The classically described pattern of TD pedicle (type 5) was found in 20% of cases, whereas the most commonly found pattern was type 1. This means that the pattern of TD branching is unpredictable, and a preoperative ultrasound is essential to define the existing pattern and plan the best LD flap design for each patient. In types 1 and 5, the flap can be designed using the transverse medial branch or branches. In type 2, one of the lateral transverse branches can be used. In types 3, 4, and 5, the long descending vertical branch can be used. It has a sizeable diameter (1.80.23 mm), length (12.31.64 cm), and can be located 6.50.96 cm below the inferior angle of scapula.

It can make an impact on the different stages of cancer development (Jomova and Valko, 2011). It can alter the DNA sequence in the initiation step, increase cell division/ reduce apoptosis in the promotion stage and can also promote additional changes to the DNA in the progression

Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

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1) Background: Non coding RNAs (ncRNAs) have recently been identified to play a pivotal role in many diseases including breast cancer (BC). This study aims to investigate the relative quantification of long non-coding RNA (lncRNA) H19, microRNA (miR) 675-5p, 675-3p and miR-let 7 in BC patients.2) Methods: The study was performed on three groups, group 1; 30 non-intervened BC female patients about to undergo breast surgery, group 2; 30 postoperative female BC patients about to receive adjuvant anthracycline chemotherapy and group 3; 30 apparently healthy female volunteers as the control group. Plasma samples were drawn before and after the intervention in groups 1 and 2, with a single sample drawn from group 3. The relative quantification levels were compared with healthy control subjects and were related with the clinicopathological statuses of these patients.3) Results: There was a statistically significant increase in H19, miR-675-5p, miR-675-3p and miR-let 7 in the non-intervened BC patients when compared to the control group. Surgery resulted in a significant reduction in all four ncRNAs under investigation. Chemotherapy resulted in a significant increase in the level of miR-let 7. The assay discriminated normal from BC where the area under the receiver operating characteristic curve (AUC-ROC) of miR-675-3p showed the maximal AUC-ROC of 1.000. The diagnostic sensitivity and specificity was also 100% when CA 15-3 and H19 were combined.4) Conclusion: The results indicate that the panel of ncRNAs can all potentially act as novel biomarkers whether alone or combined in the diagnosis of BC.