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At least 451 records · Page 25Linked to original sources
PubMed2006

The efficacy of breast MRI in predicting breast conservation therapy.

BACKGROUND: Breast conservation therapy (BCT) has equal efficacy compared to mastectomy in treating breast cancer. Accurate pre-operative measurement of tumor size can limit re-excision procedures. Breast MRI may improve pre-operative evaluation of extent of disease. OBJECTIVE: To examine the correlation of extent of disease on breast MRI with pathologic data to determine the utility of breast MRI in surgical planning of BCT. METHODS: We retrospectively reviewed our prospective database of women undergoing breast MRI. We identified 115 women with breast cancer who underwent a breast MRI and a surgical resection from 2000 to 2003. We compared patients with high-grade tumors (HG, n = 40) to patients with low grade (LG, n = 75). RESULTS: The size of the tumor on MRI correlated with the pathologic size for HG tumors (HG R = 0.76 vs. LG R = 0.45, P = 0.033). Mastectomy was performed in 53 patients. In 10 patients with LG tumors, the MRI findings overestimated their disease. In 11 out of 115 patients the primary tumor or a second tumor was only seen by MRI. CONCLUSION: Breast MRI does change surgical management by detecting additional malignancies. Breast MRI is accurate in staging extent of disease in the breast in patients with HG tumors.

Adult↗
PubMed1989

Cancerous versus noncancerous breasts. A comparative morphological analysis of the entire glandular tree of the breast.

Cancerous and clinically normal autopsy obtained breasts were collected in order to compare the physiopathological profile of both types of glandular tree. Each breast was visualized by whole thin sections and observed under a stereomicroscope with removal of the more interesting changes for histology. The comparison was made between 67 atrophic cancerous breasts and 88 atrophic control breasts. The results were as follows: 25% of the cancerous breasts versus 47% of control breasts showed no changes, atypical lobules, microfoci of "in situ" and/or infiltrating cancer were present in 46% of cancerous breasts and in 16% of control breasts, showing a significant correlation with clinical cancer. All other types of functional and proliferative changes, variously associated each other, were found in 29% of cancerous and in 37% of control breasts. Our morphological data agree completely with the statements in follow-up studies carried out on benign breast biopsies. The significant differences in the physiopathological profile of the glandular tree between "normal" and cancerous breasts, confirms that some changes are causally related to clinical cancer.

Adult↗
PubMed1999

Dynamic contrast enhanced magnetic resonance imaging of the breast is superior to triple assessment for the pre-operative detection of multifocal breast cancer.

BACKGROUND: Inadequately treated multifocal and multicentric disease results in increased local recurrence following breast-conserving surgery. The accurate preoperative diagnosis of multifocal/ centric breast cancer would facilitate the planning of appropriate surgery and prevent reoperation for residual disease. While triple assessment remains the established diagnostic technique, its sensitivity for the diagnosis of multifocal disease remains poor. Dynamic contrast enhanced Magnetic Resonance Imaging (DCE-MRI) of the breast represents an alternative emerging diagnostic modality that has been shown to be highly sensitive for the delineation of primary breast cancer. The aim of this study was to prospectively compare the diagnostic accuracy of DCE-MRI of the breast with conventional triple assessment for the preoperative diagnosis of multifocal/centric breast cancer. METHODS: Patients were recruited from the symptomatic breast clinics. All patients underwent standard triple assessment and DCE-MRI. The MRI scans were reported by a single radiologist blinded to the results of the triple assessment. Surgery was then planned accordingly to all available scan results and the specimens examined by a single pathologist. All patients who did not undergo surgery have been followed up for a minimum of 18 months. RESULTS: A total of 334 women were recruited. There were 178 (52%) cancers that were histologically confirmed and multifocal/centric breast cancer was diagnosed provisionally by the preoperative investigations in 68 (38%); multifocal n = 33, multicentric n = 35, of these patients. In this group, subsequent histology confirmed multifocal/centric disease in 50 (73.5%): multifocal n = 15, multicentric n = 35. Unifocal cancer was found in 15 (22%) and benign disease in 3 (4.4%). The resultant sensitivity, specificity, positive, and negative predictive values were 18%, 100%, 100%, and 76% for triple assessment and 100%, 86%, 73%, and 100% for DCE-MRI. CONCLUSION: DCE-MRI identified a subgroup of breast cancer patients with multifocal/centric disease not evident on standard triple assessment. MRI of the breast should be considered for the preoperative planning of surgery for primary breast cancer.

Aged↗
PubMed2005

Intensity modulated radiation therapy (IMRT) reduces the dose to the contralateral breast when compared to conventional tangential fields for primary breast irradiation.

PURPOSE: To determine the dose received by the contralateral breast during primary breast irradiation using IMRT compared to conventional tangential field techniques. METHODS AND MATERIALS: Between March 2003 and March 2004, 83 patients with breast carcinoma were treated using 6, 10, or mixed 6/18 MV photons (65 with tangential IMRT technique and 18 with 3-dimensional technique using tangential fields with wedges) for primary breast irradiation following breast-conserving surgery. Paired thermoluminescent dosimeters (TLDs) were placed on each patient's contralateral breast, 4 and 8 cm from the center of the medial border of the tangential field. The TLDs were left on the patient during a single fraction and then measured 24 h afterwards. RESULTS: The mean dose delivered with photons to the primary breast for all patients was 4999 cGy (SD = 52) with a mean single fraction dose of 199 cGy (SD = 8). The mean percent of the prescribed dose to the contralateral breast measured at the 4- and 8-cm positions were 7.19% (SD = 2.28) and 4.63% (SD = 2.12), respectively, for patients treated with IMRT compared to 11.22% (SD = 2.73) and 10.70% (SD = 3.44), respectively, for the patients treated with conventional tangential field techniques. This represented a 36% and 57% reduction at the 4 and 8-cm contralateral positions, respectively, in the mean dose to the contralateral breast using IMRT compared to 3-D technique which was statistically significant (p < 0.0005, <0.0005, respectively). CONCLUSION: Primary breast irradiation with tangential IMRT technique significantly reduces the dose to the contralateral breast compared to conventional tangential field techniques.

Breast↗
PubMed1991

Breast size, handedness and breast cancer risk.

Bra cup size and handedness were studied as possible risk factors for breast cancer. Data for 3918 cases and 11,712 controls from 7 centres were used to examine the association of handedness with laterality of breast cancer; data for 2325 cases and 7008 controls from 4 centres were used to assess the relation of bra cup size to breast cancer risk. There was a suggestive (P about 0.10) association of handedness with breast cancer laterality: odds ratio of a left-handed (or ambidextrous) woman having a left-sided cancer 1.22 (95% CI 0.96-1.56). Handedness may affect the lateral occurrence of breast cancer, although this tumour is in general more common in the left breast, possibly because this breast is usually slightly larger. Premenopausal women who do not wear bras had half the risk of breast cancer compared with bra users (P about 0.09), possibly because they are thinner and likely to have smaller breasts. Among bra users, larger cup size was associated with an increased risk of breast cancer (P about 0.026), although the association was found only among postmenopausal women and was accounted for, in part, by obesity. These data suggest that bra cup size (and conceivably mammary gland size) may be a risk factor for breast cancer.

Adult↗
PubMed1985

Dose to the contralateral breast due to primary breast irradiation.

The radiation dose received by the contralateral breast during primary breast irradiation is of concern because breast tissue is subject to cancer induction from low to moderate doses of radiation. In this paper the dose to the opposite breast has been studied in detail for common breast treatment techniques. Measurements have been made on 16 patients, a water phantom, a polystyrene phantom with cork inserts to simulate lung tissue, and a body-shaped phantom with wax breasts. Thermoluminescent dosimeters (TLD), ion chambers, diodes, and film have been used in the various configurations. The patient measurements have shown that there is a wide variation in the opposite breast dose received by patients, even when all are treated with, for example, tangential fields alone. Addition of more radiation fields, such as supraclavicular/axillary and internal mammary fields, may increase the dose to the opposite breast for a particular patient. Variations in the details of the technique such as what wedges are used, the use of blocks, and the orientation of the field edges are all important to the final dose received by the patient's contralateral breast. With the phantom measurements, it has been possible to determine the contributions to the opposite breast dose from each of the relevant factors. This makes it possible to explain the wide variation in patient dose measurements, and to make some relatively simple recommendations that will allow the reduction of the dose to the opposite breast from several hundred cGy to about 50 cGy for a typical treatment course dose of 5000 cGy.

Breast↗
PubMed1994

A simple device to position large/flaccid breasts during tangential breast irradiation.

PURPOSE: It is technically difficult to irradiate large pendulous or flaccid breasts with tangential photon fields because they often lie very high or lateral on the chestwall. We, therefore, designed a device to reposition the breast on the chestwall to facilitate treatment. METHODS AND MATERIALS: A device to aid in repositioning the breast on the chestwall has been designed. The device consists of a reinforced polyvinylchloride tube formed into a ring that is placed around the breast. A strap around the patient's chest holds the ring in place. The breast tissue is manually moved to the desired position on the chestwall, whereafter the strap is tightened to maintain the position. Treatment setup marks are placed on the skin peripheral to the breast and on the immobilization mold. RESULTS: Twelve patients with large/flaccid breasts were successfully treated with this device. The technical and physician staff find the reproducibility and acute treatment reactions to be acceptable. Anatomically, the use of this device reduces the volume of lung tissue otherwise included in the tangential fields in patients where the breast lies far lateral. In patients where the breast lies too far cephalad on the chestwall for tangential fields to clear the arm, repositioning of the breast with this device makes tangential fields possible. CONCLUSION: This repositioning appliance aids in the radiation treatment of patients with large or flaccid breasts and, in some instances, renders otherwise nontreatable patients treatable with radiation therapy.

Breast↗
PubMed2000

The impact of dose-specification policies upon nominal radiation dose received by breast tissue in the conservation treatment of breast cancer.

PURPOSE: In the context of breast conservation treatment, absorbed dose is influenced by (1) prescribed nominal dose, and (2) dose-specification characteristics employed. Breast doses are generally specified either at tangent isocenter, varying anatomical points within the breast, or at isodoses varying from 90% to 100%. Boost doses are generally specified at 80-100%. METHODS: An idealized axial slice of breast tissue at central axis is presented. Assuming varying dose-specification characteristics, absorbed doses are normalized and compared to those received by nominal prescriptions of 46 Gy to the breast and 20 Gy to the boost volume, both specified at 100%. RESULTS: Absorbed doses vary from the normalized total of 66 Gy (with specification of breast and boost at 100%) in gradations up to a maximum of 76.11 Gy (when breast dose is specified at the 90% isodose and boost dose at 80%), a 13.3% difference. CONCLUSION: The impact of dose specification is largely ignored in the breast irradiation literature and unappreciated in clinical practice. Its impact, however, is illustrated as dwarfing modest nominal dose escalations commonly recommended and prescribed among margin compromised patients. Progress in delineation of a dose-response relationship for treatment of breast cancer requires consensus as to dose specification. Arguments are offered that ICRU Report 50 dose-specification standards, as verified for reproducibility by the EORTC (22881/10882) trial group, constitutes the best data source currently available from which dose-specification consensus may be reached (1, 2). Dose to PTV(1) (whole breast plus 1- to 2-cm margin) should be specified at the tangent beam intersection on the central plane or, where such point is irrelevant, at two-thirds distance from dorsal beam edge to skin along the perpendicular breast bisector. Where irradiated via electrons, dose to the boost PTV(2) (lumpectomy cavity plus 1- to 3-cm margins) should be specified at 90%. Electron energy sufficient to provide 85% isodose coverage to all aspects of PTV(2) is recommended.

Breast↗
PubMed1999

A mobile shield to reduce scatter radiation to the contralateral breast during radiotherapy for breast cancer: preclinical results.

PURPOSE: To design a practical breast shield and to investigate its efficacy in reducing scattered radiation to the contralateral breast of patients undergoing radiation therapy for breast cancer. METHODS AND MATERIALS: We constructed a mobile shield consisting of (a) a mobile base and a counterweight; (b) a vertical column adjustable in height and a diagonal arm adjustable in angle; (c) a curved, 2.5-cm thick lead sheet with a 1-cm thick polystyrene liner for blocking scattered radiation; and (d) diode detectors to verify that the edge of the lead sheet is not in the useful beam in addition to the use of the field light. Measurements were performed with thermoluminescent dosimeters on 10 patients without the shield and on an anthropomorphic phantom with a pair of wax breasts with and without the shield. All of the patients were treated with 6-MV photons (Varian 6/100). The scattered radiation from the medial and lateral fields was measured separately. RESULTS: The contribution of the medial field to the total scattered dose was 70% to 75%, whether a medial wedge was used or not. However, without a medial wedge, the scattered dose was reduced by nearly 33% at 3 to 9 cm away from the medial border. In the anthropomorphic phantom study with wax breast, the mobile shield reduced the medial field contribution to the total scatter dose to less than the contribution from the lateral field without a shield. With a prescribed dose of 50 Gy and a medial wedge, the median scatter dose to the contralateral breast from 6 patients was 5.3 Gy; without a medial wedge, it was 3.8 Gy from 4 patients at 6 cm from the medial border. In the phantom study, with the shield the total dose to the contralateral breast was 1.0 Gy at 6 cm from the medial border with a same prescribed dose. CONCLUSION: The mobile shield reduced the scatter dose to the contralateral breast from the linear accelerator (Varian 6/100, 6-MV photons) by a factor of 3 to 4. The shield greatly reduced the scattered dose in the wax phantom. Equivalent reductions in patients may be clinically significant by reducing the risk of radiation-induced breast cancer in the contralateral breast of woman undergoing radiation therapy for breast cancer. The shield is safe and easy to adjust to each patient.

Breast↗
PubMed2001

The BRCA1 syndrome and other inherited breast or breast-ovarian cancers in a Norwegian prospective series.

Inherited breast cancer is a heterogenous group of diseases. We examined this heterogeneity in a prospective series of inherited breast and ovarian cancers, previously demonstrated to include 84% of inherited cancers. Ninety-two tumours (65 breast and 27 ovarian) in 82 patients from 70 kindreds were prospectively diagnosed. Fifteen of the breast cancers were in situ, 50 were infiltrating. 40 (49%) of the 82 women carried a BRCA1 mutation, whereas no mutation in BRCA2 was found. Approximately, two-thirds of the BRCA1 mutation carriers had one of the four most frequent Norwegian founder mutations. Ninety-five per cent of the epithelial ovarian cancers occurred in BRCA1 mutation carrying women versus 38% of infiltrating breast cancers and 7% of carcinoma in situ of the breast. The BRCA1 syndrome was phenotypically distinct with invasive, high grade, oestrogen receptor-negative breast cancers and epithelial ovarian cancers. Non-BRCA1/2 inherited breast cancers included carcinoma in situ and lobular carcinoma and were frequently bilateral. Non-BRCA1/2 inherited breast cancer is not associated with epithelial ovarian cancer and in breast cancers has distinct biological characteristics, indicating that the different subgroups of inherited breast cancer may need different healthcare services.

Adult↗
PubMed1997

'Dosimetric breast size': a new and useful parameter for the prediction of local recurrence after breast conservative treatment.

To evaluate the risk of local recurrence following breast-conserving therapy for breast cancer, we measured the distance between each entry point of the irradiation on the surface of the breast in line with the axis of the external and internal tangential fields (dosimetric breast size). 652 breast cancer patients were retrospectively analysed, with a median age of 51 years and a median follow-up of 99 months (range 84-192). There were 50 local recurrences, 44 isolated and 6 associated with nodal recurrence or metastases. The global rates of local recurrences at 5 and 10 years were 5.3% and 9%, respectively (Kaplan-Meier analysis). Following a Cox's multivariate analysis, the only significant and independent parameters related to local recurrence were quality of excision, age at diagnosis and dosimetric breast size. For a small dosimetric breast size (< or = 10 cm), the rate of local recurrence was 14.1 compared with 11.8 for medium dosimetric breast size (> 10 cm-< or = 12 cm) and 5.2 for large dosimetric breast size (> 12 cm). If the analysis was restricted to only those with complete excision, then the relative risk for a patient with a small dosimetric breast size was three times that for a large breast size.

Adult↗
PubMed1995

Prostaglandin E2 production and metabolism in human breast cancer cells and breast fibroblasts. Regulation by inflammatory mediators.

Malignant human breast tumours contain high levels of prostaglandin E2 (PGE2). However, the mechanisms controlling PGE2 production in breast cancer are unknown. This in vitro study investigates the capacity for PGE2 synthesis and metabolism in several human breast cancer cell lines and early passage human breast fibroblasts and seeks to identify potential regulatory factors which may control these pathways. Basal PGE2 production rose up to 30-fold in breast fibroblast lines on addition of exogenous arachidonic acid (10 microM), whereas no such changes were observed in six out of seven cancer cell lines, with the exception of modest increases in MDA-MB-231 cells. Interleukin 1 beta (IL-1 beta) also induced PGE2 production in breast fibroblasts in the presence of excess substrate, consistent with cyclo-oxygenase induction by the cytokine. Under these conditions only Hs578T cells and MDA-MB-231 cells demonstrated large increases in PGE2 in response to IL-1 beta or phorbol ester; no such responses were seen in MCF-7, T47-D, ZR-75-1, BT-20 or CLF-90-1 cells. In the absence of added arachidonate, bradykinin (BK) and endothelin-1 (ET-1), potentiated PGE2 production in IL-1 beta-treated fibroblasts, possibly by mobilising endogenous substrate. PGE2 also stimulated ET-1 production by breast cancer cells. In co-cultures with T47-D cells both basal and stimulated PGE2 production by breast fibroblasts was greatly reduced. This appeared to be due to metabolic inactivation by the cancer cell since T47-D cells readily converted PGE2 to 15-keto-PGE2. This apparent 15-hydroxy-PG dehydrogenase activity was stimulated by TPA and inhibited by cycloheximide. In conclusion, breast fibroblasts, particularly under the influence of inflammatory mediators, provide a potentially rich source for PGE2 production in breast tumours, whereas significant contributions from the epithelial tumour component may be restricted to cancer cells exhibiting an invasive phenotype. Metabolic inactivation by the cancer cells may also play an important role in the regulation of breast tumour PGE2 levels.

Arachidonic Acid↗
PubMed1995

Expression of fibroblast growth factor 1 is lower in breast cancer than in the normal human breast.

We have measured the amount of fibroblast growth factor 1 (FGF-1) mRNA and protein in primary breast cancers and non-malignant breast tissue and have found greatly reduced levels in breast cancer compared with non-malignant tissue. A total of 116 breast cancers and 37 biopsies taken from non-malignant breast were compared for FGF-1 mRNA expression using reverse transcriptase-polymerase chain reaction (RT-PCR) and significantly lower levels were found in the cancer tissues (P < 0.001). These findings were confirmed at the protein level where four out of five breast cancers contained no detectable FGF-1 and a fifth cancer had a low level of FGF-1 compared with three samples from reduction mammoplasties. Similar results were obtained from breast cell lines in which 80% of cancer cell lines had very low levels of FGF-1, whereas all non-malignant breast cell lines contained higher levels of FGF-1. Immunohistochemical analysis indicated that FGF-1 was present in the luminal epithelial cells of the non-malignant breast but was absent from cancer cells. The decreased levels of FGF-1 in breast cancer may indicate that stimulation of cancer cells is resulting in down-regulation of FGF-1 expression or may implicate FGF-1 as a differentiation factor rather than a growth factor at its physiological concentration in the breast.

Adult↗
PubMed2001

Color Doppler sonography of the lateral thoracic (breast-feeding) arteries: a new approach to the diagnosis of breast disease?

OBJECTIVE: The main arteries to the breast are the lateral thoracic artery and to a lesser extent the internal thoracic artery. In this prospective open diagnostic study involving 94 women, we compared the intraindividual differences of Doppler indices in the lateral thoracic (breast-feeding) artery of breasts affected by cancer with those unaffected by disease. METHODS: Sixty-seven consecutive patients were recruited from an outpatient unit for breast surgery and 27 volunteers were studied who were known to be without any breast disease (controls). In each patient we attempted to obtain Doppler indices from the lateral thoracic artery of both breasts. The difference in Doppler indices in each individual was assessed and statistical analysis was performed to assess whether these differences were significantly altered in women with cancer compared to healthy women. RESULTS: Lateral thoracic arteries could be visualized in 88% of the study population. Significantly lower values for pulsatility and resistance indices and systolic/diastolic ratios were obtained in the lateral thoracic arteries of breasts affected by cancer as compared to the contralateral breasts (1.73 +/- 0.39 vs. 2.05 +/- 0.47, P = 0.003; 0.78 +/- 0.06 vs. 0.84 +/- 0.06, P < 0.0001; 4.71 +/- 1.24 vs. 6.75 +/- 3.38, P = 0.0008, respectively). Using the intraindividual difference of pulsatility index, resistance index and systolic/diastolic ratio to screen for malignancy, sensitivities for breast cancer of 78%, 85% and 83%, respectively, were achieved. Depending on the cut-off level, specificity reached 94%. CONCLUSION: The intraindividual difference in Doppler indices in women with breast cancer may be a useful test for the diagnosis of breast lesions.

Adolescent↗
PubMedDate not supplied

Introduction of breast cancer screening in Chernihiv Oblast in the Ukraine: report of a PATH Breast Cancer Assistance Program experience.

The incidence of breast cancer and mortality from this disease remain high in countries with limited resources such as the Ukraine. Because of a lack of mammography equipment and formal screening programs, as well as educational and other factors, breast cancer is usually diagnosed in late stages in such countries. We report the experience of the PATH Breast Cancer Assistance Program in introducing a pilot breast cancer screening program in one territory of the Ukraine, the Chernihiv oblast. The program entailed educating the public, training health care providers in clinical breast examination (CBE) and mammography, opening a dedicated mammography facility, designating a center for breast cancer care, building diagnostic capacity, and fostering the formation of support groups. From 1998 to 2002, 18,000 women underwent screening with CBE and 8778 women underwent screening with mammography. When implementing the program we encountered various cultural, economic, and logistic difficulties, such as reservations about showing bare breasts in educational materials, the lack of an established system for collecting screening data, and barriers to follow-up in women with positive screening results. Screening mammography proved to be more effective in detecting small and nonpalpable lesions; 8.7% of cancers detected in the mammography group were in situ, compared with 0% in the CBE group. However, introduction of CBE as a screening modality required fewer financial resources compared with mammography and was recommended as a transitional method before the introduction of mammography screening programs in countries with limited resources. The introduction of screening was associated with favorable changes in indicators of breast cancer care, including an increase in the percentage of breast-preserving operations and new legislation to provide funding for breast cancer services. We conclude that this successful pilot program of breast cancer screening in a limited-resource setting can serve as an example for other similar programs.

Breast Neoplasms↗
PubMed1996

Breast enlargement and reduction: results from a breast cancer case-control study.

In a population-based case-control study of breast cancer that included 2174 cases and 2009 population controls under 55 years of age, prior breast implants were reported by 36 cases versus 44 controls. After adjustment for the matching factors as well as variables associated with both breast cancer risk and breast enlargement (race, family history of breast cancer, body size, screening history), the relative risk of breast cancer associated with a prior implant was 0.6 (95% CI 0.4-1.0). The reduced risk persisted with increasing interval since surgery, arguing against selection bias as an explanation. Further, although a deficit of in situ tumors was seen among women with implants (RR = 0.2), the risk associated with implants remained reduced for both localized and distant tumors (RR = 0.8 for both stages). In a smaller group of women who had prior breast reduction surgery (10 cases, 13 controls), a reduced risk of breast cancer also was observed (RR = 0.7, 95% CI 0.3-1.6). The results of this study must be interpreted cautiously because of the small number of women involved and reliance on patient reports of prior operations. In not showing any elevation in breast cancer risk following a breast implant, our results confirm several record linkage studies but contradict some clinical studies that suggest an adverse effect. Additional investigations are needed in relation to specific types of breast implants, including the polyurethane-coated implants, which have been linked to high cancer rates in laboratory animals.

Adult↗
PubMed1996

Silicon analysis of breast and periprosthetic capsular tissue from patients with saline or silicone gel breast implants.

The ubiquitousness of silicon is well known. Recent work has demonstrated measurable baseline levels of silicon in nonaugmented cadavers, subsequent to numerous reports of significant elevations of such levels within patients with silicone breast implants and even more reports alleging a causal relation between silicone gel prostheses and connective-tissue diseases. Despite the lack of scientifically substantiated data that such a relation exists, the calamitous silicone breast implant controversy has ensued. Saline-filled breast implants are constructed with a silicone elastomer envelope that remains in direct contact with periprosthetic capsular tissue following implantation. Although there is no evidence to link saline implants with any disorders, it is important to know if saline breast implants contribute any silicon to human body baseline silicon levels. The present study measured tissue silicon levels in 28 breasts of 16 patients with saline-filled implants to determine if the silicone envelope of these prostheses can contribute to the elevation of such levels. These data were compared with data from 116 breasts of 65 patients with silicone gel-filled prostheses as well as breast tissue from 17 patients (controls) who had never been exposed to either type of implant. Samples of breast tissue and periprosthetic capsular tissue were obtained from patients with both intact and ruptured implants. Silicon levels of breast tissue specimens from patients with saline-filled implants were within the range of the controls if the implants were intact. Silicon levels in periprosthetic capsular tissue from patients with intact saline-filled implants were significantly higher than controls (p < 0.02); however, they were still 100-fold less than capsular tissue levels from patients with intact gel-filled implants. Silicon levels measured in both types of tissue were significantly elevated in patients with silicone gel-filled implants compared with controls (p < 0.01). In the case of ruptured gel implants, breast tissue demonstrated higher silicon levels than did similar specimens from patients with intact implants (p < 0.054); periprosthetic capsular tissue levels also were elevated, although the differences were not statistically significant (p = 0.54). These findings are independent of the implant brand or length of exposure to the particular prosthesis. The finding of elevated levels of silicon in both breast and periprosthetic capsular tissue in patients with silicone gel-filled implants in no way implies or substantiates any claim of a causal relationship between silicone and any reported illnesses.

Adult↗
PubMed2006

Breast volume determination in breast hypertrophy: an accurate method using two anthropomorphic measurements.

BACKGROUND: Precise determination of breast volume facilitates reconstructive procedures and helps in the planning of tissue removal for breast reduction surgery. Various methods currently used to measure breast size are limited by technical drawbacks and unreliable volume determinations. The purpose of this study was to develop a formula to predict breast volume based on straightforward anthropomorphic measurements. METHODS: One hundred one women participated in this study. Eleven anthropomorphic measurements were obtained on 202 breasts. Breast volumes were determined using a water displacement technique. Multiple stepwise linear regression was used to determine predictive variables and a unifying formula. RESULTS: Mean patient age was 37.7 years, with a mean body mass index of 31.8. Mean breast volumes on the right and left sides were 1328 and 1305 cc, respectively (range, 330 to 2600 cc). The final regression model incorporated the variables of breast base circumference in a standing position and a vertical measurement from the inframammary fold to a point representing the projection of the fold onto the anterior surface of the breast. The derived formula showed an adjusted R of 0.89, indicating that almost 90 percent of the variation in breast size was explained by the model. CONCLUSION: Surgeons may find this formula a practical and relatively accurate method of determining breast volume.

Adolescent↗