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BackgroundThere is a paucity of data comparing the oncologic properties of breast cancer among patients previously having undergone breast augmentation in either the subglandular or subpectoral planes. The objective of the present systematic review was to evaluate whether implant location influenced the characteristics of breast tumors in previously augmented women.MethodsA systematic literature search was performed to identify relevant articles reporting tumor characteristics in augmented patients. The search included published articles in three electronic databases; Ovid MEDLINE, EMBASE, and PubMed. Comparative studies (subglandular vs. subpectoral) were included.ResultsAnalysis of data pooled from the included studies showed that subglandular implants had a higher frequency of tumors between 2 to 5 cm (26.5% vs. 9.9%, P = 0.0130). Subglandular implants also had a higher frequency of stage 2 tumors (42.9% vs. 23.7%, P = 0.0308). There was no significant difference in lymphovascular invasion between the 2 groups. These results of this systematic review suggest that the prognosis of patients undergoing augmentation is unaffected by implant location (subpectoral vs. subglandular).ConclusionsWith the absence of large randomized controlled trials, our study provides surgeons with an evidence-based reference to improve informed consent with regards to implant placement.

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Background: Syndactyly is one of the most common congenital hand malformations, involving an abnormal fusion of digits and with treatment varying according to its complexity. The internet has become a primary source of information for both families and patients with congenital hand anomalies. The purpose of this study was to evaluate both the readability and quality of available web content for syndactyly, using validated instruments. Methods: Two independent reviewers conducted searches for “Syndactyly” using three of the largest online search engines: Bing, Google, and Yahoo. The top 10 websites for each search engine, along with any webpage within one click of the parent website, were analyzed. Readability was assessed using seven established quantitative tests. The quality of the web pages was analyzed using the Discern questionnaire and handbook. Results: A total of 15 websites were included in the analysis. The average readability of all websites was equivalent to comprehension at a grade 11.3 level. The average Flesch reading ease score was 49.3 out of 100, which is considered difficult to read. Quality was assessed using Discern, a brief questionnaire consisting of 16 questions with five points attributed per question. The mean quality score using Discern was 33.3 points out of a maximum of 80 points. Conclusions: Online materials pertaining to the treatment of syndactyly far exceed the recommended sixth-grade reading level, and lack in terms of quality and comprehensiveness of information. Health care professionals should be cognizant of the paucity of available online information and provide patients with more appropriate resources.

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