Successful treatment of soft-tissue sarcomas is highly dependent on total tumour resection coupled with adjuvant radiation therapy to achieve local control and decrease recurrence. Reconstruction of soft-tissue defects after resection aims to cover vital structures, while providing enough stable tissue to withstand adjuvant brachytherapy treatment. In the present study, pedicled myocutaneous flaps were used as a vital adjunct in the treatment of soft-tissue sarcoma, and our experience with 2 such patients is described. The flaps served to reconstruct large three-dimensional defects while providing stable coverage over brachytherapy hardware to allow for delivery of radiation in the immediate postoperative period. Pedicled locoregional myocutaneous flaps provide a safe, easy, and reliable reconstructive technique in the treatment of soft-tissue sarcoma.

Purpose:The overriding goal of post-mastectomy breast reconstruction is to restore body image and satisfy patient expectations. Measuring individual patient expectations would allow surgeons to identify patients who have unrealistic expectations, and subsequently to address their issues preoperatively through focused pre-surgical education. The purpose of our study is to develop a questionnaire to measure individual patient expectations for breast reconstruction.Methods: Interviews were conducted with 44 women undergoing breast reconstruction. The interviews were recorded, transcribed, and analyzed thematically. Conceptual domains were used to organize statements into a preliminary version of the questionnaire. The preliminary version was then pilot tested with 30 women undergoing breast reconstruction, and was reviewed by an expert panel, to create the field test version. The field test version was then administered to 150 women prior to undergoing breast reconstruction.Results: Patient interviews revealed that expectations for breast reconstruction fall into four main domains: Breast Appearance and Outcome, Physical Well-being, Psychosocial Well-being, and Process of Care. These domains formed the organizational structure for the questionnaire. Pilot testing resulted in minor wording changes, clarified ambiguities, and recognized missing content. Using field test data, item reduction was performed to create the final scales.Conclusions: Patient expectations for the results of breast reconstruction are complex, and encompass not only breast appearance, but physical well-being, psychological wellbeing, and process of care. This study is essential in the quest to improve patient satisfaction with the results of breast reconstruction. A formalized appreciation of expectations will initiate further research into the link between expectations, satisfaction and quality of life for breast cancer survivors. The questionnaire will provide surgeons and patients with a valid tool to guide discussions about expectations.Background: Current options for immediate breast reconstruction following partial mastectomy or lumpectomy include latissimus dorsi myocutaneous flap and simple closure among others. Latissimus dorsi flap reconstruction is currently the most widely accepted option, however it can be associated with significant complications. Acellular dermal matrix has been used to improve cosmetic results of various flap reconstructions. One type of cadaveric dermal matrix is AlloDerm (Lifecell, NJ). To date, no studies have evaluated the use of AlloDerm as filler for breast defects using patient satisfaction surveys for qualitative outcomes. Our goal is to determine whether the use of acellular dermal matrix in lumpectomy or partial breast reconstruction produces satisfactory results compared to current reconstructive options. We also aim to establish a quantitative and qualitative scale for evaluation. Finally, we will evaluate whether post reconstruction radiation affects outcomes when using AlloDerm. Methods:Retrospecti...

Background: The appropriate utilization of Breast MRI in breast cancer care remains controversial. As part of a quality improvement initiative for breast cancer screening and treatment, we sent out a survey to physicians who treat breast cancer patients. All respondents are participants in the ATHENA initiative, a program which unites physicians, researchers, and patients at the five University of California medical centers. Objective: To use the ATHENA infrastructure to perform a qualitative analysis of variations in breast cancer care. Methods: Surveys were sent to 50 physicians in the ATHENA network whose practices are focused on breast cancer. Respondents were presented with clinical scenarios, and asked whether they would recommend MRI always/usually or sometimes/never. Differences were compared by Chi square. Results: 39 physicians completed the survey (78% response rate). Of these physicians 29% were surgeons, 26% radiation oncologists and 45% medical oncologists. Athena physicians were more likely to order MRI for high risk screening of mutation carriers than not (85% yes vs. 15% no, p < 0.003) but not based on breast density alone or previous history of breast cancer. They were also more likely to order it for monitoring neo-adjuvant chemotherapy (70% yes vs. 30% no, p < 0.03). Although the majority answered that they would order a Breast MRI for new breast cancer the difference between responses was not significantly different (56% yes vs. 44%, p = 0.07). Conclusion: Athena physicians follow established published guidelines which demonstrate a benefit for Breast MRI screening for BRCA mutation carriers but not based on density or previous history of breast cancer. The Athena network allows a forum for new practice guidelines to be implemented as data becomes available to improve patient outcomes and utilize the best evidence for patient care, where both the patterns of MRI use as well as the outcomes of practice patterns will be evaluated prospectively. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-01-13.

Behaviour of materials under high pressure. P. SaviC and R. Kaganin (Serb. Acad. Sci. Monogr. nut. Sci. Math., 1964, 378, No. 34, 64 pp.).-On the basis of models of spherical celestial bodies at O' K, the influence of temp. on the formation of a system of particles under high pressure is discussed, showing that the temp., as a consequence of accumulated energy, is k 7.35 x loB OK. From the relationship between temp. and the mass, radius, moment of inertia and d of a complete spherica1 body of given order, the max. possible mass ( 2 . 6~ loa9 9.) and radius ( 1 . 8 8~ l O l 8 cm.), of a spherical body is determined. From these general results the radius, mass and moment of inertia, the no. of layers, d, temp. and pressure in each layer, height of the atm. and the chemical composition of the sun (H2 63, He 340/) are computed. (In English.) Industrial process control. VIII. Vapour-pressure and gas filled instruments and electric-signal thermometers. IX. Measuring instruments. 0. G. Pamely-Evans (Mech. World, 1964, 144, 462-463; 522-529).-VIII. Peculiarities of v.p. thermometers are discussed with reference to their limitations; including all solid devices such as rod thermostats, gas-filled systems and simple thermocouple circuits.IX. Electrical methods of measuring temp. and instruments for measuring fluid flow are considered, including dynamic and potential head instruments and those depending upon differential pressure or J. M. JACOBS. deflexions caused by restrictions. c. v.Atomic Energy, etc. Plastics in nuclear establishments. H. Wells (Chem. Engr, 1964, CE 271-CE 276).-Basic properties of plastics relevant to their use in nuclear establishments, namely, their resistance to contamination by radioactive substances and to nuclear radiation, and their neutron absorption or attenuation capacities, are discussed, together with the effects of radiation on the chemical structure of plastics and applications of plastics in radiation environments, particularly for the vac. vessels in the 'Nimrod' proton synchroton and as 'rabbit' containers for studying the effects of radiation on materials placed in reactors.Dosimetry of mixed radiations, involving more than one energy or type of radiation, with the R.P.S./A.E.R.E. film dosimeter. B. E. Jones and T. 0. Marshall (J. photogr. Sci., 1964, 12, 319--327).-Use of the R.P.S./A.E.R.E. film holder for the evaluation of radiation doses, e.g. X-, p-and y-radiations, and the interpretation of the results are described. Above but not below G. H. EMMOTT.squares analysis is applied to calculate equilibrium constants and their variation with medium in the solvent extraction equilibria based on a model involving a Debye-Huckel term for low and a linear term for high ionic concn. corrections in the aq. phase. A relatively simple model may be used to describe solvent-extraction equilibria over wide range of concn. of material being extracted, of salting agent, and of extractant; more elaborate systems introduce mathematical difficulties. The analysis detailed specifically the...