Obesity and Complications in Mammoplasty: A Retrospective Review in an Obese Patient Population.

With trends of obesity increasing, plastic surgeons are resecting larger weights from larger patients. Published literature has demonstrated the association between body mass index (BMI) and resection weight to postsurgical complications; however, these relationships are unclear in a population that is primarily overweight or obese. Our study examines these relationships to assist plastic surgeons in identifying high-risk patients and discussing preoperative measures to decrease the likelihood of surgical complications. Methods: We performed a retrospective electronic medical record review of a cohort of 182 bilateral reduction mammoplasty procedures performed at a single institution over a four-year period. Patient data were obtained and correlated with postoperative complications. Results: Within our identified patient cohort, 95% were classified as either overweight or obese. Incidence of complications was 51%, with wound dehiscence having the highest incidence of 36.26%. Using a multivariate regression, our analysis found statistical significance between surgical complications and both smoking status and BMI (P = 0.042 and P = 0.025, respectively). Smokers had an increased risk of complications with an odds ratio of 5.165. For every additional 1 kg/m2 increase in BMI, the odds for surgical complication increased by 1.079. In a subanalysis focusing on wound dehiscence, the use of postoperative drains was a protective factor (P = 0.0065). Conclusions: Our study population, with a high average BMI and smoking status, demonstrated a statistically significant increase in postsurgical complications. These findings will help counsel obese patients preoperatively on their increased risk of complications.

Human snoRNA-93 is processed into a microRNA-like RNA that promotes breast cancer cell invasion.

Genetic searches for tumor suppressors have recently linked small nucleolar RNA misregulations with tumorigenesis. In addition to their classically defined functions, several small nucleolar RNAs are now known to be processed into short microRNA-like fragments called small nucleolar RNA-derived RNAs. To determine if any small nucleolar RNA-derived RNAs contribute to breast malignancy, we recently performed a RNA-seq-based comparison of the small nucleolar RNA-derived RNAs of two breast cancer cell lines (MCF-7 and MDA-MB-231) and identified small nucleolar RNA-derived RNAs derived from 13 small nucleolar RNAs overexpressed in MDA-MB-231s. Importantly, we find that inhibiting the most differentially expressed of these small nucleolar RNA-derived RNAs (sdRNA-93) in MDA-MB-231 cells results primarily in a loss of invasiveness, whereas increased sdRNA-93 expression in either cell line conversely results in strikingly enhanced invasion. Excitingly, we recently determined sdRNA-93 expressions in small RNA-seq data corresponding to 116 patient tumors and normal breast controls, and while we find little sdRNA-93 expression in any of the controls and only sporadic expression in most subtypes, we find robust expression of sdRNA-93 in 92.8% of Luminal B Her2+tumors. Of note, our analyses also indicate that at least one of sdRNA-93's endogenous roles is to regulate the expression of Pipox, a sarcosine metabolism-related protein whose expression significantly correlates with distinct molecular subtypes of breast cancer. We find sdRNA-93 can regulate the Pipox 3'UTR via standard reporter assays and that manipulating endogenous sdRNA-93 levels inversely correlates with altered Pipox expression. In summary, our results strongly indicate that sdRNA-93 expression actively contributes to the malignant phenotype of breast cancer through participating in microRNA-like regulation.