In the shoes of a person with Gynaecomastia

In this narrative, I step into the shoes of someone who has lived with gynaecomastia — male breasts. Using the imaginary character of Aarav, I reflect on the themes of the stigma associated with body image, the courage to face it, and the role human relationships can play in fostering self-acceptance.

Compromiso secundario de glándulas mamarias por linfoma folicular / Secondary involvement of breasts by follicular lymphoma

Resumen Las lesiones metastásicas que comprometen la glándula mamaria son excepcionales, ocupando las neoplasias hematolinfoides el segundo lugar en orden de frecuencia en series de casos reporta dos en la literatura con una prevalencia de 0.04% a 1.6% en relación a todos los tumores malignos de la mama, alcanzando una incidencia anual de 0.07%, los cuales corresponden principalmente a linfomas secundarios. El 80% de estos son linfomas B difusos de células grandes, seguido de linfoma folicular y linfoma de la zona marginal. Presentamos una mujer de 60 años con diagnóstico de linfoma folicular que comenzó con una masa perirrenal derecha y ganglios linfáticos ipsilaterales retroperitoneales e inguinales, quien, durante su tratamiento, presentó avance en el estadio clínico con compromiso secundario inusual de ambas glándulas mamarias por esta neoplasia hematolinfoide. Se evaluó el comportamiento biológico de esta enfermedad para comprender los mecanismos fisiopatológicos, mediante el análisis de factores clínicos, histológicos y pronósticos, permitiendo la estadificación definitiva, la cual fue determinante para la elección de la terapia individualizada acorde a las guías de práctica clínica basada en la evidencia científica, impactando positivamente en la evolución médica de la paciente.

Abstract Metastatic lesions involving the breast are exceptional; hematolymphoid neoplasias rank second as per their frequency in case series reported in the literature with a prevalence of 0.04% to 1.6% when consider ing all malignant breast tumors and reaching an annual incidence of 0.07%, mainly accounted for by secondary lymphomas. Eighty percent of them are diffuse, large B cells lymphomas (DLBCL), followed by follicular lymphoma and marginal zone lymphoma. This case is about a 60 year-old woman with a diagnosis of follicular lymphoma, who presented with a right perirenal mass and ipsilateral retroperitoneal and inguinal lymph nodes, whose clinical status progressed during the treatment with unusual secondary involvement of both breasts by hematolymphoid neoplasia. The biological behavior of the condition was evaluated to understand the pathophysiological mecha nisms; this was done analyzing clinical, histologic and prognostic factors that led to a definitive staging, which was key to select the individualized therapy following the clinical practice guidelines based on scientific evidence, with a positive impact on the patient's medical progress.

Secondary involvement of breasts by follicular lymphoma / Compromiso secundario de glándulas mamarias por linfoma folicular

Abstract Metastatic lesions involving the breast are exceptional; hematolymphoid neoplasias rank second as per their frequency in case series reported in the literature with a prevalence of 0.04% to 1.6% when considering all malignant breast tumors and reaching an annual incidence of 0.07%, mainly accounted for by secondary lymphomas. Eighty percent of them are diffuse, large B cells lymphomas (DLBCL), followed by follicular lymphoma and marginal zone lymphoma. This case is about a 60 year-old woman with a diagnosis of follicular lymphoma, who presented with a right perirenal mass and ipsilateral retroperitoneal and inguinal lymph nodes, whose clinical status progressed during the treatment with unusual secondary involvement of both breasts by hematolymphoid neoplasia. The biological behavior of the condition was evaluated to understand the pathophysiological mechanisms; this was done analyzing clinical, histologic and prognostic factors that led to a definitive staging, which was key to select the individualized therapy following the clinical practice guidelines based on scientific evidence, with a positive impact on the patient's medical progress.

Resumen Las lesiones metastásicas que comprometen la glándula mamaria son excepcionales, ocupando las neoplasias hematolinfoides el segundo lugar en orden de frecuencia en series de casos reportados en la literatura con una prevalencia de 0.04% a 1.6% en relación a todos los tumores malignos de la mama, alcanzando una incidencia anual de 0.07%, los cuales corresponden principalmente a linfomas secundarios. El 80% de estos son linfomas B difusos de células grandes, seguido de linfoma folicular y linfoma de la zona marginal. Presentamos una mujer de 60 años con diagnóstico de linfoma folicular que comenzó con una masa perirrenal derecha y ganglios linfáticos ipsilaterales retroperitoneales e inguinales, quien, durante su tratamiento, presentó avance en el estadio clínico con compromiso secundario inusual de ambas glándulas mamarias por esta neoplasia hematolinfoide. Se evaluó el comportamiento biológico de esta enfermedad para comprender los mecanismos fisiopatológicos, mediante el análisis de factores clínicos, histológicos y pronósticos, permitiendo la estadificación definitiva, la cual fue determinante para la elección de la terapia individualizada acorde a las guías de práctica clínica basada en la evidencia científica, impactando positivamente en la evolución médica de la paciente.

Efectividad de intervenciones basadas en mindfulness en mujeres con cáncer de mama

RESUMEN Fundamento Resulta relevante obtener un panorama más amplio del uso de las estrategias, conocidas como de tercera generación, y en particular, de su efectividad en el apoyo psicológico a corto y largo plazos en pacientes con cáncer de mama tratadas mediante las diferentes modalidades terapéuticas conocidas para este padecimiento. Objetivo describir las principales características y efectividad de intervenciones basadas en mindfulness en mujeres con cáncer de mama. Métodos se realizó una revisión sistemática, con artículos publicados en bases de datos de acceso libre como Crossref, Springer Open, PUBMED y EBSCO, con fecha de publicación entre enero de 2016 y diciembre de 2020. Los criterios de inclusión de artículos fueron determinados atendiendo a la estrategia PICO: pacientes o población, intervenciones, comparación o control y resultados. Los términos de búsqueda empleados: cáncer de mama y reducción del estrés basada en mindfulness. Resultados fueron identificados 110 artículos inicialmente, y al aplicar los criterios de inclusión se seleccionaron 15. En todos los estudios participaron mujeres con cáncer de mama en tratamiento, las cuales fueron objeto de intervenciones basadas en el Programa de Reducción del Estrés Basado en Atención Plena. Se encontraron efectos significativos en variables como calidad de vida, síntomas de ansiedad, depresión, estrés, distress, trastornos del sueño, fatiga y en biomarcadores como la frecuencia cardiaca. Conclusión el Programa de Reducción del Estrés Basado en Atención Plena evidencia su efectividad en pacientes con cáncer de mama sobre variables psicosociales en diferentes países.

ABSTRACT Background It is relevant to obtain a broader panorama of the strategies use, known as third generation, and in particular, of their effectiveness in short and long-term psychological support in patients with breast cancer treated through the different therapeutic modalities known for this condition. Objective to describe the main characteristics and effectiveness of mindfulness-based interventions in women with breast cancer. Methods a systematic review was carried out, with articles published in open access databases such as Crossref, Springer Open, PUBMED and EBSCO, with a publication date between January 2016 and December 2020. The inclusion criteria of articles were determined according to the PICO strategy: patients or population, interventions, comparison or control, and results. The search terms used: breast cancer and mindfulness-based stress reduction. Results 110 articles were initially identified, and when applying the inclusion criteria, 15 were selected. In all the studies, women with breast cancer undergoing treatment participated, which were the object of interventions based on the Full Attention-Based Stress Reduction Program. Significant effects were found in variables such as quality of life, symptoms of anxiety, depression, stress, distress, sleep disorders, fatigue and in biomarkers such as heart rate. Conclusion the Stress Reduction Program Based on Mindfulness shows its effectiveness in patients with breast cancer on psychosocial variables in different countries.

Enfermedad de Mondor y mamoplastías / Mondor's disease and mammoplasty

Resumen Objetivo: Revisar la incidencia de esta enfermedad en pacientes sometidos a mamoplastías en una clínicaprivada en el período de 11 años, con el fin de describir sus síntomas y signos, diagnóstico, tratamiento y evolución. Materiales y Método: Se estudiaron 355 mujeres que se sometieron a mamoplastías estéticas. Se excluyó aquellas cirugías reconstructivas secundarias a cáncer de mama y aquellas con otros antecedentes oncológicos previos. La información fue recolectada de las fichas clínicas. Resultado: Se analizan 710 mamas operadas en el período 2008-2018, de las cuales seis mamas (6/710) evolucionaron con enfermedad de Mondor (0,8%). El diagnóstico se realizó clínicamente. Todos los casos recibieron terapia antiinflamatoria oral y local, respondiendo favorablemente. Discusión: Existe poca literatura publicada al respecto. Casos bilaterales son menos reportados. Pareciera asociarse con cirugías del surco submamario y no está claro que requiera curación terapéutica. Conclusiones: La enfermedad de Mondor es infrecuente, puede presentarse secundario a mamoplastías, es de diagnóstico clínico y sólo tratamiento sintomático con evolución satisfactoria sin secuelas.

Aim: Review the disease incidence in patients who had mammoplasties in a private clinic on a 11 year-period. The purpose is to describe their symptoms and signs, diagnosis, treatment and evolution. Materials and Method: 355 women who underwent cosmetic mammoplasties were studied. Those reconstructive surgeries secondary to breast cancer and those with other previous oncological history were excluded. The information was collected from clinical files. Results: 710 breasts operated between 2008-2018 are analyzed, six of them (6/710) evolved Mondor disease (0.8%). The diagnosis was made clinically. All cases received oral and local antiinflammatory therapy, responding favorably. Discussion: There is a few published literature about it. Bilateral cases are less reported. It appears to be associated with surgeries of the submammary sulcus and it is not clear that it requires therapeutic cure. Conclusions: Mondor's disease is infrequent, can occur secondary to mammoplasty, diagnosis is clinical, treatment is symptomatic, all cases had satisfactory evolution without sequelae.

Clinical and surgical evaluation of gynecomastia: tactic and results

Objectives: To perform an assessment of the clinical and surgical characteristics of gynecomastia as a tactic used and the results obtained in the breast. Methods: A prospective and observational study was carried out in the mastology service of Hospital Barão de Lucena in 40 patients. To determine which factors are associated with the cosmetic outcome, the contingency table was constructed and the χ2 test for independence was applied. In cases in which the assumptions of the χ2 test were violated, Fisher's exact test was applied. Results: Findings showed that most patients were from the metropolitan region of Recife (72.5%), studied until high school (62.5%), were aged 10 to 20 (42.5%), were in gynecomastia grade III (47.5%), underwent double incision (52.5%), had no complications (75.0%), and had a good and excellent cosmetic outcome (75.0%). The proportion comparison test was significant in all factors evaluated (p<0.05), except for the variable level of education (p=0.114), indicating that the numbers of patients who studied until high school and had higher education are close. The independence test was significant only in the variable complications (p<0.001), indicating that having complications significantly increases the risk for regular/bad cosmetics. Conclusion: Gynecomastia is a pathology of strong social impact. We observed this after analyzing the epidemiological, clinical, and surgical characteristics of our patients. In patients who underwent surgical treatment and who had no complications, there was a greater degree of satisfaction.

Automated Breast Ultrasound System for Breast Cancer Evaluation: Diagnostic Performance of the Two-View Scan Technique in Women with Small Breasts

0.05).CONCLUSION: 2-VST of ABUS achieved comparable scan coverage and diagnostic performance to that of conventional 3-VST in women with small breasts.

Efeitos do ultrassom terapêutico no ingurgitamento mamário: estudo piloto / Effects of therapeutic ultrasound in mammary engagement: pilot study

INTRODUÇÃO: A amamentação constitui uma importante etapa no processo reprodutivo, oferecendo benefícios tanto para mãe como para a criança. O Ingurgitamento mamário é uma complicação que ocorre do terceiro ao quinto dia de pós-parto. O Ultrassom Terapêutico (UST) é amplamente utilizado, e consiste em um aparelho capaz de produzir energia acústica de alta frequência. OBJETIVO: verificar o efeito agudo do ultrassom no processo terapêutico do ingurgitamento mamário. METODOLOGIA: Estudo transversal, que avaliou a mama e classificou o ingurgitamento, além de realizar avaliação da dor e da percepção subjetiva das mamas. Foi administrado o protocolo com ultrassom terapêutico na frequência de 1Mh, modo pulsado, intensidade/ dose de 0,5w/cm2, ciclo ativo de 20% com tempo de aplicação de 02 minutos por área de radiação efetiva (ERA). Após aplicação, a lactente foi submetida à amamentação e realizada nova avaliação das mamas. RESULTADOS: A amostra foi composta por 4 mulheres entre 20 e 30 anos com quadro de ingurgitamento mamário. O valor inicial do ingurgitamento mamário foi de 2 a mediana e a final foi de 1 a mediana. Em relação à dor mamária, inicialmente foi de 5 mediana e a final 2 a mediana. Em todos os casos analisados houve melhora na dor, na disponibilidade do leite e no aspecto de ingurgitamento da mama. CONCLUSÃO: O ultrassom terapêutico se mostrou eficaz na redução da dor, no aumento da disponibilidade do leite e na melhora do enrijecimento característico do ingurgitamento mamário.

INTRODUCTION: Breastfeeding is an important step in the reproductive process, providing benefits for both mother and child. Breast engorgement is a complication that occurs from the third to the fifth postpartum day. Therapeutic Ultrasound (UST) is widely used, and consists of an apparatus capable of producing high frequency acoustic energy. OBJECTIVE: to verify the acute effect of ultrasound in the therapeutic process of breast engorgement. METHODOLOGY: Cross-sectional study, which evaluated the breast and classified the engorgement, besides evaluating the pain and the subjective perception of the breasts. The protocol with therapeutic ultrasound was administered at a frequency of 1Mh, pulsed mode, intensity / dose of 0.5w / cm2, active cycle of 20% with application time of 02 minutes per effective Radiation Area (ERA). After application, the infant was submitted to breastfeeding and a new breast evaluation was performed. RESULTS: The sample consisted of 4 women between 20 and 30 years of age with breast engorgement. The initial value of breast engorgement was 2 the median and the final value was 1 to median. Regarding breast pain, it was initially 5 median and the final 2 median. In all the analyzed cases there was improvement in pain, milk availability and breast engorgement aspect. CONCLUSION: Therapeutic ultrasound has been shown to be effective in reducing pain, increasing milk availability and improving the stiffness characteristic of breast engorgement.

Mammary gland morphology in the northern Amazon red squirrel (Sciurus igniventris) / Morfologia da glândula mamária em esquilo do Norte Amazônico (Sciurus igniventris)

Sciurus igniventris is a squirrel with broad distribution in South America. We examined one female adult specimen which was donated after death by trampling. The aim of this work was describe the morphological characteristics of mammary gland of one specimen. The body was fixed using 10% aqueous formaldehyde. Tissues were processed and slides prepared following standard histological protocols. Morphological analysis of the mammary glands revealed similarities to those described in the literature for domestic and wild mammals. As special features in kind, macroscopically identified a pair of thoracic glands, followed by three pairs of abdominal glands. Microscopically the abundant presence of connective tissue dividing the alveolar-tubular glands. Similar to that described for domestic and wild mammals.

Sciurus igniventris é um esquilo com distribuição na América do Sul. Nós examinamos uma fêmea adulta que foi doada após morte por atropelamento. O objetivo do trabalho foi descrever as características morfológicas da glândula mamária de um exemplar da espécie. O animal foi fixado utilizando solução aquosa de formoldeído a 10%. Os tecidos foram processados e lâminas foram preparadas seguindo protocolos histológicos padrões. A análise morfológica da glândula mamária revelou similaridades com o que temos descrito na literatura para animais domésticos e selvagens. Como particularidades na espécie, macroscopicamente foi identificado um par de glândulas torácicas, seguidas por três pares de glândulas abdominais. Microscopicamente ocorreu a presença abundante de tecido conectivo dividindo as glândulas túbuloalveolares. Semelhante ao descrito para mamíferos domésticos e selvagens.

The value of multi-modal MRI in diagnosis of breast cancer in the dense breasts / 实用放射学杂志

Objective To explore the multi-modal MRI characteristics of breast cancers in dense breasts.Methods 120 patients with breast cancer shown on mammography underwent breast MRI,which were solitary and confirmed by pathological examination. According to the BI-RADS classification of breast,the 120 cases were divided into two groups including dense type breast and non-dense type one.The differences in morphological features,ADC values (b=1 000 s/mm2 )and time-signal intensity curve (TIC)of the lesions between two groups were analyzed and compared.Statistical analysis was performed using SPSS1 6.0.Results The breast cancers in dense breast were vulnerable to have a spiculated margin (44/68 in the dense breast group vs.1 6/52 in the non-dense breast group,P =0.000).The size of the lesion in dense breast (1.83 ±0.98)cm was bigger than that in non-dense breast (1.40±0.46)cm (P =0.005).The non-mass-like enhancement of the lesion in dense breast was much more than that in non-dense breast (P =0.000).In addition,the average ADC values of the lesion in dense breast (0.89±0.12)×10 -3 mm2/s were lower than in non-dense breast (0.95±0.10)×10 -3 mm2/s(P =0.01 6).Conclusion The breast cancer in the dense breast has different MRI findings in comparison with non-dense breast.

Influencia de la apariencia de las mamas en la calidad de vida: diferencias entre población preoperatoria de mamoplastía de reducción y población control / Criterion validity of a questionnaire to assess quality of life associated to the appearance of breasts in women

Objetivo: El Breast Q Reduction and Mastopexy Module es un instrumento específico para la evaluación de calidad de vida asociado a mamas desde la perspectiva del paciente, recientemente validado para uso en español en Chile. Cuenta con evaluación pre y postoperatoria. El objetivo del presente estudio es conocer la validez de criterio al comparar las distribuciones en distintas poblaciones de individuos así como la diferencia del puntaje entre el pre y postoperatorio. Materiales y Métodos: El instrumento validado en español Breast Q Reduction-Mastopexy Module fue sometido a prueba para evaluar su validez de criterio comparando los resultados de la escala en pacientes que deseaban someterse a cirugía versus 2 grupos control, uno de pacientes hospitalizados por otra causa y otro de estudiantes de medicina. Resultados: Se aplicó la encuesta a 46 mujeres, 6 pacientes preoperatorios de mamoplastía de reducción, 20 alumnas de medicina y 20 pacientes hospitalizadas por otra causa. Hubo diferencias estadísticamente significativas entre las pacientes y los grupos control en los dominios autoimagen corporal (p = 0,0001), desempeño social (p = 0,0035) y síntomas físicos (p = 0,0058), no se observaron diferencias en el dominio de sexualidad (p = 0,1432), sin embargo, sólo 4/6 pacientes contestaron la encuesta ya que las otras 2 declararon no tener vida sexual. Conclusiones: Estos resultados preliminares sugieren que la versión en español del Breast Q Reduction-Mastopexy Module es un instrumento útil para evaluar calidad de vida asociada a las mamas en mujeres chilenas.

Background: The Breast QoL Reduction and Mastopexy Module assesses quality of life associated to breast appearance from the point of view of the patient. Its Spanish version was recently validated in Chile. Aim: To assess the criterion validity of the instrument applying it in different populations of women and in the pre and post-operative periods. Material and Methods: The questionnaire was applied to six women subjected to reduction mammoplasty in the pre and post-operative period. It was also applied to 20 women hospitalized for other causes and 20 female medical students. Results: There were significant differences between operated women and their non-operated counterparts in the domains body self-image, social performance and physical symptoms. No differences in sexuality were found. However this last question was answered only by four operated patients, since two declared not to have sex life. Conclusions: The questionnaire is useful to assess quality of life associated to the appearance of breasts.

Effect of auricular point sticking on menstrual distending pains of breasts / 现代临床护理

Objective To observe the curative effect of auricular point sticking on menstrual distending pains of breasts. Methods Sixty-two patients with hyperplasia of mammary glands were randomized evenly into experiment group and control group:the former were managed with auricular point sticking and the latter with oral administration of Xiaoyao Pills for three treatment courses, each menstrual cycle as a course.The two groups were compared in terms of menstrual distending pains of breasts.Results The experiment group was significantly better than the control group in terms relieves of pains as well as the curative effect after the trial (P<0.01 for both).Conclusions Auricular point sticking is effective in relieving the menstrual distending pains of breasts.It is simple for manipulation and thus worth clinical spreading.

Carcinoma of the Ectopic Breast.

A 43-year-old woman presented with bilateral ectopic breasts in both the axillae in Chittagong Medical College Hospital in July 1996. She was diagnosed having carcinoma in the left ectopic breast. She was successfully treated with local surgical excision and regional lymph node dissection, adjuvant chemotherapy, loco-regional radiotherapy and hormone therapy. The patient continued tamoxifen for 5 years. Till last follow-up in December 2011, the patient was asymptomatic without any evidence of residual disease or local recurrence and evidence of metastases.

Simultaneous Visualization of the Sublingual Thyroid and Lactating Breasts with Tc-99m Pertechnetate Scintigraphy / 대한핵의학회잡지

PURPOSE: The thyroglossal duct runs from the base of the tongue to the thyroid. Rarely the thyroid completely fails to migrate and results in ectopic thyroid tissue, which can be demonstrated scintigraphically. A 31-year old female patient was referred for thyroid scintigraphy due to protruding mass at the base of the tongue. She was mildly hypothyroid. Tc-99m pertechnetate thyroid scan was performed to rule out ectopic thyroid gland. There showed a focal area of intense tracer uptake in sublingual area, suggesting the sublingual thyroid. In addition there noted diffusely increased tracer uptake in both breasts. The patient delivered a baby 6 months prior to the scan and was on breast-feeding. Free Tc-99m pertechnetate physiologically secrets into the salivary glands, the stomach, the gastrointestinal tract, the genitourinary tract and the mammary glands and sodium-iodide symporter plays a role in the accumulation of free Tc-99m pertechnetate. We report simultaneous visualization of lactating breasts and ectopic thyroid gland in the base of the tongue.

Endoscopic thyroidectomy via areola of breasts approach / 中国微创外科杂志

Objective To investigate the cosmetic results of endoscopic thyroidectomy via areola of breasts approach.Methods The incision was chosen to be along the areolar margin.One 12 mm incision was made at 3-clock position of the right areolar to introduce a 30? flexible laparoscope.Another 7 mm incision was made at 9-clock position of the right areolar for a grasping forceps.An additional 12 mm incision for the performance of ultrasonic scalpel was made at 11-clock position of the left areolar.Subcutaneous tissues were separated to create enough space for partial or subtotal thyroidectomy according to patient's conditions.Results The surgery was finished successfully in all 10 cases.The operation time ranged 110~230 min(mean,140 min).The estimated blood loss ranged 3~15 ml(mean,9 ml).There were no surgical complications after operation.Follow-up checkups for 3~5 months(mean,3.5 months) in 10 cases showed inconspicuous scars and no recurrence.Conclusions Endoscopic thyroidectomy via areola of breasts approach is a feasible and safe procedure with satisfactory cosmetic results.