Almost half of women who had lumpectomies for breast cancer were the work of the second can not be required because the surgeons were unable to agree on guidelines for the most common operation for breast cancer, a new study Notes. It also hints that some women who could benefit from further surgery may be missing it. The surgery recurrence rates can vary significantly from the doctor, from zero percent to 70 percent, according to the study.
Additional work is carried out when pathology reports on tumor samples show that the first operation may have left behind some cancer cells. But surgeons differ when it comes to interpreting these reports.
The uncertainty about the operation of a cancer that was in use for 30 years is "shameful," said Dr. Laurence E. McCahill, first author of the study and director surgeon and his assistant Lacks Cancer Center in Grand Rapids, Mich. Dr. Monica Morrow, chief of breast surgery at Memorial Sloan-Kettering Cancer Center in New York, said the study and attention by the public can help boost business groups to develop guidelines for surgeons. The details of the surgery is not organized, but surgeons generally follow expert advice.
"It's getting to be time for leaders in radiation oncology and surgery to get together and make a statement of consensus that could help to guide their members," Dr. Morrow said.
The study by Dr. McCahill, published online Tuesday by the Journal of American Medical Association, based on medical records of 2,206 women who had lumpectomies in one of four hospitals in different parts of the country. Above all, 22.9 percent had more than one function.
Almost half of the operations were repeated in women whose pathology reports did not indicate that any stray cancer cells were left behind, which means that the work probably did not help patients. In most disturbing findings, 14 percent of patients had evidence of cancer left behind had no business, for unknown reasons.
The rates of repeat surgery varied by surgeon, and from hospitals, from 1.7 percent to 20.9 percent. Differences in patients is not caused much change, although very thin women, who tend to have small breasts were more likely to need the work of the second. The surgeons say it is because they try to remove as little tissue as possible from small breasts for cosmetic reasons.
"The number of business women are definitely depends on where you are treated, even at higher level at which surgeon you see," Dr. McCahill said. "We put the math behind it and said, this is a very work that the second might not make a difference."
Dr. McCahill said that such a high repeat function does not occur in other forms of cancer surgery, partly because surgeons do not try to spare tissue for aesthetic reasons, such as a lumpectomy.
One major reason for the difference in repeat business after lumpectomy is that there is no consensus among surgeons about how big the rim or "margin" of healthy tissue should be taken out when the cancer is removed. The surgeons are trying to cut net around a tumor and remove a sufficient margin to ensure that the cancer is removed.
Or negative net margins in general, the entire tumor was removed. Positive margins indicate any cancer was probably left behind and the other work is necessary to prevent recurrence.
But how great must be the room? When the tumor and healthy tissue removed from the surface of the entire sample is impregnated, so that when it is sliced and viewed through a microscope, the pathologist can use the signals ink to find room between cancer and healthy tissue and measure how close the cancer cells.
Some doctors believe the operation is not complete if the cancer cells are touching ink. Others want a wider margin of healthy tissue between cancer cells and ink: one, two or even five millimeters. If there is less operate again.
The surgeons say some radiation oncologists and medical insist on a certain size room before the rest of the patient's treatment. The decision to reoperate also depends in part on the type tumor of the patient. But there is no indication that a margin greater than any "do not contact ink" affect cancer recurrence or survival, said Dr. Morrow, who wrote an editorial accompanying the study. In the hospital said, "do not contact ink" is generally considered quite good.
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Tuesday, January 31, 2012
Thursday, January 26, 2012
PIP breast implant boss Jean-Claude Mas charged
His lawyer, Yves Haddad, told AFP news agency: "He is not well, he is tired and he is waiting for your doctor."
Women who were fitted with PIP implants represent the lawyer said he welcomed the arrest of Mr. Mas.
During the probe to leave French soil. "
Mr. Mas told police in an interview last year that was deceiving inspectors for 13 years pip European security.
He also said that he "not" women and their removal is facing surgery for the victims had filed complaints only "make money".
Excerpts from the interview, Mr. Mas has been re-examined by a French magistrate.
In France, 30,000 women have been advised to remove the implants and the 2,700 complaints filed against Mr. Mas.
'Medically necessary'
Mainly in Latin America and elsewhere in Europe - 65 countries, women in information technology company, which closed in March 2010 is created by the implant.
Germany, the Czech Republic and in Venezuela, health officials have advised women to remove them.
But medical advice, the UK, where 40,000 are affected in that there is no need for all the implants be removed, just as pain or tenderness is due to those problems.
Pip by the NHS in England, patients fitted with implants be replaced by the health service, while the private patients if the clinic will refuse to remove the implants. NHS in Wales said it considered medically necessary only when it was replaced by implants.
Northern Ireland, the women who received transplants for health reasons pip will replace them, but only out of the NHS, inserted for cosmetic reasons is not to replace them.
Scottish Health Secretary Nicola Sturgeon said the person was fit them concerned women will be offered the option of consultation and remove if necessary. NHS is being used by PIP implants are no records.
And private companies in the UK on Thursday said they pip free would remove the implants.
Conversion, which is just over 4000 patients with implants originally told Britain will pay for the removal of patients. Now it says that since 2001 they have fitted implant removal may be free - but must pay for replacement of approximately 2,500 pounds.
Since 2006 was the replacement is still within the warranty period and therefore the removal and replacement will be found for free.
Hospitals Group also announced the patients had PIP implants to fit between the 2001 and 2009 Free will offer removal, but the replacement will be charged between 1500 £ and £ 3.500.
International police agency Interpol wants Mr. Mas, Costa Rica has a drunk driving charge.
It said the alleged incident in June 2010 on the "red notice" "totally detached" pip.
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Women who were fitted with PIP implants represent the lawyer said he welcomed the arrest of Mr. Mas.
During the probe to leave French soil. "
Mr. Mas told police in an interview last year that was deceiving inspectors for 13 years pip European security.
He also said that he "not" women and their removal is facing surgery for the victims had filed complaints only "make money".
Excerpts from the interview, Mr. Mas has been re-examined by a French magistrate.
In France, 30,000 women have been advised to remove the implants and the 2,700 complaints filed against Mr. Mas.
'Medically necessary'
Mainly in Latin America and elsewhere in Europe - 65 countries, women in information technology company, which closed in March 2010 is created by the implant.
Germany, the Czech Republic and in Venezuela, health officials have advised women to remove them.
But medical advice, the UK, where 40,000 are affected in that there is no need for all the implants be removed, just as pain or tenderness is due to those problems.
Pip by the NHS in England, patients fitted with implants be replaced by the health service, while the private patients if the clinic will refuse to remove the implants. NHS in Wales said it considered medically necessary only when it was replaced by implants.
Northern Ireland, the women who received transplants for health reasons pip will replace them, but only out of the NHS, inserted for cosmetic reasons is not to replace them.
Scottish Health Secretary Nicola Sturgeon said the person was fit them concerned women will be offered the option of consultation and remove if necessary. NHS is being used by PIP implants are no records.
And private companies in the UK on Thursday said they pip free would remove the implants.
Conversion, which is just over 4000 patients with implants originally told Britain will pay for the removal of patients. Now it says that since 2001 they have fitted implant removal may be free - but must pay for replacement of approximately 2,500 pounds.
Since 2006 was the replacement is still within the warranty period and therefore the removal and replacement will be found for free.
Hospitals Group also announced the patients had PIP implants to fit between the 2001 and 2009 Free will offer removal, but the replacement will be charged between 1500 £ and £ 3.500.
International police agency Interpol wants Mr. Mas, Costa Rica has a drunk driving charge.
It said the alleged incident in June 2010 on the "red notice" "totally detached" pip.
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Wednesday, January 4, 2012
Clinics' breast implant data 'poor'
Some private clinics have provided poor quality data for a review of the risks of rupture that causes a breast implant, health minister Andrew Lansley has warned.
The government is prepared to lend expertise to private clinics for the next 48 hours, if necessary, to help gather statistics for a government commissioned panel investigating the risks posed by the French-made implants PIP.
He said the BBC Breakfast medical advice at this time was that there was no safety concern exists to justify the routine removal of implants, but any woman who is concerned should speak with a surgeon or GP.
He said: "Some of the private providers, as of yesterday, had not provided any evidence, many had some had provided what at first glance looks pretty good evidence, other than it seemed to be very poor."
His comments come after Mr Lansley consultant plastic surgeon Fazel Fatah, who sits on the panel investigating the scandal implant, said Tuesday that no information company in the United Kingdom on what percentage of devices have ruptured.
Medicines and healthcare products Regulatory Authority (MHRA) has announced the details of the show 1% of the implants in the United Kingdom have ruptured, but a clinic, Transform, to set its own rate of implant rupture closer to 7%. Some 42,000 women in the United Kingdom believed that the implants were made from the now-closed French company PIP.
In France, the government has said that women should have the implants removed after having been found to contain non-medical grade silicone for use in mattresses. Speaking to Sky News, Mr Lansley denied the cost of removal of the implants had affected the NHS advice.
Mr. Fatah, who is chairman of the British Association of Aesthetic Plastic Surgery (BAAPS), said Tuesday that the revision of rates rupture, expected to be published Friday, will not produce reliable data. "The truth is that none of these elements are absolutely reliable, or is a true reflection of what happens," he saihttp://www.blogger.com/img/blank.gifd.
"There may be a significant number of silent ruptured implants do not know about. A significant number of patients also did not go back to the clinic where he had surgery, if they rupture. Instead, go to the NHS and examined under the NHS. We do not know the exact rate of rupture in the United Kingdom. "
Mr. Fatah said he believes women need to plan for the fact that the implants removed. "The issue is not that the rates of rupture, but that the quality of the silicone implants are not medical grade. Therefore, the implants are not able to be implanted in humans. It is degraded, it is defective."
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The government is prepared to lend expertise to private clinics for the next 48 hours, if necessary, to help gather statistics for a government commissioned panel investigating the risks posed by the French-made implants PIP.
He said the BBC Breakfast medical advice at this time was that there was no safety concern exists to justify the routine removal of implants, but any woman who is concerned should speak with a surgeon or GP.
He said: "Some of the private providers, as of yesterday, had not provided any evidence, many had some had provided what at first glance looks pretty good evidence, other than it seemed to be very poor."
His comments come after Mr Lansley consultant plastic surgeon Fazel Fatah, who sits on the panel investigating the scandal implant, said Tuesday that no information company in the United Kingdom on what percentage of devices have ruptured.
Medicines and healthcare products Regulatory Authority (MHRA) has announced the details of the show 1% of the implants in the United Kingdom have ruptured, but a clinic, Transform, to set its own rate of implant rupture closer to 7%. Some 42,000 women in the United Kingdom believed that the implants were made from the now-closed French company PIP.
In France, the government has said that women should have the implants removed after having been found to contain non-medical grade silicone for use in mattresses. Speaking to Sky News, Mr Lansley denied the cost of removal of the implants had affected the NHS advice.
Mr. Fatah, who is chairman of the British Association of Aesthetic Plastic Surgery (BAAPS), said Tuesday that the revision of rates rupture, expected to be published Friday, will not produce reliable data. "The truth is that none of these elements are absolutely reliable, or is a true reflection of what happens," he saihttp://www.blogger.com/img/blank.gifd.
"There may be a significant number of silent ruptured implants do not know about. A significant number of patients also did not go back to the clinic where he had surgery, if they rupture. Instead, go to the NHS and examined under the NHS. We do not know the exact rate of rupture in the United Kingdom. "
Mr. Fatah said he believes women need to plan for the fact that the implants removed. "The issue is not that the rates of rupture, but that the quality of the silicone implants are not medical grade. Therefore, the implants are not able to be implanted in humans. It is degraded, it is defective."
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