Explantation with Lateral Pedicle Mastopexy.

Background: While breast explantation combined with mastopexy is an increasingly common procedure, it does present certain technical difficulties. We present a technique of explantation mastopexy with the use of an extended lateral pedicle for auto-augmentation.

Methods: A consecutive series of 40 cases was retrospectively reviewed, with patient reported outcome questionnaire and photography at 3 and 12 months.

Changing practice: moving to a specialist nurse-led service for BRCA gene testing.

Some 5-10% of all breast cancers are associated with a pathogenic variant in a breast cancer-associated gene (BRCA1/BRCA2). Historically, with referral to the Nottingham University Hospitals NHS Trust's clinical genetics department for genetic testing, waiting times were on average 12-14 weeks for an initial appointment and 4-6 months to obtain results from the date of testing. A specialist, nurse-led mainstreaming cancer genetics (MCG) service was set up in the trust's Nottingham Breast Institute (NBI) to: reduce waiting times for the initial consultation, counselling, consent and obtaining results for BRCA1/BRCA2 gene testing; and to ensure appropriate patients with breast cancer were offered genetic testing.

Oncoplastic Breast-Conserving Surgery in Iceland: A Population-Based Study.

Background And Aims: In Iceland, oncoplastic breast-conservation surgery has been performed since 2008. The aim of this population-based study was to assess and compare the efficacy and patient satisfaction of standard breast-conservation surgery with oncoplastic breast-conservation surgery.

Materials And Methods: This is a population-based, retrospective, observational cohort study on all women undergoing breast-conservation surgery in Iceland from the 1 January 2008 to 31 December 2014.

A Prospective Analysis on Functional Outcomes Following Extended Latissimus Dorsi Flap Breast Reconstruction.

Background: To prospectively assess the functional effect of using the extended latissimus dorsi flap in immediate breast reconstructions.

Materials And Methods: A total of 15 consecutive patients undergoing breast reconstruction with extended latissimus dorsi flap participated. Shoulder range of motion, muscle strength, lateral flexion of the torso, and position of scapula were measured pre-operatively and 1, 6, and 12 months post-operatively, in addition to donor-site post-operative complications.

Tumor Size of Invasive Breast Cancer on Magnetic Resonance Imaging and Conventional Imaging (Mammogram/Ultrasound): Comparison with Pathological Size and Clinical Implications.

Background And Aim: In Landspitali University Hospital, magnetic resonance imaging is used non-selectively in addition to mammogram and ultrasound in the preoperative assessment of breast cancer patients. The aim of this study was to assess invasive tumor size on imaging, compare with pathological size and evaluate the impact of magnetic resonance imaging on the type of surgery performed.

Material And Methods: All women with invasive breast cancer, diagnosed in Iceland, between 2007 and 2009 were reviewed retrospectively.

[Results of immediate breast reconstructions at Landspítali-The National University Hospital of Iceland, in 2008-2010].

Introduction: In late 2007, the availability of immediate breast reconstructions increased as a result of the establishment of an oncoplastic breast surgical service at Landspítali-The National University Hospital The aim of this study was to look at the rates and early complications of immediate breast reconstructions in our hospital in 2008-2010 and compare with the results from the UK National Mastectomy and Breast Reconstruction Audit (NMBRA).

Material And Methods: This is a retrospective population-based study, including all women who had immediate breast reconstruction at Landspítali in 2008-2010.

Results: 319 mastectomies and 157 breast reconstructions were performed.

Pregnancy-associated breast cancer.

Currently, it is estimated that approximately one in every 3,000 births are from women who have or are being treated for breast cancer. Although rare, the incidence of pregnancy-associated breast cancer (PABC) is increasing as women are delaying childbirth. Diagnostic and treatment recommendations have been mainly based on evidence from retrospective single institutional and collective series and expert consensus, as randomized trials on this entity are understandably lacking.

[Primary hyperparathyroidism due to an intrathoracic parathyroid adenoma. - A case report and review of the literature].

A 72 year old gentleman presented to the emergency department with symptoms of diffuse joint and muscular pain, fatigue and diminished memory. Serum calcium and parathyroid hormone levels were raised, consistent with primary hyperparathyroidism. No abnormality was found on an ultrasound scan of the neck.

Neoadjuvant endocrine treatment in primary breast cancer - review of literature.

Chemotherapeutic agents have dominated neoadjuvant treatment compared to endocrine agents in the past and have demonstrated their ability to produce tumour shrinkage to allow breast conservation. However, in the more recent setting, studies have been emerging with the use of aromatase inhibitors, especially comparing its use with tamoxifen in selected group of patients. The role of tamoxifen in its ability to achieve tumour shrinkage has been evaluated in the past, and has shown to produce slow but sustained response.

Neoadjuvant chemotherapy for locally advanced breast cancer: a review of the literature and future directions.

Background: Most patients with locally advanced primary breast cancer have micrometastases at the time of presentation. Randomised trials on the use of neoadjuvant chemotherapy have not been carried out specifically in a population of breast cancer patients with locally advanced disease (LAPC). Despite this, its use for cytoreduction in these patients is an established option which may facilitate excision of the primary tumour and local lymph node metastasis for local control.

Primary endocrine therapy in locally advanced breast cancers--the Nottingham experience.

Introduction: There are trials comparing different neoadjuvant chemotherapy regimens for locally advanced primary breast cancer (LAPC). Few studies have evaluated alternative therapeutic approaches towards LAPC. A previous trial from our institute in LAPC patients unselected for oestrogen receptor (ER) status, comparing primary endocrine therapy versus multimodal treatment, showed no difference in breast cancer related deaths or overall survival.

Serum epidermal growth factor receptor and HER2 expression in primary and metastatic breast cancer patients.

Background: Breast tissue expression of the ERBB proto-oncogene family has been extensively studied. It was recently shown that expression of epidermal growth factor receptor (EGFR; c-erbB-1) and epidermal growth factor receptor (HER)2 (c-erbB-2) can be detected in the serum of breast cancer patients. The clinical relevance of this has not been fully established.

Neoadjuvant chemotherapy in locally advanced primary breast cancers: the Nottingham experience.

Aim: Of our study was to assess and compare the outcome of patients undergoing anthracycline based neoadjuvant chemotherapy in locally advanced primary breast cancers with patients receiving mitoxantrone, methotrexate and mitomycin (MMM) as neoadjuvant agents.

Methods: Records of 50 consecutive patients receiving anthrcycline based chemotherapy for locally advanced breast cancers from July 1996 to July 2004 were analysed with regard to locoregional recurrence, metastasis and survival. The MMM group comprised of 56 consecutive patients receiving MMM chemotherapy between 1989 and 1994.

The position of the vermiform appendix at laparoscopy.

Background: The vermiform appendix has no constant position and the data on the variations in its position are limited. The aim of this study was to determine the frequency of the various positions of the appendix at laparoscopy.

Methods: Patients undergoing emergency or elective laparoscopy at a university teaching hospital between April and September 2004 were studied prospectively.

[Acute pancreatitis. Prospective study of incidence, aetiology, severity, and mortality in Iceland.].

Objective: To evaluate the aetiology, severity and mortality of patients with acute pancreatitis at Landspítali - University Hospital (LSH) and to estimate the incidence in Iceland.

Material And Methods: A prospective study of all patients diagnosed with acute pancreatitis LSH during the one-year period October 1998 - September 1999 inclusive. The main outcome measures were APACHE II, Ranson, and Imrie scores, and C-reactive protein (CRP) concentrations.

Selective use of post-mastectomy flap irradiation in high-risk breast cancer patients.

The incidence of local recurrence after mastectomy can be reduced by chest wall radiotherapy. However, only a minority of patients are at substantial risk. No UK national guidelines exist for the use of mastectomy flap radiotherapy.

Oncological and cosmetic outcomes of oncoplastic breast conserving surgery.

Background: Breast-conserving surgery and radiotherapy is firmly established as a good and safe option for most women with early breast cancer. The important outcome measures of breast conservation are survival, local recurrence, cosmesis and patient satisfaction. Partial breast reconstructive techniques may improve cosmesis and patient satisfaction without compromising the oncological outcomes.

Size of invasive breast cancer and risk of local recurrence after breast-conservation therapy.

Risk of local recurrence is one important factor that determines a woman's suitability for breast-conservation therapy. With the evolution of oncoplastic surgery, tumours of a size that traditionally require mastectomy may be treated by breast conservation and partial breast reconstruction. This article reviews the evidence relating to tumour size as a risk factor for local recurrence to assess whether this change in practice is appropriate.

Acute pancreatitis: a prospective study of its incidence, aetiology, severity, and mortality in Iceland.

Objective: To evaluate the incidence, aetiology, severity and mortality of patients with acute pancreatitis.

Design: Prospective study.

Setting: University hospital, Iceland.

Altered expression of E-cadherin in breast cancer. patterns, mechanisms and clinical significance.

Reduced cell adhesion brought about by altered surface expression of E-cadherin has been implicated in invasive and metastatic malignant growth. We investigated the patterns of immunohistochemical E-cadherin expression in 120 breast carcinomas. Furthermore, we analysed DNA from the same samples for loss of heterozygosity (LOH) using three separate microsatellite markers on chromosome 16q22.