Obesity and inflammation: new insights into breast cancer development and progression.

The importance of inflammation in promoting carcinogenesis and tumor progression is well recognized. Chronic inflammation caused by a variety of infectious agents can lead to the development of several common malignancies. Similarly, inflammatory bowel disease is a well-known risk factor for colorectal cancer.

Surveillance and monitoring in breast cancer survivors: maximizing benefit and minimizing harm.

Although the incidence of breast cancer has increased, breast cancer mortality has decreased, likely as a result of both breast cancer screening and improved treatment. There are well over two million breast cancer survivors in the United States for whom appropriate surveillance continues to be a subject of controversy. The guidelines from the American Society of Clinical Oncology (ASCO) and the American College of Physicians are clear: only performance of yearly screening mammography is supported by evidence.

The magnitude of effect of cosmetic breast augmentation on patient satisfaction and health-related quality of life.

Background: The objective of this study was to gain a better understanding of the magnitude of clinical change in health-related quality of life and patient satisfaction brought about by cosmetic breast augmentation.

Methods: A prospective, longitudinal study was performed. Women undergoing cosmetic breast augmentation were asked to complete the BREAST-Q Augmentation module both before and after augmentation.

Melanoma of the lentigo maligna subtype: diagnostic challenges and current treatment paradigms.

Melanoma of the lentigo maligna subtype presents diagnostic and treatment challenges because of ill-defined clinical margins in cosmetically and functionally sensitive areas of the head and neck with extensive sun damage. This review highlights the natural history, varied clinical presentations, and pitfalls in histologic diagnosis. The focus is on the surgical management, comparing excision and pathologic tissue processing techniques of wide excision, Mohs micrographic surgery, and staged excision.

Encountering grief in patient care.

Grief is essentially unavoidable and is a normal reaction to loss. Grief may be experienced by patients and their loved ones as well as by physicians and members of the health care team in response to the consequences of illness or death. Grief is typified by certain indicators that may significantly effect one's emotional and physical well-being.

Planning for the future: the role of nurse practitioners and physician assistants in survivorship care.

The number of cancer survivors in the United States now approaches 12 million individuals, with an estimated 7.2% of the general population aged 18 years or older reporting a previous cancer diagnosis. These figures highlight a number of questions about the care of survivors-how patients at risk for a known set of health problems should be followed, by whom, and for how long.

The oncologist as the patient with cancer or relative.

To an extent, physicians are familiar with the consequences of illness through their interactions with patients. However, when cancer becomes personal, the physician has an opportunity to gain greater insight into the intricacies of medical care, including its humanistic elements. Physicians who encounter cancer in themselves or in a relative may deepen their understanding of the patient experience.

Antiemetic Use in Oncology: Updated Guideline Recommendations from ASCO.

In 2011, ASCO updated its guideline for the use of antiemetics in oncology, informed by a systematic review of the medical literature. This is an abbreviated version of that guideline, which is available in full at www.asco.

Uterine sarcomas: histology and its implications on therapy.

Uterine sarcomas are rare cancers, they comprise only 5% of all uterine malignancies. There are about 2,000 cases of uterine sarcoma diagnosed annually in the United States. Uterine sarcomas may be categorized as either favorable-risk, low-grade malignancies with a relatively good prognosis or as poor-risk, high-grade cancers that carry a high risk for tumor recurrence and disease progression.

The interventional radiologist role in treating liver metastases for colorectal cancer.

Interventional radiologists (IRs) have an expanding role in the treatment of liver metastases from colorectal cancer. Increasing data on the ability to treat liver metastases with locoregional therapies has solidified this position. Ablative approaches, such as radiofrequency ablation and microwave ablation, have shown durable eradication of tumors.

Advanced imaging techniques for the detection of breast cancer.

Mammography is the only breast imaging examination that has been shown to reduce breast cancer mortality. Population-based sensitivity is 75% to 80%, but sensitivity in high-risk women with dense breasts is only in the range of 50%. Breast ultrasound and contrast-enhanced breast magnetic resonance imaging (MRI) have become additional standard modalities used in the diagnosis of breast cancer.

Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q.

Background: Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. The objective of this study was to develop a new patient-reported outcome measure to assess the unique outcomes of breast surgery patients.

Methods: Patient interviews, focus groups, expert panels, and a literature review were used to develop a conceptual framework and a list of questionnaire items.

A systematic review of patient-reported outcome measures after facial cosmetic surgery and/or nonsurgical facial rejuvenation.

Background: Patient satisfaction and improved quality of life are the predominant considerations determining success in cosmetic surgery. However, few studies have examined patients' perceptions of their appearance following cosmetic facial surgery and/or nonsurgical facial rejuvenation. This study identified patient-reported outcome measures developed and validated for use in patients undergoing surgical and/or nonsurgical cosmetic procedures.

Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments.

Background: Patient-reported outcomes in cosmetic and reconstructive breast surgery are increasingly important for clinical research endeavors. Traditional surgical outcomes, centered on morbidity and mortality, remain important but are no longer sufficient on their own. Quality of life has become a crucial research topic augmenting traditional concerns focused on complications and survival.

The effect of closed-suction drains on the incidence of local wound complications following tissue expander/implant reconstruction: a cohort study.

Background: The purpose of this investigation was to evaluate the effect of drains on complications, including infection, seroma, and hematoma formation, in patients undergoing exchange of a temporary expander for a permanent breast implant.

Methods: A review of all tissue expander/implant breast reconstructions performed at a single center from 1997 to 2004 was undertaken. Two patient cohorts were identified: patients who underwent exchange of their expander to a permanent implant with the use of closed-suction drains and patients who underwent the exchange procedure without the use of drains.

Challenging the platinum combinations: Docetaxel (Taxotere) combined with gemcitabine or vinorelbine in non-small cell lung cancer.

The limited single-agent activity of cisplatin, its toxicity profile, and the inconvenience involved in hydrating patients has compelled researchers to investigate other treatments as possible alternative therapies in non-small cell lung cancer. More recently, interest has focused on the potential of nonplatinum combinations. Phase II studies show that the combination of docetaxel (Taxotere; Aventis, Antony, France) and gemcitabine is active in stage IIIB/IV non-small cell lung cancer not previously treated by chemotherapy.