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Shamsunder MG, Polanco TO, McCarthy CM, Allen RJ, Matros E, Coriddi M, Mehrara BJ, Pusic A, Nelson JA. Understanding Preoperative Breast Satisfaction among Patients Undergoing Mastectomy and Immediate Reconstruction: BREAST-Q Insights. Plast Reconstr Surg 2021; 148:891e-902e. [PMID: 34847108 PMCID: PMC8638966 DOI: 10.1097/prs.0000000000008521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aims to present normative values for satisfaction with breasts among preoperative breast reconstruction patients as assessed using the BREAST-Q instrument and to delineate factors associated with preoperative breast satisfaction. METHODS A retrospective analysis of prospectively collected data was performed examining women undergoing postmastectomy breast reconstruction at a tertiary care center who preoperatively completed the BREAST-Q from 2010 to 2017. Because breast satisfaction scores were nonnormally distributed, scores were categorized into quartiles for analysis. Patient- and treatment-level variables were tested in a multivariable ordinal logistic regression model as predictors of breast satisfaction. Preoperative satisfaction was also tested for association with choice of reconstructive modality. RESULTS Among 1306 postmastectomy reconstruction patients included in the study, mean preoperative Satisfaction with Breasts score was 61.8 ± 21.5 and the median score was 58.0 (interquartile range, 48 to 70). Factors associated with significantly lower preoperative satisfaction included history of psychiatric diagnosis, preoperative radiotherapy, marital status (married), and higher body mass index. Factors associated with significantly higher scores were malignancy (localized tumor), medium bra size (B to C cup), and self-identification as black. Preoperative breast satisfaction was lower among patients who elected autologous reconstruction than among those with implant reconstruction (p < 0.001). CONCLUSIONS Preoperative breast satisfaction is influenced by multiple factors. Understanding these factors may improve preoperative counseling and expectation management for patients who undergo postmastectomy breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Meghana G Shamsunder
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Thais O Polanco
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Colleen M McCarthy
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Robert J Allen
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Evan Matros
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Michelle Coriddi
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Babak J Mehrara
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Andrea Pusic
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Jonas A Nelson
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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Levine L, Kassira W. BreastImplantAnalyzer: An easy-to-use, validated tool for calculating breast implant volume from MRI data. J Plast Reconstr Aesthet Surg 2021; 74:2885-2890. [PMID: 33972201 DOI: 10.1016/j.bjps.2021.03.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/02/2020] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Given the prevalence of breast augmentation and prosthetic-based breast reconstruction, it is common for the plastic surgeon to see patients presenting for revisional implant surgery. A frequent issue encountered in such procedures is uncertainty of implant size, which presents numerous challenges and may lead to undesired outcomes for both the patient and the surgeon. There is currently no tool available with the purpose of measuring implant volume from magnetic resonance imaging (MRI) data. In this study, such a program was designed and tested. METHODS An open-source software was developed that provides volume measurement of a chosen breast implant with minimal interaction from the user, allowing for precision in the planning of breast implant revisional surgery. It was developed to be as easy to use as possible for clinicians who may not have experience with imaging analysis platforms. The program was tested on patients who underwent revisional implant surgery and had documented implant volumes and pre-operative breast MRIs. Twenty-two implants were tested in total, including saline and both smooth and textured silicone implants. RESULTS The software has shown to be highly accurate with an average accuracy of 98.6%. A Spearman correlation coefficient of 0.967 was obtained. The software also performed faster than previously proposed methods. CONCLUSION Plastic surgeons can easily calculate breast implant volume pre-operatively using BreastImplantAnalyzer, which is available to download for free from www.BreastImplantAnalyzer.com or as an extension for the popular medical imaging platform 3D Slicer.
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Affiliation(s)
- Lance Levine
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA.
| | - Wrood Kassira
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
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Obourn PJ, Benoit J, Brady G, Campbell E, Rizzone K. Sports Medicine-Related Breast and Chest Conditions-Update of Current Literature. Curr Sports Med Rep 2021; 20:140-149. [PMID: 33655995 DOI: 10.1249/jsr.0000000000000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT This article reviews the most up-to-date evidence-based recommendations pertaining to breast and upper chest conditions, specifically for the sports medicine physician. Because of the unique circumstances of the team physician, they can see a wide breadth of pathology. Athletes may not have a primary care physician and may prefer to present to their team physician for breast and upper chest conditions. It is often more comfortable and convenient for athletes to seek treatment in the team setting. Therefore, it is important that the medical professional be aware of not only common pathology but also of that which is rarer. Any delay in evaluation can result in unnecessary morbidity and lead to complications or extended time lost from sport. Consequently, it also is important to facilitate an atmosphere encouraging early presentation and workup.
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Affiliation(s)
- Peter J Obourn
- Department of Orthopaedics, Division of Sports Medicine, University of Rochester Medical Center, Rochester, NY
| | - Janeeka Benoit
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN
| | - Geena Brady
- Sports and Spine Rehabilitation, University of Rochester Medical Center, Rochester, NY
| | - Elisabeth Campbell
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN
| | - Katherine Rizzone
- Department of Orthopaedics, Division of Sports Medicine, University of Rochester Medical Center, Rochester, NY
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Carbonaro LA, Schiaffino S, Clauser P, Tomkova L, Iodice M, Zuiani C, Sardanelli F. Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI. Acta Radiol 2021; 62:19-26. [PMID: 32228030 DOI: 10.1177/0284185120912408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Motion is a relevant cause of artifacts in breast magnetic resonance imaging (MRI), potentially degrading image quality, even with optimized protocols. PURPOSE To investigate the causes of motion artifacts (MA) impacting on image quality (IQ) of contrast-enhanced breast MRI. MATERIAL AND METHODS Retrospective two-center study on consecutive 1.5-T contrast-enhanced breast MRI, independently reviewed by two radiologists on first subtracted and maximum intensity projection images to define the side most affected by MA. IQ was scored as 1 (optimal), 2 (reduced, but without reduction of diagnostic power), or 3 (reduced, with reduced diagnostic power). Correlations with injection side, breast size (A/B vs. C/D cups), patient age, clinical indication, and MRI scanner/protocol were assessed using χ2 and Fisher's exact statistics. RESULTS In total, 237 examinations were included, with right injection performed in 124 (52%) and left in 113 (48%). MA were more frequent on the side ipsilateral to the injection (144/237, 61%, 95% confidence interval [CI] 54-67%) than on the contralateral (93/237, 95% CI 33-46%) (P < 0.001); IQ was scored 1 in 154/237 (65%), 2 in 63/237 (27%), and 3 in 20/237 (8%) examinations; patients with A/B cups showed higher IQ score than patients with C/D cups (scores 1, 2, and 3: 54% vs. 70%; 29% vs. 25%; 17% vs. 5%, respectively, P = 0.002). No significant correlations were found for MA (P≥0.106) or IQ (P ≥ 0.318) between ipsi- or contralateral injection and right/left injection, breast size, age, indication, or scanner/protocol. CONCLUSION MA were more frequent in breasts ipsilateral to contrast injection and showed a reduced IQ for small breasts.
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Affiliation(s)
- Luca A Carbonaro
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Simone Schiaffino
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Paola Clauser
- Medical University of Vienna/General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Wien, Austria
| | - Ludmila Tomkova
- Institute of Radiology, University of Udine, Department of Medical and Biological Sciences, Azienda Ospedaliero - Universitaria S. Maria della Misericordia, Udine, Italy
| | - Maria Iodice
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Chiara Zuiani
- Institute of Radiology, University of Udine, Department of Medical and Biological Sciences, Azienda Ospedaliero - Universitaria S. Maria della Misericordia, Udine, Italy
| | - Francesco Sardanelli
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences of Health, Università degli Studi di Milano, Milan, Italy
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Kasielska-Trojan A, Mikołajczyk M, Antoszewski B. BreastIdea Volume Estimator: A New Tool for Breast Volume Estimation-Presentation and Validation for Women. Plast Reconstr Surg 2020; 146:744e-748e. [PMID: 33234954 DOI: 10.1097/prs.0000000000007373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Breast volume assessment is crucial in a breast surgeon's clinical practice. The aim of this study was to present and validate a new Web application, BreastIdea Volume Estimator, a module for breast estimation of the already validated BreastIdea application. Forty breasts in 20 women were scanned using a three-dimensional scanner. They were then photographed in nonstandardized conditions, and volume estimations were calculated using BreastIdea Volume Estimator. Accuracy in addition to relative and absolute reliability of BreastIdea Volume Estimator measurements were investigated. In addition, breast volume differences were analyzed. Breast volume estimation using BreastIdea Volume Estimator yielded satisfactory accuracy and presented precision of the level of clinical measures. The mean absolute difference for both observers was 4.33 ± 3.79 cc and 6.78 ± 4.66 cc, which correspond to 1.87 ± 1.89 percent and 2.75 ± 2.05 percent errors of measurement. Similar relations were found for measurements of breast volume differences. BreastIdea Volume Estimator is a clinically oriented, reliable tool for breast volume evaluation. It provides results of appropriate accuracy regardless of chest abnormality and photograph standardization.
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Affiliation(s)
- Anna Kasielska-Trojan
- From the Plastic, Reconstructive, and Aesthetic Surgery Clinic, Medical University of Łódź
| | - Maksym Mikołajczyk
- From the Plastic, Reconstructive, and Aesthetic Surgery Clinic, Medical University of Łódź
| | - Bogusław Antoszewski
- From the Plastic, Reconstructive, and Aesthetic Surgery Clinic, Medical University of Łódź
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Shi Y, Shen H, Taylor LW, Cheung V. The impact of age and body mass index on a bra sizing system formed by anthropometric measurements of Sichuan Chinese females. Ergonomics 2020; 63:1434-1441. [PMID: 32658607 DOI: 10.1080/00140139.2020.1795276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Existing bra sizing systems are based only on bust and underbust girths, which do not guarantee an accurate fit or comfort for consumers. This study presents a comprehensive investigation of the impact of age and body mass index (BMI) on bra sizing systems, and the distributions of band and cup sizes based on anthropometric measurement data. The first four principal components were extracted by principal component analysis, and the factor loadings of age and BMI were found to be significant determinants of bra size along with 12 other variables. Furthermore, chi-square analysis revealed that bra size allocations were significantly influenced by age and BMI. Thus, we propose that age and BMI should be considered as auxiliary criteria for the bra sizing system. Taken together, these findings will be of value to designers and bra manufacturers in developing well-fitting bras for their target consumers, and to consumers for selecting well-fitting bras with confidence. Practitioner Summary: This study contributes to an understanding of how bra sizing systems are affected by age and BMI. This understanding is valuable to bra designers, manufacturers, and retailers, as it will enable the adjustment of bra sizes for different target markets and in turn improve consumer confidence in selecting proper fitting and comfortable bras.
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Affiliation(s)
- Yuyuan Shi
- School of Design, University of Leeds, Leeds, UK
| | - Hong Shen
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
| | | | - Vien Cheung
- School of Design, University of Leeds, Leeds, UK
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Li X, Zhou C, Wu Y, Chen X. Relationship between formulaic breast volume and risk of breast cancer based on linear measurements. BMC Cancer 2020; 20:989. [PMID: 33046044 PMCID: PMC7552486 DOI: 10.1186/s12885-020-07499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 10/06/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Whether breast volume is a risk factor for breast cancer is controversial. This study aimed to evaluate whether a significant association between breast volume and risk of breast cancer, based on linear measurements, was present by applying propensity score matching (PSM). METHODS The study was designed as a hospital-based case-control study. Between March 2018 and May 2019, 208 cases and 340 controls were retrospectively reviewed. Information on menarche, smoking, feeding mode, oral contraceptives, reproductive history and family history was obtained through a structured questionnaire. Breast volume was calculated using a formula based on linear measurements of breast parameters. Cox regression and PSM were used to estimate odds ratios and 95% confidence intervals for breast cancer using risk factors adjusted for potential confounders. RESULTS There was a significant difference in breast volume between the two groups before propensity score matching (P = 0.014). Binary logistic regression showed that the risk of breast cancer was slightly higher in the case group with larger breast volumes than in the control group(P = 0.009, OR = 1.002, 95%CI:1.000 ~ 1.003). However, there was no significant statistical difference between the two groups using an independent sample Mann-Whitney U test (P = 0.438) or conditional logistic regression (P = 0.446). CONCLUSIONS After PSM for potential confounding factors, there is no significant difference in breast volume estimated by BREAST-V formula between the case group and the control group. The risk of breast cancer may not be related to breast volume in Chinese women.
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Affiliation(s)
- Xiaoxia Li
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Yanni Wu
- Department of Nursing, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Xiaohong Chen
- Department of Thyroid Breast Surgery, the First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, Guangdong 515041 P. R. China
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Brisbine BR, Steele JR, Phillips EJ, McGhee DE. Breast and torso characteristics of female contact football players: implications for the design of sports bras and breast protection. Ergonomics 2020; 63:850-863. [PMID: 32301393 DOI: 10.1080/00140139.2020.1757161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to provide normative data characterising the breast size, breast position and torso size of female contact football players. 117 AFL, Rugby League, Rugby Union and Rugby 7s players attended a single testing session where a three-dimensional scan was taken of their naked breasts and torso. Dimensions relevant to the design of sports bras and breast protective equipment were then calculated from the scans. Several breast and torso characteristics of female contact football athletes differed to measurements reported for females in the general population and amongst the contact football codes. Designers and manufacturers of sports bras or breast protective equipment should consider the specific breast and torso dimensions of female contact football players to maximise the fit, comfort and efficacy of these garments. Practitioner summary: Using three-dimensional scanning, this study characterised the breast and torso size and shape of 117 female contact football players. These normative data should be used to improve the fit and comfort of sports bras and breast protective equipment for female contact football players.
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Affiliation(s)
- Brooke R Brisbine
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
- Applied Technology and Innovation, Australian Institute of Sport, Canberra, Australia
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
| | - Elissa J Phillips
- Performance People and Teams, Australian Institute of Sport, Canberra, Australia
| | - Deirdre E McGhee
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
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Abstract
BACKGROUND The anatomical descriptions of the attachments of the female breast to the chest wall vary in their structure, location, and terminology within the published literature. METHODS A dissection study of the attachments of the breast to the chest wall was conducted on 18 female embalmed breasts in the coronal (n = 15) and sagittal planes (n = 3). RESULTS Perimeter, posterior wall, and horizontal septum attachments were observed. The perimeter along its entire length was attached to the chest wall. Regional and anatomical variation was observed in this structure and location. Sharp dissection was required to remove it from the chest wall, in contrast to the blunt dissection required to remove the posterior wall and horizontal septum attachments. CONCLUSIONS The breast attaches to the chest wall along its entire perimeter, posterior wall, and horizontal septum, with the perimeter functioning as the primary anchor of the breast to the chest wall. The structure of the perimeter attachment is both periosteal and fascial and requires sharp dissection to remove it from the chest wall. The fascial structures of the posterior wall and horizontal septum require blunt dissection only. The structure of the perimeter has regional variation, and its location on the chest wall has anatomical variation. Detailed anatomical descriptions and illustrations are supported by photographic evidence of cadaver dissections in two planes. Clinical and anatomical terminology are linked, with clinical implications for medical anatomy education, breast modeling, and breast surgery.
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Affiliation(s)
- Kathryn M Gaskin
- From the Anatomy Laboratory, School of Medicine, University of Wollongong
| | - Gregory E Peoples
- From the Anatomy Laboratory, School of Medicine, University of Wollongong
| | - Deirdre E McGhee
- From the Anatomy Laboratory, School of Medicine, University of Wollongong
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Zubia EC. Steps for Obtaining an Optimal MLO Projection. Radiol Technol 2020; 91:494-496. [PMID: 32381670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Malbon C, Knock DC, Critchley DR, Debra J Carr P. The effect of breast size and bra type on comfort for UK female police officers wearing body armour. Appl Ergon 2020; 84:103012. [PMID: 31987508 DOI: 10.1016/j.apergo.2019.103012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/28/2019] [Accepted: 11/24/2019] [Indexed: 06/10/2023]
Abstract
Within the Police service of England and Wales the wearing of ballistic and stab resistant body armour is common, with most police forces mandating its usage when away from the police station. Of all the serving police officers in England and Wales 29.1% are female (Hargreaves et al., 2017). A survey was developed and then distributed by the Police Federation of England and Wales to all servicing police officers up to the rank of Inspector. The survey returned 2633 responses after cleaning of the data. From the responses it was seen that the predominant bra type worn is underwired (71%) and the predominant UK bra size is 34B (9%). It was also determined that the predominant areas where the body armour either rubbed or caused discomfort were the left and right anterior mammary regions and the posterior lateral sacral region. By understanding the distribution of bra size, type of bra worn and areas of discomfort or rubbing it helps further understand the issues faced by female police officers and how body armour design could be improved.
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Affiliation(s)
- Chris Malbon
- Centre for Defence Engineering, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, Wiltshire, SN6 8LA, UK.
| | - Dr Clare Knock
- Centre for Defence Engineering, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, Wiltshire, SN6 8LA, UK
| | - Dr Richard Critchley
- Centre for Defence Engineering, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, Wiltshire, SN6 8LA, UK
| | - Prof Debra J Carr
- Defence and Security Accelerator, Porton Down, Salisbury, SP4 0JQ, UK
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Kościński K, Makarewicz R, Bartoszewicz Z. Stereotypical and Actual Associations of Breast Size with Mating-Relevant Traits. Arch Sex Behav 2020; 49:821-836. [PMID: 31562583 PMCID: PMC7058577 DOI: 10.1007/s10508-019-1464-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 06/10/2023]
Abstract
Breast size varies substantially among women and influences perception of the woman by other people with regard to her attractiveness and other characteristics that are important in social contexts, including mating. The theory of sexual selection predicts that physical criteria of partner selection should be markers of the candidate's desirable properties, mainly biological quality. Few studies, however, have examined whether breast size really signals biological quality or its components and whether observers accurately interpret these signals. Our first study encompassed 163 young women and aimed to establish actual correlates of breast size. The aim of the second study was to determine preferences and stereotypes related to breast size: 252-265 women and men evaluated female digital figures varying in, among other characteristics, breast size. Breast size (breast circumference minus chest circumference) was negatively associated with body asymmetry and positively associated with infections of the respiratory system, but did not correlate with infections of the digestive system, openness to casual sex, and testosterone and estradiol level. Women and men perceived breasts in a similar way to each other: the bigger the breasts the higher the reproductive efficiency, lactational efficiency, sexual desire, and promiscuity attributed to the woman. Nevertheless, large breasts were not regarded more attractive than average ones, though small breasts were the least attractive. In addition, big-breasted women were perceived as less faithful and less intelligent than women with average or small breasts. We discuss our results from the perspectives of evolutionary psychology, perceptual biases, and social stereotypes.
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Affiliation(s)
- Krzysztof Kościński
- Department of Human Evolutionary Ecology, Faculty of Biology, Adam Mickiewicz University, Umultowska 89, 61-614, Poznan, Poland.
| | - Rafał Makarewicz
- Department of Human Evolutionary Ecology, Faculty of Biology, Adam Mickiewicz University, Umultowska 89, 61-614, Poznan, Poland
| | - Zbigniew Bartoszewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
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Fusco R, Raiano N, Raiano C, Maio F, Vallone P, Mattace Raso M, Setola SV, Granata V, Rubulotta MR, Barretta ML, Petrosino T, Petrillo A. Evaluation of average glandular dose and investigation of the relationship with compressed breast thickness in dual energy contrast enhanced digital mammography and digital breast tomosynthesis. Eur J Radiol 2020; 126:108912. [PMID: 32151787 DOI: 10.1016/j.ejrad.2020.108912] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/20/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To quantitatively assess the dose of Dual energy contrast enhanced digital mammography (CEDM) and digital breast tomosynthesis (DBT) and to investigate the relationship between average absorbed glandular dose (AGD), compressed breast thickness (CBT) and compression force (CF). MATERIALS AND METHODS All CEDM and DBT examinations were performed in cranio-caudal (CC) and medio-lateral oblique (MLO) view. Exposure parameters of 135 mammographic procedures that using AEC (automatic exposure control) mode were recorded. AGDs were calculated. Kruskal Wallis test was performed. RESULTS CBT population ranged from 23 to 94 mm with a thickness median value of 52 mm in CC view and of 57 mm in MLO views. CEDM AGD median value was significatively lower than DBT AGD in each views (p << 0.01). AGD showed a positive correlation and linear regression with CBT for both CEDM and DBT while CF did not show a correlation and linear regression with AGD. The highest values were found for MLO view: R2 of 0.74 for CEDM and R2 of 0.61 for DBT. Kruskal Wallis test shows that there was a difference statistically significant between AGD values of CEDM and DBT in CC view respect to MLO views (p < 0.01). CONCLUSIONS Dose values of both techniques meet the recommendations for maximum dose in mammography. The results of the present study indicated that there was significant difference between AGD for CEDM and DBT exposure in different views (AGD in CC views had the lowest value) and that CBT could influence the AGD while CF was not correlated to AGD.
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Affiliation(s)
- Roberta Fusco
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Nicola Raiano
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Concetta Raiano
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Francesca Maio
- Radiology Division, "UNIVERSITA' DEGLI STUDI DI NAPOLI FEDERICO II", Via Pansini, Naples, Italy
| | - Paolo Vallone
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Mauro Mattace Raso
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Vincenza Granata
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Maria Rosaria Rubulotta
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Maria Lusia Barretta
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Teresa Petrosino
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Antonella Petrillo
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy.
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15
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Steele JR, Coltman CE, McGhee DE. Effects of obesity on breast size, thoracic spine structure and function, upper torso musculoskeletal pain and physical activity in women. J Sport Health Sci 2020; 9:140-148. [PMID: 32099722 PMCID: PMC7031809 DOI: 10.1016/j.jshs.2019.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 05/04/2023]
Abstract
PURPOSE This study investigated the effects of obesity on breast size, thoracic spine structure and function, upper torso musculoskeletal pain and physical activity participation in women living independently in the community. METHODS A total of 378 women were divided into 3 groups (Not Overweight: body mass index (BMI) = 22.5 ± 0.2 kg/m2 (mean ± SE); Overweight: BMI = 27.4 ± 0.3 kg/m2; Obese: BMI = 35.4 ± 0.3 kg/m2). Outcome variables of breast volume (mL), thoracic flexion torque (N·m), thoracic kyphosis (degrees), upper torso musculoskeletal pain (score) and time spent in physical activity (min) were calculated and compared among the 3 groups, adjusting for between-group differences in age. RESULTS There was a significant main effect of BMI on all outcome variables. Participants classified as Obese displayed significantly larger breasts, had greater thoracic flexion torques and reported less time participating in physical activity relative to the participants who were classified as Not Overweight and Overweight. Participants in the Obese group also displayed significantly more thoracic kyphosis and reported significantly more upper torso musculoskeletal pain compared to their counterparts who were classified as Not Overweight. CONCLUSION This study is the first to demonstrate that increased obesity levels were associated with compromised kyphosis and loading of the thoracic spine, as well as increased symptoms of upper torso musculoskeletal pain and reduced time spent in physical activity in women living in the community. We recommend further research to determine whether evidence-based interventions designed to reduce the flexion torque generated on the thoracic spine can improve these symptoms of upper torso musculoskeletal pain and the ability of women with obesity to participate in physical activity.
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Affiliation(s)
- Julie R Steele
- Biomechanics Research Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Celeste E Coltman
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
| | - Deirdre E McGhee
- Biomechanics Research Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
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Southworth A, Clough H, Roberts N. An audit of radiation-induced skin reactions in the inframammary fold; does breast size impact on the severity of the reaction? Radiography (Lond) 2020; 26:192-197. [PMID: 32052757 DOI: 10.1016/j.radi.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/05/2019] [Accepted: 12/07/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Skin toxicity is a clinically significant side effect of external beam radiation; moist desquamation is particularly prevalent for breast patients, mainly in the axilla and inframammary fold (IMF). The aim of this audit was to assess if there is a correlation between patient breast size and the presence and extent of radiotherapy skin reaction in the IMF. METHODS Between 22/12/2017 and 31/05/2018 forty patients undergoing standard whole breast radiotherapy using 3D planned medial and lateral tangential fields had their skin reaction recorded weekly, whilst on treatment, using the Radiotherapy Oncology Group (RTOG) scoring system. Skin reactions were also documented at three and eight weeks post radiotherapy. A measurement of the patients IMF length and bra size were also noted. Statistical analysis was carried out using IBMÒ SPSS Statistics 24. RESULTS Six patients presented with grade ≥2 during week three of radiotherapy. The mean IMF length of six patients with adverse reactions 6.1 cm (±3.6 cm). As the length of the IMF increases, severity of skin reactions also increases; a positive correlation was identified between the two at both week three of radiotherapy and three weeks post radiotherapy (r = 0.401, n = 34, p = 0.05 and r = 0.671, n = 29, p = 0.00 respectively). Only one patient displayed grade 2 at eight weeks post radiotherapy (IMF length 7.5 cm). CONCLUSION The findings from this study would suggest that larger breasted patients do present earlier, and with more severe radiation-induced skin reactions. IMPLICATIONS FOR PRACTICE Changes to skin care practice could be considered for patients with larger breasts. This could be in the form of more frequent check-ups during treatment or proactive side effect management rather than reactive management.
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Affiliation(s)
- A Southworth
- Radiotherapy Department, Leeds Cancer Centre, St James's Hospital, Becket Street, Leeds, LS9 7TF, United Kingdom.
| | - H Clough
- Radiotherapy Department, Leeds Cancer Centre, St James's Hospital, Becket Street, Leeds, LS9 7TF, United Kingdom
| | - N Roberts
- Radiotherapy Department, Leeds Cancer Centre, St James's Hospital, Becket Street, Leeds, LS9 7TF, United Kingdom; Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, United Kingdom
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17
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Kabir MM, Rajput HS, Kelkar VA, Salazar Coariti AC, Toussaint KC. Demonstration of flat-top beam illumination in widefield multiphoton microscopy. J Biomed Opt 2019; 25:1-8. [PMID: 31729201 PMCID: PMC7008505 DOI: 10.1117/1.jbo.25.1.014503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/24/2019] [Indexed: 06/10/2023]
Abstract
Multiphoton microscopy provides a suitable technique for imaging biological tissues with submicrometer resolution. Usually a Gaussian beam (GB) is used for illumination, leading to a reduced power efficiency in the multiphoton response and vignetting for a square-shaped imaging area. A flat-top beam (FTB) provides a uniform spatial intensity distribution that equalizes the probability of a multiphoton effect across the imaging area. We employ a customized widefield multiphoton microscope to compare the performance of a square-shaped FTB illumination with that based on using a GB, for both two-photon fluorescence (TPF) and second-harmonic generation (SHG) imaging. The variation in signal-to-noise ratio across TPF images of fluorescent dyes spans ∼5.6 dB for the GB and ∼1.2 dB for the FTB illumination, respectively. For the GB modality, TPF images of mouse colon and Convallaria root, and SHG images of chicken tendon and human breast biopsy tissue showcase ∼20 % area that are not imaged due to either insufficient or lack of illumination. For quantitative analysis that depends on the illuminated area, this effect can potentially lead to inaccuracies. This work emphasizes the applicability of FTB illumination to multiphoton applications.
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Affiliation(s)
- Mohammad M. Kabir
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- Laboratory for Photonics Research of Bio/Nano Environments (PROBE Lab), Urbana, Illinois and Providence, Rhode Island, United States
| | - Hemangg S. Rajput
- Laboratory for Photonics Research of Bio/Nano Environments (PROBE Lab), Urbana, Illinois and Providence, Rhode Island, United States
- University of Illinois at Urbana-Champaign, Department of Mechanical Science and Engineering, Urbana, Illinois, United States
| | - Varun A. Kelkar
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- Laboratory for Photonics Research of Bio/Nano Environments (PROBE Lab), Urbana, Illinois and Providence, Rhode Island, United States
| | - Adriana C. Salazar Coariti
- Laboratory for Photonics Research of Bio/Nano Environments (PROBE Lab), Urbana, Illinois and Providence, Rhode Island, United States
| | - Kimani C. Toussaint
- Laboratory for Photonics Research of Bio/Nano Environments (PROBE Lab), Urbana, Illinois and Providence, Rhode Island, United States
- Brown University, School of Engineering, Providence, Rhode Island, United States
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18
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Charlier P, Deo S, Galassi FM, Benmoussa N. Poland syndrome before Alfred Poland: the oldest medical description (Paris, France, 1803). Surg Radiol Anat 2019; 41:1117-1118. [PMID: 30937564 DOI: 10.1007/s00276-019-02232-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/28/2019] [Indexed: 11/28/2022]
Abstract
Here, we present a description of Poland syndrome from the second session of the Anatomical Society (Paris, France) on 11 December 1803 of congenital mammary absence and muscular atrophy on the right side. This case report predates the first official description of the disease published by Alfred Poland in Guy's Hospital Reports (London, 1841). Consequently, perhaps would it be necessary to do justice to its French discoverer, and to name from now on this nosological entity the "syndrome of Marandel"?
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Affiliation(s)
- Philippe Charlier
- Section of Medical and Forensic Anthropology (UVSQ/EA4498 DANTE Laboratory), UFR of Health Sciences, 2 avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France
- Quai Branly Museum-Jacques Chirac, Paris, France
| | - Saudamini Deo
- Section of Medical and Forensic Anthropology (UVSQ/EA4498 DANTE Laboratory), UFR of Health Sciences, 2 avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Francesco Maria Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, 5001, Australia
| | - Nadia Benmoussa
- Section of Medical and Forensic Anthropology (UVSQ/EA4498 DANTE Laboratory), UFR of Health Sciences, 2 avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France.
- Department of ENT, Institut Gustave Roussy, Villejuif, France.
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19
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Mikołajczyk M, Kasielska-Trojan A, Antoszewski B. A New Tool for Breast Anthropometric Measurements: Presentation and Validation for Women and Men. Aesthetic Plast Surg 2019; 43:1160-1170. [PMID: 31372741 PMCID: PMC6746688 DOI: 10.1007/s00266-019-01467-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/20/2019] [Indexed: 12/04/2022]
Abstract
Introduction Anthropometric measurements of breasts are crucial for planning surgical procedures; however, there are no practical solutions for their quick, digital performance. The aim of the study was to present and validate a self-designed web application BreastIdea (BI) designed for indirect breast anthropometry. Methods Ten male and 10 female volunteers had their chests measured directly according to the routine clinical practice. Then their chests were photographed in non-standardised conditions. Corresponding measurements were performed using BI. Accuracy and both relative and absolute reliability of BI measurements were investigated. Results Breast assessments using BI yielded highly accurate results and presented near-perfect precision when compared to direct anthropometric measurements of the breast. Indirect anthropometry eliminates the necessity to trace the body’s curves, which usually introduces a bias to linear measurements. Conclusion BI web application is a reliable tool for indirect breast measurements in a clinical setting, providing accurate results regardless of chest pathology and photograph standardisation. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Maksym Mikołajczyk
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Łódź, Kopcinskiego 22, 90-153, Lodz, Poland.
| | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Łódź, Kopcinskiego 22, 90-153, Lodz, Poland
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Łódź, Kopcinskiego 22, 90-153, Lodz, Poland
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20
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Brisbine BR, Steele JR, Phillips EJ, McGhee DE. The Occurrence, Causes and Perceived Performance Effects of Breast Injuries in Elite Female Athletes. J Sports Sci Med 2019; 18:569-576. [PMID: 31427880 PMCID: PMC6683617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/25/2019] [Indexed: 06/10/2023]
Abstract
Female breasts are vulnerable to direct blows or frictional injuries during sport; however, little research has investigated breast injuries experienced by female athletes. This study aimed to investigate the occurrence, causes and perceived performance effects of breast injuries in elite female athletes across a wide range of sports. A custom-designed survey was distributed to female athletes aged over 18 years who were competing nationally or internationally in their chosen sport. The survey included questions about breast injuries sustained during training and competition and any perceived performance effects of these injuries. 504 elite female athletes from 46 different sports completed the survey. 36% of participants (n = 182) reported experiencing breast injuries and 21% (n = 37) perceived that their breast injury negatively affected their performance. Contact breast injuries were reported by significantly more athletes involved in contact or combat sports and by athletes with larger breasts or a higher body mass index. Frictional breast injuries were reported by significantly more older athletes or those with larger breasts. Less than 10% of participants who experienced breast injuries reported their injury to a coach or medical professional and only half used any prevention strategies. Athletes, coaches and medical professionals associated with women's sport need to be made aware of the occurrence and potential negative effects of breast injuries. It is critical to normalise conversations around breast health so that athletes can be encouraged to report and, when necessary, receive treatment for breast injuries. Further research is also required to better understand factors that affect breast injuries in sport in order to develop evidence-based breast injury prevention strategies.
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Affiliation(s)
- Brooke R Brisbine
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
- Applied Technology & Innovation, Australian Institute of Sport, Canberra, Australia
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
| | - Elissa J Phillips
- Performance Networks & Partnerships, Australian Institute of Sport, Canberra, Australia
| | - Deirdre E McGhee
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
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21
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Chen K, Feng CJ, Ma H, Hsiao FY, Tseng LM, Tsai YF, Lin YS, Huang LY, Yu WC, Perng CK. Preoperative breast volume evaluation of one-stage immediate breast reconstruction using three-dimensional surface imaging and a printed mold. J Chin Med Assoc 2019; 82:732-739. [PMID: 31335631 DOI: 10.1097/jcma.0000000000000155] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Accurate assessment of breast volume is an essential component of preoperative planning in one-stage immediate breast reconstruction (IBR) for achieving breast symmetry and a satisfactory cosmetic outcome. In this study, we compared breast volume estimation using three-dimensional (3D) surface imaging with magnetic resonance imaging (MRI) to determine the accuracy of breast volume measurements. Further, a 3D printing mold for facilitating autologous breast reconstruction intraoperatively is described. METHODS Patients scheduled to therapeutic or prophylactic mastectomy with one-stage IBR, either by autologous tissue transfer or direct implant, from 2016 to 2019, were enrolled in this study. 3D surface image and MRI were performed to evaluate breast volume and shape. The results were validated by the water displacement volume of the mastectomy specimen. Finally, a 3D printing mold was designed for breast reconstruction with autologous tissue. RESULTS Nineteen women who were scheduled to have 20 mastectomies (18 unilateral and one bilateral) were included. There was a strong linear association between breast volume measured using the two different methods and water displacement of mastectomy specimens when a Pearson correlation was used (3D surface image: r = 0.925, p < 0.001; MRI: r = 0.915, p < 0.001). Bland-Altman plots demonstrated no proportional bias between the assessment methods. The coefficient of variation was 52.7% for 3D surface imaging and 59.9% for MRI. The volume of six breasts was evaluated by both measurements and the intraclass correlation coefficient was 0.689 for 3D surface image (p = 0.043) and 0.743 for MRI (p = 0.028). CONCLUSION Using 3D surface image to evaluate breast shape and volume is a quick, effective, and convenient method. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study. In addition, 3D-printed molds can achieve better symmetry and aesthetic outcomes in immediate autologous breast reconstructions.
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Affiliation(s)
- Keng Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chin-Jung Feng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hsu Ma
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Surgery, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Fu-Yin Hsiao
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Doctoral Degree Program of Translational Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ling-Ming Tseng
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine and Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Fang Tsai
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine and Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yen-Shu Lin
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Li-Ying Huang
- 3D Printing Technology and Resource Integration Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Chan Yu
- 3D Printing Technology and Resource Integration Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cherng-Kang Perng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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22
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Zehr KR. Diagnosis and Treatment of Breast Cancer in Men. Radiol Technol 2019; 91:51M-61M. [PMID: 31471487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Breast cancer occurs in about 1% of men, but the number of men receiving a diagnosis is increasing. Data on male breast cancer (MBC) is limited, and treatment for men is based primarily on treatments used for women. However, some argue that breast cancer in men is a different disease than breast cancer in women. Multiple risk factors, including those with genetic and environmental origins, affect the likelihood of men receiving a breast cancer diagnosis. This article discusses types of MBC, risk factors, treatment options, and ethical concerns men encounter after they receive a breast cancer diagnosis.
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MESH Headings
- Biopsy
- Breast/anatomy & histology
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/metabolism
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Genetic Predisposition to Disease
- Humans
- Inflammatory Breast Neoplasms/diagnosis
- Inflammatory Breast Neoplasms/therapy
- Magnetic Resonance Imaging
- Male
- Mammography
- Neoplasm Staging
- Occupational Exposure/adverse effects
- Prognosis
- Receptor, ErbB-2/metabolism
- Risk Factors
- Transgender Persons
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Affiliation(s)
- Karla Kerlikowske
- Department of Medicine, University of California, San Francisco
- General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco
| | - Diana L Miglioretti
- Department of Public Health Sciences, University of California, Davis
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Celine M Vachon
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
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Wesselius TS, Verhulst AC, Xi T, Ulrich DJO, Maal TJJ. Effect of skin tone on the accuracy of hybrid and passive stereophotogrammetry. J Plast Reconstr Aesthet Surg 2019; 72:1564-1569. [PMID: 31229406 DOI: 10.1016/j.bjps.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/11/2019] [Accepted: 05/02/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Three-dimensional (3D) surface images acquired from stereophotogrammetry are increasingly being used to plan or evaluate treatment by plastic surgeons. Stereophotogrammetry exists in active, passive, and hybrid forms. Active and hybrid stereophotogrammetry are believed to capture darker surfaces more accurately than passive stereophotogrammetry. The purpose of this study was to investigate whether skin tone has a clinically relevant effect on the accuracy of hybrid and passive stereophotogrammetry. MATERIALS AND METHODS Seven subjects with different skin tones were recruited. 3D-printed face and breast were spray-painted in six different colors, ranging from white to black. The skin tones and paint colors were objectified by measuring their melanin index. 3D photos of the subjects and 3D prints were acquired with hybrid and passive stereophotogrammetry. These 3D photos were matched with specialized software, and their geometric differences were calculated. RESULTS None of the 3D photos showed a clinically relevant mean inaccuracy. On the 3D prints, hybrid stereophotogrammetry resulted in a smaller standard deviation of the inaccuracies than passive stereophotogrammetry (0.20 ± 0.06 mm vs. 0.35 ± 0.07 mm, p < 0.001). Passive stereophotogrammetry yielded a correlation between the melanin index of the spray paint colors and the standard deviation of the inaccuracy (Pearson's R = 0.60, p = 0.04). On human subjects, no correlation or difference in standard deviation of the accuracy was found. CONCLUSION Skin tone does not influence the accuracy of hybrid and passive 3D stereophotogrammetry in a clinically relevant way.
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Affiliation(s)
- T S Wesselius
- Department of Plastic, Reconstructive, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands; 3D Lab Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - A C Verhulst
- Department of Plastic, Reconstructive, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands; 3D Lab Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands
| | - T Xi
- 3D Lab Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands; Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D J O Ulrich
- Department of Plastic, Reconstructive, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands
| | - T J J Maal
- 3D Lab Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands
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Ooi BNS, Loh H, Ho PJ, Milne RL, Giles G, Gao C, Kraft P, John EM, Swerdlow A, Brenner H, Wu AH, Haiman C, Evans DG, Zheng W, Fasching PA, Castelao JE, Kwong A, Shen X, Czene K, Hall P, Dunning A, Easton D, Hartman M, Li J. The genetic interplay between body mass index, breast size and breast cancer risk: a Mendelian randomization analysis. Int J Epidemiol 2019; 48:781-794. [PMID: 31243447 PMCID: PMC6659372 DOI: 10.1093/ije/dyz124] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Evidence linking breast size to breast cancer risk has been inconsistent, and its interpretation is often hampered by confounding factors such as body mass index (BMI). Here, we used linkage disequilibrium score regression and two-sample Mendelian randomization (MR) to examine the genetic associations between BMI, breast size and breast cancer risk. METHODS Summary-level genotype data from 23andMe, Inc (breast size, n = 33 790), the Breast Cancer Association Consortium (breast cancer risk, n = 228 951) and the Genetic Investigation of ANthropometric Traits (BMI, n = 183 507) were used for our analyses. In assessing causal relationships, four complementary MR techniques [inverse variance weighted (IVW), weighted median, weighted mode and MR-Egger regression] were used to test the robustness of the results. RESULTS The genetic correlation (rg) estimated between BMI and breast size was high (rg = 0.50, P = 3.89x10-43). All MR methods provided consistent evidence that higher genetically predicted BMI was associated with larger breast size [odds ratio (ORIVW): 2.06 (1.80-2.35), P = 1.38x10-26] and lower overall breast cancer risk [ORIVW: 0.81 (0.74-0.89), P = 9.44x10-6]. No evidence of a relationship between genetically predicted breast size and breast cancer risk was found except when using the weighted median and weighted mode methods, and only with oestrogen receptor (ER)-negative risk. There was no evidence of reverse causality in any of the analyses conducted (P > 0.050). CONCLUSION Our findings indicate a potential positive causal association between BMI and breast size and a potential negative causal association between BMI and breast cancer risk. We found no clear evidence for a direct relationship between breast size and breast cancer risk.
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Affiliation(s)
| | - Huiwen Loh
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Peh Joo Ho
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Chi Gao
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health Boston, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health Boston, USA
| | - Esther M John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology and Division of Breast Cancer Research, Institute of Cancer Research, London UK
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - D Gareth Evans
- Genomic Medicine, Division of Evolution & Genomic Sciences, The University of Manchester Manchester, UK
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Centre, Vanderbilt University Nashville, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - Jose Esteban Castelao
- Oncology and Genetics Unit, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong Pok Fu Lam, Hong Kong
| | - Xia Shen
- Department of Medical Epidemiology and Biostatistics, Karolinska Insititute Stockholm, Sweden
- Biostatistics Group, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
- Center for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Kamila Czene
- Oncology and Genetics Unit, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Per Hall
- Oncology and Genetics Unit, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Alison Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas Easton
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jingmei Li
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Courtier N, Gambling T, Barrett-Lee P, Oliver T, Mason MD. The volume of liver irradiated during modern free-breathing breast radiotherapy: Implications for theory and practice. Radiography (Lond) 2019; 25:103-107. [PMID: 30955681 DOI: 10.1016/j.radi.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Incidental liver irradiation during breast radiotherapy can increase the risk of second primary malignancy and induce adverse inflammatory states. This study establishes the volume of liver irradiated during free-breathing breast radiotherapy. Novel associations between liver dose-volume data and systemic interleukin-6 soluble receptor and blood counts are evaluated. METHODS The volume of liver within the 10%, 50% and 90% isodose was determined for 100 women with stage 0 to II breast carcinoma undergoing 40Gy in 15 fractions over three weeks tangential irradiation. Blood counts and interleukin 6 soluble receptor concentration were recorded before, during and four weeks after radiotherapy. Dose-volume data for right-sided treatments was associated with longitudinal measures at bivariate and multivariable levels. RESULTS A maximum of 226cm3 (19%), 92 cm3 (8%) and 62 cm3 (5%) of the liver was irradiated within the 10%, 50% and 90% isodose. Liver irradiation was almost exclusively a feature of the 52 right-sided treatments and was strongly correlated with breast volume (ρ = 0.7, p < 0.0001). Liver V10% was significantly associated with interleukin-6 soluble receptor concentration four weeks post-radiotherapy (beta = 0.38, p = 0.01) after controlling for theoretical confounding variables. CONCLUSION Up to 8% of the liver is irradiated within the primary beam during local right-sided breast radiotherapy. Select use of a deep inspiration breath hold technique would reduce this volume, and minimise the risk of radiation-induced malignancy and acute systemic elevation of inflammatory interleukin 6 soluble receptor.
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Affiliation(s)
- N Courtier
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, Heath Park, Cardiff, CF24 0AB, UK.
| | - T Gambling
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, Heath Park, Cardiff, CF24 0AB, UK.
| | - P Barrett-Lee
- Velindre Cancer Centre, Velindre Road, Cardiff, CF14 2TL, UK.
| | - T Oliver
- Rutherford Cancer Centres Celtic Springs, Spooner Close, Newport, NP10 8FZ, UK.
| | - M D Mason
- Velindre Cancer Centre, Velindre Road, Cardiff, CF14 2TL, UK; Cardiff University School of Medicine, UHW Main Building, Health Park, Cardiff, CF14 4XN, UK.
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De Matheo LL, Geremia J, Calas MJG, Costa-Júnior JFS, da Silva FFF, von Krüger MA, Pereira WCDA. PVCP-based anthropomorphic breast phantoms containing structures similar to lactiferous ducts for ultrasound imaging: A comparison with human breasts. Ultrasonics 2018; 90:144-152. [PMID: 29966842 DOI: 10.1016/j.ultras.2018.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 06/04/2018] [Accepted: 06/22/2018] [Indexed: 05/11/2023]
Abstract
The purpose of this work was to obtain an anthropomorphic phantom with acoustic properties similar to those of breast tissue, possessing lactiferous duct-like structures, which would be a first for this type of phantom. Breast lesions usually grow in glandular tissues or lactiferous ducts. Shape variations in these structures are detectable by using ultrasound imaging. To increase early diagnosis, it is important to develop computer-aided diagnosis (CAD) systems and improve medical training. Using tissue-like materials that mimic known internal structures can help achieve both of these goals. However, most breast ultrasound phantoms described in the literature emulate only fat tissues and lesion-like masses. In addition, commercially available phantoms claim to be realistic, but do not contain lactiferous duct structures. In this work, we collected reference images from both breasts of ten healthy female volunteers aged between 20 and 30 years using a 10 MHz linear transducer of a B-mode medical ultrasound system. Histograms of the grey scale distribution of each tissue component of interest, the grey level means, and standard deviations of the regions of interest were obtained. Phantoms were produced using polyvinyl chloride plastisol (PVCP) suspensions. The lactiferous duct-like structures were prepared using pure PVCP. Solid scatterers, such as alumina (mesh #100) and graphite powders (mesh #140) were added to the phantom matrix to mimic glandular and fat tissue, respectively. The phantom duct-like structure diameters observed on B-mode images (1.92 mm ± 0.44) were similar to real measures obtained with a micrometer (2.08 mm ± 0.23). The phantom ducts are easy to produce and are largely stable for at least one year. This phantom allows the researchers to elaborate the structure at their will and may be used in training and as a reference for development of CAD systems.
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Affiliation(s)
- Lucas Lobianco De Matheo
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Juliana Geremia
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Maria Júlia Gregorio Calas
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - José Francisco Silva Costa-Júnior
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Flavia Fernandes Ferreira da Silva
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marco Antônio von Krüger
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Wagner Coelho de Albuquerque Pereira
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, RJ, Brazil; Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Zehr KR. Sporadic and Hereditary Breast Cancer Genetics. Radiol Technol 2018; 90:51M-64M. [PMID: 30352929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Genetic research provides the basis for sporadic and hereditary breast cancer diagnoses. Several mutated genes in sporadic breast cancer (eg, ERBB2 and myc) and hereditary breast cancer (eg, BRCA1 and BRCA2) influence how health care professionals assess breast cancer screenings and risks. The knowledge of these genetic mutations in the context of risk management, genetic counseling, genetic testing, and ethics might improve breast cancer treatment, prevention, and awareness.
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Karagiannis E, Leczynski A, Tselis N, Psanis E, Steckenreiter O, Milickovic N, Bon D, Strouthos I, Ferentinos K, Hass P, Gademann G, Baltas D, Zamboglou N. Inverse planning and inverse implanting for breast interstitial brachytherapy. Introducing a new anatomy specific breast interstitial template (ASBIT). Radiother Oncol 2018; 128:421-427. [PMID: 29934109 DOI: 10.1016/j.radonc.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 04/30/2018] [Accepted: 06/04/2018] [Indexed: 11/19/2022]
Abstract
An innovative template, based on thoracic cage surface reconstructions for breast interstitial brachytherapy was developed. Hybrid-inverse-planning-optimisation-based implantations and brachytherapy plans, using three custom anthropomorphic breast phantoms, were utilised for its validation. A user independent, inverse planning and inverse implanting technique is proposed.
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Affiliation(s)
| | - Agnes Leczynski
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus
| | - Nikolaos Tselis
- Department of Radiation Oncology, Radiotherapy and Oncology, J. W. Goethe University, Frankfurt am Main, Germany
| | - Emmanouil Psanis
- Department of Electrical Engineering and Computer Science, University of Liege, Montefiore Institute, Belgium
| | | | - Natasa Milickovic
- Department of Radiation Oncology, Sana Klinikum Offenbach, Offenbach am Main, Germany
| | - Dimitra Bon
- Institute of Biostatistic and Mathematical Modeling, J. W. Goethe University, Frankfurt am Main, Germany
| | - Iosif Strouthos
- Department of Radiation Oncology, Medical Center, University of Freiburg, Germany
| | | | - Peter Hass
- Department of Radiation Oncology, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Günther Gademann
- Department of Radiation Oncology, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Dimos Baltas
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, University of Freiburg, Faculty of Medicine and German Cancer Consortium (DKTK), Partner Site, Freiburg, Germany
| | - Nikolaos Zamboglou
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus; Department of Radiation Oncology, Radiotherapy and Oncology, J. W. Goethe University, Frankfurt am Main, Germany
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Ormachea J, Castaneda B, Parker KJ. Shear Wave Speed Estimation Using Reverberant Shear Wave Fields: Implementation and Feasibility Studies. Ultrasound Med Biol 2018; 44:963-977. [PMID: 29477745 DOI: 10.1016/j.ultrasmedbio.2018.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 06/08/2023]
Abstract
Elastography is a modality that estimates tissue stiffness and, thus, provides useful information for clinical diagnosis. Attention has focused on the measurement of shear wave propagation; however, many methods assume shear wave propagation is unidirectional and aligned with the lateral imaging direction. Any deviations from the assumed propagation result in biased estimates of shear wave speed. To address these challenges, directional filters have been applied to isolate shear waves with different propagation directions. Recently, a new method was proposed for tissue stiffness estimation involving creation of a reverberant shear wave field propagating in all directions within the medium. These reverberant conditions lead to simple solutions, facile implementation and rapid viscoelasticity estimation of local tissue. In this work, this new approach based on reverberant shear waves was evaluated and compared with another well-known elastography technique using two calibrated elastic and viscoelastic phantoms. Additionally, the clinical feasibility of this technique was analyzed by assessing shear wave speed in human liver and breast tissues, in vivo. The results indicate that it is possible to estimate the viscoelastic properties in each scanned medium. Moreover, a better approach to estimation of shear wave speed was obtained when only the phase information was taken from the reverberant waves, which is equivalent to setting all magnitudes within the bandpass equal to unity: an idealization of a perfectly isotropic reverberant shear wave field.
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Affiliation(s)
- Juvenal Ormachea
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA.
| | - Benjamin Castaneda
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, Lima, Peru
| | - Kevin J Parker
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA
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McGhee DE, Ramsay LG, Coltman CE, Gho SA, Steele JR. Bra band size measurements derived from three-dimensional scans are not accurate in women with large, ptotic breasts. Ergonomics 2018; 61:464-472. [PMID: 28673203 DOI: 10.1080/00140139.2017.1349936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/23/2017] [Indexed: 06/07/2023]
Abstract
This study investigated differences in standard measurements used to determine bra size, under-bust chest circumference (UBCC) and over-bust chest circumference (OBCC), measured from a three-dimensional scan (hand-held scanner) compared to the direct measurement in 111 women (age 21-56 years; right breast volume 57-1672 mL; bra size 10A-18G). Bland-Altman plots of UBCC measurements showed a large positive bias and wide limits of agreement (12 cm; -4.6 to 28 cm), which increased as band size increased but decreased when the breasts were digitally removed from the scan prior to the UBCC measurement. The difference in UBCC measurements determined from scans compared to direct measurement had a strong positive correlation with breast volume and breast ptotis. The OBCC measurements showed a small positive bias (2.4 cm; -3.4 to 8.4), consistent across the range of bra sizes. Bra band size measurements determined from three-dimensional scans can be inaccurate in women with large, ptotic breasts. Practitioner Summary: We investigated potential errors in anthropometric data derived from three-dimensional scans used for bra design and fit. Bra band size measurements taken from three-dimensional scans were over-estimated in women with large breasts, whereas bra cup size measurements were accurate to within one-cup size across the entire range of bra sizes.
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Affiliation(s)
- Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine , University of Wollongong , Wollongong , Australia
| | - Lauren G Ramsay
- a Biomechanics Research Laboratory, School of Medicine , University of Wollongong , Wollongong , Australia
| | - Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine , University of Wollongong , Wollongong , Australia
| | - Sheridan A Gho
- a Biomechanics Research Laboratory, School of Medicine , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine , University of Wollongong , Wollongong , Australia
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Montemurro P, Cheema M, Hedén P, Agko M, Quattrini Li A, Avvedimento S. Do Not Fear an Implant's Shape: A Single Surgeon's Experience of Over 1200 Round and Shaped Textured Implants in Primary Breast Augmentation. Aesthet Surg J 2018; 38:254-261. [PMID: 29106482 DOI: 10.1093/asj/sjx145] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Breast implants can be characterized by their fill material, surface texture, or shape. Whereas long-term good quality studies have provided evidence for the fill material and texture, there is still little consensus for choosing the shape of an implant. Surveys indicate that many surgeons choose only one implant shape, for reasons that may not always agree with outcomes from long-term studies. OBJECTIVES We reviewed the first author's experience over the last six years with both round and anatomical implants, compared the rate of complications with either implant shape, and discussed the importance of keeping an open mind about using both implant shapes for primary breast augmentation. METHODS A review of all consecutive primary breast augmentation patients by the first author over a six-year time period who had a minimum follow up of 6 months after surgery. RESULTS Six-hundred and forty-eight female patients had 1296 silicone breast implants inserted over the six-year period. Mean age at surgery was 30.5 years and mean BMI was 20.6 kg/m2. All implants were textured, 134 (in 67 patients, 10.3%) were round in shape with mean volume of 338 cc (range, 220-560 cc), while 1162 implants (in 581 patients, 89.7%) were anatomical shaped with a mean volume of 309 cc (range, 140-615 cc). Among these patients, 11.9% (n = 8) with round implants and 9.0% (n = 52) of those with anatomical implants developed complications postoperatively. CONCLUSIONS A single, ideal implant that is suitable for every primary breast augmentation does not exist. The optimum choice of implant shape in any given situation should take into account the patient's physical characteristics, available implant types, patient's desires, and the surgeon's experience. Together with round implants, anatomical devices ought to be considered as one of the tools in the surgeon's toolbox. By choosing to ignore them a priori means that the surgeon will only have access to half of his armamentarium and will therefore be able to offer a limited set of options to his patients. LEVEL OF EVIDENCE 4
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Affiliation(s)
| | - Mubashir Cheema
- plastic surgeon and consultant at University Hospital Birmingham, Birmingham, UK
| | - Per Hedén
- plastic surgeons in private practice in Stockholm, Sweden
| | - Mouchammed Agko
- fellows at a private plastic surgery practice in Stockholm, Sweden
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Abstract
INTRODUCTION Several factors, such as aging, pregnancy, and weight loss, reduce the elasticity of the breast tissue, and ptosis occurs. Due to aging and gravity, it is not possible to completely prevent breast ptosis. The goal is to delay the recurrence of ptosis as much as possible. PATIENTS AND METHODS This study included 20 female patients aged 25-55 years. The patients who underwent surgery had different levels of ptosis. Although the patients wanted their breasts to be lifted and an increase in projection, they did not want implants to be used. For this reason, autologous flaps were prepared from the patients, and these flaps were called autoprosthesis flaps. The flap donor area (FA) boundaries consisted of the inframammary fold at the bottom, the medial and lateral pillar legs at the two sides and the lower margin of the areola at the top. The skin on the FA was de-epithelialized. A hand dermatome was used to ensure that the extracted skin was not too thick because the rest of the dermal skin would form the cover of the planned autoprosthesis flap. Before surgery, the autoprosthesis flap baseline width, projection, and shape (round or anatomic) were planned for each patient. The autoprosthesis flap was prepared as a central pedicle, and the dermal layer, which was 1 cm wider than the flap, was then attached over the autoprosthesis flap to the pectoral muscle fascia with at least 10 sutures in the recipient area. For a round autoprosthesis flap, the flap base diameter was 10-12 cm on average, whereas for an anatomic autoprosthesis flap, the width of the flap was 10-12 cm and the height was 12-14 cm. Autoprosthesis flap projections varied from 4 to 6 cm. RESULTS Because of the autoprosthesis flap, breast projection was more prominent, even in the lying position. All the patients were very satisfied with their size, shape, projection, and natural appearance. In particular, the image in the lying position was very similar to a mastopexy performed with an actual breast implant; thus, sagging was not observed. CONCLUSION In augmentation mastopexy patients who do not want implants, upper pole filling and adequate breast projection can be easily achieved with this method. The potential risks of capsule formation, implant rejection, and implant rupture were not observed with this technique. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Safvet Ors
- SO-EP Aesthetic and Plastic Surgery Clinic, Seyitgazi Mah. Seyyid Burhaneddin Bulv. No: 51/A, 38050, Kayseri, Turkey.
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Kashyap KL, Bajpai MK, Khanna P, Giakos G. Mesh-free based variational level set evolution for breast region segmentation and abnormality detection using mammograms. Int J Numer Method Biomed Eng 2018; 34:e2907. [PMID: 28603939 DOI: 10.1002/cnm.2907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 04/28/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
Automatic segmentation of abnormal region is a crucial task in computer-aided detection system using mammograms. In this work, an automatic abnormality detection algorithm using mammographic images is proposed. In the preprocessing step, partial differential equation-based variational level set method is used for breast region extraction. The evolution of the level set method is done by applying mesh-free-based radial basis function (RBF). The limitation of mesh-based approach is removed by using mesh-free-based RBF method. The evolution of variational level set function is also done by mesh-based finite difference method for comparison purpose. Unsharp masking and median filtering is used for mammogram enhancement. Suspicious abnormal regions are segmented by applying fuzzy c-means clustering. Texture features are extracted from the segmented suspicious regions by computing local binary pattern and dominated rotated local binary pattern (DRLBP). Finally, suspicious regions are classified as normal or abnormal regions by means of support vector machine with linear, multilayer perceptron, radial basis, and polynomial kernel function. The algorithm is validated on 322 sample mammograms of mammographic image analysis society (MIAS) and 500 mammograms from digital database for screening mammography (DDSM) datasets. Proficiency of the algorithm is quantified by using sensitivity, specificity, and accuracy. The highest sensitivity, specificity, and accuracy of 93.96%, 95.01%, and 94.48%, respectively, are obtained on MIAS dataset using DRLBP feature with RBF kernel function. Whereas, the highest 92.31% sensitivity, 98.45% specificity, and 96.21% accuracy are achieved on DDSM dataset using DRLBP feature with RBF kernel function.
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Affiliation(s)
- Kanchan L Kashyap
- Computer Science & Engineering, Indian Institute of Information Technology, Design & Manufacturing Jabalpur, Jabalpur, India
| | - Manish K Bajpai
- Computer Science & Engineering, Indian Institute of Information Technology, Design & Manufacturing Jabalpur, Jabalpur, India
| | - Pritee Khanna
- Computer Science & Engineering, Indian Institute of Information Technology, Design & Manufacturing Jabalpur, Jabalpur, India
| | - George Giakos
- Department of Electrical and Computer Engineering, Manhattan College Riverdale, New York City, NY, USA
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Faguy K. Infectious and Inflammatory Breast Disease. Radiol Technol 2018; 89:279M-295M. [PMID: 29298955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Breast inflammation can signal an array of breast conditions, from difficulties with breastfeeding to a rare and aggressive type of breast cancer. In some cases, these diseases resemble each other clinically and on imaging examinations. This article explains the inflammatory process and discusses a variety of localized benign inflammatory breast diseases, including lactational and nonlactational mastitis, ductal ectasia, idiopathic granulomatous mastitis, fat necrosis, and diabetic mastopathy. Inflammatory breast cancer also is presented, with an emphasis on its signs and symptoms, diagnosis, staging, multimodality treatment, and prognosis.
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Abstract
Breast masses and nipple discharge are common symptoms that lead women to seek medical care. Many of the findings on subsequent examination are benign. When evaluating a patient who presents with breast masses or nipple discharge, it is useful to take a holistic approach to evaluating the patient, including a detailed history, structural and directed physical examination, and, if indicated, laboratory studies, diagnostic imaging, and biopsy. The goal of this review is to assist physicians in understanding the evaluation, diagnosis, and management of benign breast conditions.
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Shelton SE, Lindsey BD, Dayton PA, Lee YZ. First-in-Human Study of Acoustic Angiography in the Breast and Peripheral Vasculature. Ultrasound Med Biol 2017; 43:2939-2946. [PMID: 28982628 PMCID: PMC6267932 DOI: 10.1016/j.ultrasmedbio.2017.08.1881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 08/20/2017] [Accepted: 08/21/2017] [Indexed: 05/07/2023]
Abstract
Screening with mammography has been found to increase breast cancer survival rates by about 20%. However, the current system in which mammography is used to direct patients toward biopsy or surgical excision also results in relatively high rates of unnecessary biopsy, as 66.8% of biopsies are benign. A non-ionizing radiation imaging approach with increased specificity might reduce the rate of unnecessary biopsies. Quantifying the vascular characteristics within and surrounding lesions represents one potential target for assessing likelihood of malignancy via imaging. In this clinical note, we describe the translation of a contrast-enhanced ultrasound technique, acoustic angiography, to human imaging. We illustrate the feasibility of this technique with initial studies in imaging the hand, wrist and breast using Definity microbubble contrast agent and a mechanically steered prototype dual-frequency transducer in healthy volunteers. Finally, this approach was used to image pre-biopsy Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions <2 cm in depth in 11 patients. Results indicate that sensitivity and spatial resolution are sufficient to image vessels as small as 0.2 mm in diameter at depths of ~15 mm in the human breast. Challenges observed include motion artifacts, as well as limited depth of field and sensitivity, which could be improved by correction algorithms and improved transducer technologies.
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Affiliation(s)
- Sarah E Shelton
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Brooks D Lindsey
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA; Biomedical Research Imaging Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
| | - Yueh Z Lee
- Biomedical Research Imaging Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA; Department of Radiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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Wang Y, Nasief HG, Kohn S, Milkowski A, Clary T, Barnes S, Barbone PE, Hall TJ. Three-dimensional Ultrasound Elasticity Imaging on an Automated Breast Volume Scanning System. Ultrason Imaging 2017; 39:369-392. [PMID: 28585511 PMCID: PMC5643218 DOI: 10.1177/0161734617712238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Ultrasound elasticity imaging has demonstrated utility in breast imaging, but it is typically performed with handheld transducers and two-dimensional imaging. Two-dimensional (2D) elastography images tissue stiffness of only a plane and hence suffers from errors due to out-of-plane motion, whereas three-dimensional (3D) data acquisition and motion tracking can be used to track out-of-plane motion that is lost in 2D elastography systems. A commercially available automated breast volume scanning system that acquires 3D ultrasound data with precisely controlled elevational movement of the 1D array ultrasound transducer was employed in this study. A hybrid guided 3D motion-tracking algorithm was developed that first estimated the displacements in one plane using a modified quality-guided search method, and then performed an elevational guided-search for displacement estimation in adjacent planes. To assess the performance of the method, 3D radiofrequency echo data were acquired with this system from a phantom and from an in vivo human breast. For both experiments, the axial displacement fields were smooth and high cross-correlation coefficients were obtained in most of the tracking region. The motion-tracking performance of the new method was compared with a correlation-based exhaustive-search method. For all motion-tracking volume pairs, the average motion-compensated cross-correlation values obtained by the guided-search motion-tracking method were equivalent to those by the exhaustive-search method, and the computation time was about a factor of 10 lesser. Therefore, the proposed 3D ultrasound elasticity imaging method was a more efficient approach to produce a high quality of 3D ultrasound strain image.
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Affiliation(s)
- Yuqi Wang
- Department of Medical Physics, University of Wisconsin, Madison, WI 53705, USA
| | - Haidy G Nasief
- Department of Medical Physics, University of Wisconsin, Madison, WI 53705, USA
| | - Sarah Kohn
- Department of Medical Physics, University of Wisconsin, Madison, WI 53705, USA
| | - Andy Milkowski
- Siemens Healthcare USA, Ultrasound Division, Issaquah, WA 98029, USA
| | - Tom Clary
- The Inception Group, LLC, Sammamish, WA 98075, USA
| | - Stephen Barnes
- Siemens Healthcare USA, Ultrasound Division, Issaquah, WA 98029, USA
| | - Paul E Barbone
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
| | - Timothy J Hall
- Department of Medical Physics, University of Wisconsin, Madison, WI 53705, USA
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Abstract
BACKGROUND This study aimed to establish normative breast volume data for women of varying ages, body masses and breast sizes, and to determine the effect of age and body mass index (BMI) on breast volume. METHODS The breast volume of 356 women (age range: 18.1-83.7 years; BMI range: 18.4-54.5 kg/m²) was measured using three-dimensional scanning in a prone position. RESULTS Breast volumes ranged from 48 to 3100 mL. Although breast volume was not significantly affected by age, it was significantly affected by BMI, with the breast volume of overweight and obese women being two-to-three times greater than women with normal BMI's. CONCLUSION It is recommended that bra cups must be designed to support the wide range and increasing magnitude of breast volumes exhibited by women. Practitioner summary: This original research provides evidence for bra designers and manufacturers on the range of breast volumes of women and the significant effect of BMI on breast volume. Bra cups need to be designed to support the wide range and increasing magnitude of breast volumes exhibited by women.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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Butner JD, Cristini V. Development of a three dimensional, lattice-free multiscale model of the mammary terminal end bud. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:6134-6137. [PMID: 28269652 DOI: 10.1109/embc.2016.7592128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The terminal end bud (TEB) is a bulbous structure composed of highly proliferative cells that is responsible for mammary gland development during the pubertal stage. This is a highly organized process, involving cellular differentiation hierarchies regulated by endocrine and paracrine signaling. Here, we present development of a lattice-free, three dimensional multiscale agent based model of the TEB to study the effects of cellular phenotypic hierarchies, endocrine and paracrine signaling, and proliferation demographics on pubertal mammary gland development. Cells in the TEB experience complex physical interaction during the active growth involved in pubertal ductal elongation, which we represent mathematically based on the physical forces involved in cell-cell and cell-microenvironment interactions. We observe that maximum ductal elongation rates are achievable due to each progenitive phenotype cell only undergoing a couple proliferation cycles before losing the progenitive capability, and that molecular signaling is necessary to restrict ductal elongation to biologically relevant rates. Cellular proliferation and growth is sufficient to achieve these elongation rates in the absence of other cellular behaviors such as migration or conformational changes. This model serves as a valuable tool to gain insights into the cell population dynamics of mammary gland development, and can serve as a foundation to study the early stages of breast cancer development based on endocrine-mediated phenotypic population shifts.
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Montemurro P, Agko M, Quattrini Li A, Avvedimento S, Hedén P. Implementation of an Integrated Biodimensional Method of Breast Augmentation with Anatomic, Highly Cohesive Silicone Gel Implants: Short-Term Results With the First 620 Consecutive Cases. Aesthet Surg J 2017; 37:782-792. [PMID: 28333220 DOI: 10.1093/asj/sjx024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The previously described Akademikliniken (AK) method is a comprehensive approach to breast augmentation with form stable implants that has been shown to afford favorable outcomes when applied by experienced surgeons. OBJECTIVES To evaluate outcomes of a surgeon newly adopting this method at the beginning of his career. METHODS A retrospective review of patients undergoing dual plane subpectoral augmentation with Style 410 implants between April 2009 and December 2014 was undertaken. The review was performed one year after the last operation. The first author (P.M.) performed all operations. Complications and reoperation rates were analyzed and correlated with patient and implant characteristics using the chi-square or Fisher's exact test, as appropriate. RESULTS A total of 620 consecutive patients met the inclusion criteria with a mean follow up of 8 months (range, 1 week-60 months). Complications occurred in 14.8% of the patients: request for larger size (3.3%), rotation (3%), and Baker III/IV capsular contracture (2.2%) were the most common ones. Low implant projection was a statistically significant risk factor (P < 0.05) for the most common complication - request for a larger size. The overall reoperation rate was 8.7%. The most common indication for reoperation was request for larger size (2.2%) followed by rotation (2.2%) and capsular contracture (2%). CONCLUSIONS Breast augmentation with form stable anatomical implants requires a considerably different process. By implementing a systematic approach such as the AK method, novices in this terrain can expect to achieve reasonable outcomes. LEVEL OF EVIDENCE 4.
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Wengert GJ, Pinker K, Helbich TH, Vogl WD, Spijker SM, Bickel H, Polanec SH, Baltzer PA. Accuracy of fully automated, quantitative, volumetric measurement of the amount of fibroglandular breast tissue using MRI: correlation with anthropomorphic breast phantoms. NMR Biomed 2017; 30:e3705. [PMID: 28295818 DOI: 10.1002/nbm.3705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 01/09/2017] [Accepted: 01/09/2017] [Indexed: 06/06/2023]
Abstract
To demonstrate the accuracy of fully automated, quantitative, volumetric measurement of the amount of fibroglandular breast tissue (FGT), using MRI, and to investigate the impact of different MRI sequences using anthropomorphic breast phantoms as the ground truth. In this study, 10 anthropomorphic breast phantoms that consisted of different known fractions of adipose and protein tissue, which closely resembled normal breast parenchyma, were developed. Anthropomorphic breast phantoms were imaged with a 1.5 T unit (Siemens, Avantofit) using an 18-channel breast coil. The sequence protocol consisted of an isotropic Dixon sequence (Di), an anisotropic Dixon sequence (Da), and T1 3D FLASH sequences with and without fat saturation (T1). Fully automated, quantitative, volumetric measurement of FGT for all anthropomorphic phantoms and sequences was performed and correlated with the amounts of fatty and protein components in the phantoms as the ground truth. Fully automated, quantitative, volumetric measurements of FGT with MRI for all sequences ranged from 5.86 to 61.05% (mean 33.36%). The isotropic Dixon sequence yielded the highest accuracy (median 0.51%-0.78%) and precision (median range 0.19%) compared with anisotropic Dixon (median 1.92%-2.09%; median range 0.55%) and T1 -weighted sequences (median 2.54%-2.46%; median range 0.82%). All sequences yielded good correlation with the FGT content of the anthropomorphic phantoms. The best correlation of FGT measurements was identified for Dixon sequences (Di, R2 = 0.999; Da, R2 = 0.998) compared with conventional T1 -weighted sequences (R2 = 0.971). MRI yields accurate, fully automated, quantitative, volumetric measurements of FGT, an increasingly important and sensitive imaging biomarker for breast cancer risk. Compared with conventional T1 sequences, Dixon-type sequences show the highest correlation and reproducibility for automated, quantitative, volumetric FGT measurements using anthropomorphic breast phantoms as the ground truth.
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Affiliation(s)
- Georg J Wengert
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Katja Pinker
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
- Memorial Sloan-Kettering Cancer Center, Dept. of Radiology, New York, USA
| | - Thomas H Helbich
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Wolf-Dieter Vogl
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Sylvia M Spijker
- University of Vienna, Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Science, Vienna, Austria
| | - Hubert Bickel
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Stephan H Polanec
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Pascal A Baltzer
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
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Lee JH, Yeo CH, Kim T, Chung KJ, Lee SJ, Kang SH, Choi JE. Conversion from weight to volume of mastectomy specimen: Convenient equations. J Plast Reconstr Aesthet Surg 2017; 70:792-794. [PMID: 28408284 DOI: 10.1016/j.bjps.2017.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/12/2017] [Accepted: 02/17/2017] [Indexed: 11/17/2022]
Abstract
Accurate restoration of the volume lost during breast removal is the key to achieve beautiful, symmetric breasts. This study aimed to devise a simpler and more accurate method for measuring breast tissue volume by studying the relationship between weight and volume of the excised tissue according to density. Mammograms of 276 women who were advised to undergo breast reconstruction surgery were divided into 4 different groups according to tissue densities. The correlation between weight and volume was studied for each group. The regression equations are as follows: 1st group: V = 1.218 × W+7.45 (V: volume, W: weight). 2nd group: V = 1.036 × W + 10.36. 3rd group: V = 0.969 × W-7.47. 4th group: V = 0.871 × W-14.13. These equations will be useful for reconstruction of natural-appearing and symmetric breasts following mastectomy.
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Affiliation(s)
- Jun Ho Lee
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
| | - Chi-Ho Yeo
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Taegon Kim
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Kyu-Jin Chung
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Soo Jung Lee
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Su Hwan Kang
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jung Eun Choi
- Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Elangovan P, Mackenzie A, Dance DR, Young KC, Cooke V, Wilkinson L, Given-Wilson RM, Wallis MG, Wells K. Design and validation of realistic breast models for use in multiple alternative forced choice virtual clinical trials. Phys Med Biol 2017; 62:2778-2794. [PMID: 28291738 DOI: 10.1088/1361-6560/aa622c] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A novel method has been developed for generating quasi-realistic voxel phantoms which simulate the compressed breast in mammography and digital breast tomosynthesis (DBT). The models are suitable for use in virtual clinical trials requiring realistic anatomy which use the multiple alternative forced choice (AFC) paradigm and patches from the complete breast image. The breast models are produced by extracting features of breast tissue components from DBT clinical images including skin, adipose and fibro-glandular tissue, blood vessels and Cooper's ligaments. A range of different breast models can then be generated by combining these components. Visual realism was validated using a receiver operating characteristic (ROC) study of patches from simulated images calculated using the breast models and from real patient images. Quantitative analysis was undertaken using fractal dimension and power spectrum analysis. The average areas under the ROC curves for 2D and DBT images were 0.51 ± 0.06 and 0.54 ± 0.09 demonstrating that simulated and real images were statistically indistinguishable by expert breast readers (7 observers); errors represented as one standard error of the mean. The average fractal dimensions (2D, DBT) for real and simulated images were (2.72 ± 0.01, 2.75 ± 0.01) and (2.77 ± 0.03, 2.82 ± 0.04) respectively; errors represented as one standard error of the mean. Excellent agreement was found between power spectrum curves of real and simulated images, with average β values (2D, DBT) of (3.10 ± 0.17, 3.21 ± 0.11) and (3.01 ± 0.32, 3.19 ± 0.07) respectively; errors represented as one standard error of the mean. These results demonstrate that radiological images of these breast models realistically represent the complexity of real breast structures and can be used to simulate patches from mammograms and DBT images that are indistinguishable from patches from the corresponding real breast images. The method can generate about 500 radiological patches (~30 mm × 30 mm) per day for AFC experiments on a single workstation. This is the first study to quantitatively validate the realism of simulated radiological breast images using direct blinded comparison with real data via the ROC paradigm with expert breast readers.
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Affiliation(s)
- Premkumar Elangovan
- Medical Imaging Group, Centre for Vision, Speech, and Signal Processing, University of Surrey, Guildford, GU2 7XH, United Kingdom. National Coordination Centre for the Physics of Mammography (NCCPM), Royal Surrey County Hospital, Guildford, GU2 7XX, United Kingdom
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Abstract
Nowadays, the optimization in digital mammography is one of the most important challenges in diagnostic radiology. The new digital technology has introduced additional elements to be considered in this scenario. A major goal of mammography is related to the detection of structures on the order of micrometers (μm) and the need to distinguish the different types of tissues, with very close density values. The diagnosis in mammography faces the difficulty that the breast tissues and pathological findings have very close linear attenuation coefficients within the energy range used in mammography. The aim of this study was to develop a methodology for optimizing exposure parameters of digital mammography based on a new Figure of Merit: FOM ≡ (IQFinv)2/AGD, considering the image quality and dose. The study was conducted using the digital mammography Senographe DS/GE, and CDMAM and TORMAM phantoms. The characterization of clinical practice, carried out in the mammography system under study, was performed considering different breast thicknesses, the technical parameters of exposure, and processing options of images used by the equipment's automatic exposure system. The results showed a difference between the values of the optimized parameters and those ones chosen by the automatic system of the mammography unit, specifically for small breast. The optimized exposure parameters showed better results than those obtained by the automatic system of the mammography, for the image quality parameters and its impact on detection of breast structures when analyzed by radiologists.
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Affiliation(s)
- Agnes M F Fausto
- Departamento de Ciências Exatas e Tecnológicas-DCET/CPqCTR, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brazil, CEP 45662-900.
| | - M C Lopes
- IPOCFG, E.P.E., Serviço de Física Médica, Coimbra, Portugal
- Departamento de Física, I3N, Universidade de Aveiro, Aveiro, Portugal
| | - M C de Sousa
- IPOCFG, E.P.E., Serviço de Física Médica, Coimbra, Portugal
| | - Tânia A C Furquim
- Instituto de Física, Laboratório de Dosimetria, Universidade de São Paulo-USP, São Paulo, Brazil
| | - Anderson W Mol
- Departamento de Ciências Exatas e Tecnológicas-DCET/CPqCTR, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brazil, CEP 45662-900
| | - Fermin G Velasco
- Departamento de Ciências Exatas e Tecnológicas-DCET/CPqCTR, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brazil, CEP 45662-900
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Wamalwa AO, Stasch T, Nangole FW, Khainga SO. Surgical anatomy of reduction mammaplasty: a historical perspective and current concepts. S AFR J SURG 2017; 55:22-28. [PMID: 28876554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Reduction mammaplasty is the volumetric reduction in the bulk of the breast. Techniques have evolved from primarily reducing the breast bulk to reducing with emphasis on functional and aesthetic outcome. The deeper understanding of the surgical anatomy of the breast has guided this development. While Paulus Aegina (sixth century AD), Dieffenbach (1848) and Gaillard-Thomas (1882) set the pace in glandular reduction; Pousson (1897) and Dehner (1908) focused on breast ptosis. It took quite some time before the enigma of the vascularization to the nipple areolar complex could be solved. Progress over a decade saw Thorek's (1922) free nipple grafting replaced by the periareolar de-epithelialization introduced by Schwarzmann (1930); which subsequently gave way to the Gillies and McIndoe (1939) skin-gland undermining technique. The era of breast remodeling while preserving the nipple areolar complex was soon ushered forward. This was driven by Arie (1957), Strombeck (1960) and Pitanguy (1961). The preservation of the subdermal plexus became crucial whilst retaining sensory supply to the breast as the pectoral fascia was spared. Skoog's (1963) nipple transposition without skin-gland undermining formed the basis for modern day reduction mammaplasty. Aesthetics was in mind throughout this period as different skin incisions were developed and advanced following Dieffenbach's small submammary incision in 1848. Surgical landmarks that ensured reproducible aesthetic outcomes were described by Penn (1955) and Wise (1956). Liposuction-assisted reduction was introduced by Teimourian in 1985 and is best utilised in patients with predominantly fatty breast tissue.
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Affiliation(s)
- A O Wamalwa
- 1Plastic Surgery Registrar, School of Medicine, University of Nairobi
| | - T Stasch
- Consultant Plastic, Reconstructive, Aesthetic and Hand Surgeon, Valentis Clinic, Nairobi, Kenya
| | | | - S O Khainga
- Consultant Plastic Surgeon and Associate Professor; Department of Surgery (Plastic), University of Nairobi
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Coltman CE, McGhee DE, Steele JR. Three-dimensional scanning in women with large, ptotic breasts: implications for bra cup sizing and design. Ergonomics 2017; 60:439-445. [PMID: 27066812 DOI: 10.1080/00140139.2016.1176258] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 04/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND This study aimed to compare breast volume calculated from scanning large, ptotic breasts of women while they were standing upright relative to when lying prone in order to identify the error associated with breast volume calculations. METHODS Breast volume and visualisation were compared in 50 women with large breasts (D+ bra cup size) while they were scanned in three different positions. RESULTS Full visualisation of both breasts occurred in 100% of participants in the prone position and only 5% of participants in either standing position. Breast volume was significantly greater (p < 0.01) in the prone position, with the percentage of underestimation in the standing position increasing as breast volume increased. CONCLUSION Breast volume measured by three-dimensional scanning in the standing position will be underestimated by 7-10% in large, ptotic breasts. Consideration of these inaccuracies in breast volume relative to breast size can assist bra manufacturers when designing bras. Practitioner Summary: Errors have been reported when measuring the breast volume of women with large, ptotic breasts using three-dimensional scanning. This original research provides evidence for bra designers and manufacturers on the degree of error associated with this measurement. These errors should be accounted for in future bra designs.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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48
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van der Kemp WJ, Stehouwer BL, Boer VO, Luijten PR, Klomp DW, Wijnen JP. Proton and phosphorus magnetic resonance spectroscopy of the healthy human breast at 7 T. NMR Biomed 2017; 30:e3684. [PMID: 28032377 PMCID: PMC5248643 DOI: 10.1002/nbm.3684] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 05/18/2023]
Abstract
In vivo water- and fat-suppressed 1 H magnetic resonance spectroscopy (MRS) and 31 P magnetic resonance adiabatic multi-echo spectroscopic imaging were performed at 7 T in duplicate in healthy fibroglandular breast tissue of a group of eight volunteers. The transverse relaxation times of 31 P metabolites were determined, and the reproducibility of 1 H and 31 P MRS was investigated. The transverse relaxation times for phosphoethanolamine (PE) and phosphocholine (PC) were fitted bi-exponentially, with an added short T2 component of 20 ms for adenosine monophosphate, resulting in values of 199 ± 8 and 239 ± 14 ms, respectively. The transverse relaxation time for glycerophosphocholine (GPC) was also fitted bi-exponentially, with an added short T2 component of 20 ms for glycerophosphatidylethanolamine, which resonates at a similar frequency, resulting in a value of 177 ± 6 ms. Transverse relaxation times for inorganic phosphate, γ-ATP and glycerophosphatidylcholine mobile phospholipid were fitted mono-exponentially, resulting in values of 180 ± 4, 19 ± 3 and 20 ± 4 ms, respectively. Coefficients of variation for the duplicate determinations of 1 H total choline (tChol) and the 31 P metabolites were calculated for the group of volunteers. The reproducibility of inorganic phosphate, the sum of phosphomonoesters and the sum of phosphodiesters with 31 P MRS imaging was superior to the reproducibility of 1 H MRS for tChol. 1 H and 31 P data were combined to calculate estimates of the absolute concentrations of PC, GPC and PE in healthy fibroglandular tissue, resulting in upper limits of 0.1, 0.1 and 0.2 mmol/kg of tissue, respectively.
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Affiliation(s)
| | | | - Vincent O. Boer
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Peter R. Luijten
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Dennis W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Jannie P. Wijnen
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
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49
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Lopes D, Clain S, Pereira RMS, Machado GJ, Smirnov G, Vasilevskiy I. Numerical simulation of breast reduction with a new knitting condition. Int J Numer Method Biomed Eng 2017; 33:e02796. [PMID: 27113034 DOI: 10.1002/cnm.2796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 03/16/2016] [Accepted: 04/07/2016] [Indexed: 06/05/2023]
Abstract
Breast reduction is one of the most common procedures in breast surgery. The aim of this work is to develop a computational model allowing one to forecast the final breast geometry according to the incision marking parameters. This model can be used in surgery simulators that provide preoperative planning and training, allowing the study of the origin of the errors in breast reduction. From the mathematical point of view, this is a problem of calculus of variations with unusual boundary conditions, known as knitting conditions. The breast tissue is considered as a hyperelastic material, discretized with three-dimensional finite elements for the body, whereas the skin is modelled with two-dimensional finite elements on the curved surface. Although the model is of low precision, we show that it is sufficient for a satisfactory prediction of breast reduction surgery results, allowing an analysis of errors frequently performed during the surgery and giving an understanding of how to avoid or correct them. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Diogo Lopes
- Department of Informatics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
| | - Stéphane Clain
- Centre of Mathematics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
| | - Rui M S Pereira
- Centre of Mathematics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
- Centre of Physics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
| | - Gaspar J Machado
- Centre of Mathematics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
| | - Georgi Smirnov
- Centre of Physics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
| | - Igor Vasilevskiy
- Centre of Physics, University of Minho, Campus of Gualtar, Braga, 4710-057, Portugal
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50
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Kim J, Santini T, Bae KT, Krishnamurthy N, Zhao Y, Zhao T, Ibrahim TS. Development of a 7 T RF coil system for breast imaging. NMR Biomed 2017; 30:10.1002/nbm.3664. [PMID: 27859861 PMCID: PMC5943082 DOI: 10.1002/nbm.3664] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 09/23/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Abstract
In ultrahigh-field MRI, such as 7 T, the signal-to-noise ratio (SNR) increases while transmit (Tx) field (B1+ ) can be degraded due to inhomogeneity and elevated specific absorption rate (SAR). By applying new array coil concepts to both Tx and receive (Rx) coils, the B1+ homogeneity and SNR can be improved. In this study, we developed and tested in vivo a new RF coil system for 7 T breast MRI. An RF coil system composed of an eight-channel Tx-only array based on a tic-tac-toe design (can be combined to operate in single-Tx mode) in conjunction with an eight-channel Rx-only insert was developed. Characterizations of the B1+ field and associated SAR generated by the developed RF coil system were numerically calculated and empirically measured using an anatomically detailed breast model, phantom and human breasts. In vivo comparisons between 3 T (using standard commercial solutions) and 7 T (using the newly developed coil system) breast imaging were made. At 7 T, about 20% B1+ inhomogeneity (standard deviation over the mean) was measured within the breast tissue for both the RF simulations and 7 T experiments. The addition of the Rx-only array enhances the SNR by a factor of about three. High-quality MR images of human breast were acquired in vivo at 7 T. For the in vivo comparisons between 3 T and 7 T, an approximately fourfold increase of SNR was measured with 7 T imaging. The B1+ field distributions in the breast model, phantom and in vivo were in reasonable agreement. High-quality 7 T in vivo breast MRI was successfully acquired at 0.6 mm isotropic resolution using the newly developed RF coil system.
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Affiliation(s)
- Junghwan Kim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kyongtae Ty Bae
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Yujuan Zhao
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiejun Zhao
- MR Research Support, Siemens Healthcare, Pittsburgh, PA, USA
| | - Tamer S. Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
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