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Tattooing in reconstruction of the nipple and areola: a new method.

In order to produce the characteristic color of the nipple-areola complex and in unilateral reconstructions to match the other side, a modified tattooing method has been introduced. The quite different requirements between reconstruction and ornamental studio tattooing can only be satisfied by different techniques. For the first time, pigment particles have been suspended in a gel rather than adsorbed on an opaque mineral. Our porcine study has shown how the pigment is distributed in the dermis without penetration of the gel particles. The first 16 of the authors' 29 patients have been reviewed with an analysis of their appearance. Using this new method, a third achieved a completely natural appearance and two-thirds were judged to be intermediate, compared with an unnatural, although sometimes acceptable, result in all the earlier conventional tattoos.

Breast↗

Herpes simplex of the nipple: infant-to-mother transmission.

Intrafamilial spread of herpes simplex is a recognized problem. A case is presented in which a 15-month-old child was infected by a five-year-old sibling with presumed gingivostomatitis. The young child then transmitted symptomatic herpes infection to both maternal nipples during breast feeding. Although mouth-to-breast transmission of herpes simplex virus may be rare, it is appropriate to advise breast-feeding mothers of children with herpes gingivostomatitis of this possibility.

Adult↗

Cytologic diagnosis of male breast cancer with nipple discharge. A case report.

The cytologic findings in a nipple discharge from a male patient with breast cancer are described. Malignant epithelial cells and cell clusters believed to be derived from ductal carcinoma were observed. The subsequent mastectomy specimen contained a ductal carcinoma with minute foci of stromal invasion.

Breast↗

Reduction mammoplasty utilizing nipple-areola transplantation.

Reduction mammoplasty using nipple-areola transplantation has proved to be a satisfactory procedure. It will probably be performed in an ever-increasing number of patients undergoing reduction mammoplasty as more surgeons realize that aesthetically pleasing results can be achieved.

Adult↗

[Cancer and nipple discharge].

The authors, in a retrospective study, have looked at the clinical and paraclinical parameters that suggest that a cancer may be present when there is a nipple discharge. By using logistic regression on these criteria a model has been able to be constructed with four variables (bloody discharge, and associated palpable tumour, a suspicious mammographic appearance and atypical or proliferating cells in cytology). The probability of a cancer being present varies between three per thousand when none of the four variables are present to 99.1% when all four are present. A first outline of the therapy that can be used is suggested.

Adolescent↗

Results of 317 contraction stress tests with controlled nipple stimulation using an electric breast pump.

Nipple stimulation is widely used for producing uterine contractions. High rates of hyperstimulation have been reported with various manual methods of stimulation. A study was undertaken in an effort to standardize the mode and amount of stimulation. Three hundred seventeen contraction stress tests were done using an automatic electric breast pump with precise pressure control. This method was successful in achieving adequate contractions in 84.2%. Hyperstimulation of the uterus was encountered in 4.1% of all tests performed. Side effects and complications were minimal.

Breast↗

Demodex folliculorum in a nipple imprint.

Demodex mites were found in a nipple imprint. Their morphologic features in this cytologic preparation have been described and illustrated. These mites are common parasites of human skin and are apparently of little or no pathologic significance.

Animals↗

[Demonstration of blood in nipple discharges using the Hemoccult].

Evidence of blood in discharge from one breast and from one duct in an indication to operate on for most surgeons. We have used hemoccult to demonstrate the presence of blood in certain discharges. Discharge cytology was systematic and when it was possible a correlation was done with the operative specimen. 55 patients were studied. In 23 cases hemoccult was positive and there was blood on the cytological smear. In 28 cases hemoccult was negative and the cytological smear showed no blood. In the remaining 4 cases the hemoccult was positive but the cytological smear failed to show any blood. There was no false negative test. There were three breast cancers. Among this series of 55 patients and the test was positive in each case. Using slides of hemoccult to detect blood in a nipple discharge is rapid and simple can be done in the doctor's office. However, the results of the test have to be strictly correlated with other elements of the work up in particular with mammography and galatography.

Adult↗

Contraction stress testing with nipple stimulation.

The contraction stress test (CST) is used widely as a measure of fetoplacental respiratory reserve. With contractions traditionally induced by intravenous oxytocin, the test has been limited in its use by time, expense and patient discomfort. In a prospective evaluation of the effectiveness of nipple stimulation for the production of uterine contractions, a successful CST was obtained in 94% of the attempts, with a mean total test time of 12 minutes.

Adolescent↗

[Exfoliative cytology of nipple discharge (author's transl)].

Due to the exfoliative cytology of the nipple discharge, intracanalicular proliferations within the millimeter range can be detected. Accordingly, this diagnostic method is firmly integrated in the mammary early diagnostics. Within the period reported on so far 3420 women with a pathological secretion could be examined. In 1669 cases there was a bilateral secretion. Thus, altogether 5089 mammae could be cytologically explored. Mammary cytodiagnostics was centered on the bleeding mamma, the myotheliae and galactophoritis. In addition exfoliative cytology can also yield some other diagnostic results, such as the detection of fungiproved in respective cultures. Galactography which was performed in 1053 cases, may be considered to be the only diagnostic consequence resulting from a pathological cytotest. Every 6th galactogram had to be judged as being pathological, and every 5th galactogram histologically clarified revealed a malignant or premalignant proliferation. Accordingly, women manifesting a pathological secretion should be regarded as risk-patients.

Adolescent↗

Klinefelter's syndrome associated with breast carcinoma and Paget's disease of the nipple.

We describe a patient with Klinefelter's syndrome associated with multi-focal breast carcinoma and Paget's disease of the nipple. Reviewing the 16 previously documented cases in the world literature, it is apparent that patients with this syndrome have an increased incidence of breast carcinoma. There is no evidence to date to suggest that such tumour is morphologically or biologically different from breast cancer in females and normal men.

Adenocarcinoma↗

Nipple aspirate cytology for the study of breast cancer precursors.

The association of abnormal nonmalignant cells in nipple aspirate fluid (NAF) and atypical proliferative disease (APD) of breast ducts was examined in the presence and absence of breast cancer in 134 patients. A high frequency of NAF samples with cellular abnormalities (atypical hyperplasia) was found when APD occurred with either breast cancer (70%) or benign breast biopsy specimens (54%). APD was present in 27 malignant cases (80%) and in 39 benign cases (39%). Inasmuch as APD may represent an intermediate step in the malignant transformation of duct epithelium, the cytologic examination of NAF offers a new approach with which to study the spectrum of breast cancer precursors and to assist in identifying women at risk for breast cancer.

Biopsy, Needle↗

Bilateral nipple necrosis after intravenous vasopressin therapy.

Bilateral nipple necrosis developed in two patients after intravenous vasopressin therapy for bleeding esophageal varices. When vasopressin therapy was promptly tapered and discontinued, recovery of skin changes occurred gradually. The role and some of the reported complications of vasopressin therapy in bleeding esophageal varices are discussed herein.

Adult↗