Contribution à la chirurgie oncoplastique du sein

Contribution à la chirurgie oncoplastique du sein PDF Author: Nizet Jean-Luc
Publisher: Omniscriptum
ISBN: 9783841632784
Category :
Languages : fr
Pages : 224

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Book Description
Les cancers du sein sont les premiers cancers de la femme en termes de frequence. Le traitement conservateur du sein est le traitement standard de ce cancer, l'alternative etant la mastectomie. Ce traitement conservateur peut etre la source de deformations importantes du sein. La chirurgie oncoplastique du sein consiste a l'application des techniques de chirurgie plastique dans le cadre du traitement conservateur, permettant des resections plus larges lors du traitement initial necessaire du point de vue oncologique et ameliorant les resultats esthetiques. Ce travail retrace brievement l'historique de la chirurgie oncoplastique du sein, evalue les sequelles des traitements conservateurs et rappelle les principes des reductions mammaires therapeutiques, avec leurs avantages et leurs inconvenients. Une attention particuliere a ete apportee a la problematique des marges de resection, au cas specifique de la chimiotherapie neoadjuvante et a la duree d'hospitalisation liee ou non aux complications postoperatoires. L'importance du calcul du volume du sein et l'evaluation des resultats esthetiques dans le cadre des traitements conservateurs ont ete investiguees."

Chirurgie oncoplastique et reconstruction dans le cancer du sein

Chirurgie oncoplastique et reconstruction dans le cancer du sein PDF Author: A. Fitoussi
Publisher: Springer Science & Business Media
ISBN: 2287714766
Category : Medical
Languages : fr
Pages : 148

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Book Description
La prise en charge chirurgicale des cancers du sein évolue. Le siège du cancer et le rapport taille du cancer/taille du sein sont cependant générateurs de résultats esthétiques post opératoires parfois médiocres, résultats qui seront aggravés et fixés par l’irradiation post opératoire. Il importe donc d’anticiper la qualité des résultats et de proposer aux patientes des interventions qui vont prévenir les défects esthétiques, tout en assurant un contrôle cancérologique correct. C’est l’application des techniques de chirurgie plastique aux situations cancérologiques qui s’appelle la chirurgie "oncoplastique". L’équipe de l’Institut Curie fait le point sur ces techniques et indications appliquées en France.

La chirurgie oncoplastique dans la prise en charge des cancers du sein

La chirurgie oncoplastique dans la prise en charge des cancers du sein PDF Author: Laure Delmond
Publisher:
ISBN:
Category :
Languages : fr
Pages : 115

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Book Description
Introduction: La chirurgie oncoplastique associe aux techniques d'exérèse tumorale. des techniques de remodelage glandulaire et de reconstruction immédiate du sein empruntées à la chirurgie plastique. Elles permettent la réalisation de tumorectomies emportant plus de 20% du volume du sein, seuil au-delà duquel les résultats esthétiques sont compromis avec les techniques classiques de tumorectomie élargies. Objectifs: Evaluer de façon prospective et multicentrique les données techniques, oncologiques et esthétiques des interventions oncoplastiqucs dans la prise en charge conservatrice des cancer du sein. Matériel et méthode: Essai multicentrique de phase Il, stratifié sur deux niveaux: patientes opérées d'emblée (strate 1) ou après traitement néo adjuvant (strate 2). La strate 1 incluait des patientes présentant des carcinomes intra canalaires étendus seuls ou associés à une composante infiltrante. La strate 2 concernait des cancers infiltrants n'ayant pas bien répondu à un traitement néo adjuvant. Les gestes retenus étaient: exérèse glandulaire supérieure à 30% du volume du sein, poids de l'exérèse supérieur à 100g, remodelages glandulaires avec repositionnement de la plaque aréolo-mamelonnaire (PAM), comblement du défect glandulaire par lambeau autologue de grand dorsal (LGD) et les gestes nécessitant une symétrisation controlatérale. Une évaluation de la qualité de vie a été réalisée par les questionnaires QLQ-C30 et QLQ-BR23. Résultats: Entre avril 2007 et février 2011, 158 patientes ont été incluses dans la strate 1 et 105 dans la strate 2. Le poids médian des pièces opératoires était de 1 03.5g et 94.5g avec un ratio moyen poids de la résection 1 poids du sein de 19 et 18% dans les strates 1 et 2 respectivement. Les marges étaient ≥ 2 mm pour 66% des patientes dans la strate 1 et 69% dans la strate 2 avec des taux de mastectomie de rattrapage de 15.6% et 7.6% respectivement. On observait 24% de complications immédiates dans la strate 1 et 28% dans la strate 2 mais elles étaient à l'origine d'un délai dans l'initiation du traitement adjuvant pour seulement 2.3% des patientes. A 5 ans. il n'y avait aucune récidive locorégionale (RLR) dans la strate 1 et 3 RLR (3%) dans la strate 2. et la survie globale était de 94% et 82%. A 1 an post opératoire 89% des patientes avaient de bons résultats esthétiques mais on observait une dégradation dans le temps avec seulement 71 % de bons résultats à 5 ans. La qualité de vie était préservée. Conclusion: Les techniques d'oncoplastie sont oncologiquement fiables avec des résultats esthétiques satisfaisants. Cependant, il faut rester prudent en cas de lésions de carcinome infra canalaire étendues et bien informer les patientes du risque de marges non saines et de mastectomie de rattrapage.

Oncoplastic and Reconstructive Surgery for Breast Cancer

Oncoplastic and Reconstructive Surgery for Breast Cancer PDF Author: A. Fitoussi
Publisher: Springer Science & Business Media
ISBN: 3642001440
Category : Medical
Languages : en
Pages : 155

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Book Description
"Oncoplastic and Reconstructive Surgery for Breast Cancer" describes the reconstructive techniques that have been refined over the past decade by surgeons in a very high volume unit. It provides clear descriptions of all the available techniques. With proven experience in the procedures described and detailed scientific evaluation, it furthermore provides evidence-based literature reviews. The book starts with the relevant anatomical background and passes through all the major oncoplastic and reconstructive procedures available to the breast cancer patient. It includes management of breast and nipple-areolar complex reconstruction in addition to symmetrising surgery and the new technique of fat transfer. It also covers all multidisciplinary aspects and genetics thus giving an up-to-date status report.

Breast Cancer: Diagnostic Imaging and Therapeutic Guidance

Breast Cancer: Diagnostic Imaging and Therapeutic Guidance PDF Author: Uwe Fischer
Publisher: Thieme
ISBN: 3132019410
Category : Medical
Languages : en
Pages : 680

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Book Description
Breast Cancer: Diagnostic Imaging and Therapeutic Guidance provides a concise, practical, and practice-based source of up-to-date diagnostic and therapeutic information for the general radiologist. In the diagnostic phase of evaluating breast disorders, the overriding consideration in the examination and assessment is to reduce false diagnoses to the absolute minimum-a principle wholly in the interests of the patient. The particular diagnostic pathway chosen will depend on the highly variable individual presentations and the associated findings. A major focus of the book is the comparative value of the various diagnostic imaging modalities. As well as discussing conventional mammography and adjunct modalities such as breast ultrasound and galactography, the text also showcases the superior utility of contrast-enhanced magnetic resonance imaging in providing the highest rate of detection of cancers at any stage. As well as radiological diagnosis, sections written by top specialists cover the interventional procedures for obtaining biopsies and also the surgical and medical therapy of breast carcinoma. Key Features: Combined authors' experience of more than 100 years provides this work with great depth and expertise. Richly illustrated with almost 600 images, including full color histology, patient photographs, and hundreds of radiological studies. BI-RADS classification for mammography, breast ultrasound, and breast MRI. Adjunct topics covered include screening and staging; lymph nodes; breast reconstruction; chemotherapy, also with respect to endocrine-active tumors; radiation therapy; tumors of the male breast; logistics in the breast care center; and psychosocial care. Breast Cancer: Diagnostic Imaging and Therapeutic Guidance is certain to prove an invaluable tool for all general radiologists involved in the evaluation and treatment of patients with breast cancer.

Abuse of Dominant Position: New Interpretation, New Enforcement Mechanisms?

Abuse of Dominant Position: New Interpretation, New Enforcement Mechanisms? PDF Author: Mark-Oliver Mackenrodt
Publisher: Springer Science & Business Media
ISBN: 3540699651
Category : Political Science
Languages : en
Pages : 210

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Book Description
As part of its review of competition law that started in the late 1990s, the European Commission proposes to revise its interpretation and application of the Treaty’s prohibition of abuses of dominant positions. Also, it has instigated a debate about the promotion of private enforcement of EC competition law. On the former subject, the Commission published a Discussion Paper in 2005; on the latter, a Green Paper in 2005, followed by a White Paper in 2008. The chapters in this volume critically appraise the Commission’s proposals, including the most recent ones. The authors also highlight the repercussions of the proposed ‘more economic approach’ to abuses of dominant positions on private litigants’ opportunities to bring damages actions in national courts for such abuses.

Contrast-Enhanced MRI of the Breast

Contrast-Enhanced MRI of the Breast PDF Author: Sylvia Heywang-Köbrunner
Publisher: Springer
ISBN: 9783642646294
Category : Medical
Languages : en
Pages : 234

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Book Description
Since the first edition of Contrast-Enhanced MRI of the Breast was published in 1990, further progress has been made in the field and interest in magnetic resonance imaging (MRI) as an additional tool in the diagnosis of breast disease has increased. However, further questions have arisen concerning the best choice of technique, the most appropriate way to interpret MR images, and the role which MRI might play in the work-up of breast disease. In this edition we give an overview of the latest technical possibilities and present knowledge, which today is based on a much greater range of experience gained by various excellent research groups. It is our aim to help the interested reader in choosing an appropriate technique and in finding those applications which promise the greatest benefit for the patient. The particular advantages and limitations of MRI have been pointed out and the currently known capabilities and still existing limitations of other imaging modalities, including transcutaneous biopsy, discussed. Finally, a chapter concerning the use of MRI in the diagnosis of implant failure, a new situation, has been added. Acknowledgements. Since the first edition was published, much further work and research has been necessary. This would not have been possible without the continuous support of many colleagues, coworkers, and advisors.

Oncoplastic and Reconstructive Management of the Breast, Third Edition

Oncoplastic and Reconstructive Management of the Breast, Third Edition PDF Author: Steven J. Kronowitz
Publisher: CRC Press
ISBN: 1000762572
Category : Medical
Languages : en
Pages : 815

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Book Description
Oncoplastic and Reconstructive Management of the Breast, Third Edition provides a comprehensive and contemporary account of techniques in oncoplastic and reconstructive breast surgery. Uniquely, this book includes short, concise chapters containing only the most critical information. Many of the chapters are entitled "My Approach" and this enables the reader to gain an insight into the clinical practice of the world's breast disease experts. The true multidisciplinary nature of the book ensures that the perspectives of all members of the breast cancer team are included. This transfer of knowledge between disciplines leads to improved patient care and the integration of multidisciplinary treatment, thus providing an educational and practical multidisciplinary breast cancer book for practicing breast cancer doctors, and trainees worldwide.

Breast Ultrasound

Breast Ultrasound PDF Author: Anne-Marie Dixon
Publisher: Churchill Livingstone
ISBN: 9780443100765
Category : Health & Fitness
Languages : en
Pages : 282

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Book Description
This book is a detailed, accessible and comprehensive reference manual reflecting current guidance & citing recent peer-reviewed evidence. It is written by and for radiographers. Through text and diagrams the fundamental skills and techniques for acquisition of high quality diagnostic images are explained and demonstrated; high quality ultrasound images throughout underpin instruction on accurate image interpretation and diagnosis. Inclusion of unusual and rare appearances allow the reader to avoid common pitfalls and resolve diagnostic dilemmas. Step-by-step guide to performing, interpreting and reporting breast ultrasound examinations Extensive coverage of underlying principles and practice of breast ultrasound Holistic chapter on ultrasound of the male breast Experienced editor and contributing team with current experience in clinical practice and educational delivery Application specific physics and equipment chapters

Breast Imaging

Breast Imaging PDF Author: Uwe Fischer
Publisher: Thieme
ISBN: 3131626917
Category : Medical
Languages : en
Pages : 260

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Book Description
Dx-Direct is a series of eleven Thieme books covering the main subspecialties in radiology. It includes all the cases you are most likely to see in your typical working day as a radiologist. For each condition or disease you will find the information you need -- with just the right level of detail.Dx-Direct gets to the point:- Definitions, Epidemiology, Etiology, and Imaging Signs- Typical Presentation, Treatment Options, Course and Prognosis- Differential Diagnosis, Tips and Pitfalls, and Key References...all combined with high-quality diagnostic images. Whether you are a resident or a trainee, preparing for board examinations or just looking for a superbly organized reference: Dx-Direct is the high-yield choice for you!The series covers the full spectrum of radiology subspecialties including: - Brain- Gastrointestinal- Cardiac- Breast- Urogenital- Spinal- Head and Neck- Musculoskeletal- Pediatric- Thoracic- Vascular