Functional Cerebral MRI Evaluation of Integration of Breast Reconstruction into the Body Schema.

Background: The objective of breast reconstruction (BR) is to erase the after-effects of total mastectomy by allowing patients to restore their breast shape. The aim of our study was to investigate the body map integration of different types of BR using functional magnetic resonance (fMRI).

Patients And Methods: We prospectively enrolled all women undergoing BR for breast cancer to the Remasco study (NCT02553967).

Palpable Nodules After Autologous Fat Grafting in Breast Cancer Patients: Incidence and Impact on Follow-up.

Introduction: Autologous fat grafting (AFG) is a promising breast reconstruction technique, following surgery. However, fat necrosis after AFG can cause palpable nodules, inducing anxiety and prompting additional investigations. We aimed to determine the occurrence rate and to identify the risk factors of palpable nodules in breast cancer patients prompting complementary explorations.

Prospective Multicenter Study Validate a Prediction Model for Surgery Uptake Among Women with Atypical Breast Lesions.

Background: Diagnosis of atypical breast lesions (ABLs) leads to unnecessary surgery in 75-90% of women. We have previously developed a model including age, complete radiological target excision after biopsy, and focus size that predicts the probability of cancer at surgery. The present study aimed to validate this model in a prospective multicenter setting.

Reducing the seroma volume by quilting suture after breast reconstruction with a latissimus dorsi flap: Single institutional experience.

Introduction: After breast reconstruction (BR) with latissimus dorsi flap (LDF) postoperative seroma is a frequent source of functional discomfort. The aim of this study was to evaluate the quilting suture on reducing the seroma volume by reducing the dead space created by LDF harvest for BR.

Material And Methods: This retrospective monocenter study was designed to compare patients who underwent BR using LDF with or without quilting suture.

Decision-making determinants for breast reconstruction in women over 65 years old.

Despite the positive effects that breast reconstruction (BR) has on quality of life, access to it remains limited for older women. The aim of this study was to identify decision-making determinants for BR in women over 65 years old, using a specifically designed questionnaire. We included in a case-control study 134 patients treated by mastectomy for breast cancer with or without BR in a cancer center performing BR.

[Ductal carcinoma in situ diagnosis: 3 French national guidelines].

Objective: Since the last guidelines published by the French National Cancer Institute (INCa) and the learning society "Société française de sénologie et de pathologie mammaire (SFSPM)" in 2009 about diagnosis and management of ductal carcinoma in situ, new data raised issues about overdiagnosis and its consequences, overtreatment. Therefore, an update was necessary, to provide healthcare professionals up-to-date guidelines and study therapeutic desescalation in particular.

Methods: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by a multidisciplinary experts workgroup.

Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF): benign breast tumors - short text.

Screening with breast ultrasound in combination with mammography is needed to investigate a clinical breast mass (Grade B), colored single-pore breast nipple discharge (Grade C), or mastitis (Grade C). The BI-RADS system is recommended for describing and classifying abnormal breast imaging findings. For a breast abscess, a percutaneous biopsy is recommended in the case of a mass or persistent symptoms (Grade C).

Shear Wave Elastography (SWE): An Analysis of Breast Lesion Characterization in 83 Breast Lesions.

Qualitative and quantitative shear wave elastography (SWE) criteria were assessed to differentiate between malignant and benign breast lesions. This prospective study included 83 lesions. SWE features measured included maximal stiffness values inside the lesion (E(lesion)) and in the peri-lesion area (E(perilesion)) and ratio values (R(lesion) and R(perilesion)) according to the formula E(lesion) or E(perilesion)/E(fat), with E(fat) corresponding to normal fatty tissue.

Implications of a two-step procedure in surgical management of patients with early-stage endometrioid endometrial cancer.

Objective: Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomy should not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperatively assessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices after ESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after the first surgery.

Methods: This retrospective single-center study included women with EEC preoperatively assessed at presumed low- or intermediate-risk who had surgery between 2006 and 2013.

Ultrasound-guided high-intensity focused ultrasound treatment of breast fibroadenoma-a multicenter experience.

Background: The aim of our multicenter study was to assess the clinical outcome and safety of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) in patients with breast fibroadenoma (FA).

Methods: From May 2011 to February 2013, 42 women with 51 FA in one or both breasts were selected for treatment with US-guided HIFU. Eight of 51 FA were treated twice.

[Genital prolapse surgery: state of the art of the vaginal approach].

Treatment of genital prolapse is mainly surgical. The vaginal approach is a shorter procedure than the abdominal approach with a quicker resumption of activity for the patients. We describe different techniques which are most often performed in our daily practice.

Benefit of robot-assisted laparoscopy in nerve-sparing radical hysterectomy: urinary morbidity in early cervical cancer.

Objective: To evaluate the feasibility of nerve-sparing radical hysterectomy in early cervical cancer by robot-assisted laparoscopy and atonic bladder rate.

Methods: This was a retrospective study with consecutive patients in three gynecological oncology departments. Patients with <2 cm cervical cancer had nerve-sparing radical hysterectomy by robot-assisted laparoscopy and pelvic lymphadenectomy.

Adenoid basal hyperplasia of the uterine cervix: a lesion of reserve cell type, distinct from adenoid basal carcinoma.

Adenoid basal hyperplasia is an underrecognized cervical lesion, resembling adenoid basal carcinoma, except the absence of deep invasion into the stroma. We report a series of 10 cases, all extending less than 1 mm from the basement membrane. Our results support the hypothesis that adenoid basal hyperplasia arises from reserve cells of the cervix.

Fetal microchimerism: benevolence or malevolence for the mother?

For a long time, the conventional view was that the fetus and maternal vascular system are kept separate. In fact there is a two way traffic of cells through the placenta and the transplacental passage of cells is in fact the norm. The fetal cells can persist in a wide range of woman's tissues following a pregnancy or an abortion and she becomes a chimera.

[Advanced ovarian cancer: upfront or interval debulcking surgery?].

In the French standard treatment of ovarian cancer in 2007, interval debulcking surgery is an option. The standard treatment is always upfront debulcking surgery when no macroscopic residu is possible. In the recent EORTC randomized study, there was no significative difference between upfront debulcking surgery and interval debulcking surgery after neo-adjuvant chemotherapy.

Bacteriological analysis of meshes removed for complications after surgical management of urinary incontinence or pelvic organ prolapse.

The aim of this study is to examine the role of bacterial infection in complications following surgical management of urinary incontinence and genital prolapse using meshes. There were sixteen prostheses removed. Eight were monofilament polypropylene-knitted meshes, one was a silicone-coated polypropylene mesh, another was a collagen-coated polypropylene mesh, four were silicone-coated polyester meshes and two were polyester meshes.

Study of the biomechanical properties of synthetic mesh implanted in vivo.

Objective: The objective was to assess in an animal model the mechanical properties of five prostheses used for pelvic floor repair.

Study Design: Two months after pre-peritoneal implantation of the five types of prosthesis: Prolene, Prolene Soft, Mersuture, Vicryl and Vypro, we sacrificed the animals to measure retraction of the prosthesis, maximal resistance to traction, and maximal elongation.

Results: Non-absorbable prostheses retracted least.

Tissue integration and tolerance to meshes used in gynecologic surgery: an experimental study.

Objective: To evaluate the tissue integration of and tolerance to five different mesh types used in genital prolapse surgery to provide mechanical support.

Study Design: We placed five different meshes (Vicryl, Vypro, Prolene, Prolene soft, and Mersuture) on the peritoneums of 12 pigs. After 10 weeks, we used light microscopy to analyze the tissue integration of and tolerance to these meshes.

Objective analysis of mechanical resistance of tension-free devices.

Introduction: The "tension-free" procedures are widely used by surgeons for the treatment of urinary incontinence and prolapse. The clinical results are largely in favour of these procedures. The aim of our study is to determine objectively the mechanical tissue resistance when using these techniques, before healing begins.