Does Preoperative MRI Workup Affect Mastectomy Rates and/or Re-excision Rates in Patients with Newly Diagnosed Breast Carcinoma? A Retrospective Review.

The purpose of this study is to determine whether including breast magnetic resonance imaging (MRI) in the preoperative workup of patients with known breast cancer has an impact on mastectomy and/or re-excision rates. This is an Institutional Review Board approved HIPAA compliant retrospective study reviewing the impact MRI has on mastectomy and re-excision rates in patients with newly diagnosed breast cancer. Our study compares two groups: (i) 154 patients who did not receive preoperative MRIs and served as a control group and (ii) 96 patients who received preoperative breast MRIs. Patient race and age between the two populations were not statistically different. The difference in mastectomy rates between the two populations was 10.7%; although not statistically different, the p value of 0.10 suggests a trend toward significance. The re-excision rates between the two populations, however, were significantly different (p < 0.001), with women in the control group having a higher re-excision rate than those in the study group. The difference between involved and clear margins was significant as well (p = 0.002), with patients undergoing preoperative MRI more likely to have negative margins. Preoperative breast MRI significantly decreases the likelihood of involved margins as well as the need for surgical re-excision. Preoperative breast MRI does not result in a statistically significant difference in mastectomy rates, although further investigation is required to determine whether there is a trend towards statistical significance.

Successful Treatment of a Recalcitrant Mondor's Cord Following Breast Augmentation.

Mondor's disease, a superficial thrombophlebitis, is a common complication of thoracoabdominal wall surgeries. While most patients experience disease resolution with expectant management, occasionally the disease may persist. The authors present a case of a 49-year-old woman who had persistent, symptomatic Mondor's disease 15 months status post-breast augmentation. The patient responded rapidly to intralesional triamcinolone injections resulting in complete disease resolution. To the authors' knowledge, this is the first report of intralesional corticosteroids being used to treat this common surgical complication.

Modified genetic algorithm for parameter selection of compartmental models.

A Modified Genetic Algorithm has been developed for the task of optimal parameter selection for compartmental models. As a case study, a predictive model of the emerging health threat of obesity in America was developed which incorporated varying levels of three treatment strategies in an attempt to decrease the amount of overweight Americans over a ten-year period. The Genetic Algorithm was then applied to the task of minimizing the number of overweight persons while minimizing the costs associated with implementing the chosen treatment plans. Throughout repeated trials, the GA was able to converge to consistent, high-scoring treatment strategies after only a few minutes of computation on a desktop PC. This result demonstrates the ability of the modified Genetic Algorithm to effectively perform multivariate, nonlinear, simulation-based optimization routines in a short time.