The US Preventive Services Task Force (USPSTF) currently recommends initiating breast cancer screening at 50 years of age in patients at average risk. 1 However, we hypothesize that these guidelines may not be sensitive to racial differences and may be inappropriately extrapolating data from largely white populations for use in racially diverse populations. This process could result in underscreening of nonwhite female patients. These concerns are similar to broader discussions regarding sex bias in the clinical research process, leading to recent policy changes at the National Institutes of Health and the US Food and Drug Administration. 2 The goal of this study is to assess the age distribution of breast cancer diagnosis across race/ethnicity in the United States.Methods | We analyzed the Surveillance, Epidemiology, and End Results (SEER) Program database from January 1, 1973, through December 31, 2010. Female patients aged 40 to 75 years with malignant breast neoplasms were included. The primary end point was age and stage at breast cancer diagnosis across racial groups. Institutional review board approval was not required because these data are publicly available.
Studies show some return of breast sensation after breast reconstruction; however, recovery is variable and unpredictable. Efforts are being made to restore innervation by reattaching nerves (neurotization). We sought to systematically review the literature addressing breast sensation after reconstruction. The following databases were searched: EMBASE, Cochrane, and PubMed. Additionally, the PLASTIC AND RECONSTRUCTIVE SURGERY journal was hand searched from 1960 to 2009. Inclusion criteria included breast reconstruction for cancer, return of sensation with objective results, and patients aged 18 to 90 years. Studies with purely cosmetic procedures, case reports, studies with less than 10 patients, and studies involving male patients were excluded. The initial search yielded 109 studies, which was refined to 20 studies with a total pool of 638 patients. Innervated flaps have a greater magnitude of recovery, which occurs at an earlier stage compared with the noninnervated flaps. Overall, sensation to deep inferior epigastric artery perforator flaps may recover better sensation than transverse rectus abdominis myocutaneous flaps, followed by latissimus dorsi flaps, and finally implants. Women's needs and expectations for sensation have led plastic surgeons to investigate ways to facilitate its return. Studies, however, depict conflicting data. Larger series are needed to define the role of neurotization as a modality for improving sensory restoration.
This statewide study on survival after acute UTBADs shows an independent survival advantage for TEVAR over medical therapy. These data add further evidence for a paradigm shift in acute management of type B dissection in favor of early TEVAR.
3D CTA with stereotactic fiducials allows surgeons to adequately estimate abdominal flap volume before surgery, potentially giving guidance in the amount of tissue that can be harvested from a patient's lower abdomen.
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