Impacts of Chemokine (C-X-C Motif) Receptor 2 C1208T Polymorphism on Cancer Susceptibility

Background. The CXC chemokines belong to a unique family of cytokines that participates in the progression and development of many malignant tumors. Evidence for the relationship between chemokine (C-X-C motif) receptor 2 (CXCR2) C1208T polymorphism and susceptibility to cancer remains inconsistent. Methods. Odds ratios (ORs), 95% confidence intervals (CIs), and combined analysis were used to investigate the effect of CXCR2 variation on cancer risk. Gene Set Enrichment Analysis (GSEA) and enzyme-linked immunosorbent assay (ELISA) were also used to evaluate the expression of CXCR2 in prostate cancer (PCA). Results. Across 11 case-control studies, 4,909 cases and 5,884 controls were involved in the current analysis. Individuals with a TT genotype were associated with increased risk of digestive cancer, compared to those with a TC+CC genotype ( OR = 1.16 , 95 % CI = 1.02 -1.31, P = 0.025 ). Individuals carrying the TT genotype had a 39% higher risk of urinary cancer than those carrying CC genotype ( OR = 1.39 , 95 % CI = 1.04 -1.87, P = 0.025 ). Individuals with a TT genotype showed a 56% augmented breast cancer risk, compared to those with a CC genotype ( OR = 1.56 , 95 % CI = 1.03 -2.35, P = 0.034 ). It was found that CXCR2 expression was downregulated in PCA. Compared with PCA subjects carrying the CC genotype, the expression of CXCR2 was decreased in patients with the TT genotype. Conclusions. The CXCR2 C1208T variation was associated with elevated risk of urinary, breast, and digestive cancer. However, the C1208T polymorphism was correlated with attenuated risk of lung cancer.

An anthropometric evaluation of the augmented breast: differences between cis-and transgender women and possible clinical implications

Background The morphometric results after breast augmentations are generally understood to be clinically different between trans(gender) and cis(gender) women. The objective of this study was to establish these morphometric differences between the augmented breasts of trans and cis women and their implications for preoperative planning and expectation management of trans women. Methods A single-center, observational cross-sectional study was conducted. Three-dimensional images (VECTRA) of the chest were taken and used to measure preset morphometric parameters. Subsequently, several proportional morphometric outcome variables were calculated. We compared body, breast, and nipple dimensions and their interdependence between trans and cis women. The main outcome sets were (1) the relative dimensions of the chest, (2) the position of the breasts relative to the chest, (3) and the position of the nipple relative to the breast and nipple size. Results A total of 22 transgender and 22 cisgender women were included. The results showed that the breasts of the trans women were positioned more cranial. Furthermore, the nipple-areola complexes (NAC) were significantly smaller and positioned relatively more latero-cranial on the breasts. Conclusions Morphological characteristics of augmented breasts differ significantly between trans and cis women. The results of this study identified distinct differences between the augmented breasts of trans and cis women. Because of the apparent differences in results, surgical considerations, expectation management, and shared decision-making should play an even more pronounced role in breast augmentations in trans women. Level of evidence: Level III, risk/prognostic study.

Utility of augmented breast self-examination as an education and screening tool in Rural India for early detection of breast cancer

Background: Breast cancer contributes 19-34%, the percentages vary according to the region. There is an immense need for the structured breast cancer screening, which should start with education of breast self-examination (BSE). However due to poor literacy and education, we thought of augmenting the same (aBSC) with use of hand held device across various camps and compared with clinical breast examination (CBE) and conducting feasibility study.Methods: Data from screening camps between 2018-2020 using standardized AV tools (15 minutes duration) were analysed followed by a question answer section to elicit the understanding with 20:1 random check. For BSE and a aBSE we did verification for the understanding and adoption of techniques as per instruction manual. The participants were observed and supervised by trained personal during the process followed by CBE. The results BSE, aBSE and CBE were documented.Results: We trained 7214 women 2018-2020. Of the total trained persons, 93.8% of women understood accurately. aBSE was done for 1085. Comparison was done between the aBSC and CBE. aBSE could detect 92.6% of all the lumps identified by CBE, which is much better than 68% of BSE. There are 23.4% more suspicious lumps were unearthed after aBSE after conventional BSE. Of all the camps we detected 356 new lumps and malignancies were confirmed in 142 participants, which indicated high impact of such training programs in Rural India.Conclusions: BSE and aBSE are quite useful in clinical detection of lump and is easy to implement. With detection rate of 1.9%, which is quite high especially in the rural areas where medical facilities are poor, we feel that aBSE can be adopted in large scale and is well accepted among rural women and can improve on conventional breast self-examination and is comparable with clinical breast examination.

Implant-based multiplane breast augmentation—a personal surgical concept for dynamic implant–tissue interaction providing sustainable shape stability

Background The aesthetic long-term stability in shape, symmetry, and natural appearance of an aesthetically augmented breast remains a constant challenge. It has become clear that the results depend strongly on the technique applied and the experience of the surgeon. An ongoing controversy concerns the positioning of the implants. Subglandular, submuscular, partial submuscular, and subfascial pockets have different tradeoffs and advantages. However, secondary deformity, unnatural feel, and appearance are not addressed uniformly. The aim of the following study was to establish a standard procedure allowing for the desired and reproducible results to provide long-term stability and aesthetic quality. Methods The authors have developed a standardized dissection of a dynamic implant pocket. In this approach, a submuscular dissection with lower and medial release of the pectoralis muscle is combined with a wide subfascial release of the breast gland and a scoring of the deep plane of the superficial glandular fascia. In the final step, the deep layer of the glandular fascia is sutured tightly and firmly to the deep layer of the abdomino-pectoral fascia. A total of 867 patients received a 4D pocket–based breast implant by the authors. A subset of 33 patients was further analyzed for long-term results. Retrospectively, all data were analyzed from the electronic patient information system and files of patients using GraphPad 8. For comparison of multiple experimental groups, one-way ANOVA was performed where indicated. Results The concept not only addresses the biplanar approach of submuscular implant placement (3D) but adds the 4th dimension (4D) of an aesthetically pleasing dynamic shape of the augmented breast providing long-term stability. Measurements—taken at 3 months, and 1, 2, 3, 5, and ≥ 7 years post augmentation—for SN-N, N-IMF, N-ML, and MC-N distances did not show any significant changes over time. In the patient cohort of 867 patients (1734 implants), the overall complication rate was < 5%. Revisions for bleeding were below 0.5%. Shape stability was observed over 7 years in more than 95% of the patients. Conclusions Our results indicate that our technique of multiplane breast augmentation provides long-term stability and aesthetic quality. It may solve some of the existing tradeoffs of the different methods by combining the benefits of each technique supported by an additional shaping through a controlled deep fasciotomy. Level of evidence: Level IV, therapeutic study.

Metaplastic Carcinoma with Mesenchymal Differentiation in Augmented Breast using Liquid Silicone Injection: A Case Report

The relationship between the use of liquid silicone for breast augmentation and carcinogenesis remains undetermined due to limited data reported, especially regarding its risks for acquiring cancer. We documented a case of an 81-year-old woman who presented with bilateral enlarging breast masses with a known history of breast augmentation using liquid silicone. On microscopic examination, the malignancy showed both mesenchymal and epithelial components in a background of stromal changes related to liquid silicone. Based from morphology and immunohistochemistry studies (p63, CK, HMW-CK, and CK5/6, CD34, and BcL-2), this case was signed out as metaplastic carcinoma with mesenchymal differentiation. This rare case of metaplastic carcinoma with mesenchymal differentiation coexisting with liquid silicone, provides evidence supporting the link between cancer development and siliconomas.