development and testing of an instrument to assess body shape related quality of life background: The assessment of patient satisfaction and quality of life after body remodeling surgery is important. aim: To develop and assess a self-report instrument to evaluate the results of bariatric and body remodeling surgery. material and methods: A three phase methodology was used. In phase 1, literature was reviewed and in depth interviews to patients were carried out, creating a preliminary instrument that was applied to 1,340 patients in phase 2. In phase 3, the final assessment of the instrument was performed, applying it to 34 patients. The psychometric properties of the in instrument were evaluated. results: The instrument has four domains (satisfaction with abdomen, sexual life, self-esteem and social life and psychological symptoms) and 20 items. Its score ranges from 20 (worst) to 100 (better). Response rate was 100%, internal reliability was 93% and test-re test concordance was 98%. Body shape related quality of life was significantly higher in men than in women. It decreases with age and with increasing body mass index. Patients subjected to bariatric surgery had lower scores than patients subjected to esthetic surgery. In the postoperative period, the score improved by 21.9 ± 16.9 points. conclusions: The instrument developed can reliably measure quality of life associated with body shape.key words: quality of life, body shape, bariatric surgery.

Hamartoma and nodular pseudoangiomatous stromal hyperplasia. Differential diagnosis Introduction: Hamartoma and nodular pseudoangiomatous stromal hyperplasia (PASH) are inusual breast tumor entities, however, can simulate breast cancer. The only accurate tool is preoperative biopsy. Surgical treatment is curative with low recurrence rate. Objective: To present a case of mammary hamartoma associated with PASH whose initial presentation was suggestive of probable malignancy. Case Report: Woman, 44 years old, admitted to controls because of probable malignant breast disease, mammography was reported as BIRADS 0, breast ultrasound as BIRADS U.S: 5, CORE biopsy reported PASH. Partial mastectomy was performed. On delayed biopsy mammary hamartoma with extensive stromal hyperplasia pseudoangiomatosa was diagnosed. Discussion: PASH and hamartomas are diseases with no specific clinical presentation, radiological findings may be pathognomonic of hamartoma, while not in PASH. In the reported case the pathological study showed an association of these conditions, described in a 16% to 71% breast hamartoma cases. The analysis of the entire surgical specimen is essential for a definitive diagnosis.

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effects of breast reduction surgery on the quality life background: The results of breast reduction surgery are usually reported in terms of anthropometric assessments. However the impact of surgery in quality of life is seldom informed. aim: To assess the effects of breast reduction surgery on the quality of life of patients. material and methods: The "Breast-Q Reduction and Mastopexy Module" was prospectively applied to all women subjected to breast reduction surgery in a University Hospital during one year. results: Twenty women answered the survey in the preoperative period and 20 in the postoperative period. The most commonly cutaneous pattern employed that the inverted T in 10 women, followed by the Wise pattern in six patients. The most commonly used pedicles were superior in 10 patients, followed by superomedial in seven patients. Mean excision weight was 923 g (range 150-2850). Mean Breast Q score improved from 45 to 65%. Satisfaction with breast appearance improved from 31 to 83%, self-esteem from 39 to 80%, sexuality from 50 to 81% and physical symptoms decreased from 48 to 16%. There was a significant association between the magnitude of excision and improvement in physical symptoms. conclusions: Quality of life improves notably in women after breast reduction surgery.