissertações, teses e monografias. Elaborado por Anneliese Carneiro da Cunha, Maria Julia de A. -
Ductal Lavage in Women from BRCA1/2 Families: Is There a Future for Ductal Lavage in Women at Increased Genetic Risk of Breast Cancer?
1243 Ductal Lavage in Women from BRCA1/2 Families: Is There a Future for Ductal Lavage in Women at Increased Genetic Risk of Breast Cancer? Jennifer T. Loud,1 Anne C.M. Thie´baut,4 Andrea D. Abati,2 Armando C. Filie,2 Kathryn Nichols,5 David Danforth,2 Ruthann Giusti,6 Sheila A. Prindiville,3 and Mark H. Greene1 1Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, 2Division of Clinical Sciences, and 3Office of the Director, National Cancer Institute, NIH, Bethesda, Maryland; 4INSERM, U657, Pasteur Institute, Paris, France; and 5Westat Corporation; 6Center for Biologics Evaluation and Research, Food and Drug Administration, Department of Health and Human Services, Rockville, Maryland Abstract Purpose: Ductal lavage has been used for risk stratifi- z10 cells. Postmenopausal women with intact ovaries cation and biomarker development and to identify compared with premenopausal women [odds ratio intermediate endpoints for risk-reducing intervention (OR), 4.8; P = 0.03] and women without a prior breast trials. Little is known about patient characteristics cancer history (OR, 5.2; P = 0.04) had an increased associated with obtaining nipple aspirate fluid (NAF) likelihood of yielding NAF. Having breast-fed (OR, and adequate cell counts (z10 cells) in ductal lavage 3.4; P = 0.001), the presence of NAF before ductal specimens from BRCA mutation carriers. lavage (OR, 3.2; P = 0.003), and being premenopausal Methods: We evaluated patient characteristics associat- (OR, 3.0; P = 0.003) increased the likelihood of ductal ed with obtaining NAF and adequate cell counts in lavage cell count adequacy. In known BRCA1/2 ductal lavage specimens from the largest cohort of mutation carriers, only breast-feeding (OR, 2.5; P = women from BRCA families yet studied (BRCA1/2 = 0.01) and the presence of NAF (OR, 3.0; P = 0.01) were 146, mutation-negative = 23, untested = 2). -
NDA/BLA Multi-Disciplinary Review and Evaluation
NDA/BLA Multi-disciplinary Review and Evaluation NDA 214154 Nextstellis (drospirenone and estetrol tablets) NDA/BLA Multi-Disciplinary Review and Evaluation Application Type NDA Application Number(s) NDA 214154 (IND 110682) Priority or Standard Standard Submit Date(s) April 15, 2020 Received Date(s) April 15, 2020 PDUFA Goal Date April 15, 2021 Division/Office Division of Urology, Obstetrics, and Gynecology (DUOG) / Office of Rare Diseases, Pediatrics, Urologic and Reproductive Medicine (ORPURM) Review Completion Date April 15, 2021 Established/Proper Name drospirenone and estetrol tablets (Proposed) Trade Name Nextstellis Pharmacologic Class Combination hormonal contraceptive Applicant Mayne Pharma LLC Dosage form Tablet Applicant proposed Dosing x Take one tablet by mouth at the same time every day. Regimen x Take tablets in the order directed on the blister pack. Applicant Proposed For use by females of reproductive potential to prevent Indication(s)/Population(s) pregnancy Recommendation on Approval Regulatory Action Recommended For use by females of reproductive potential to prevent Indication(s)/Population(s) pregnancy (if applicable) Recommended Dosing x Take one pink tablet (drospirenone 3 mg, estetrol Regimen anhydrous 14.2 mg) by mouth at the same time every day for 24 days x Take one white inert tablet (placebo) by mouth at the same time every day for 4 days following the pink tablets x Take tablets in the order directed on the blister pack 1 Reference ID: 4778993 NDA/BLA Multi-disciplinary Review and Evaluation NDA 214154 Nextstellis (drospirenone and estetrol tablets) Table of Contents Table of Tables .................................................................................................................... 5 Table of Figures ................................................................................................................... 7 Reviewers of Multi-Disciplinary Review and Evaluation ................................................... -
Breast Care / Breast Cancer
BREAST CARE / BREAST CANCER Overview The Kaiser Permanente Breast Care Management Algorithm provided on this site was developed by the Inter-Regional Breast Cancer leaders group (IRBC). This multidisciplinary group includes physicians from Primary Care, Surgery, Oncology, Obstetrics and Gynecology, Radiology, Mammography, Genetics and Women’s Services and representatives from various regional Breast Cancer Task force groups, Clinical Nursing, Quality Resource & Risk Management, Public Relations & Issues Management, Prevention Services, and the Permanente Federation. The algorithm was developed to: • Improve the quality of care for our members with breast complaints, • Improve the timeliness of the identification of breast abnormalities and diagnosis of breast cancer, • Improve the satisfaction of members with breast complaints, and • Respond to the increase in malpractice allegations of failure to diagnose breast cancer. In 2002, the IRBC group held periodic conference calls to develop information to assist primary care clinicians in improving the quality of care for patients with breast complaints. A multidisciplinary consensus-based method was used to develop the content of the algorithm. The group also identified additional information and resources available internally and externally which would support implementation.The Breast Care Leaders in each Region have been encouraged to review and modify the algorithm to reflect local operations. Therefore, prior to use, PCPs are advised to contact a Regional member of the Inter-Regional Breast Care leaders group about revisions for your Region This site is for use within Kaiser Permanente only. What is Available on this Site? The IRBC group and the project management staff from the Permanente Federation worked together to define the project scope and develop the following products and information: I. -
Low Risk of Skin and Nipple Sensitivity and Lactation Issues
Breast Surgery Aesthetic Surgery Journal 2016, Vol 36(6) 672–680 Low Risk of Skin and Nipple Sensitivity and © 2016 The American Society for Aesthetic Plastic Surgery, Inc. This is an Open Access article Lactation Issues After Primary Breast distributed under the terms of the Creative Commons Attribution- Augmentation with Form-Stable Silicone NonCommercial-NoDerivs licence (http://creativecommons.org/ Implants: Follow-Up in 4927 Subjects licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that Herluf G. Lund, MD, FACS; Janet Turkle, MD; Mark L. Jewell, MD; the work is properly cited. For commercial re-use, please contact and Diane K. Murphy, MBA [email protected]. DOI: 10.1093/asj/sjv266 Downloaded from www.aestheticsurgeryjournal.com Abstract http://asj.oxfordjournals.org/ Background: Natrelle 410 implants (Allergan, Inc., Irvine, CA) are approved in the United States for breast augmentation, reconstruction, and revision. Objectives: To assess the risk of nipple and skin sensation changes and lactation issues in subjects receiving implants for primary breast augmentation and ascertain whether differences based on incision site exist. Methods: We used 410 Continued Access study data to assess safety and effectiveness of devices implanted via inframammary or periareolar incision sites. Subjects were evaluated preoperatively and at 4 weeks, 6 months, and annually up to 10 years postoperatively. Lactation issues and nipple and skin sensation changes (hypersensitivity/paresthesia, loss of sensation) were assessed. Results: The inframammary and periareolar cohorts comprised 9217 and 610 implanted devices, with mean follow-up of 4.1 years (range, 0-10.1 years) and 4.8 years (range, 0-10.1 years), respectively. -
ISAPS Global Survey Results 2018
ISAPS INTERNATIONAL SURVEY ON AESTHETIC/COSMETIC PROCEDURES performed in 2018 CONTENTS About ISAPS ..................................................................................................................page 3 Surgical Totals Ranked by Category ...............................................................page 29 About the International Survey on Nonsurgical Totals Ranked by Category .......................................................page 30 Aesthetic/Cosmetic Procedures ..........................................................................page 4 Countries Ranked by Total Number of Procedures ................................page 31 Countries Ranked by Estimated HIGHLIGHTS OF THE 2018 STATISTICS Number of Plastic Surgeons .............................................................................page 32 2018 Statistics at a Glance .......................................................................................pages 6-7 Surgical Procedure Group Ranking by Country ........................................page 33 Nonsurgical Procedure Group Ranking by Country ................................page 34 NUMBER OF WORLDWIDE PROCEDURES PROCEDURES PERFORMED BY PLASTIC SURGEONS Number of Worldwide Surgical Procedures ...............................................page 9 Number of Worldwide Surgical Procedures Number of Worldwide Nonsurgical Procedures .........................................page 10 Performed by Plastic Surgeons ........................................................................page 36 Surgical Procedures -
Breast Disorders in Girls and Adolescents. Is There a Need for a Specialized Service?
Original Study Breast Disorders in Girls and Adolescents. Is There a Need for a Specialized Service? Lina Michala MRCOG, PhD *, Alexandra Tsigginou MD, PhD, Dimitris Zacharakis MD, Constantine Dimitrakakis MD, PhD 1stDepartment of Obstetrics and Gynaecology, University of Athens, Alexandra Hospital, Athens, Greece abstract Introduction: Minor breast concerns in childhood and adolescence are common and lead to increased anxiety among young patients and their families, particularly due to high correlation with breast cancer. However, most breast services aim at managing adults and triaging patients with breast cancer, whereas adolescent medicine specialists or pediatricians are usually not appropriately trained to identify and treat breast pathology. Methods: We reviewed hospital records of all patients attending a pediatric and adolescent gynecology or breast clinic of a tertiary referral hospital, with a breast related symptom, between January 2009 and December 2011. We collected information regarding age at presen- tation, age at menarche, diagnosis, management and outcome. Results: We identified 81 patients of which 11 presented with an abnormal nipple or areolar secretion, 33 had a palpable lump, 20 had mastitis, and 16 had unequal breast development. One patient presented with virginal breast hypertrophy. Three out of 11 of the patients with an abnormal secretion had a cyst identified on ultrasonography. Out of the palpable lumps 12 were fibroadenomas, 3 were phyllodes tumors, and 14 were cystic in nature. The phyllodes tumors and half of the fibroadenomas were removed. The remaining fibroadenomas remain under regular ultrasonographic follow-up. All cases of mastitis were treated conservatively and resolved with broad spectrum antibiotic treatment. Conclusion: In our series, no malignancies were identified. -
5. Effectiveness of Breast Cancer Screening
5. EFFECTIVENESS OF BREAST CANCER SCREENING This section considers measures of screening Nevertheless, the performance of a screening quality and major beneficial and harmful programme should be monitored to identify and outcomes. Beneficial outcomes include reduc- remedy shortcomings before enough time has tions in deaths from breast cancer and in elapsed to enable observation of mortality effects. advanced-stage disease, and the main example of a harmful outcome is overdiagnosis of breast (a) Screening standards cancer. The absolute reduction in breast cancer The randomized trials performed during mortality achieved by a particular screening the past 30 years have enabled the suggestion programme is the most crucial indicator of of several indicators of quality assurance for a programme’s effectiveness. This may vary screening services (Day et al., 1989; Tabár et according to the risk of breast cancer death in al., 1992; Feig, 2007; Perry et al., 2008; Wilson the target population, the rate of participation & Liston, 2011), including screening participa- in screening programmes, and the time scale tion rates, rates of recall for assessment, rates observed (Duffy et al., 2013). The technical quality of percutaneous and surgical biopsy, and breast of the screening, in both radiographic and radio- cancer detection rates. Detection rates are often logical terms, also has an impact on breast cancer classified by invasive/in situ status, tumour size, mortality. The observational analysis of breast lymph-node status, and histological grade. cancer mortality and of a screening programme’s Table 5.1 and Table 5.2 show selected quality performance may be assessed against several standards developed in England by the National process indicators. -
Cirugía De La Mama
25,5 mm 15 GUÍAS CLÍNICAS DE LA ASOCIACIÓN ESPAÑOLA DE CIRUJANOS 15 CIRUGÍA DE LA MAMA Fernando Domínguez Cunchillos Sapiña Juan Blas Ballester Parga Gonzalo de Castro Fernando Domínguez Cunchillos Juan Blas Ballester Sapiña Gonzalo de Castro Parga CIRUGÍA DE LA MAMA CIRUGÍA SECCIÓN DE PATOLOGÍA DE LA MAMA Portada AEC Cirugia de la mama.indd 1 17/10/17 17:47 Guías Clínicas de la Asociación Española de Cirujanos CIRUGÍA DE LA MAMA EDITORES Fernando Domínguez Cunchillos Juan Blas Ballester Sapiña Gonzalo de Castro Parga SECCIÓN DE PATOLOGÍA DE LA MAMA © Copyright 2017. Fernando Domínguez Cunchillos, Juan Blas Ballester Sapiña, Gonzalo de Castro Parga. © Copyright 2017. Asociación Española de Cirujanos. © Copyright 2017. Arán Ediciones, S.L. Castelló, 128, 1.º - 28006 Madrid e-mail: [email protected] http://www.grupoaran.com Reservados todos los derechos. Esta publicación no puede ser reproducida o transmitida, total o parcialmente, por cualquier medio, electrónico o mecánico, ni por fotocopia, grabación u otro sistema de reproducción de información sin el permiso por escrito de los titulares del Copyright. El contenido de este libro es responsabilidad exclusiva de los autores. La Editorial declina toda responsabilidad sobre el mismo. ISBN 1.ª Edición: 978-84-95913-97-5 ISBN 2.ª Edición: 978-84-17046-18-7 Depósito Legal: M-27661-2017 Impreso en España Printed in Spain CIRUGÍA DE LA MAMA EDITORES F. Domínguez Cunchillos J. B. Ballester Sapiña G. de Castro Parga AUTORES A. Abascal Amo M. Fraile Vasallo B. Acea Nebril G. Freiría Barreiro J. Aguilar Jiménez C. A. Fuster Diana L. -
Incidence of Breast and Nipple Abnormalities Among Primigravid Women in Sri Lanka
Original Articles Incidence of breast and nipple abnormalities among primigravid women in Sri Lanka Sujeewa Amarasena 1 Sri Lanka Journal of Child Health , 2006; 35 : 51-4 (Key words: incidence, breast and nipple abnormalities, primigravid women, Sri Lanka) Abstract breast 4, unilateral or bilateral absence of breast Objective To determine the incidence of breast and (amastia) and tubular breast deformity 1. These are nipple abnormalities among primigravid women and well-recognized causes of lactation failure. Some their effects on lactation in Sri Lanka. abnormalities are correctable with antenatal interventions. One study identified the incidence of Design Prospective descriptive survey. inverted or nonprotractile nipples resulting in attachment difficulties to be 10% among 1926 Method All primigravid women attending antenatal nulliparous women 5. Incidence of these abnormalities clinics of the university obstetric unit, giving and their correctability among Sri Lankan women is informed consent, were recruited into the study. Their not known. breasts were examined clinically and breast abnormalities noted. They were followed up until Objectives successful lactation was established. 1. To assess the incidence of breast and nipple Results 956 mothers were examined. 768 had normal abnormalities among primigravid women breasts and 188 abnormalities were noted. 725 attending antenatal clinics in Sri Lanka. completed the study. 72.5% established successful lactation. 80 had flat nipples of whom 52 completed 2. To assess the correctability of flat or inverted the study. 44 flat nipples were corrected antenatally nipples with Hoffman 4 exercises. with exercises. All established lactation successfully. Other abnormalities included breast surgery, 3. To assess the effects of antenatal interventions hypoplastic breasts or breast asymmetry. -
Official Proceedings
Scientific Session Awards Abstracts presented at the Society’s annual meeting will be considered for the following awards: • The George Peters Award recognizes the best presentation by a breast fellow. In addition to a plaque, the winner receives $1,000. The winner is selected by the Society’s Publications Committee. The award was established in 2004 by the Society to honor Dr. George N. Peters, who was instrumental in bringing together the Susan G. Komen Breast Cancer Foundation, The American Society of Breast Surgeons, the American Society of Breast Disease, and the Society of Surgical Oncology to develop educational objectives for breast fellowships. The educational objectives were first used to award Komen Interdisciplinary Breast Fellowships. Subsequently the curriculum was used for the breast fellowship credentialing process that has led to the development of a nationwide matching program for breast fellowships. • The Scientific Presentation Award recognizes an outstanding presentation by a resident, fellow, or trainee. The winner of this award is also determined by the Publications Committee. In addition to a plaque, the winner receives $500. • All presenters are eligible for the Scientific Impact Award. The recipient of the award, selected by audience vote, is honored with a plaque. All awards are supported by The American Society of Breast Surgeons Foundation. The American Society of Breast Surgeons 2 2017 Official Proceedings Publications Committee Chair Judy C. Boughey, MD Members Charles Balch, MD Sarah Blair, MD Katherina Zabicki Calvillo, MD Suzanne Brooks Coopey, MD Emilia Diego, MD Jill Dietz, MD Mahmoud El-Tamer, MD Mehra Golshan, MD E. Shelley Hwang, MD Susan Kesmodel, MD Brigid Killelea, MD Michael Koretz, MD Henry Kuerer, MD, PhD Swati A.