Many Women Get Unnecessary Mammograms Before Breast Reduction Surgery

Getting a mammogram before breast reduction surgery is not required or recommended. But thousands of younger women with no known breast cancer risk still get them, a new study suggests.

Although the pre-surgical screening has been a longtime practice among physicians, no professional society recommends routine screening until a woman turns 40.

Erika D. Sears, MD, MS, a Michigan Medicine plastic surgeon who studies appropriateness and efficiency in health care, wondered how often the practice takes place.

Her new study, published in JAMA Surgery, found that nearly one-third of women younger than 40 underwent mammography before breast reduction surgery. Health services researchers culled the records of 52,486 women of all ages being evaluated for breast reduction between 2009 and 2015.

Few may realize the unnecessary screenings come at a price — and not just a monetary one that adds to the nation’s health care bill, Sears says.

“Altering screening mammography for patients younger than 40 years in the setting of evaluation for breast surgery has a risk for subsequent tests and invasive procedures,” says Sears, also an assistant professor of surgery at the University of Michigan.

The study showed 30 percent of women ages 30 to 39 had mammograms before breast reduction surgery, a rate five times higher than that of other women their age.

About 4 percent of women ages 29 and younger received mammograms as they considered breast reduction — compared with 0.2 percent of the population of millennial women.

When performing the analysis, researchers had excluded women whose medical records indicated a personal or family history of breast cancer, genetic predisposition or prior benign breast disease — although there’s a chance the risk existed but wasn’t noted in their records, explains a media release from Michigan Medicine – University of Michigan.

Among the women in their 30s who had mammograms before breast reduction surgery, 14 percent went on to have an MRI, ultrasonography, or a biopsy in which breast tissue or fluid is removed for laboratory testing.

Cancer was found in only 0.5 percent of the women, the study showed.

That finding could help shift the conversation on both sides.

“I think that if there’s more awareness among patients, they may be motivated to have a conversation with their doctor about whether screening mammography is right for them,” Sears says. “It’s also about education on the provider’s part about the downstream impact of future testing that women may experience.”

[Source(s): Michigan Medicine – University of Michigan, Science Daily]

Researchers Discover Method to ‘Turn Off’ Mutated Melanoma

Melanoma is the deadliest form of skin cancer and notorious for its resistance to conventional chemotherapy. Approximately 25 percent of melanoma is driven by oncogenic mutations in the NRAS gene, making it a very attractive therapeutic target. However, despite decades of research, no effective therapies targeting NRAS have been forthcoming.

Reportedly for the first time, an international group of researchers has discovered a novel activator of NRAS and developed a specific inhibitor to effectively prevent NRAS mutant melanoma growth. These findings provide a promising therapeutic option to treat NRAS mutant melanoma.

These findings appear in the journal CELL, according to a media release from Boston University School of Medicine.

The researchers first identified STK19 (an enzyme encoded by the STK19 gene) to be a critical regulator of NRAS function. Then they characterized the mechanism by which this activation takes place through biochemical and cellular experiments. Finally, they designed an STK19 inhibitor that efficiently prevented NRAS activation and development of NRAS mutant melanoma in an experimental model.

“This study provides a promising therapeutic strategy for melanoma treatment. Furthermore, the STK19 inhibitor might be a therapeutic option in 25 percent of all cancers with RAS mutations,” explained corresponding author Rutao Cui, MD, PhD, professor of pharmacology & experimental therapeutics at Boston University School of Medicine. “We hope our findings ultimately will be clinically translated into improved care for cancer patients.”

[Source(s): Boston University School of Medicine, EurekAlert]

Lutronic and Syneron-Candela Settle Lawsuit

Syneron Medical Ltd and Candela Corporation, and Lutronic Corp and Lutronic Aesthetics Inc, announce that they have entered into a mutually agreeable comprehensive settlement agreement ending the patent disputes between the companies.

Terms of the settlement agreement were not disclosed.

The mutually agreed-upon settlement, limited to Lutronic, protects Candela’s investment in Profound and its patented long pulse and temperature-controlled technology today and in the future. The settlement, through a sublicense from Syneron-Candela, allows Lutronic to market its product in the short pulse category, protecting Candela’s investment in the development of products in the long pulse category with a thermocouple.

For more information, read the full news release at www.prnewswire.com

Phase 2 Trial of Thykamine for Atopic Dermatitis Progressing as Planned, Per Update

Devonian Health Group Inc, a clinical stage botanical pharmaceutical corporation focused on developing a unique portfolio of botanical prescription drugs and cosmeceutical products, recently provided an update on its phase 2 clinical trial in adult patients suffering from atopic dermatitis.

The phase 2 clinical trial of Thykamin in adult patients with Mild-to-Moderate Atopic Dermatitis is progressing as planned. In order to accelerate the recruitment of patients, Devonian is expanding the number of sites from 6 to 12 clinics across Canada. The study should be completed later this year, according to a news release.

Devonian also announces that its Cosmeceutical R&D initiative is progressing as expected. Devonian’s Cosmeceutical R&D program is focused on external Exposome associated with skin aging namely sun radiation (UVA/UVB, Infrared A and Blue Light), Blue light radiation from other sources than sun and pollution.

Blue light emission, which is also called high-energy visible light (HEV), stems from the sun and also from digital screens of computers, smartphones, televisions, tablets and from LED lamps.  The negative impact of Blue light on ocular health and on circadian system ( sleep pattern) has been reported in several scientific manuscripts. There is also evidence that it has adverse effects on different dermal cells, that it generates Reactive Oxygen Species (oxidants) and is inducing skin aging.

Devonian has completed the formulation of a new Blue light photoprotection product. The product has been developed as a day cream with, as one of the main ingredients, Devonian’s patented R-Spinasome. The product will be tested in human during 2019 and is expected to be ready for commercialisation in 2020, the release continues.

“This is the first product emerging from our Cosmeceutical R&D program focused on Exposome. Blue light is around us all the time, and consumers are now aware of the increased risks of daily exposition to this radiation. We are therefore developing this new product in order to offer consumers an effective product with protective attributes against the negative impacts of Blue light may have on their skin.

“As all our products, the efficacy and safety of our Blue light protection cream will be assessed through a double-blind, placebo controlled clinical study. Our team is currently selecting skin biomarkers to be included in this study which should be completed by year-end.” says Devonian’s resident & CEO, Dr Andre P. Boulet, in the release.

[Source(s): Devonian Health Group Inc, Business Wire]

School of Oncoplastic Surgery Offers CME Course Feb 8-10

The School of Oncoplastic Surgery (SOS) has added several world-renowned experts to the faculty of its February course on oncoplastic surgery (OPS), the most advanced form of breast cancer surgery.

Surgeons will gather in Newport Beach, February 8-10, 2019, to learn from a panel of experts, including several of the world’s pioneers in OPS. The two-and-a-half-day course – which provides more than 20 hours of certified medical education (CME) credits – instructs surgeons on how to optimize cosmetic results without compromising cancer control.

“We continually build and expand our faculty, and this meeting will include some of the world’s pre-eminent oncoplastic surgeons,” says Gail Lebovic, MD, in a media release. “Our program gives surgeons from all generations the opportunity to broaden their skills in the oncologic and aesthetic aspects of breast surgery under the instruction of those of us who developed these very techniques.”

For more information and to register, read the full press release at www.prnewswire.com

Evolus Receives FDA Approval for Jeuveau prabotulinumtoxinA-xvfs for Injection

Evolus Inc announces that the US Food and Drug Administration has approved its lead product, Jeuveau, for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adults.

David Moatazedi, president and chief executive officer of Evolus, states, “Evolus is the first company in nearly a decade to enter the fast-growing US aesthetic neurotoxin market. What makes Evolus unique is our focus on delivering performance beauty products with a customer-centric approach. We are pleased to introduce Jeuveau, the first FDA approved neurotoxin dedicated to aesthetics and manufactured in a state-of-the-art facility using Hi-Pure technology.”

To read the full press release, including safety information, visit globenewswire.com

Apollo Endosurgery Inc Sells Its Surgical Product Line

Apollo Endosurgery Inc, a global leader in less invasive medical devices for bariatric and gastrointestinal procedures, announces the sale of its Surgical product line, which consists of the Lap-Band adjustable gastric banding system and other accessories used in laparoscopic bariatric surgery, to ReShape Lifesciences Inc.

The definitive transaction agreements were signed and closed simultaneously on December 17, 2018.

This transaction will allow Apollo to focus all its efforts on growing the clinical adoption of its Endo-bariatric product offerings, which consists of its OverStitch Endoscopic Suturing Systems and the Orbera Intragastric Balloon technologies.

“Our Surgical product line has served an important purpose for us, but it is no longer a strategic fit with our focus on our Endo-bariatric products and therapies,” states Todd Newton, Apollo’s chief executive officer, in a media release.

“The future for therapeutic endoscopy is very promising, especially due to flexible endoscopic suturing delivered by our OverStitch technology. By allowing physicians to suture with precision and assurance from a flexible endoscope, OverStitch enables many improved core gastrointestinal and bariatric therapy options for physicians and their patients.

“We also remain very bullish on the potential of the intra-gastric balloon market. We believe it is in the best interest of Apollo’s customers and shareholders that we direct our attention exclusively to the growth opportunities being afforded to us from these products.”

At closing Apollo received cash of $10 million and ReShape’s intra-gastric balloon product line. Apollo will also receive payments of $2 million each on the first and second anniversaries of the closing, and a final payment of $3 million on the third anniversary of the closing.

As part of the transaction, Apollo retains a secured interest in the assets of ReShape until the earlier of a) satisfaction of the payments due, or b) the completion by ReShape of a qualifying equity raise of at least $15 million.

Apollo and ReShape also entered into a set of transition services agreements under which Apollo will continue to manufacture the Surgical product line for ReShape for up to 2 years, continue distributing the products in markets outside the United States for up to 12 months, and other specified services.

While the ReShape intra-gastric balloon will remain available for the near term, Apollo intends to focus its commercial efforts exclusively on its Orbera intra-gastric balloon products.

Apollo used the upfront cash proceeds from ReShape of $10 million to pay down its borrowings under its senior secured credit facility.

[Source(s): Apollo Endosurgery Inc, Business Wire]

Volume Loss, Not Just ‘Sagging,’ Causes Upper Lip Aging

Are aging-related changes in the face related more to “deflation” or “sagging”? A new study helps settle the debate, showing significant loss of volume in the upper lip in older adults, reports the February issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Our results suggest that the aging perioral area is affected with a combination of soft tissue lengthening, thinning, and volume loss,” concludes the new research, led by Patrick L. Tonnard, MD, PhD, of Coupre Centre for Plastic Surgery, Ghent, Belgium. For plastic surgeons, the findings may help to inform and improve evidence-based approaches to facial rejuvenation.

The researchers analyzed magnetic resonance imaging (MRI) scans of the head obtained for other reasons in 200 adults: 100 women and 100 men. Participants were divided into a younger group aged 20 to 30 and an older group aged 65 to 80. Detailed measurements of the “upper lip unit” were analyzed to evaluate differences between the two groups, with an average age difference of nearly 50 years.

The measurements revealed several age-related differences in the anatomy of the upper lip. These included significant lengthening of the upper lip in older adults: about 19 percent longer in women and 18 percent longer in men, compared to the younger group.

The older group also had decreased soft tissue thickness of the upper lip: by about 41% in women and 33% in men. Most of the reduction in tissue thickness occurred at the “alar nasolabial fold” – the top of the lines running from the base of the nose to the corners of the lips.

The findings suggest that age-related lengthening and thinning of the upper lip represents more than just “sagging.”

“[V]olume loss is an obvious feature of the aging upper lip,” Tonnard and colleagues write. Loss of soft tissue volume also seems to contribute to deepening of the nasolabial folds, a prominent feature of the aging face.

“The mouth and perioral area play a primary role in emotional expression and attractiveness of the face,” according to the authors. “Unfortunately, the mechanisms of centrofacial aging are poorly understood” – as illustrated by the debate over “sagging versus deflation.”

The new study provides insights into these mechanisms, based on detailed MRI measurements in a large sample of older versus younger adults.

Lengthening, thinning, and volume loss all contribute to aging of the area around the mouth, the study suggests. The findings add to the evidence base underlying plastic surgery and other cosmetic procedures for facial rejuvenation.

Tonnard and colleagues plan a follow-up article to discuss the clinical implications of their findings, including the role of dermal fillers for minimally invasive volume augmentation.

[Source(s): Wolters Kluwer Health, EurekAlert]

Autologous Breast Reconstruction is a Safe Alternative After Implant Failure

Implants are usually the first choice for breast reconstruction after mastectomy. But when implant-based reconstruction fails, autologous reconstruction – using the patient’s own tissues – is a safe procedure that improves patient outcomes, reports a study in the February issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Autologous breast reconstruction after failed implant-based reconstruction is associated with significantly improved patient satisfaction and quality of life,” concludes the study by ASPS Member Surgeon Joseph J. Disa, MD, and colleagues of Memorial Sloan Kettering Cancer Center, New York.

Implants are the most frequent option for breast reconstruction after mastectomy, used in about 80% of patients. But in some cases, the initial reconstruction fails, due to complications or other reasons. In this situation, some patients opt for the autologous technique, with the breast reconstructed using the patient’s own tissue – typically using a flap obtained from a “donor site” in the abdomen.

Disa and colleagues analyzed 137 women who underwent autologous breast reconstruction after failed implant reconstruction. In about three-fourths of patients, the initial reconstruction failed due to scarring around the implant (capsular contracture) causing pain or deformity. Other patients had infections or other implant-related complications, or were dissatisfied with the appearance of the reconstructed breast.

The second reconstruction was performed an average of about 3.5 years after the initial procedure. Both breasts were reconstructed in 55 patients, for a total of 192 flaps. Outcomes were assessed using the validated BREAST-Q questionnaire, which evaluates various aspects of quality of life after breast reconstruction.

The results suggested that autologous reconstruction after failure of initial implant reconstruction is a safe procedure. Complication rates were similar to previous studies, despite the additional challenges posed by capsular contracture or previous radiation therapy.

Analysis of BREAST-Q responses showed “a high degree of satisfaction and quality of life” after autologous reconstruction. About one-fourth of patients filled out the BREAST-Q after both implant procedures. This group had significant improvements in satisfaction with the appearance of the breasts, psychosocial well-being, and physical well-being of the chest.

The women also reported improved satisfaction with overall well-being on the BREAST-Q. That was despite a decrease in physical well-being of the abdomen, related to the tissue donor site in the abdomen.

Implant and autologous reconstruction each have advantages for breast reconstruction after mastectomy. While reconstruction using the patient’s own tissues may provide a more natural-appearing breast, implant-based reconstruction is more widely available and less costly. Both procedures are safe and provide good reconstructive outcomes.

The new study is one of only a few to assess the outcomes of autologous reconstruction after failed implant-based reconstruction, and the first to use the validated BREAST-Q questionnaire. The results show improvements in physical and psychological well-being for this group of breast cancer survivors, as well as increased satisfaction with the appearance of the reconstructed breast or breasts.

“Regardless of reason for implant failure, this study shows changing to autologous tissue after implant removal is safe,” Disa and coauthors conclude. While there may be some additional challenges related to previous breast cancer treatment and reconstruction, they add, “The procedure has an acceptable complication rate.”

[Source(s): Wolters Kluwer Health, EurekAlert]

Modern Thread Lifts Are No Longer Just for the Face

Dubbed a quick fix for hoisting up cheeks and jowls without the need for a surgical facelift—“threads,” aka sutures, are inserted into the skin via a needle—the original thread lifts quickly fell out of favor with the rest of the  country in 2002 when the barbed polypropylene threads often resulted in facial distortion and asymmetries. Some even broke under the skin, causing infections, or protruded through thinning skin in aging patients.

In 2015, Silhouette InstaLift spearheaded the shift from permanent, polypropylene threads to dissolvable, poly-l-lactic acid (PLLA) sutures. Brands such as Nova Threads and MINT have also introduced similar versions made of polydioxanone (PDO).

These modern thread lifts—many experts are moving away from the term “thread lift” and toward “absorbable suture suspension” to shake the stigma associated with old-school methods—also provide more than just a lifting benefit.