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Breast Reconstruction After Mastectomy: Are Patients Making Good Decisions?

An outcomes article in the January 2011 issue of the Journal of Plastic and Reconstructive Surgery asks the question: “Are patients making high-quality decisions about breast reconstruction after mastectomy?”

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 medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. Only 84 patients participated (59 percent response rate). Participants answered only 37.9 percent of knowledge questions correctly. Read more »

*This blog post was originally published at Suture for a Living*

About Male Breast Cancer, Gynecomastia, And Testing

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 approximately 71 years of age. More significantly, breast cancer becomes increasingly uncommon among younger age groups.

To look at the issue, the authors did a retrospective chart review  of their patients younger than 21 years of age who had undergone subcutaneous mastectomy for gynecomastia between 1999 and 2010. A review of the literature was done, as was an informal survey of major children’s hospitals regarding their practice of histologic examination for adolescent gynecomastia. Read more »

*This blog post was originally published at Suture for a Living*

“Twilight”-Inspired Plastic Surgery: A “Vampire” Facelift?

I first saw mention of the “vampire facelift” two weeks ago as a news article listed in the July 9th issue of the Plastic Surgery SmartBrief“Vampire facelift” uses patient’s platelets and fibrin in dermal filler.”

The article begins:

Instead of a traditional facelift, patients are being offered another option to get rid of wrinkles. It’s called Selphyl or the “vampire facelift,” and it uses a person’s own blood to sculpt the face.

Selphyl, according to the company’s website:

The patented SELPHYL® System enables the safe and rapid preparation of an activated Platelet-rich Fibrin Matrix (PRFM).  A small volume of the patient’s blood is collected and the platelets and fibrin are concentrated during a simple centrifuge process.  The resulting product (liquid, gel or membrane) can be applied to a treatment area of the face or body to stimulate natural, new tissue growth.  SELPHYL® prepared PRFM has been shown to increase skin volume and rejuvenation.

SELPHYL® ensures a preparation of fibrin and platelets, with virtually no red or white blood cells. Studies have shown these platelets to be viable and intact.  Platelets will release proteins, which have been reported to trigger cell migration, proliferation and differentiation over time.

With over 45,000 procedures performed world-wide, this technology has been extensively used for soft tissue regeneration in plastic surgery, orthopedics and maxillofacial surgery.

So how does Sephyl create any face-lifting effect? Read more »

*This blog post was originally published at Suture for a Living*

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