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Archive for the ‘breast cancer’ Category
Are Breast Implants Causing Lymphoma?
If you have breast implants, whether silicone or saline, you may soon hear the buzz about a possible link between breast implants and anaplastic large cell lymphoma (ALCL), a very rare type of cancer. The FDA is aware of approximately 60 cases of ALCL in women with breast implants worldwide (Up to 10 million women worldwide have breast implants)
ALCL is not a breast cancer, instead it involves cells of the immune system found in the fluid surrounding breast implants or in the scar tissue (capsule) surrounding the breast implant. 
The FDA is NOT recommending asymptomatic women with breast implants to have them removed. If however, a woman with breast implants has swelling or pain around the implant, they should see their plastic surgeon for evaluation. Women should continue to monitor their implants and obtain regular breast screening evaluations.
The FDA and the American Society of Plastic Surgeons are establishing a registry of ALCL patients who have breast implants to better understand the association of breast implants and lymphoma.
For more information concerning breast implants and lymphoma, visit http://alturl.com/3a7n8
Mastectomy Evolution
“My friends can’t tell I’ve had a mastectomy!!” says a recent breast cancer survivor.
Look how far we’ve come in the evolution of mastectomies.
In the late 1800s, breast cancer was treated by not only removing the breast, but also removing the underlying muscles and most of the axillary contents, leaving behind an extremely disfiguring defect. Over the years, we have evolved to sparing many of the anatomic breast landmarks… and there’s a promising new trend: removing the entire breast, but keeping all the skin, areola and the nipple! In fact, when performing this type of mastectomy followed by implant reconstruction, the resulting breast looks very much like a cosmetic breast augmentation, with only a small inframammary scar! UNBELIEVEABLE!!! This type of mastectomy is termed nipple sparing, although proper nomenclature should really be nipple-areola-complex preserving mastectomy since the areola is also spared, not to be confused with skin sparing mastectomies which takes the entire nipple and areola.
So who qualifies for this type of mastectomy?? The answer is not simple and is highly variable from surgeon to surgeon. We unfortunately do not have a lot of long term data, but factors that are currently being considered include the tumor size, its location, its distance from the nipple-areola complex and whether its HER2 positive.
The improved cosmesis with this type of mastectomy must not compromise a safe oncologic outcome. A biopsy at the base of the nipple is taken at the time of mastectomy and sent for both frozen and permanent section. It has a good (80%) sensitivity and 96% negative predictive value, such that if the biopsy comes back negative, you can be reassured that your nipple is free of cancer involvement. Long term studies on recurrence rates are lacking, but short term follow up studies show no increased risk of local recurrence.
The nipple-areola-complex preserving mastectomy may be a great choice for risk reduction, especially in gene (BRCA) positive patients. We look forward to long term studies and the continued improvements in quality of life for breast cancer patients and those women at high risk. Check out our website for before/after pictures of implant reconstruction after nipple-areola-complex sparing mastectomies. www.maxwellaesthetics.com
Dr. Kristina O’Shaughnessy, M.D, Plastic and Reconstructive Surgeon, Maxwell Aesthetics, Nashville, TN
