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Breast imaging
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
A prolongation into the axilla of the supero-lateral portion of the breast along the lower border of pectoralis major is called the axillary tail. The retromammary space lies behind the glandular tissue and should be visible (at least in part) on a correctly positioned mammogram. Microscopically, the breast consists of 15–20 lobes, supported by a stroma of fibrous tissue, which contains a variable quantity of fat. Each lobe has a main duct, opening in the nipple. Deeply, the ducts branch within the breast to drain lobules. Each lobule consists of a cluster of small ductules, into which the glandular epithelium cells pass their secretions. Lobules are demonstrated radiographically as fine, nodular opacities, individually measuring 12 mm in diameter but usually superimposed to give a more or less homogeneous opacity.
Pectoral Region and Breast
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Posterior to the breast are the deep layer of the superficial fascia (membranous layer) and then the retromammary space (occupied by areolar tissue) and the deep fascia covering the pectoralis major and serratus anterior muscles. If cancer invades the retromammary space, its involvement of both the superficial fascia and the deep fascia covering the pectoralis major can result in fixation of the gland to the muscle, with consequent loss of the normal mobility of the breast.
Feasibility and efficacy of ultrasound-guided high-intensity focused ultrasound of breast fibroadenoma
Published in International Journal of Hyperthermia, 2023
Mengdi Liang, Zhizheng Zhang, Cai Zhang, Rui Chen, Yao Xiao, Zi Li, Tao Li, Yuelin Liu, Lijun Ling, Hui Xie, Lin Chen, Xiaoan Liu, Shui Wang, Tiansong Xia
Epidermal burns are the most common complication of thermal ablation techniques. In previous studies [19,20,22,24], the inclusion criteria generally consisted of tumors located at a distance of 5–15 mm or more from the skin. However, in this study, any distance from the tumor to the skin or chest wall was acceptable. The distance between the shallow margin of the fibroadenoma and the skin ranged from 1 to 34 mm and the distance between the deep margin of the fibroadenoma and pectoralis major ranged from 0 to 25.3 mm. A thorough local anesthesia of the subcutaneous and retromammary space effectively prevented adjacent tissue burns in this study. During HIFU treatment, multiple US beams generated from a transducer propagate through skin and subcutaneous tissue into the targeted area. At the interface between different types of tissues, deposition of ultrasound could be amplified, resulting in thermal damage to tissues beyond the target. Therefore, treatment for patients with skin abnormalities must be carried out with caution. This study included eight patients with skin scars resulting from previous breast surgeries. Although no serious complications related to the scar were seen, two patients with proliferative scars on the skin directly above the lesion reported pain at their scars during ablation, thus slowing down the treatment process. Therefore, patients with skin proliferative scars in the acoustic field, who tend to have a stronger inclination toward selecting noninvasive treatments, should be adequately informed. It may also be rational to divide the treatment into multiple sessions.
Short-term treatment outcomes and safety of two representative brands of the fifth-generation silicone gel-filled breast implants in Korea
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Dong Seung Moon, Woo Sik Choi, Ho Chan Kim, Jeong Pil Jeong, Jung Youp Sung, Jae Hong Kim
Peri-areolar, inframammary fold (IMF) and axillary incisions were made under general anesthesia and intravenous sedation for the purposes of preventing visible scarring. Selection of surgical incision is based on our desired outcomes, types of breast implants, the degree of augmentation, the anatomical characteristics of patients and patient-surgeon preference. Based on the Ranquist formula, we determined the distance extending from the nipple to the IMF, the size of breast implant and the scope of dissection. After the dissection, each breast was irrigated using a 100 cc of normal saline mixed with H2O2 solution at a ratio of 1:1, followed by the use of betadine 100 cc. Then, a breast implant was immersed in a normal saline mixed with ceftezole 1 vial and gentamycin 1 ample and then inserted in a pocket either under the pectoralis muscle (a submuscular placement) or in the retromammary space above the pectoralis major muscle (a subglandular/submammary placement). Methods for inserting and positioning a breast implant in the pocket were dependent on its types, the degree of augmentation, characteristics of a patient’s body and our recommendations. Thus, we performed a dual-plane I/II augmentation on a case-by-case basis. Intraoperatively, the patients were intravenously given ceftezole 1.0 g. Incisions were closed using layered sutures in the breast tissue. In addition, skin adhesive or surgical tape were used to close the skin.
Treatment of giant siliconomas of the breasts after injection of silicone
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Andreas Vassiliou, Antonia Fotiou
Breast augmentation with injection of free liquid silicone is being performed, often illicitly, despite multiple known associated complications [5]. The procedure consists of injecting medical or, in many cases, non-medical grade liquid silicone into the retromammary space, between the pectoralis major muscle and the fibroglandular breast tissue.