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Breast anatomy

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https://www.readbyqxmd.com/read/28820803/perioperative-breast-analgesia-a-qualitative-review-of-anatomy-and-regional-techniques
#1
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28819518/-a-rare-case-of-giant-galactocele-associated-with-prolactinoma
#2
Mariam Tayae, Jihad Jamor
Galactocele is a rare cystic formation, a benign breast lesion, occurring when breast duct is blocked and engorged. It generally affects postpartum women, either breastfeeding or not. Only a few cases have been reported in the literature and they were not related to lactation, as in the case of postmenopausal women or of men; moreover, their relationship to the overproduction of prolactin, a growth factor stimulating mammary epithelial cells, is not very well defined at this time. We here report the unusual case of a 30-year old patient with no personal history of childbirth or abortion...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28806291/revisiting-the-abdominal-donor-site-introducing-a-novel-nomenclature-for-autologous-breast-reconstruction
#3
Jason M Weissler, Frank P Albino, Martin J Carney, Liza C Wu
As abdominally-based free flaps for breast reconstruction continue to evolve, significant effort has been invested in minimizing donor-site morbidity. The impact on the donor-site remains a prevailing principle for breast reconstruction, and thus must be adequately reflected when classifying what is left behind following flap harvest. Although successful in describing the type of flap harvested, the existing nomenclature falls short of incorporating certain critical variables, such as degree of muscular preservation, fascial involvement, mesh implantation, and segmental nerve anatomy...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28804730/breast-dose-reduction-with-organ-based-wide-angle-tube-current-modulated-ct
#4
Wanyi Fu, Gregory M Sturgeon, Greeshma Agasthya, William Paul Segars, Anuj J Kapadia, Ehsan Samei
This study aimed to estimate the organ dose reduction potential for organ-dose-based tube current modulated (ODM) thoracic computed tomography (CT) with a wide dose reduction arc. Twenty-one computational anthropomorphic phantoms (XCAT) were used to create a virtual patient population with clinical anatomic variations. The phantoms were created based on patient images with normal anatomy (age range: 27 to 66 years, weight range: 52.0 to 105.8 kg). For each phantom, two breast tissue compositions were simulated: [Formula: see text] and [Formula: see text] (glandular-to-adipose ratio)...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28796645/on-the-use-of-particle-filters-for-electromagnetic-tracking-in-high-dose-rate-brachytherapy
#5
Theresa Ida Götz, Godehard Lahmer, Tobias Brandt, Karoline Kallis, Vratislav Strnad, Christoph Bert, Bernhard Hensel, Ana Maria Tome, Elmar W Lang
Modern radiotherapy of female breat cancers often employ high dose rate Brachytherapy, where a radioactive source is moved inside catheters, implanted in the female breast, according to a prescribed treatment plan. Source localization relative to the patient's anatomy is determined with solenoid sensors whose spatial positions are measured with an electromagnetic tracking system. Precise sensor dwell position determination is of utmost importance to assure irradiation of the cancerous tissue according to the treatment plan...
August 10, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28767166/radiological-anatomy-of-the-perforators-of-the-gluteal-region-the-radiosome-based-anatomy
#6
Enrico Vigato, Eleonora De Antoni, Cesare Tiengo, Andrea Porzionato, Cinzia Tortorella, Maurizio Governa, Veronica Macchi, Raffaele De Caro
BACKGROUND: The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure-sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. METHODS: Eighty lower-extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61-years old, range 38-81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28750134/performance-evaluation-of-a-collapsed-cone-dose-calculation-algorithm-for-hdr-ir-192-of-apbi-treatments
#7
Dario Terribilini, Veronika Vitzthum, Werner Volken, Daniel Frei, Kristina Loessl, Bob van Veelen, Peter Manser, Michael K Fix
PURPOSE: Most dose calculations for HDR brachytherapy treatments are based on the AAPM-TG43 formalism. Because patient's anatomy, heterogeneities and applicator shielding are not considered, the dose calculation based on this formalism is inaccurate in some cases. Alternatively, Collapsed Cone (CC) methods as well as Monte Carlo (MC) algorithms belong to the model based dose calculation algorithms, which are expected to improve the accuracy of calculated dose distributions. In this work, the performance of a CC algorithm, ACE in Oncentra Brachy 4...
July 27, 2017: Medical Physics
https://www.readbyqxmd.com/read/28740793/donor-site-complications-and-remnant-of-rectus-abdominis-muscle-status-after-transverse-rectus-abdominis-myocutaneous-flap-reconstruction
#8
Prakasit Chirappapha, Noppadol Trikunagonvong, Duangkamon Prapruttam, Sasiprapa Rongthong, Panuwat Lertsithichai, Thongchai Sukarayothin, Monchai Leesombatpaiboon, Rujira Panawattanakul, Panya Thaweepworadej
BACKGROUND: Transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after mastectomy in breast cancer patients has become one of the milestones in breast reconstruction. There are several techniques that have been used in an attempt to minimize untoward complications. We present the whole muscle with partial sheath-sparing technique that focuses on the anatomy of arcuate line and the closure of the anterior abdominal wall techniques with mesh and determine factors associated with its complications and outcomes...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28734644/postmastectomy-radiation-therapy-technique-and-cardiopulmonary-sparing-a-dosimetric-comparative-analysis-between-photons-and-protons-with-free-breathing-versus-deep-inspiration-breath-hold
#9
Sagar A Patel, Hsiao-Ming Lu, Jacqueline A Nyamwanda, Rachel B Jimenez, Alphonse G Taghian, Shannon M MacDonald, Nicolas Depauw
PURPOSE: Dosimetric studies have suggested greater cardiopulmonary sparing with protons over photons for left-sided postmastectomy radiation therapy (PMRT). Modern techniques such as deep inspiration breath hold (DIBH) can help spare the heart. This analysis compares photon and proton delivery with and without DIBH. METHODS AND MATERIALS: Ten women with left breast cancer referred for PMRT on a prospective clinical trial with unfavorable cardiac anatomy underwent free breathing (FB) and DIBH computed tomography simulation...
June 21, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28731841/survey-of-nutrition-management-practices-in-centers-for-pediatric-intestinal-rehabilitation
#10
Anita M Nucci, Kipp Ellsworth, Austin Michalski, Emily Nagel, Jackie Wessel
BACKGROUND: Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS: A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28716460/ten-most-important-things-to-know-about-caring-for-transgender-patients
#11
REVIEW
Stuart R Chipkin, Fred Kim
Transgender people have a gender that is not in agreement with their birth sex. Previous barriers, including lack of provider knowledge, has created significant healthcare disparities for this population. Recent societal changes are increasing the numbers of transgender people seen by primary care. Ten key principles are provided to help primary practitioners create more welcoming environments and provide quality care to transgender patients. Overall, all members of the health care team (primary and specialty) need to become aware of the transition process and maintain communication regarding risks, benefits and goals...
July 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28696856/internal-thoracic-lymphadenopathy-in-breast-cancer
#12
Ashley R Cahoon, Benjamin D Smith, Wei T Yang
The internal thoracic (IT) nodal basin is a first-echelon drainage pathway in the breast, accounting for up to a quarter of its lymphatic drainage, primarily from the deep structures of the breast. The presence of internal thoracic node (ITN) metastases upstages the breast cancer (BC) patient to a minimum of clinical stage III disease. Medial tumors, deep tumors, young age, axillary nodal metastases, tumors of a high nuclear grade, lymphovascular invasion, and triple-negative hormone receptor status are predisposing factors for ITN metastases from primary BC...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28666899/deep-inspiration-breathhold-for-left-sided-breast-cancer-patients-with-unfavorable-cardiac-anatomy-requiring-internal-mammary-nodal-irradiation
#13
Osama Mohamad, Jean Shiao, Bo Zhao, Karen Roach, Ezequiel Ramirez, Dat T Vo, Kimberly Thomas, Xuejun Gu, Ann Spangler, Kevin Albuquerque, Asal Rahimi
PURPOSE: The purpose of this study was to evaluate the utility of moderate deep inspiration breathhold (mDIBH) in reducing heart exposure in left breast cancer patients who have unfavorable cardiac anatomy and need internal mammary lymph node (IMLN) radiation therapy (RT). METHODS AND MATERIALS: We used maximum heart distance (MHD), defined as the maximum distance of the heart within the treatment field, >1 cm as a surrogate for unfavorable cardiac anatomy. Twenty-two left breast cancer patients with unfavorable cardiac anatomy requiring IMLN-RT underwent free-breathing (FB) and mDIBH computed tomography simulation and planning...
April 13, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28663853/review-of-intraoperative-optical-coherence-tomography-technology-and-applications-invited
#14
Oscar M Carrasco-Zevallos, Christian Viehland, Brenton Keller, Mark Draelos, Anthony N Kuo, Cynthia A Toth, Joseph A Izatt
During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeon's depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development of intraoperative OCT for real-time tomographic visualization of surgical interventions...
March 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28656352/staying-out-of-double-bubble-and-bottoming-out-deformities-in-dual-plane-breast-augmentation-anatomical-and-clinical-study
#15
Marzia Salgarello, Giuseppe Visconti
BACKGROUND: Double-bubble and bottoming-out deformities represent the second most common reason for revision surgery in breast augmentation. Etiopathogenesis of these complications is still unclear. The aim of this paper is to report our findings in breast cadaver dissections focusing on the inframammary fold (IMF) applied anatomy and to critically review our ten-year experience in breast augmentation. METHODS: A cadaveric study has been performed on four consecutive embalmed cadavers...
June 27, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28607855/seri-surgical-scaffold-in-2-stage-breast-reconstruction-2-year-data-from-a-prospective-multicenter-trial
#16
Nolan Karp, Mihye Choi, David A Kulber, Susan Downey, Gloria Duda, Gabriel M Kind, Mark L Jewell, Diane K Murphy, Max R Lehfeldt, Neil Fine
BACKGROUND: Soft-tissue support devices are used during breast reconstruction. This study investigated long-term clinical data following SERI Surgical Scaffold (SERI) implantation, a bioresorbable, silk-derived scaffold for soft-tissue support. METHODS: This was a prospective, multicenter study in 103 subjects who received SERI during stage 1 of 2-stage breast reconstruction with subpectoral tissue expander placement (Natrelle Style 133V; Allergan plc, Dublin, Ireland) followed by subpectoral breast implant placement...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28579017/whole-breast-nodal-irradiation-using-supine-vmat-and-prone-3d-planning-a-case-study
#17
Ashley Coffey, Lisa Renucci, Ashley Hunzeker, Nishele Lenards
The purpose of this study was to compare the variations in doses to the ipsilateral lung and heart between the supine whole breast and nodal volumetric-modulated arc therapy (VMAT) technique and the prone 3-dimensional conformal radiation therapy (3DCRT) technique. In this study, 3 patients who were simulated in the prone and supine positions were planned using supine VMAT and prone 3DCRT techniques to compare planning target volume (PTV) coverage as well as dose to organs at risk (ORs), including the heart and ipsilateral lung...
May 31, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28573551/two-dimensional-breast-dosimetry-improved-using-three-dimensional-breast-image-data
#18
REVIEW
John M Boone, Andrew M Hernandez, J Anthony Seibert
Conventional mammographic dosimetry has been developed over the past 40 years. Prior to the availability of high-resolution three-dimensional breast images, certain assumptions about breast anatomy were required. These assumptions were based on the information evident on two-dimensional mammograms; they included assumptions of thick skin, a uniform mixture of glandular and adipose tissue, and a median breast density of 50%. Recently, the availability of high-resolution breast CT studies has provided more accurate data about breast anatomy, and this, in turn, has provided the opportunity to update mammographic dosimetry...
June 2017: Radiological Physics and Technology
https://www.readbyqxmd.com/read/28550924/new-perspective-on-the-in%C3%A2-vivo-use-of-cold-stress-dynamic-thermography-in-integumental-reconstruction-with-the-use-of-skin-muscle-flaps
#19
Szymon Kolacz, Mateusz Moderhak, Jerzy Jankau
BACKGROUND: Among the problems encountered by plastic surgeons is the reconstruction of defects following tumors. One of the reconstructive options is trans rectus abdominis (TRAM) flap. Despite that anatomy is well explored, marginal flap necrosis may develop. To minimize the complications, imaging examinations were designed to determine the degree of flap perfusion. One of them is the thermographic examination. MATERIALS AND METHODS: We examined 38 patients who had undergone 10 reconstructive breast surgeries with a pedicled TRAM ipsilateral flap, 10 patients with a TRAM contralateral flap, and 18 patients with a TRAM supercharged flap...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28541199/3-d-nonlinear-acoustic-inverse-scattering-algorithm-and-quantitative-results
#20
J W Wiskin, D T Borup, E Iuanow, J Klock, Mark W Lenox
We describe a novel 3-D ultrasound technology, the quantitative transmission ultrasound system and algorithm to image a pendent breast in a water bath. Quantitative accuracy is verified using phantoms. Morphological accuracy is verified using cadaveric breast and in vivo images, and spatial resolution is estimated. This paper generalizes an earlier 2-D algorithm to a full 3-D inversion algorithm and shows the importance of such a 3-D algorithm for artifact suppression as compared with the 2-D algorithm. The resultant high-resolution ultrasound images, along with quantitative information regarding tissue speed of sound/stiffness, provide a more accurate depiction of the breast anatomy and lesions, contributing to improved breast care...
August 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
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