Breast Cancer Incidence in Adolescent Males Undergoing Subcutaneous Mastectomy for Gynecomastia: Is Pathologic Examination Justified? A Retrospective and Literature Review

Koshy, John C.; Goldberg, Jonathan S.; Wolfswinkel, Eric M.; Ge, Yimin; Heller, Lior

doi:10.1097/prs.0b013e3181f9581c

Cited by 25 publications

(30 citation statements)

References 37 publications

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“…15, 16 Briefly, all rats were anesthetized prior to performing a thoracotomy and left cardio-ventricular catheterization. Perfusion with heparinized normal saline followed by pressure fixation with normal buffered formalin solution ensured euthanasia.…”

Section: Methodsmentioning

confidence: 99%

Quantification and Characterization of Radiation-Induced Changes to Mandibular Vascularity Using Micro–Computed Tomography

Deshpande

Donneys

Farberg

et al. 2014

Annals of Plastic Surgery

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Objective Perhaps the most vexing and exigent problem confronting head and neck cancer reconstruction is overcoming the impediments of collateral damage imposed by radiation therapy (XRT) on normal surrounding tissue. XRT is detrimental to bone and soft tissue repair resulting in an unacceptably high incidence of devastating wound healing complications as well as the associated morbidity of late pathologic fractures, reduced bone healing, and osteoradionecrosis. The consequences of XRT on bone vasculature, long known to be affected by radiation, have been poorly understood. The purpose of this study was to analyze the degree by which irradiation degrades existing bone vascularity using a powerful micro-computed tomography (micro-CT) technique to attain highly precise quantitative metrics of the vascular tree. Methods Fourteen 400g male Sprague-Dawley rats underwent 35 Gy of fractionated XRT at 7 Gy/day. The animals were euthanized after 28 days and the left ventricle was fixed and injected with Microfil contrast. Left hemimandibles were dissected and scanned using high-resolution micro-CT (18μ voxels). The vessel number, thickness, separation, connectivity and vessel volume fraction were analyzed for the region of interest (ROI), defined to be the volume behind the third molar spanning a total distance of 5.1 mm. Results Stereological analysis and subsequent ANOVA test demonstrated a significant and quantifiable diminution in the irradiated vasculature when compared to control animals. The vessel volume fraction (0.016 vs. 0.032, p≤0.003) and vessel thickness (0.042mm vs. 0.067mm, p≤0.001) were markedly reduced. Interestingly, further analysis demonstrated no significant differences between vessel separation and vessel number. Conclusion The results of our study specifically quantify the corrosive affects of XRT on the vasculature of the mandible. The data from this novel technique goes even further and implies retention of blood vessels, but a degradation of their quality and size. Further experiments can now be directed at therapeutic interventions to reverse this process and better understand the underlying mechanism of XRT-induced bone injury.

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Section: Methodsmentioning

confidence: 99%

Quantification and Characterization of Radiation-Induced Changes to Mandibular Vascularity Using Micro–Computed Tomography

Deshpande

Donneys

Farberg

et al. 2014

Annals of Plastic Surgery

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“…The need for pathological examination in patients younger than 20 years without pathological findings is questionable (8,9). GM is operated on by different surgical disciplines; it is possible that there is a difference between the disciplines in the indications for surgery and the management used.…”

Section: Introductionmentioning

confidence: 98%

Surgical management of gynecomastia: 20 years’ experience

Lapid

Jolink

2013

Scand J Surg

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“…The risk of malignant transformation in men with ADH remains even more poorly understood (6). ADH has been reported to occur in <2.5% of adolescent gynecomastia; however, the existence and significance of this finding remains unclear (4).…”

Section: Discussionmentioning

confidence: 99%

“…As such, this condition has a predominantly trimodal peak of age distribution, correlating to times of higher levels of estrogen, comprising the neonatal, adolescent (prepubertal, pubertal) and elderly populations (3,4). Adult gynecomastia is rare and usually requires further evaluation for an underlying secondary cause.…”

mentioning

confidence: 99%

Is routine pathological evaluation of tissue from gynecomastia necessary? A 15-year retrospective pathological and literature review

Senger¹,

Chandran²,

Kanthan³

2014

CAN J PLAST SURG

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Breast Cancer Incidence in Adolescent Males Undergoing Subcutaneous Mastectomy for Gynecomastia: Is Pathologic Examination Justified? A Retrospective and Literature Review

Cited by 25 publications

References 37 publications

Quantification and Characterization of Radiation-Induced Changes to Mandibular Vascularity Using Micro–Computed Tomography

Quantification and Characterization of Radiation-Induced Changes to Mandibular Vascularity Using Micro–Computed Tomography

Surgical management of gynecomastia: 20 years’ experience

Is routine pathological evaluation of tissue from gynecomastia necessary? A 15-year retrospective pathological and literature review

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