RESUMEN
The number of women with stage IV disease who have breast reconstruction is small. The primary aim of this study was to examine opinions as to the appropriateness of breast reconstruction in this group. The Association of Breast Surgeons (ABS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) were invited to take part in an online survey. Of the respondents, 78.7% would operate on the primary tumour. Plastic surgeons showed a propensity for immediate reconstruction compared to their breast surgery colleagues, and 26.3% of breast surgeons would not offer reconstruction at all. Immediate latissimus dorsi (LD) flap and implant were the favoured method in early stage disease with delayed LD and implant the most popular option for stage IV disease. As survival figures continue to improve, the number of patients requesting reconstruction is likely to increase. Further debate will be necessary in anticipation of future service development.
Asunto(s)
Actitud del Personal de Salud , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Mamoplastia/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Implantes de Mama , Estética , Femenino , Humanos , Estadificación de Neoplasias , Satisfacción del Paciente , Calidad de Vida , Derivación y Consulta/estadística & datos numéricos , Colgajos Quirúrgicos , Encuestas y Cuestionarios , Reino UnidoRESUMEN
Fracture of the base of the third metacarpal with associated avulsion of the extensor carpi radialis brevis tendon is a rare injury. We report such a fracture and the unusual resulting complication of division of the extensor pollicis longus tendon by the avulsed bony fragment. Careful monitoring using lateral radiographs is needed to make the diagnosis and displacement of the avulsed fragment warrants open reduction and internal fixation.
Asunto(s)
Traumatismos de los Dedos/diagnóstico por imagen , Fracturas Óseas/complicaciones , Artes Marciales/lesiones , Huesos del Metacarpo/lesiones , Traumatismos de los Tendones/diagnóstico por imagen , Adulto , Traumatismos de los Dedos/etiología , Humanos , Masculino , Radiografía , Rotura/diagnóstico por imagen , Rotura/etiología , Traumatismos de los Tendones/etiologíaRESUMEN
Breast pain is a common complaint which usually subsides with simple reassurance or sometimes medication. This paper describes the case of a 41-year-old woman suffering from severe non-cyclical breast pain that had proved resistant to a battery of medical treatments. The pain was so disabling that it drove the patient to contemplate suicide. At the patient's request, a bilateral subcutaneous mastectomy with immediate implant reconstruction was performed, resulting in a complete resolution of the pain. Non-cyclical breast pain is less common than cyclical breast pain and tends to be more difficult to treat. This case suggests that mastectomy may be an appropriate option of last resort in the treatment of severe intractable breast pain.