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Double Mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operation as a preventive measure. Alternatively, some women can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy. The decision to perform a mastectomy is based on various factors, including breast size, the number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of t ...
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Breast
The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and secretes milk to feed infants. Subcutaneous fat covers and envelops a network of ducts that converge on the nipple, and these tissues give the breast its size and shape. At the ends of the ducts are lobules, or clusters of alveoli, where milk is produced and stored in response to hormonal signals. During pregnancy, the breast responds to a complex interaction of hormones, including estrogens, progesterone, and prolactin, that mediate the completion of its development, namely lobuloalveolar maturation, in preparation of lactation and breastfeeding. Humans are the only animals with permanent breasts. At puberty, estrogens, in conjunction with growth hormone, cause permanent breast growth in female humans. This happens only to a much lesser ...
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Cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans. Tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity, poor diet, lack of physical activity or excessive drinking of alcohol. Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants. In the developing world, 15% of cancers are due to infections such as ''Helicobacter pylori'', hepatitis B, hepatitis C, human papillomavirus infection, Epstein–Barr virus and human immunodeficiency virus (HIV). These factors act, at least partly, by changing the genes of ...
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ABIM Foundation
Choosing Wisely is a United States-based health educational campaign, led by the ABIM Foundation (American Board of Internal Medicine), about unnecessary health care. The campaign identifies over 500 tests and procedures and encourages doctors and patients to discuss, research, and possibly get second opinions, before proceeding with them. To conduct the campaign, the ABIM Foundation asks medical specialty societies to make five to ten recommendations for preventing overuse of a treatment in their field. The foundation then publicizes this information, and the medical specialty societies disseminate it to their members. The campaign has garnered both praise and criticism, and some of its ideas have spread to other countries. It does not include evaluation of its effects on costs, on discussions or on medical outcomes. Some doctors have said they lack time for the recommended discussions. History In 2002 the ABIM Foundation published ''Medical professionalism in the new millenni ...
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Choosing Wisely
Choosing Wisely is a United States-based health educational campaign, led by the ABIM Foundation (American Board of Internal Medicine), about unnecessary health care. The campaign identifies over 500 tests and procedures and encourages doctors and patients to discuss, research, and possibly get second opinions, before proceeding with them. To conduct the campaign, the ABIM Foundation asks medical specialty societies to make five to ten recommendations for preventing overuse of a treatment in their field. The foundation then publicizes this information, and the medical specialty societies disseminate it to their members. The campaign has garnered both praise and criticism, and some of its ideas have spread to other countries. It does not include evaluation of its effects on costs, on discussions or on medical outcomes. Some doctors have said they lack time for the recommended discussions. History In 2002 the ABIM Foundation published ''Medical professionalism in the new millenni ...
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Mastopexy
Mastopexy (Greek μαστός ''mastos'' "breast" + -pēxiā "affix") is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding. The breast-lift correction of a sagging bust is a surgical operation that cuts and removes excess tissues (glandular, adipose, skin), overstretched suspensory ligaments, excess skin from the skin-envelope, and transposes the nipple-areola complex higher upon the breast hemisphere. In surgical practice, mastopexy can be performed as a discrete breast-lift procedure, and as a subordinate surgery within a combined mastopexy–breast augmentation procedure. Moreover, ...
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Gross Examination
Gross processing or "grossing" is the process by which pathology specimens undergo examination with the bare eye to obtain diagnostic information, as well as cutting and tissue sampling in order to prepare material for subsequent microscopic ''examination.'' Responsibility Gross examination of surgical specimens is typically performed by a pathologist, or by a pathologists' assistant working within a pathology practice. Individuals trained in these fields are often able to gather diagnostically critical information in this stage of processing, including the stage and margin status of surgically removed tumors. Steps The initial step in any examination of a clinical specimen is confirmation of the identity of the patient and the anatomical site from which the specimen was obtained. Sufficient clinical data should be communicated by the clinical team to the pathology team in order to guide the appropriate diagnostic examination and interpretation of the specimen - if such informat ...
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Breast Prostheses
Breast prostheses are breast forms intended to look like breasts. They are often used temporarily or permanently by women after mastectomy or lumpectomy procedures, but may also be used by for aesthetic purposes. There are a number of materials and designs; although, the most common construction is gel ( silicone or water-based) in a plastic film meant to feel similar to a person's skin. Prostheses may be purchased at a surgical supply store, pharmacy, custom lingerie shop, or even through private services that come to a person's home. There are many types of ready made breast prostheses including full or standard prostheses, partial prostheses such a shell prostheses, and stick on prostheses. Customized options are also available from specialty shops, which are moulded to fit an individual's chest by taking an impression of the breast(s). The areola and nipple may be replicated as part of the breast form or as separate nipple prosthesis. Both custom made and off-the shelf breast pr ...
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Nipple Prosthesis
Nipple/Areola prostheses (prostheses is the plural of prosthesis) are made of silicone by breast prosthesis manufacturers and anaplastologists for breast cancer survivors who were treated for breast cancer with a mastectomy. Prostheses can be worn weeks after a mastectomy, breast reconstruction, or even nipple reconstruction. As an inexpensive and convenient alternative to surgery, patients may choose to wear them anytime during treatment. Patients who ultimately find nipple prostheses thought that they should be informed of them during the consultation prior to mastectomy (Janes S 2005). Fabrication Nipple prosthetics are made of silicone and are adhered to the skin. There are several different types of prostheses with different benefits and costs. * Mass-produced and “semi-custom” prostheses allow women to choose from a few colors and sizes. The majority of mass-produced prostheses are self-adhering and last three months because the materials are weaker and the adhesion be ...
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Prophylactic Mastectomy
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency. Leavell, H. R., & Clark, E. G. (1979). Preventive Medicine for the Doctor in his Community (3rd ed.). Huntington, NY: Robert E. Krieger Publishing Company. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. Each year, millions of people die of preventable deaths. A 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. Leading causes included cardiovascular disease, ...
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Subcutis
The subcutaneous tissue (), also called the hypodermis, hypoderm (), subcutis, superficial fascia, is the lowermost layer of the integumentary system in vertebrates. The types of cells found in the layer are fibroblasts, adipose cells, and macrophages. The subcutaneous tissue is derived from the mesoderm, but unlike the dermis, it is not derived from the mesoderm's dermatome region. It consists primarily of loose connective tissue, and contains larger blood vessels and nerves than those found in the dermis. It is a major site of fat storage in the body. In arthropods, a hypodermis can refer to an epidermal layer of cells that secretes the chitinous cuticle. The term also refers to a layer of cells lying immediately below the epidermis of plants. Structure * Fibrous bands anchoring the skin to the deep fascia * Collagen and elastin fibers attaching it to the dermis * Fat is absent from the eyelids, clitoris, penis, much of pinna, and scrotum * Blood vessels on route ...
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Breast Reconstruction
Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both with the goal of reconstructing a natural-looking breast. This process often also includes the rebuilding of the nipple and areola, known as nipple-areola complex (NAC) reconstruction, as one of the final stages. Generally, the aesthetic appearance is acceptable to the woman, but the reconstructed area is commonly completely numb afterwards, which results in loss of sexual function as well as the ability to perceive pain caused by burns and other injuries. Timing Breast reconstruction can be performed either immediately following the mastectomy or as a separate procedure at a later date, known as immediate reconstruction and delayed reconstruction, respectively. The decision of when breast reconstruction will take place is patient-specifi ...
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Skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have different cellular differentiation, developmental origin, structure and chemical composition. The adjective cutaneous means "of the skin" (from Latin ''cutis'' 'skin'). In mammals, the skin is an organ (anatomy), organ of the integumentary system made up of multiple layers of ectodermal tissue (biology), tissue and guards the underlying muscles, bones, ligaments, and internal organs. Skin of a different nature exists in amphibians, reptiles, and birds. Skin (including cutaneous and subcutaneous tissues) plays crucial roles in formation, structure, and function of extraskeletal apparatus such as horns of bovids (e.g., cattle) and rhinos, cervids' antlers, giraffids' ossicones, armadillos' osteoderm, and os penis/os clitoris. All mammals have som ...
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